ME/CFS Science Profile picture
Jun 27, 2019 7 tweets 2 min read Read on X
1) There’s a new interesting study out by a collaboration of ME/CFS patients and scientists.

They’ve sent Freedom of Information requests to 38 NHS specialist centers for ME/CFS and asked them about their information on harms by rehabilitative therapies such as GET or CBT.
2) The results are striking. Among the ME/CFS clinics surveyed, there was an almost universal absence of criteria for detecting harm, and no clinic reported any harm to have occurred in their patients, despite acknowledging that many dropped out of treatment.
3) No clinic reported telling patients explicitly that they could be worse after therapy than before. They only said that setbacks were possible (but temporary) or that the reported harms of GET are due to the treatment being wrongly executed.
4) So patients getting worse during treatment might think that their decline is due to something else.

The authors suggest this can result in a “misinformation loop”: the clinics say GET is safe, patients believe that and do not report harm, clinics think GET is really safe...
5) Or as the authors put it more eloquently: “if clinics presume that treatments are harmless, they will inevitably fail to record harms accurately.”

Another possibility is of course that patients do report harms but that clinics do not use or record this information.
6) The solution the authors propose is a national system for collecting information from patients who think they have been harmed by rehabilitative therapies such as GET, something similar to the Yellow Card Scheme for adverse effects arising from medical drugs or devices.
7) The study was published in The Journal of Health Psychology and can be found here: journals.sagepub.com/doi/abs/10.117…

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More from @mecfsskeptic

Jul 27
1) Had a closer look at the BioMapAI paper in Nature Medicine that is getting a lot of media coverage.

The research group of Derya Unutmaz (@DeryaTR_) and Julia Oh at The Jackson Laboratory created an impressive rich dataset and analyzed it using a deep neural network. Image
@DeryaTR_ 2) They tracked 153 ME/CFS patients and 96 age- and gender-matched controls over a period of 4 years.

The dataset includes:

- 48 standard blood parameters
- mass spectrometry of 958 metabolites in plasma
- immune cell profiling
- gut metagenomics of stool samples
@DeryaTR_ 3) These measurements were used to train an AI model to discriminate ME/CFS patients from controls. The graph below how the model performed on data it hadn't seen before.

It reached an accuracy 72.5%. Approximately 7/10 of the samples it predicted as ME/CFS were truly ME/CFS. Image
Read 10 tweets
Jul 25
1) An impressive dataset on ME/CFS was just published by the research team of Ian Lipkin.

They tested multiple proteins and metabolites in 56 ME/CFS patients and 51 controls before and after exercise and cytokines in response to mimics of viral, bacterial, and yeast infection. Image
2) Let's start with the cytokine response. The researchers measured this after exposure to antigens that mimic:

- a fungal infection (HKCA)
- a bacterial infection (LPS)
- a viral infection (poly I:C)
- superantigens (SEB) which triggers a nonspecific T-cell response
3) No group difference were found for the bacterial and viral exposure, some differences were seen after HKCA (fungal) while the biggest differences were found for the superantigen SEB.

The cytokine response to SEB was much higher in patients compared to controls. Image
Read 10 tweets
Jul 16
1) The Dutch research agency ZonMw announced a list of new Long Covid studies that will receive funding. The total budget was approximately €6 million.

There are some interesting projects that will also be relevant to #MECFS. Image
2) A study led by dr. Rob Wüst from Amsterdam University will study immune cell infiltration on muscle tissue and mast cell activation during post-exertional malaise. Focus is on how immune cells affect muscle recovery.
3) The project from Dr. Isabel Slurink at Utrecht University will identify clinically relevant phenotypes of post-COVID symptoms and possible treatment options using the PCNN platform ('Post-COVID Netwerk Nederland').
Read 9 tweets
Jul 10
1) The Canadian research group of Alain Moreau published a big study on Sphingomyelin phosphodiesterase acid-like 3B (SMPDL3B) as a potential biomarker for ME/CFS.

Unfortunately, it seems that the results could simply be due to sex differences and contraception use... Image
2) As a recap, here are their main findings.

Figure 2.A shows that SMPDL3B levels in plasma were significantly elevated in the Canadian ME cohort of 249 patients compared to 63 healthy controls. Image
3) Using flow cytometry on a much smaller sample, the researchers found that membrane-bound SMPDL3B in monocytes was reduced in 27 ME/CFS patients compared to 9 controls (Figure 3.A). Image
Read 10 tweets
Jul 6
1) A research team at the University of Surrey are studying the electrical properties of white blood cells in ME/CFS.

They reported that after salt treatment, these proporties change differently in ME/CFS donors compared to healthy controls and patients with multiple sclerosis. Image
2) This research followed up on the famous nanoneedle findings. In 2019, the team of Ron Davis found spectacular differences between ME/CFS patients and controls in the electrical impedance of white bloods cells. The effect was clearest after 1.5 hours. Image
3) The Surrey researchers found something similar in a small sample of 17 ME/CFS patients, 4 MS patients and 6 healthy controls. Frozen samples were provided by the UK bioank.
Read 7 tweets
Jun 19
1) Finally had a look at the new trial of Rapamycin, an FDA-approved drug that is used an immunosuppressant to prevent organ rejection.

86 ME/CFS patients were included in a pilot trial and received a low dose of rapamycin of 6 mg once per week. Image
2) How did the Simmaron Researchers came to Rapamycin?

They first found that ME/CFS subjects had elevated levels of the early autophagy protein ATG13 and that these were heavily phosphorylated.
3) The mammalian target of rapamycin (mTOR) is the upstream enzyme responsible for phosphorylating ATG13. So that might be where the problem lies.

Rapamycin is an inhibitor of mTor, therefore the drug might lead to less phosphorylated ATG13 (which this trial seems to confirm).
Read 10 tweets

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