MEA to fund new research into biomarkers and markers of disease activity in people with severe ME/CFS

ME Association announcement, 20 December 2016: MEA to fund new research into biomarkers and markers of disease activity in people with severe ME/CFS

We are pleased to announce that – following the normal rigorous peer review procedures – the MEA Ramsay Research Fund has agreed to fund a study that will be examining what are termed microRNA profiles in peripheral blood mononuclear cells (PBMCs) and exosome-enriched vesicles.

The study will involve the use of ME Biobank blood samples that have been obtained from people with severe ME/CFS and from our Biobank group of healthy controls.

The research will be carried out by Professor Elisa Oltra and colleagues in Spain and we are hoping that there will also be additional UK collaboration to the involvement of the ME Biobank in supplying the samples.

elisa_oltraThe study will start early in the New Year and will take 12 months to complete.

Total RRF funding = approx £50,000

Find a brief CV for Professor Oltra HERE.

Read more about the project

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Vagus Nerve Stimulation in FM & ME/CFS: a trial of one

Health rising forum post, by Cort Johnson, 8 Dec 2016: Vagus Nerve Stimulation in Fibromyalgia and ME/CFS: A Trial of One

An Emerging Treatment

My interest in vagus nerve stimulation was prompted by a number of factors. Fibromyalgia (FM) and/or chronic fatigue syndrome (ME/CFS) studies indicate that reduced heart rate variability – a sign of vagus nerve withdrawal – was not just present in these diseases, but was associated with poor sleep and reduced cognition in them. Other studies indicate that sympathetic nervous system activation – a sign of vagal withdrawal – is common in all the diseases associated with ME/CFS and FM; e.g. irritable bowel syndrome, interstitial cystitis, migraine, and Gulf War Illness. The fact that low heart rate variability is associated with a higher risk of death even in healthy individuals was a bit of an eye-opener as well.

There was my firm conviction that the “arousal” that has been with me from day one must has its roots in sympathetic nervous system activity. It was a small fibromyalgia study, though, that really piqued my interest. That study – which involved surgically implanting a vagus nerve stimulator in the neck – caused the usually pretty buttoned-down Dr. Ben Natelson to state “The results blew me away. I have never seen an effect as powerful as this.”

In a year Jean Hasse went from being bedbound and on high doses of opioid painkillers (clearly not working!) to getting her Master’s degree and regularly exercising. Many of the FM patients in the small study no longer met the criteria for FM at the end of it. The study was far too small to be definitive but these were extraordinary results. Another remarkable story concerned a woman crippled by a severe case of rheumatoid arthritis who was able to resume her normal activities.

Natelson is currently involved in a Gulf War Illness study using a non-invasive ear-attached vagus nerve stimulator (VNS) that he believes may be every bit as powerful as the surgically implanted one.

Read more about vagus nerve stimulation 

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Living with ME/CFS holiday survival guide

Bateman Horne Center article, by Leigh Reynolds, 13 Dec 2016: Holiday Survival Guide

Living with ME/CFS and FM changes most everything, including how we celebrate the holidays. Perhaps one of the greatest gifts you can give yourself, or a loved one, is a ‘free pass’ on the guilt you may be tempted take on when you are unable to do it all. We all want a happy and peaceful holiday season; celebrating within the boundaries of your illness can help make that a reality. Sometimes simply discussing your needs and expectations with family and friends can make a big difference.

The article goes on to discuss:

  • Focus on the meaning of the holiday
  • Challenge traditions, create new ones
  • Give yourself the gift of self-care
  • Allow yourself to receive
  • Set boundaries
  • Coping with unresolved family/friend problems

Read the full article

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Dr VanElzakker’s ME research using PET, MRI and Tesla-7 scans

MEAction blog post, by Jaime S, 12Dec 2016: Dr VanElzakker: two new ME/CFS studies at Harvard

#MEAction recently interviewed Dr. Michael VanElzakker regarding two, new studies on ME/CFS.

michael-vanelzakkerThe first aims to discover evidence of increased activity where the sensory vagus nerve enters the brainstem – a subtle effect that requires some intricate scans.

In order to measure the activity in the vagus nerve, Dr. VanElzakker will use a scanner that is capable of concurrently performing two different types of scans: PET and MRI.  A PET scan allows researchers to pick up very subtle differences in biological function, while an MRI captures more detailed anatomy.

The study is well underway: Dr. VanElzakker has scanned six patients and two controls so far.  It’s a small study, VanElzakker revealed, with the hope of using the results to apply for a grant down the line.  Right now, the pilot study is funded solely through Massachusetts General Hospital / Harvard Medical School’s Martinos Center for Biomedical Imaging.

The second study, still in the grant-application stage, will be a post-exercise test, using MRI to pick up the activity of different metabolites in patients’ brains.  VanElzakker plans to use a 7-Tesla scanner – a very high strength scanner – in order to produce especially high-quality images; he also hopes to perform autonomic testing.

Dr. VanElzakker is basing his study design off of previous exercise challenge studies.  He hopes to replicate their findings, as well as uncover new evidence about autonomic dysfunction and post-exertional metabolic changes in the brains of ME patients.

Dr. VanElzakker’s position about ME’s biomedical nature is unequivocal.

“People at teaching hospitals are following the research,” he said.  “Everyone here recognizes that it’s a neuroimmune condition and approaches it that way.”

“When a condition is ‘medically unexplained,’ some seem to assume that means that it must be psychogenic. We would say that if medicine cannot yet explain something, perhaps the fault lies with medicine,” he added.  “There are plenty of things [in biology] we aren’t able to image, yet.  We aren’t able to measure this thing with rudimentary scans and blood tests.”  VanElzakker laughs.  “We don’t have a test yet, therefore it’s psychogenic?  That reveals a tragic lack of humility about what we know and what we don’t know.”

An Interview with Michael VanElzakker Ph.d, 14 Feb 2014

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Heart rate variability biofeedback therapy (HRV-BT) & GET in management of CFS

Research highlights:

  • Heart rate biofeedback and graded exercise training improve fatigue as core symptom of CFS.
  • Heart rate biofeedback improves quality of life and depression in patients with CFS.
  • Graded exercise training reduces physical fatigue and betters physical functioning in patients with CFS.

Research abstract:

OBJECTIVE

Chronic fatigue syndrome (CFS) is characterised by persistent fatigue, exhaustion, and several physical complaints. Research has shown cognitive behavioural therapy (CBT) and graded exercise training (GET) to be the most effective treatments. In a first step we aimed to assess the efficacy of heart rate variability biofeedback therapy (HRV-BF) as a treatment method comprising cognitive and behavioural strategies and GET in the pilot trial. In a second step we aimed to compare both interventions with regard to specific parameters.

METHODS

The study was conducted in an outpatient treatment setting. A total of 28 women with CFS (50.3 ± 9.3 years) were randomly assigned to receive either eight sessions of HRV-BF or GET. The primary outcome was fatigue severity. Secondary outcomes were mental and physical quality of life and depression. Data were collected before and after the intervention as well as at a 5-month follow-up.

RESULTS

General fatigue improved significantly after both HRV-BF and GET. Specific cognitive components of fatigue, mental quality of life, and depression improved significantly after HRV-BF only. Physical quality of life improved significantly after GET. There were significant differences between groups regarding mental quality of life and depression favouring HRV-BF.

CONCLUSION

Both interventions reduce fatigue. HRV-BF seems to have additional effects on components of mental health, including depression, whereas GET seems to emphasise components of physical health. These data offer implications for further research on combining HRV-BF and GET in patients with CFS.

Heart rate variability biofeedback therapy and graded exercise training in management of chronic fatigue syndrome: An exploratory pilot study, by Petra Windthorst, Nazar Mazurak1, Marvin Kuske, Arno Hipp, Katrin E. Giele, Paul Enck, Andreas Nieß, Stephan Zipfel, Martin Teufel in the Journal of Psychosomatic Research, February 2017, Vol 93, Pages 6–13 [published online December 2016]

TRIAL REGISTRATION

The described trial has been registered at the International Clinical Trials Registry Platform following the number DRKS00005445.

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Peptide microarray differentiates cases in ME/CFS

Research abstract:

Myalgic encephalomyelitis (ME) is a complex, heterogeneous illness of unknown etiology. The search for biomarkers that can delineate cases from controls is one of the most active areas of ME research; however, little progress has been made in achieving this goal. In contrast to identifying biomarkers that are directly involved in the pathological process, an immunosignature identifies antibodies raised to proteins expressed during, and potentially involved in, the pathological process.

Although these proteins might be unknown, it is possible to detect antibodies that react to these proteins using random peptide arrays. In the present study, we probe a custom 125,000 random 12-mer peptide microarray with sera from 21 ME cases and 21 controls from the USA and Europe and used these data to develop a diagnostic signature.

We further used these peptide sequences to potentially uncover the naturally occurring candidate antigens to which these antibodies may specifically react with in vivo. Our analysis revealed a subset of 25 peptides that distinguished cases and controls with high specificity and sensitivity. Additionally, Basic Local Alignment Search Tool (BLAST) searches suggest that these peptides primarily represent human self-antigens and endogenous retroviral sequences and, to a minor extent, viral and bacterial pathogens.

Humoral Immunity Profiling of Subjects with Myalgic Encephalomyelitis Using a Random Peptide Microarray Differentiates Cases from Controls with High Specificity and Sensitivity, by Singh S, Stafford P, Schlauch KA, Tillett RR, Gollery M, Johnston SA, Khaiboullina SF, De Meirleir KL, Rawat S, Mijatovic T, Subramanian K, Palotás A, Lombardi VC in Mol Neurobiol. 2016 Dec 15. [Epub ahead of print]

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ME featured on radio programme Post Cyntaf

Listen to Post Cyntaf, a Welsh language morning news programme on Radio Cymru featured ME on Friday 16 Dec 2016.

Part 1  (17.47 mins – 22.22mins)
Interview with student Alwen Messmah from North Wales, and her mother Sian

Part 2 (1.13.48 – 1.20.54)
Interview with teenager Zac from Porthcawl and GP Harry Pritchard

Listen        Listen to Alwen & Sian

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A cardiac marker for disability in ME

A Cardiac Marker for Disability in Myalgic Encephalomyelitis, Written by Carol Sieverling (2004), Edited by Maryann Spurgin (2016).

Forward (2016):

The fascinating thing about this article is that everything from chemical allergies to immune dysfunction in ME is explained in terms of circulation problems.  This excellent piece on ME and heart issues was written by Carol Sieverling.

It was extremely long, putting people off from reading it. I have edited for length, but not for content, grammar or punctuation. I did edit out most treatment advice since Cheney’s treatment advice changes, and I edited out anything that made it longer if it did not contribute to understanding.

Any additions by me of new information have been put in brackets saying: [Maryann Spurgin’s note:].  All others are by Carol or are quotes from Dr. Cheney or where noted from a patient. This is Carol Sieverling’s interpretation of transcripts and tapes of conversations that took place between Dr. Paul Cheney, Carol, and Victoria Bell in 2004.

All other comments are statements from Dr. Cheney that have been slightly paraphrased [by Carol], but maintain his original meaning.

–Maryann Spurgin.

A concept central to Dr. Cheney’s understanding of this illness is decreased cardiac output:

The focus of this article is based on the following publication: “Abnormal Impedance Cardiography Predicts Symptom Severity in Chronic Fatigue Syndrome.” Peckerman, et al: The American Journal of the Medical Sciences. 2003; 326(2):55-60.

Dr. Cheney stated, “This is the best, most important publication in 20 years.” And: “This was published the year I left practice, 2003. The senior author is Natelson, and the principal author is Arnold Peckerman. [Maryann Spurgin note: this study was NIH funded]

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The RituxME & CycloME studies – video of Dr Oystein Fluge talk

Video posted on the RME Sverige You Tube channel, 19 Nov 2016:

The RituxME and CycloME studies – Ongoing Clinical Research in the ME/CFS Research Group, by Öystein Fluge, MD, Dep. Oncology and Medical Physics, Haukeland University Hospital, Bergen, Norge

Watch more videos from the Swedish National Society for ME

 

 

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Genetic variation affects adrenergic receptors in ME/CFS

ME Research UK comment, 7 Dec 2016: Genetic variation affects adrenergic receptors

Given the estimated 20,000 genes that determine the characteristics of human beings (and make up the human genome), identifying those that may be responsible for the development of ME/CFS is a challenge. But the task can be simplified by first considering the symptoms of the disease, and then targeting the search to those genes known to be involved in the underlying processes (for example, the nerve dysfunction that causes difficulties in standing).

This type of research often looks for small genetic changes, known as single nucleotide polymorphisms (SNPs), which vary between individuals. Most SNPs have no effect, but some can alter an individual’s susceptibility to disease.

An Australian study published recently in the journal, BMC Medical Genetics, has taken this approach to look at a range of potentially relevant SNPs in ME/CFS, assessing how frequently they occurred in a group of 95 patients with the illness, and in 77 healthy people.

The investigators focused on SNPs affecting three types of structure involved in transport and communication between tissues and cells in the body; namely, transient receptor potential ion channels, acetylcholine receptors and adrenergic receptors.

Their main finding was that one specific SNP, affecting the gene ADRA1A, occurred in almost half of the ME/CFS patients, but in only a quarter of the healthy people.

ADRA1A is responsible for the manufacture of a specific type of adrenergic receptor which controls the contraction of smooth muscle cells. This control is essential in a range of biological processes involving the blood vessels, gastrointestinal system, kidneys and other organs.

It may be that ADRA1A is involved in the development of ME/CFS (at least in a subgroup of patients), and that further investigation into the function of the related adrenergic receptors in the disease may help explain the cause of some of the symptoms experienced by patients.

Genetic studies of this kind represent a potentially fruitful area of ME/CFS research and, thanks to your continued support, ME Research UK has itself funded projects analysing the relevance to the illness of SNPs, microRNA molecules and DNA sequencing.

However, we are a long way from being able to apply these findings to the diagnosis and management of ME/CFS. For a start, the results of individual studies such as this need to be replicated by other research groups and in other groups of patients.

Read info about: ME Research UK ongoing studies

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