Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, U.K.
The Gut Health and Food Safety Research Programme, The Quadram Institute, Norwich Research Park, Norwich, U.K.
Clin Sci (Lond). 2018 Mar 9;132(5):523-542. doi: 10.1042/CS20171330. Print 2018 Mar 15.
Myalgic encephalomyelitis (ME)/chronic fatigue syndrome (CFS) (ME/CFS) is a disabling and debilitating disease of unknown aetiology. It is a heterogeneous disease characterized by various inflammatory, immune, viral, neurological and endocrine symptoms. Several microbiome studies have described alterations in the bacterial component of the microbiome (dysbiosis) consistent with a possible role in disease development. However, in focusing on the bacterial components of the microbiome, these studies have neglected the viral constituent known as the virome. Viruses, particularly those infecting bacteria (bacteriophages), have the potential to alter the function and structure of the microbiome via gene transfer and host lysis. Viral-induced microbiome changes can directly and indirectly influence host health and disease. The contribution of viruses towards disease pathogenesis is therefore an important area for research in ME/CFS. Recent advancements in sequencing technology and bioinformatics now allow more comprehensive and inclusive investigations of human microbiomes. However, as the number of microbiome studies increases, the need for greater consistency in study design and analysis also increases. Comparisons between different ME/CFS microbiome studies are difficult because of differences in patient selection and diagnosis criteria, sample processing, genome sequencing and downstream bioinformatics analysis. It is therefore important that microbiome studies adopt robust, reproducible and consistent study design to enable more reliable and valid comparisons and conclusions to be made between studies. This article provides a comprehensive review of the current evidence supporting microbiome alterations in ME/CFS patients. Additionally, the pitfalls and challenges associated with microbiome studies are discussed.
肌痛性脑脊髓炎/慢性疲劳综合征（ME/CFS）是一种病因不明的使人丧失能力和衰弱的疾病。它是一种异质性疾病，其特征是各种炎症、免疫、病毒、神经和内分泌症状。几项微生物组研究描述了微生物组中细菌成分的改变（失调），这与疾病发展中的可能作用一致。然而，在关注微生物组的细菌成分时，这些研究忽略了被称为病毒组的病毒成分。病毒，特别是那些感染细菌的病毒（噬菌体），通过基因转移和宿主裂解，有可能改变微生物组的功能和结构。病毒引起的微生物组变化可以直接和间接地影响宿主的健康和疾病。因此，病毒在 ME/CFS 发病机制中的作用是该疾病研究的一个重要领域。测序技术和生物信息学的最新进展现在允许更全面和包容的人类微生物组研究。然而，随着微生物组研究数量的增加，对研究设计和分析的一致性的需求也在增加。由于患者选择和诊断标准、样本处理、基因组测序和下游生物信息学分析的差异，不同 ME/CFS 微生物组研究之间的比较变得困难。因此，微生物组研究采用稳健、可重复和一致的研究设计对于在研究之间进行更可靠和有效的比较和得出结论非常重要。本文全面回顾了支持 ME/CFS 患者微生物组改变的现有证据。此外，还讨论了与微生物组研究相关的陷阱和挑战。
