Spinal Fluid Proteins Distinguish Lyme Disease from Chronic Fatigue Syndrome

Oftentimes, those with Lyme disease are lumped into the diagnostic category of Chronic Fatigue Syndrome (CFS) before being properly diagnosed with Lyme disease, as I was. Although CFS is a very real illness, the cause of it can vary from individual to individual – many with CFS develop the myriad symptoms seen in this illness as a result of mercury poisoning (commonly from “silver” amalgam fillings, which are 50% mercury), root canals, acute or chronic chemical exposure, or chronic viral and/or parasitic and/or bacterial infections. Unfortunately, doctors often don’t look further to see if any of the above are the actual cause(s) of their patient’s CFS, either out of negligence or lack of knowledge/resources available at this point of time in history or in general.

Now, some people who have been treated for Lyme disease still remain symptomatic and there is a debate over whether the bacterial infection still persists, or whether these people have what has been termed “neurological-post-treatment-lyme-disease” (nPTLS). However, many Lyme-literate doctors (LLMDs) who are part of the organization ILADS feel that the spirochetes (bacteria) responsible for Lyme disease and/or co-infections often persist despite aggressive treatment with antibiotics, causing a chronic infection(s), resulting in the symptoms seen in “nPTLS”.

Without getting further into the argument of whether those with “nPTLS” have a persistent bacterial infection or whether their symptoms are a result of a faulty immune response from their having had Lyme disease (I strongly believe that in most cases it is the former), a new report just came out showing that chronic fatigue syndrome patients, patients with persistent neurologic symptoms, Lyme disease patients and some healthy individuals possess different proteins in their cerebrospinal fluid (CSF):

“Patients who suffer from Neurologic Post Treatment Lyme disease (nPTLS) and those with the Chronic Fatigue Syndrome report similar symptoms. However unique proteins discovered in spinal fluid can distinguish those two groups from one another and also from people in normal health, according to new research conducted by a team led by Steven E. Schutzer, MD, of the University of Medicine and Dentistry of New Jersey – New Jersey Medical School, and Richard D. Smith, Ph.D., of Pacific Northwest National Laboratory. This finding, published in the journal PLoS ONE (February 23, 2011), also suggests that both conditions involve the central nervous system and that protein abnormalities in the central nervous system are causes and/or effects of both conditions.

“The investigators analyzed spinal fluid from three groups of people. One group consisted of 43 patients who fulfilled the clinical criteria for Chronic Fatigue Syndrome (CFS). The second group consisted of 25 patients who had been diagnosed with, and treated for, Lyme disease but did not completely recover. The third group consisted of 11 healthy control subjects. “Spinal fluid is like a liquid window to the brain,” says Dr. Schutzer. By studying the spinal fluid, the research team hoped to find abnormalities that could be used as markers of each condition and could lead to improvements in diagnosis and treatment.

“Taking advantage of previously unavailable methods for detailed analysis of spinal fluid, the investigators analyzed the fluid by means of high powered mass spectrometry and special protein separation techniques. They found that each group had more than 2,500 detectable proteins. The research team discovered that there were 1) 738 proteins that were identified only in CFS but not in either healthy normal controls or patients with nPTLS; 2)
692 proteins found only in the nPTLS patients. Previously there had been no available candidate biomarkers to distinguish between the two syndromes, nor even strong evidence that the central nervous system is involved in those conditions.

“This research represents the most comprehensive analysis of the complete spinal fluid proteome (collection of proteins) to date for both Chronic Fatigue Syndrome and Neurologic Post Treatment Lyme disease (nPTLS). Prior to this study, many scientists believed that CFS was an umbrella category that included nPTLS. However these results call those previous suppositions into question.

“According to Dr. Schutzer, spinal fluid proteins can likely be used as a marker of disease, and this study provides a starting point for research in that area. “One next step will be to find the best biomarkers that will give conclusive diagnostic results,” he says. “In addition, if a protein pathway is found to influence either disease, scientists could then develop treatments to target that particular pathway…”

Journal citation:
Schutzer SE, Angel TE, Liu T, Schepmoes AA, Clauss TR, et al. (2011)
Distinct Cerebrospinal Fluid Proteomes Differentiate Post-Treatment Lyme Disease from Chronic Fatigue Syndrome.
PLoS ONE 6(2): e17287. doi:10.1371/journal.pone.0017287

The full article is available at the PLoS ONE website:

Press release source:
or http://tinyurl.com/5wszahm

Contact for further information:
Jerry Carey or Rob Forman
Phone: 856-566-6171 or 973-972-7276
Email: careyge@umdnj.edu formanra@umdnj.edu


4 comments for “Spinal Fluid Proteins Distinguish Lyme Disease from Chronic Fatigue Syndrome

  1. Calee
    May 11, 2011 at 6:48 pm

    CFS is a disease. Just because you don’t have it doesn’t mean it isn’t a disease and just because the etiology is unknown doesn’t mean there isn’t a cause. They just haven’t figured it out yet.

  2. Danielle
    May 11, 2011 at 7:06 pm

    You are absolutely correct. I did not mean to deprecate CFS, and I can see how the way I wrote the opening to the article would sound that way. Thanks for pointing it out! When I said “waste-bucket diagnoses”, I meant it in the sense that doctors often don’t look for the cause of CFS and just say, well, it’s CFS and they stop there. Many doctors either are not able to make a proper diagnoses of the cause either out of negligence or lack of knowledge/resources available at this point of time in history or in general. If you re-read what I wrote, I said there is a real underlying cause for CFS and that the causes may vary: “Some causes shown to account for the myriad symptoms seen in the umbrella diagnosis of CFS are mercury poisoning, acute or chronic chemical exposure, and chronic viral and/or parasitic and/or bacterial infections.” πŸ™‚

    • Calee
      May 11, 2011 at 7:38 pm

      thanks. I have CFS and so many times get “attitude” about having a disease that they up til now can’t even properly diagnose. I look fine and healthy so many ppl don’t understand why I am so limited. After living with this for 11 years I believe it is immune related especially since my worst CFS days are when I am exposed to allergens, right now the proliferation of tree pollen, which makes me a little bit touchy. πŸ™‚

  3. Danielle
    May 12, 2011 at 10:00 am

    I completely empathize and do hope you find some relief soon πŸ™‚ Email me on my contact form if you have any questions.

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