David Systrom, a pulmonary and critical care doctor at Brigham & Women’s Hospital, Boston, believes he has found answers through studying patients with ME/CFS, an illness that in many cases is precipitated by viral infections such as Epstein-Barr and bears many similarities to long Covid.
When Systrom studied the mitochondrial DNA of these patients it appeared to be normal, but after taking a deep look and conducting muscle biopsies, he identified abnormalities at the electron level, deep within the mitochondria.
“In both ME/CFS and long Covid it’s most likely that these are acquired forms of mitochondrial dysfunction, perhaps related to the initial infection itself or an autoimmune response to a virus or both,” Systrom says. “This impedes the mitochondrial machinery, but doesn’t affect the DNA itself, and it means the mitochondria then fail to generate appropriate amounts of ATP to serve the needs of the muscles.”
Systrom is now running his own clinical trial in both ME/CFS and long Covid patients, in partnership with Japanese drug company Astellas, which has developed a drug that aims to restore normal mitochondrial metabolism.
Dr Charles Shepherd comments
This is a well written article in The Observer from David Cox looking at what mitochondria do in the body and the role of mitochondrial dysfunction and defective energy production at a cellular level in both Long Covid and ME/CFS.
Evidence of mitochondrial dysfunction in ME/CFS dates back to the early 1980s and the publication in The Lancet of the magnetic resonance spectroscopy research from Oxford, using my own skeletal muscle, which demonstrated early and excessive lactic acid production during exercise.
Since then the MEA Ramsay Research Fund has been funding research into the role of mitochondrial dysfunction and defective muscle energy production at the Universities of Oxford (Dr Karl Morten et al) and Newcastle (Professor Julia Newton et al).
Dr Karl Morten and myself have also been in contact with Dr Betty Raman in Oxford to discuss extending the clinical trial involving AXA1125, which is referred to in the article, to include a cohort of people with ME/CFS.
Dr Charles Shepherd
Trustee and Honorary Medical Adviser
(Member of The NICE Guideline Committee on ME/CFS (2019 – 2021) and The DHSC Research Working Group (2022-23)