Abstract
The mitochondrial energy score (MES) protocol, developed by the Myhill group, is marketed as a diagnostic test for chronic fatigue syndrome/Myalgic Encephalomyelitis (CFS/ME). This study assessed the reliability and reproducibility of the test, currently provided by private clinics, to assess its potential to be developed as an NHS accredited laboratory test. We replicated the MES protocol using neutrophils and peripheral blood mononuclear cells (PBMCs) from CFS/ME patients (10) and healthy controls (13). The protocol was then repeated in PBMCs and neutrophils from healthy controls to investigate the effect of delayed sample processing time used by the Myhill group. Experiments using the established protocol showed no differences between CFS/ME patients and healthy controls in any of the components of the MES (p ≥ 0.059). Delaying blood sample processing by 24 hours (well within the 72 hour time frame quoted by the Myhill group) significantly altered many of the parameters used to calculate the MES in both neutrophils and PBMCs. The MES test does not have the reliability and reproducibility required of a diagnostic test and therefore should not currently be offered as a diagnostic test for CFS/ME. The differences observed by the Myhill group may be down to differences in sample processing time between cohorts.
Highlights
Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) affects 250,000 people in the UK1
Our results suggest that the fact that the samples from chronic fatigue syndrome/Myalgic Encephalomyelitis (CFS/ME) patients are sent through the post and processed between 24–72 hours after blood is taken, while the control blood are collected in the laboratory on the same day as processing, may be the cause of the differences seen between the two cohorts by the Myhill group
Given the evidence presented here, we advise that the mitochondrial energy score (MES) test should not be used as a diagnostic test in its current form as in this study shows there to be no differences between CFS/ME and control results when the MES protocol was followed using fresh blood samples
Summary
Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) affects 250,000 people in the UK1. The Mitochondrial Energy Score procedure was developed by Myhill et al and first published in 20097 It has been described as a test which should be made available to all CFS/ME patients and used as part of treatment management[8,9]. If the Myhill test can be confirmed as a specific and reliable test for mitochondrial dysfunction in CFS/ME it would be a great benefit to patients in management of their symptoms and assessing the effectiveness of new clinical treatments. Follow the Myhill protocol in order to determine if live cells isolated from whole blood can be reliably used to assess mitochondrial function and whether this approach has the potential to be developed as an NHS accredited laboratory test. We went on to explore whether the conditions recommended for transport and storage, and the cell type used, could have influenced test outcome
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