Chronic Fatiguing Illnesses: Entering the era of new biomarkers and therapies

Ritchie C. Shoemaker, Andrew Heyman, Annalaura Mancia, James C Ryan


Illnesses characterized by chronic fatigue are often defined by symptoms and not by objective biomarkers that support both diagnosis and treatment. Without readily obtained biomarkers, clinical management can be compromised by lack of certainty. Using biomarkers previously confirmed as useful in diagnosis and treatment of chronic inflammatory response syndrome (CIRS), including transcriptomics, the authors present evidence of benefit in assessment of a “symptoms-only illness.” By focusing on persistent symptoms seen in antibiotic-treated Lyme disease (Post-Lyme Syndrome, PLS), CIRS-biomarkers have utility to define both an initial infectious process and a subsequent inflammatory illness. Use of Next Generation Sequencing brings transcriptomics to the Lyme community, avoiding over-reliance on antibody testing alone for diagnosis. Transcriptomics also brings objective testing to assess remaining abnormalities at a given treatment stage of PLS.

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