ME-studier på internasjonal konferanse om immunologi

Vi får ta med oss de gode nyhetene vi kan, er det ikke noe som heter det?

I dag leser jeg på Facebook-gruppen ME/CFS Evolving Science at hele fem studier om ME/CFS skal presenteres på en internasjonal kongress om immunologi, ICI 2013.

Sammendrag av innsendte forskningsartikler, posterpresentasjoner etc. kan lastes ned som pdf.

For å spare dere for å lete gjennom en stor «blekke», legger jeg inn det som er relevant for oss her. Husk at dette kun er en kort presentasjon av det som vil legges frem på konferansen, og at det helt sikkert vil komme noe mer informasjon i etterkant. (Rød skrift: Mine uthevinger.) Hvis du ikke orker å lese «forskningsspråk», kan du hoppe til slutten av denne posten for et par korte kommentarer fra meg.

Bidrag 1: Posterpresentasjon om NK-celler for pasienter med moderat eller alvorlig ME

P1.03.04
Assessment of natural killer receptors and activity in severe and moderate Chronic Fatigue Syndrome
S. L. Hardcastle1, E. W. Brenu1, D. Staines2, S. Marshall-Gradisnik1; 1National Centre for Neuroimmunology and Emerging Diseases, Griffith
Health Institute, Griffith University, Gold Coast, Australia, 2Queensland Health, Gold Coast Public Health Unit, Gold Coast, Australia.

Abnormalities in the immune system are a common finding within sufferers of Chronic Fatigue Syndrome (CFS).Research has consistently  found compromised Natural Killer (NK) cell function in CFS subjects. The mechanism of the reduced NK function is unknown and however this may potentially be related to the presence of NK receptors. It is also unknown whether reduced NK function is further compromised within CFS subjects who are very severely affected by the disease. The purpose of this study was to examine NK activity and Killer Immunoglobulin-like Receptors (KIRs) in moderate (MFS) and severely affected CFS (SFS) subjects in comparison to controls. CFS subjects were characterised as either moderate or severely affected based on health and quality of life questionnaires. Severe subjects were housebound. Blood samples were collected s from controls (n=9; 50.9 + 2.5 years), MFS (n=9; 49.9+ 3.7years) and SFS subjects (n=9; 42.3 + 3.9 years). Using flow cytometry NK cells were measured for their activity based on their ability to lyse K562 cells and cell surface expression of KIRs. ANOVA was the  statistical method used to assess all data collected. Preliminary data from CFS subjects showed significant reductions NK cell activity and an increase in KIR3DL1 in CFS subjects when compared to the controls. Results suggest that CFS patients have further compromised immune function, particularly reduced NK cell activity, when compared to controls. Additionally, increased levels of KIR, particularly KIR3DL1 in CFS patients, may potentially explain why these patients have a decrease in NK lysis.

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Bidrag 2: Posterpresentasjon om dendrittiske celler og monocytter hos CFS/ME-pasienter

P1.08.02
The role of Dendritic Cells and Monocytes in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis

E. W. Brenu1,2, T. K. Huth1,2, S. K. Hardcastle1,2, L. Cosgrave2, D. R. Staines3,2, S. M. Marshall-Gradisnik1,2; 1School of Medical Sciences, Griffith University, Gold Coast, Australia, 2The National Centre for Neuroimmunology and Emerging Diseases, Griffith Health
Institute, Griffith University, Gold Coast, Australia, 3Queensland Health, Gold Coast Public Health Unit, Robina,, Gold Coast, Australia.

Bidirectional communication between the adaptive and innate immune system is necessary for optimal immune function. Irregularities in innate immune cell function may affect cellular processes in the adaptive system and vice versa. In Chronic Fatigue Syndrome/ Myalgic  Encephalomyelitis (CFS/ME) a dysfunctional immune system has been described and this is characterised by reduced cytotoxic function in Natural Killer (NK) cells and CD8+T cells, altered neutrophil respiratory burst and equivocal levels in cytokine secretion. Dendritic cells (DCs) and macrophages are innate immune cells with highly versatile functions as they have a role in the development and function of almost all immune cells. Hence, the objective of this study was to determine the role of monocytes and DCs in CFS/ME patients. 20 CFS/ME patients  (age=51.8±1.74 years) and 30 controls (age= 53.19±1.35years) were recruited for the study. Inclusion into the CFS/ME group was based on the Centre for Disease Prevention and Control (CDC 1994) criteria for CFS/ME. 10mL of whole blood was collected from all participants. Samples
were stained with a cocktail of monoclonal antibodies containing HLA.DR, CD123, CD33, CD16 and CD11c. Samples were analysed on the flow cytometer to determine the levels of total monocytes, total DCs, myeloid DCs and lymphoplasmacytoid DCs. ANOVA was the statistical analysis used to analyse all data collected. Compared to the other immune cells, monocytes were significantly elevated in the CFS/ME patients in comparison to the controls. These results suggest further highlight the role of impaired immune function in the pathogenesis of CFS/ME.
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Bidrag 3: Posterpresentasjon om IL-15-nivåer hos pasienter med ME/CFS

P1.14.20
Content of IL-15 in patients with myalgic encephalomyelitis / chronic fatigue syndrome

N. Didkovski1,2, I. Malashenkova1,2, I. Zuykov1, O. Gurskaya1, J. Sarsania1, G. Kazanova2, N. Hailov2, D. Ogurtzov2; 1Institute of Physico-Chemical Medicine FMBA Russia, Moscow, Russian Federation, 2National Research Center “Kurchatovskiy Institute”, Moscow, Russian Federation.

Myalgic Encephalomyelitis/Chronic fatigue syndrome (ME/CFS) is considered as a neurological disorder with a dysfunction of the immune system. Patients have cognitive impairment, depression, sleep disorders, headaches and others. Previously we have found that the majority of patients with ME/CFS associated with herpes virus infection had reduced levels of IL-2. It is important to search biomarkers of ME/CFS and new approaches for the treatment. We studied the level of IL-15 – functional agonist IL-2. IL-15 and proinflammatory cytokines: IL-1β, IL-8, IL-12 were measured by ELISA using BCM Diagnostics Ltd. 19 patients with ME/CFS associated with chronic herpes infection at the age of 22 to 51 years had a mixed infection: HHV 7 and/or HHV 6 and/or EBV in blood samples, saliva and oropharyngeal swabs measured by PCR. The comparison group consisted of 20 patients (21 to 50 years) with genital HPV infection. The control group: 18 healthy volunteers (20 to 45 years). Results. Levels of IL-1β, IL-8 and IL-12 were increased or had a tendency to increase in patients with ME/CFS, and in the control group. The principal difference was observed in the level of IL-15. Thus, in patients with ME/CFS the level of IL-15 was lower than in the control group – 8,66 ± 0,93 pg/ml and 16,33 ± 2,1 pg/ml, (p<0,05), while in the control group the level was increased to 35,72 ± 4,22 pg/ml  (p<0,01). Data obtained on the reduced level of IL-15, which has antiapoptotic effects, suggest its involvement in the pathogenesis of ME/CFS.
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Bidrag 4: Posterpresentasjon om T-celle dysregulering hos CFS/ME-pasienter

P3.11.06
T Cell Dysregulation in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis

E. W. Brenu1,2, S. L. Hardcastle1,2, T. K. Huth1,2, L. Cosgrave2, D. R. Staines3,2, S. M. Marshall-Gradisnik1,2; 1School of Medical Sciences, Griffith University, Gold Coast, Australia, 2The National Centre for Neuroimmunology and Emerging Diseases, Griffith Health Institute, Griffith University, Gold Coast, Australia, 3Queensland Health, Gold Coast Public Health Unit, Robina,, Gold Coast, Australia.

Gamma delta (γδ) T lymphocytes comprise about 1-10% of peripheral lymphocytes. Although, functionally distinct from the more diverse αβ T cells, γδ T cells have important roles in pathogenesis and inflammation. γδ T cells secrete cytokines and chemokines essential for regulating adaptive immunity. In diseases such as Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) decreased activity of cytotoxic T cells and elevations in FOXP3 secreting T cells have been reported. Dysregulation in T cell function may be an important component of the CFS/ME immune profile. Hence, the objective of this study was to determine the role of γδ T cells in CFS/ME patients. 20 CFS/ME patients (age=51.8±1.74 years) and 30 non-fatigued controls (age= 53.19±1.35years) were recruited for the study. Inclusion into the CFS/ME group was based on the Centre for Disease Prevention and Control (CDC 1994) criteria definition for CFS/ME. 10mL of whole blood was collected from all participants. The whole blood samples were stained with a cocktail of monoclonal antibodies containing CD4, CD62L, CD27, CD45RA, CD3, CD11a, CD94, V delta-1 and V delta-2. Following which samples were analysed on the flow cytometer. The statistical analysis used to determine differences in the data was ANOVA with significant set at P=0.05. Compared to non-fatigue controls, modifications in cell number were observed in the CFS/ME patients. The results demonstrate that CFS/ME may be characterised by discrepancies in other subsets of T cells.
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Bidrag 5: Posterpresentasjon om neutrofil funksjon hos pasienter med alvorlig og moderat CFS

P5.17.07

Analysis of neutrophil function in severe and moderately affected Chronic Fatigue Syndrome subjects

S. L. Hardcastle1, E. W. Brenu1, D. Staines2, S. Marshall-Gradisnik1; 1National Centre for Neuroimmunology and Emerging Diseases, Griffith Health Institute, Griffith University, Gold Coast, Australia, 2Queensland Health, Gold Coast Public Health Unit, Gold Coast, Australia.

Research has commonly shown that people with Chronic Fatigue Syndrome (CFS) have immune system abnormalities. Decreases have been found in neutrophil respiratory burst in a CFS cohort. Reduced ability of neutrophils to eliminate pathogens can contribute to the impaired immune function in CFS subjects. It is unknown whether neutrophil function is more impaired in patients severely affected by CFS. The purpose of this study was to examine neutrophil activity including phagocytosis and respiratory burst in patients with severe CFS in comparison to those with moderate symptoms and non-fatigued controls. CFS subjects were characterised using the CDC Case Definition and the International Consensus Criteria for CFS. CFS subjects were then grouped as either moderate or severely affected based on health and quality of life questionnaires. Blood samples were taken from age and sex matched non-fatigued controls, moderately affected and severely affected CFS subjects. Response to E.coli bacteria was measured in neutrophils by assessing phagocytic activity and respiratory burst, these were then analysed on the flow cytometer. Preliminary data from CFS subjects showed differences in neutrophil function based on respiratory burst and phagocytic activity when compared to the control group. These results suggest that differences in neutrophil function in CFS patients
may contribute to CFS related immune dysfunction.
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Så hva forteller dette oss?

Vel, hvis man ikke kan mye om immunologi, er det nok begrenset hva man kan lære av dette. Likevel er det alltid interessant å se på forskernes konklusjoner, som jo bekrefter funn av abnormaliteter i immunsystemet hos pasienter med ME (CFS som det først og fremst kalles internasjonalt). Det er jo dessuten oppløftende å se at det foregår forskning som gir interessante resultater som kanskje fører til fremtidige biomarkører og tester. Jeg merker meg også at flere av presentasjonene kommer fra Australia, vi vet jo at det foregår en del biomedisinsk forskning på ME der.

Det har jo lenge vært kjent at ME-pasienter har immunologiske problemer, så å få utvidet kunnskapsgrunnlaget om dette, og ikke minst spredt resultatene på en stor, internasjonal kongress er jo et godt tegn.

Noen praktisk betydning her og nå for den som er syk, har det nok ikke at disse resultatene blir presentert på konferansen.

Forhåpentligvis følger forskere og helsepersonell i Norge også med på dette, og kanskje noen blir interessert i å forske mer på noen av problemstillingene som legges frem her? Det får tiden vise.

Man kan ikke vurdere forskning kun ut fra slike sammendrag, og jeg håper at vi får se mer fyldige rapporter om disse resultatene. Likevel merker jeg meg at de nye, intenasjonale konsensuskriteriene nå også blir brukt i forskningen (nevnt i det siste bidraget: CFS subjects were characterised using the CDC Case Definition and the International Consensus Criteria for CFS.), selv om de altså har skrevet feil navn: Det riktige navnet er: Myalgic encephalomyelitis: International Consensus Criteria. Men dette viser vel også at CFS (på norsk: kronisk utmattelsessyndrom) og ME brukes så mye om hverandre at det enda trengs en stor grad av avklaring på skillet mellom de to.