As mentioned by Maureen Hansen, I believe the next big push should be tissue studies to find the trigger for persistent antigen in pwMECFS within the gut/colon. nature.com/articles/s4146…

Thank you NPR for covering this story. one.npr.org/i/1232998694:1… An ambitious NIH study has brought new attention to chronic fatigue syndrome

I think we need studies to show effects of exercise on blood brain barrier of pwMECFS. pubmed.ncbi.nlm.nih.gov/30678702/

NIH study showed decreased CFS catechols. The catecholamine nuclei of the reticular formation has very important functions. How is this area in the brainstem affected in piMECFS patients? Does viral hit cause permanent damage? ncbi.nlm.nih.gov/pmc/articles/P…

Nicotine binds to nAChRs. Activation of these receptors leads to the release of neurotransmitters such as dopamine, norepinephrine, and serotonin. Perhaps this is the mechanism of why some LC and MECFS patients have noticed improvement after nicotine trial

Another missed opportunity for NIH intramural study is that they did not assess post exercise cerebral blood flow. Reduced CBF may be responsible for reduced perfusion to TPJ area noted in motor tasks. iCPET indicates pre load failure. CNS requires the most blood flow

What some theories of why ME and LC patients have dysbiosis? What is happening to the immune system on a tissue level of GI tract? Can a new PET tracer be developed to examine altered gut immune profile? Would endoscopic tissue biopsies be sufficient?

Rejuvenating immune cells led to reduction of brain inflammation and anti-Alzheimer's disease impact in the mouse model science.org/doi/epdf/10.11… Science Advances

It would be nice if we could better understand the perturbed immunological regulation of skeletal muscle adaptation to exercise in MECFS patients.

The ability to manipulate the gut microbiome was restricted to pre- and probiotics,FMT. Now there's successful #CRISPR base editing nature.com/articles/s4158… justsaysinmice nature Eligo Bioscience David Bikard Xavier Duportet