Monday, 2 March 2015

Distinct plasma immune signatures in ME/CFS and Quo vadis, Science Media Centre?

Distinct plasma immune signatures in ME/CFS are present early in the course of illness


Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is an unexplained incapacitating illness that may affect up to 4 million people in the United States alone. There are no validated laboratory tests for diagnosis or management despite global efforts to find biomarkers of disease. We considered the possibility that inability to identify such biomarkers reflected variations in diagnostic criteria and laboratory methods as well as the timing of sample collection during the course of the illness. Accordingly, we leveraged two large, multicenter cohort studies of ME/CFS to assess the relationship of immune signatures with diagnosis, illness duration, and other clinical variables. Controls were frequency-matched on key variables known to affect immune status, including season of sampling and geographic site, in addition to age and sex. We report here distinct alterations in plasma immune signatures early in the course of ME/CFS (n = 52) relative to healthy controls (n = 348) that are not present in subjects with longer duration of illness (n = 246). Analyses based on disease duration revealed that early ME/CFS cases had a prominent activation of both pro- and anti-inflammatory cytokines as well as dissociation of intercytokine regulatory networks. We found a stronger correlation of cytokine alterations with illness duration than with measures of illness severity, suggesting that the immunopathology of ME/CFS is not static. These findings have critical implications for discovery of interventional strategies and early diagnosis of ME/CFS.

(To read the whole article, click on the link above.  A PDF version can be downloaded by clicking here.)

Quo vadis, Science Media Centre? (Saturday 28 February 2015)

Yesterday saw some positive media headlines for the ME community. The research from Columbia University by Hornig et al, concerning the level of cytokine activation as a potential biomarker for ME, looks promising[1]. ME research indicating a biological pathology is often dismissed due to the small number of participants but this was a study comprising 298 ME patients and 348 controls, which will hopefully give it more weight in scientific circles[1]. Unfortunately, as is usual with UK media coverage, reporting was not unequivocally positive; the difference in tone between the UK and US media coverage was marked. In the former, most of the usual suspects promoting the psychogenic paradigm were quoted, aided by the Science Media Centre (SMC). There is little hope of this group of psychiatrists going quietly into the night and we will probably experience a backlash from that quarter; they have much to lose if and when the psychogenic model of ME is discredited and the disease is proven to have a biological foundation.

Regarding specific coverage: ‘First Biological Proof that ME is Real Found by Scientists’ states the Telegraph’s headline[2]. Hardly the first given the thousands of papers published showing biological abnormalities in ME patients, and proof is a charged term in science but quite a good headline for a British newspaper (to be fair the ME Association’s reporting was hardly exemplary[3]). The Independent lives up to its usual poor standards when reporting anything ME related; its headline, ‘Scientists Claim to have ‘Robust’ Evidence that ME has a Biological Cause'[4], being especially bad. Note the use of the word claim and the inverted commas around robust and contrast this with their reporting of the PACE trial based research a few weeks ago, ‘Sufferers of Chronic Fatigue Syndrome can Benefit from Exercise'[5]. No doubt is expressed there in the veracity of the researchers’ claims, the suggestion that ME sufferers can benefit from exercise is stated as fact.

The Science Media Centre surpassed itself in its coverage of the Columbia University study[6]. Of seven experts chosen to respond to the study, not one gives a positive analysis, no medical adviser from an ME charity or, non-psychosomatic promoting, ME researcher is quoted. The featured experts are:

Professors Michael Sharpe and Peter White, and Dr Esther Crawley, all notorious proponents of the psychogenic ME model

Professor Stephen Lawrie, head of The Division of Psychiatry at the University of Edinburgh: ‘This is a small study’ he states[6]; a study encompassing 20 participants is small professor Lawrie, one involving over 600 participants is not[1]. One has to ask why is a psychiatrist being consulted?

Professor Derek Hill, a professor of Medical Imaging Science with no known expertise in the field of ME[7]

Professor Naveed Sattar: Professor of Metabolic Medicine at the University of Glasgow. He does have expertise in the field of biomarkers but has shown zero interest in the field of ME research heretofore[8]

Dr Diana Prata: Group Leader, Institute of Molecular Medicine. Again, no evidence of any interest in the field of ME research[9] ‘This specific illness is not in my area of expertise’ really? Yet the SMC calls you an expert[6].

If the SMC wanted to skew their response towards dismissing the Columbia study and avoid undermining their preferred psychogenic model of ME it would be hard to choose better sources of expertise. The study is by no means flawless or conclusive (what study is?) but it’s a better piece of work than the SMC would lead you to believe. Connie St Louis, former president of the Association of British Science Writers and a senior lecturer at City University, has detailed the SMC’s malign influence on media reporting of scientific stories in the UK[10], revealing that over half of the SMC’s expert reactions were covered in the press and in nearly a quarter of stories, the only quotes were from the SMC[10]. Louis states ‘The SMC never claims to deliver a balanced [argument], so it’s really interesting that many of them weren’t using somebody independent of what the SMC offered’[10]. The SMC’s media briefings are reported uncritically, with 60 per cent of articles based on their information containing no non-SMC mediated sources[10]. This is especially relevant concerning ME coverage in the British media and explains its bias towards reporting research from the psychogenic realm[11].

We recently published a blog post concerning a vitriolic article about ME sufferers from the University of Toronto’s Professor Edward Shorter[12]. One of the particularly insightful claims made in his piece was,

‘There have been no convincing new studies, no breakthrough findings of organicity, nothing.

And there never will be.'[13]

I’m not quite sure why he split the sentence up, no doubt to enhance the effect of such a momentous, nay paradigm-shifting statement, but it looks more foolish now than it did a week ago, which is quite an achievement. Needless to say Professor Shorter’s scientific knowledge is zero, I’m only surprised the SMC didn’t choose him as one of their expert commentators on the Columbia study.

A serious point to finish: let us not forget Karina Hansen, currently being ‘treated’ by Per Fink and his followers in Denmark. I believe forcibly removing a young woman from her home to an institution that restricts her liberty, access to her family and subjects her to who knows what form of ‘therapy’, is nothing less than torture. I also find it disturbing that it is another case of a young woman being abused by middle-aged male members of the medical profession. The current climate surrounding ME, ‘all in the mind’, ‘lazy malingerers’ etc. encouraged by the likes of Wessely, White and Sharpe (and formerly by Beard at al), has allowed such cruelties to be inflicted on ME patients. Hopefully we are coming to the end of this era of abuse and can look forward to more biomedical research and effective medical therapy, consigning the over-used biosocial model and psychogenic explanations for physical illness[14] to the dustbin of history.

14) Kennedy, A (2012). Authors of our own misfortune?: The problems with psychogenic explanations for physical illnesses. CreateSpace Independent Publishing Platform

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