FAQs on the IiME/UEA Gut Microbiota Project 

UEA and IFR are world-renowned organisations with some of the best researchers and facilities in the UK.
The institutions and researchers have expertise in this area and are well placed to perform this research.

Yes, it is and it is using advanced techniques.
Invest in ME originally proposed this in April 2010. It took two years for our supporters - patients and carers and friends - to raise the required funds to begin this project. Now, in 2013, this area is very topical regarding the study of ME as we move into looking at ME as an autoimmune disease and other establishments are  thinking of performing similar work.

Yes, it can and it will.

“I think that this is extremely important because the microbiome in our intestinal tract has the potential to polarize and modulate immune responses. It is imperative, then, that we characterize those."
"That’s one more thing that I want to mention with respect to the microbiome. I think that the microbiome is going to be where the action is."

- Professor Ian Lipkin, John Snow Professor of Epidemiology Director, Center for Infection and Immunity Professor of Neurology and Pathology, Mailman School of Public Health and College of Physicians and Surgeons, Columbia University

The project began in October 2013. This is a three year studentship project.

This will depend on how long it takes to recruit sufficient numbers of patients and to fully optimise and validate the assays to be used on the patient samples. The team would, however, expect to have some preliminary findings with 18 months of beginning to receive patients’ samples.

There are standard clinical tests that have been used for decades to determine the permeability of the gut wall. It involves the patient drinking a sugar-based solution and then producing a urine sample at a later time point to determine whether or not the consumed sugar has crossed the gut wall and is present systemically and in the urine: a positive finding would be indicative of a leaky gut wall and would warrant further corroborative investigation. A leaky gut would no longer be an effective barrier to intestinal microbes or the factors and antigens they produce which could then gain access to the bloodstream and other parts of the body to trigger inflammation and if uncontrolled, tissue injury.

From a therapeutic standpoint and needing to know more about disease causality there is limited value in looking at or screening samples for the presence of inflammatory mediators or markers in isolation if the possible causes and origins are not known or investigated. Our project will be testing the hypothesis that the originating source of inflammation in ME is the gut and the leakage of microbial products from the gut lumen across and through a compromised gut barrier, which then initiate and perpetuate inflammatory reactions throughout the body. If a "leaky gut" can be established in these patients and we can demonstrate that their immune system and blood lymphocytes have reacted to the presence of microbial products normally found in the gut, then this provides a means of formally identifying over-stimulated immune cells and lymphocytes as a cause of disease and the source of inflammatory mediators, and what their identity and mechanism of action is. This information is of great value in designing more targeted and specific interventional therapies for ME.

There are standard clinical tests that have been used for decades to determine the permeability of the gut wall. It involves the patient drinking a sugar-based solution and then producing a urine sample at a later time point to determine whether or not the consumed sugar has crossed the gut wall and is present systemically and in the urine: a positive finding would be indicative of a leaky gut wall and would warrant further corroborative investigation. A leaky gut would no longer be an effective barrier to intestinal microbes or the factors and antigens they produce which could then gain access to the bloodstream and other parts of the body to trigger inflammation and if uncontrolled, tissue injury.

The study is focused on the cause and consequences of altered populations of gut microbes in ME patients.

The student will analyse serum samples from patients with ME for integrity of intestinal barrier function. Faecal samples from patients will be analysed by high throughput pyrosequencing and appropriate bioinformatics to profile the microbiota in terms of bacteria and virus populations. Parallel studies will assess microbiota metabolism by LC/MS/NMR analysis by the IFR Metabolomics Partnership.

For the foundation project patients will be selected from Dr Bansal's patient cohort. This will use standard NHS guidelines and procedures for patient participation.

The charity is funding this study in full - thanks to our supporters. Depending on the study results this is an option which will be considered by the the charity and advisors as the project continues.

The UEA team are collaborating with Dr Amolak Bansal, who is the consultant immunologist and founder of the CFS service at St Helier Hospital. Dr Ian Gibson has also been the charity's advisor throughout the proposal for an examination and research facility in Norwich Research Park.

Invest in ME have run an international biomedical research conference on ME every year since 2006, now attended by representatives from most of the world’s main biomedical ME research teams. We have also initiated, with the Alison Hunter Memorial Foundation of Australia, a biomedical research collaborative meeting to foster collaboration among researchers, including a 2012 meeting on autoimmunity. Autoimmunity is, of course, an important aspect of the possible mechanism of rituximab in ME.
The funds for this project have been raised by supporters of Invest in ME. Via determination and effort and the positivity of the Let's Do It For ME campaign we have been able to raise this funding when nobody else was considering this line of research. As part of a proposal for an examination and research facility which would lead to a Centre of Excellence for ME this foundation project proves what determination can achieve.

Other projects being funded include the UK rituximab clinical trial for ME and B-cell related studies - with IiME working with University College London.

Invest in ME are working with researchers, as part of the examinations facility proposal and to support the rituximab trial, on a more comprehensive and detailed analysis of antibodies binding the hypothalamus.

We will also be funding a medical student to perform a Masters degree within the ME gut microbiota project.

More details via this link.

We welcome support from other organisations, companies, groups and individuals for our proposal and we continue to raise funds for other biomedical research projects for ME via our Biomedical Research Fund which will be solely used for high-quality biomedical research.

We welcome your support in the form of donating, fundraising, spreading word of the project and other research being proposed and initiated by IiME, or simply letting us know that you are behind us in this effort. Invest in ME is run entirely by volunteers. There are no salaries and no funds will be used for administration costs. All funds raised will be used in full for financing the biomedical research projects which are initiated. We need to raise awareness and interest from as many sources as possible.

We will update this page and other pages on the web site with information about the project at regular intervals but if you have something you want to know but don't find it here then please email us at info@investinme.org. We will also accept questions using an interface on this site which will be developed - info@investinme.org