Dr Katie Peppercorn, on the left, and Professor Warren Tate with their recently published book Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) – Methods and Protocols.
Being asked to produce a book by an international publishing giant was an exciting milestone for Emeritus Professor Warren Tate – one that that recognised a decades-long crusade to get recognition for a debilitating illness.
Warren and Dr Katie Peppercorn planned and co-edited the recently published book Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) – Methods and Protocols.
The book brings together technologies used in published studies from 48 authors around the world into different aspects of the causes and treatment for this disease, including New Zealand researchers with diverse skills, Ros Vallings (Auckland GP), Anna Brooks (Liggins Institute) and Lyn Hodges (Massey University). Warren and Katie also contributed several chapters with their University of Otago collaborators.
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome is a complex, long-term illness with debilitating symptoms, characterised by extreme fatigue that doesn't improve with rest. It significantly impacts multiple body systems, particularly the nervous and immune systems.
One of a series on Methods in Molecular Biology published by Springer Nature, this new guide includes cutting-edge techniques used by researchers studying ME/CFS, provides step-by-step detail essential for reproducible results and has key implementation advice from the experts.
Warren says the book is represents this holistic view to the illness, with contributors from around the globe providing what is basically a recipe for their particular field of ME/CFS research.
It brings together clinical diagnosis, diagnostics, immunology, molecular biology changes in DNA, RNA and protein, metabolism and energy production.
“It’s an honour to be asked to lead this project. I’m happy that bringing completed research under one umbrella helps to better recognise the disease and understand its complexity,” Warren says.
Katie, who is based in Biochemistry, has worked alongside Warren over the last 25 years.
She says the helping to edit the book has been a hugely satisfying experience.
“It was a great opportunity for us to recruit and interact with other researchers around the world working in this field.
The book details expertise in specific techniques. It will enable other researchers to perform similar experiments and help clinicians get an overall view of the many different facets of the disease. and direct them to suitable treatment options. It could also act as a resource for new clinicians and medical students who don’t know where ME fits in.
Katie says this will help clinicians and researchers to better understand post viral stressor conditions and potentially spur on new ideas for research projects.
And while the book is a guide by researchers for researchers and clinicians rather than patients or the public, Warren says those affected by the illness recognised its importance and are thrilled to see such a large body of research all together.
“Combining this large body of robust research into one publication validates for patients their illness.
“The people and their families who live with ME know it’s a devastating disease – the vast majority of those people can’t work, some can’t get out of their home, or even their bed. This book therefore sheds light on what they experience.”
Warren says the motivation underpinning this massive project was to improve the lives of those affected with ME/CFS and, most recently, Long Covid.
“Those who live with chronic fatigue don’t know from one day to the next what their health will be like. They experience a lack of understanding from other people, from insurers and even from GPs. They often have treatments prescribed that are aren’t individualised to their symptoms, which don’t work or even make the condition worse.”
A long road to success
Now based in the Dunedin School of Medicine, Warren has been researching ME in the Department of Biochemistry since 2012, working for 15 years with the one clinician treating New Zealand patients.
His interest in the condition was personal - his daughter was struck down by debilitating fatigue following a bout of glandular fever when she was 14.
“It was awful to see her spiral from a healthy teenager desperate to go to school and live a normal life, to chronic fatigue that overwhelmed her, and which has changed the way she now lives. And although there was no evidence of a psychological problem, and it seemed to have developed from glandular fever, at the time she like many others with similar symptoms were told it was in her head and encouraged to get on with life,” he recalls.
“The extreme fatigue associated with the illness clearly indicated to me as a biochemist there was likely something wrong with energy production. I wanted to see if there was a biological basis.
“Why were some people’s immune system only temporarily stressed by a virus, while for others there was a massive inflammatory response which led to the brain not regulating temperature, blood sugar and gut responses, leading to a life of severe fatigue.
“Many years later we’re answering those questions - we know there are biological causes and energy production is dysfunctional. We see molecular changes resulting in dysfunctional physiology,” he says.
Since initial immunology trials by researchers, research has expanded to investigate what was happening in muscles, the brain, the microbiome, and in the DNA of ME sufferers, each contributing different perspectives which led to the identification of the ME disease.
It was a long fight to have the disease recognised, but knowing what they know now, Warren hopes ultimately research will be able to come together not only to give patients a significantly better quality of life but also be able to reverse these processes.
Click here to view the book.
Kōrero by Claire Grant, Communications Advisor, School of Biomedical Sciences
Department of Biochemistry
Biochemists find out how the molecules in living things work. By unravelling the secrets underlying fundamental biological processes, we can find innovative approaches to challenges in medicine, biotechnology and agriculture.
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