We hypothesize that toxic nitrogen-containing by-products of energy metabolism accumulate more readily in the cells of ME/CFS patients. This accumulation, in turn, creates a cycle of energy generation to overcome a stressed state while generating more toxic nitrogen by-products in the process. We will also identify the compounds that can circumvent the production of toxic nitrogen by-products and release patients from this cycle.
To test this hypothesis, we will culture white blood cells in growth media with added nitrogen-labelled amino acids and measure the nitrogen-labelled by-products of energy metabolism. Cells from 30 ME/CFS patients and 20 age and sex-matched controls will be collected and processed at the Stanford Genome Technology Center and cultured for our nitrogen tracking experiment. These experiments will be conducted on blood cells directly from ME/CFS patients and cells cultured from ME/CFS patients.