Anthony Komaroff, MD, is the distinguished Simcox-Clifford-Higby Professor of Medicine at Harvard Medical School and Senior Physician at Brigham and Women’s Hospital in Boston. He has published over 230 research articles and two books. From 1997-2015 he was editor in chief of the Harvard Health Publications Division of Harvard Medical School, the division responsible for disseminating all of the medical school’s health information for the general public. He has been publishing research papers on myalgic encephalomyelitis (ME) since the late 1980’s, and currently serves on the National Institutes of Health’s advisory council for ME/CFS research.
Also, check out this twitter thread of Anthony Komaroff, MD, summarizing more than 30 talks at the NIH “Accelerating ME” conference.
Professor Komaroff took time out from his busy schedule to be interviewed for our Meet The Scientist blog.
How did you get involved with the field of ME research?
In the early 1980s I saw several patients in my internal medicine practice with what we now would call ME/CFS, and it was clear that virtually nothing was known about the illness. That intrigued me.
Can you tell us something about your own research into ME.
I am an internal medicine physician and clinical epidemiologist. My work on ME/CFS, in collaboration with experts in various areas, has included: 1) studying how common the illness is; 2) studying how severely the illness affects a person’s ability to function; 3) understanding the underlying biological abnormalities in the brain, autonomic nervous system, immune system and energy metabolism; 4) studying whether the illness can sometimes be triggered by infectious agents.
The U.S. National Academy of Sciences (through its Institute of Medicine) has summarized a scientific literature of over 9,000 published research reports. The reports document many underlying biological abnormalities in people with ME/CFS, and that the illness is not imaginary. Moreover, it is clear that some cases of the illness can be triggered by different kinds of infectious agents, including viruses.
There are over 17 million people internationally who suffer from ME. Yet minimal resources have been put into research for this debilitating neurological illness. Why do you think ME has consistently faced significant underinvestment compared to other neurological illnesses?
One big problem has been that most researchers already have their own fields of special interest, and haven’t been interested in turning their attention to ME/CFS. However, I’m encouraged that the number of scientists all over the world who are studying this illness has grown greatly over the past 30 years.
Post Exertion Malaise (PEM) remains an important characteristic symptom of ME/CFS that helps distinguish it from other conditions yet it is poorly understood. Please could you explain what PEM is and the importance of developing an accurate assessment tool?
Here I would refer you to the U.S. Institute of Medicine report that laid this out nicely.
How far away do you think we are from effective treatments for ME?
It’s always hard to make such predictions. One problem is that it takes such a large investment for a pharmaceutical company to pay for the studies necessary to test whether a treatment is effective. As the underlying biology of the illness becomes clearer, I’m optimistic that useful treatments will follow.
In your opinion, what needs to be done by public health authorities to bring about better health outcomes for people suffering from ME?
One of the greatest causes of suffering among people with ME/CFS is that some doctors, friends, family members, and employers wonder if the illness is imaginary, or fabricated. Public health authorities can help disseminate the scientific evidence that the illness has objective underlying biological abnormalities, involving the brain, autonomic nervous system, immune system and energy metabolism. They also can provide more support services for those who are homebound.