CFS/ME highlight notice
Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) is a complex and serious debilitating medical condition with a diverse range of symptoms. Profound physical and/or mental fatigue is the most well-known manifestation, while others include pain, disturbed sleep patterns and gastrointestinal problems. Each patient experiences their own personal combination of symptoms but certain ones dominate.
Building our portfolio of CFS/ME research has been a high priority for the MRC for a number of years. This highlight notice builds on a call for proposals in 2011, through which the MRC committed £1.65m to high-quality CFS/ME research.
Some areas considered important and tractable for research by the MRC CFS/ME Expert Group (chaired by Professor Stephen Holgate), and highlighted in that call, were not well covered in the funded applications. These are highlighted below, alongside the other call topics, and now our Research Boards would particularly welcome applications in these areas.
Research proposals – application and assessment process
Through this highlight notice, applicants are invited to submit innovative research proposals that address the mechanisms underlying chronic changes related to CFS/ME in one or more of the areas shown below:
- Immune dysregulation: There is evidence for a disturbance in innate and adaptive immunity in CFS/ME including alterations in cytokine profile, absolute and functional alterations in T cells and NK cells and occurrence of autoantibodies and allergic reactions that may explain some of the manifestations such as fatigue and flu-like symptoms. A number of infectious and environmental exposures have been associated as triggering these changes.
- Pain: Headache, facial pain and myalgia are reported symptoms of CFS/ME that may involve altered sensory and/or cognitive processing in the relevant neural pathways.
- Improved sub-phenotyping and stratification of CFS/ME: CFS/ME is often considered a broad spectrum disorder or syndrome and, as in other disease areas, it may be that the causes and mechanisms underpinning diverse symptom profiles are different. Better patient phenotyping and stratification could provide valuable new insights into the natural history of the disease and enable the development of more effective, better targeted treatments.
- Mechanisms of CFS/ME in children: The manifestations of CFS/ME in children represent a major clinical management challenge. There is a need for research aimed at improving understanding of the mechanisms that lead to the early onset of the disease; this knowledge can then be used for the development and evaluation of new treatment options, as a prelude to their assessment in large-scale clinical trials.
- Neuropathology: There is now preliminary evidence supporting the view that inflammatory mechanisms in the brain and spinal cord may underlie the pathophysiology of some severe disease CFS/ME phenotypes. Biobanks are now becoming available and create a unique opportunity for interrogation.
Applications should seek to improve mechanistic understanding in these areas through the study of cross-disease symptomatology, and pathways, in the clinic and/or laboratory.
Additionally, this highlight notice aims to build on the success of the recent call in increasing capacity in CFS/ME research and address the need for multidisciplinary teams to tackle the significant research challenges in this area.
Proposals submitted under this highlight notice should, therefore, involve partnerships between CFS/ME researchers and established, leading investigators working in relevant areas, but who are new to the CFS/ME field. It is expected that those investigators who are new to CFS/ME research will make a substantial contribution to the programme of work, to enable them to build their own track record in CFS/ME research.
When outlining the skill sets of the investigator group, applicants should highlight which investigator(s) are new to the CFS/ME field and how their experience and expertise will add to the UK CFS/ME research base.
MRC encourages (but does not require) applicants to work in partnership with other funders where appropriate. Depending on the programme of work to be undertaken, applicants may wish to seek cash or in-kind support from charitable and/or industrial partners; details of support from any project partners should be included on the Je-S application form and in the case for support.
Applicants will be required to attach a letter of support from any project partner(s) to their application.
This is a cross-Board highlight notice and proposals may be submitted to any of the MRC’s four Research Boards as appropriate based on scientific or clinical area. All applications received under this highlight notice will be assessed through MRC’s standard assessment procedure.
General guidance on how to apply for funding from the MRC can be found in the Applicants’ Handbook. (PDF, 1.25MB)
Potential applicants are advised to contact Dr Neha Issar-Brown if they are considering submitting an application under this highlight so the appropriate strategic uplift is given where proposals meet the terms of this notice and all applicants are requested to reference this highlight in the ‘Objectives’ and the ‘Case for Support’ sections of their proposals. Unfortunately, the MRC is not able to broker new research partnerships on the part of applicants as we do not have the resources to do this.
Dr Neha Issar-Brown, Head of Population and Systems Medicine
Dr Ana Antunes-Martins, Programme Manager