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Research Digest 29/6/23

Welcome to the 96th Emerge Australia Research Digest, where you will find summaries of some of the latest research and information about ME/CFS, with links to the complete articles.

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Orthostatic intolerance and chronotropic incompetence in patients with Myalgic Encephalomyelitis or Chronic Fatigue Syndrome 


Authors:
 Miwa, K (Toyama, Japan).

Publication: Circulation Reports

Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9908528/pdf/circrep-5-55.pdf

Orthostatic intolerance is a common symptom in ME/CFS, and the symptoms induced by sitting or standing can leave patients bedridden. Chronotropic incompetence (CI) refers to the inability of the heart to increase its beat rate to a level that is proportionate to the activity being undertaken, or a reduced increase in heart rate during activity. Previous studies have observed CI in ME/CFS patients. This study aimed to explore the role of POTS and CI in ME/CFS patients during orthostasis.

The recordings of 101 ME/CFS patients (International Consensus Criteria) who completed an active 10-minute standing test at least 3 times from July 2017 to December 2020 at the Miwa Naika Clinic (Japan) were included in this study. This test involved recumbent rest for 5 minutes, and then standing with feet shoulder width apart for 10 minutes. Inability to reach 10 minutes was recorded as a failure, and postural orthostatic tachycardia syndrome (POTS), orthostatic hypotension or neurally mediated hypotension, were subsequently diagnosed depending on symptom and heart rate responses to the test. CI was considered positive if a patient failed the test without POTS but, succeeded with POTS on other attempts.

The authors found that 13 participants completed standing tests with and without exhibiting POTS, whilst also completing and failing the test on different occasions. Of these patients, they were categorised as CI positive if test success occurred with POTS and test failure occurred without POTS being exhibited. Amongst these 13 patients, the authors found that 92% were CI positive, and 38% exclusively failed the test without experiencing POTS.

The authors conclude that these results demonstrate that the presence of POTS in ME/CFS patients is essential for the maintenance of orthostasis during 10-minute standing tests. The authors also conclude that some ME/CFS patients experience CI during standing tests, suggesting the presence of impaired sympathetic activation.

Proteomics and cytokine analyses distinguish myalgic encephalomyelitis/chronic fatigue syndrome cases from controls 

 

Authors: Giloteaux L, Li J, Hornig M, Lipkin WI, Ruppert D, Hanson MR (Cornell University, USA)

Publication: Journal of Translational Medicine

Link: https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-023-04179-3

Cytokines are known to modulate inflammation and their action relies upon their encapsulation into extracellular vesicles (EVs). EVs are critical for cell-to-cell communication and are implicated in inflammatory, autoimmune and infectious disease pathologies. 

In this study, blood sample constituents (plasma and EVs) from 49 ME/CFS patients (Fukuda; 41F:8M) and 49 healthy controls (40F:9M) were assessed, to determine whether EVs or specific EV or plasma cytokines, could distinguish ME/CFS subjects from healthy controls.  A multi-omic approach was then applied to correlate cytokine data with clinical data from the same study subjects.

Study outcomes indicated that EV size and concentration were significantly different between ME/CFS and controls. Among the EV cytokines investigated, Interleukin 2 (IL2) levels were significantly different between ME/CFS and control subjects; with 16 other EV cytokines showing promise. No differences were observed for plasma cytokines and proteomics. When correlated to clinical metadata, significant associations were noted between plasma cytokines and proteomics, but not for the EV cytokine dataset. Individuals with ME/CFS and IBS exhibited higher levels of colony-stimulating factor 2 (CSF2) and leptin, compared to those with ME/CFS and no IBS. ME/CFS data from the SF-36 and MFI-20 questionnaires suggested that CFS2 and leptin negatively correlated with physical function and positively correlated with general fatigue, respectively. Other cytokines, CCL2, CXCL10 and CCL11 positively correlated with age for ME/CFS subjects, but not controls. Cytokines TNFa and IL1RA positively correlated with BMI and IL13 positively correlated with the reduced activity score for those with ME/CFS and not control subjects.

The authors conclude that these findings add to existing knowledge that implicates the dysregulation of cytokine signalling in ME/CFS. The authors have also potentially identified 20 proteins with high sensitivity and specificity that could distinguish ME/CFS from control samples and note that further study, utilising a larger dataset, will be critical to determine the usefulness of these findings in the clinic.

Parliamentary Friends of ME/CFS 


Authors:
Emerge Australia

Link: https://emerge.org.au/news/parliamentary-friends-for-me-cfs/

Emerge Australia along with members of the ME/CFS community and key stakeholders met in Canberra on Tuesday June 13 for the much-awaited launch of the Parliamentary Friends of ME/CFS Group.

The cross-party group, co-chaired by Senator Jordon Steele-John and Maria Vamvakinou MP, will provide a non-partisan forum for MPs to speak with advocates, researchers and patients to further the interests of people living with ME/CFS. The launch at Parliament House had one of the largest attendances for any Parliamentary Friends group, with over 200 people in attendance, both in person and online.

Visit our website for a summary of the event.

Queensland scientists push for new national treatment guidelines for chronic fatigue syndrome and Long COVID


Authors:
 Miles J

Publication: ABC News

Link: https://www.abc.net.au/news/2023-06-13/griffith-university-scientists-researching-chronic-fatigue-mecfs/102471386

Emerge Australia along with members of the ME/CFS community and key stakeholders met in Canberra on Tuesday June 13 for the much-awaited launch of the Parliamentary Friends of ME/CFS Group.

The cross-party group, co-chaired by Senator Jordon Steele-John and Maria Vamvakinou MP, will provide a non-partisan forum for MPs to speak with advocates, researchers and patients to further the interests of people living with ME/CFS. The launch at Parliament House had one of the largest attendances for any Parliamentary Friends group, with over 200 people in attendance, both in person and online.

Visit our website for a summary of the event.

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