Project Team

Peter Novak MD, PhD, Inaugural Chief of the Autonomic Neurology Division, Harvard Medical School

Richard Scheuermann, PhD, Director of Informatics and La Jolla Campus Director, J. Craig Venter Institute; Adjunct Professor of Pathology, University of California San Diego

Project Summary:

Project co-lead Dr. Richard Scheuermann

A project to determine if immune dysregulation, blood vessel dysfunction or microclotting contribute to small fiber neuropathy in patients with Long COVID and ME/CFS. Punch biopsy tissue samples containing peripheral nerves are being collected from Long COVID and ME/CFS patients with a diagnosis of small fiber neuropathy. The project team is using advanced sequencing to identify the potential loss of nerve or other types of cells in samples, and to characterize the genetic and immune landscape of the tissue. A stain will be used to see if blood vessels in the tissue samples contain fibrinaloid microclots.

Project Background: 

Several research studies have shown that some LongCOVID and ME/CFS patients develop small fiber neuropathy. This occurs when the small fibers of the peripheral nervous system that regulate autonomic functions such as heart rate and breathing are damaged or diminished. Symptoms of small fiber neuropathy include chronic pain, sensory impairment, gastrointestinal dysmotility, and autonomic dysfunction. While small fiber neuropathy can be diagnosed in LongCOVID and ME/CFS patients via a punch biopsy procedure, the molecular mechanisms underlying small fiber neuropathy development remain to be characterized. This project will work to identify these molecular mechanisms using advanced genomic and machine learning methods.

(Image from Narasimhaiah & Mahadevan 2022)