Association of T and NK cell phenotype with the diagnosis of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), Rivas et al, 2018

Indigophoton · Apr 25, 2018

The paper has been provisionally accepted by Frontiers in Immunology, and the full text is due to be published soon.

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a pathological condition characterized by incapacitating fatigue and a combination of neurologic, immunologic and endocrine symptoms. At present its diagnosis is based exclusively on clinical criteria. Several studies have described altered immunologic profiles; therefore we proposed to further examine the more significant differences, particularly T and NK cell subpopulations that could be conditioned by viral infections, to discern their utility in improving the diagnosis and characterization of the patients.

The study included 76 patients that fulfilled the revised Canadian Consensus Criteria (CCC 2010) for ME/CFS and 73 healthy controls, matched for age and gender. Immunophenotyping of different T cell and natural killer cell subpopulations in peripheral blood was determined by flow cytometry.

ME/CFS patients showed significantly lower values of T regulatory cells (CD4+CD25++(high)FOXP3+) and higher NKT-like cells (CD3+CD16±CD56+) than the healthy individuals. Regarding NK phenotypes, NKG2C was significantly lower and NKCD69 and NKCD56 bright were significantly higher in the patients group. A classification model was generated using the more relevant cell phenotype differences (NKG2C and T regulatory cells) that was able to classify the individuals as ME/CFS patients or healthy in a 70% of cases.

The observed differences in some of the subpopulations of T and NK between patients and healthy controls cells could define a distinct immunological profile that can help in the diagnostic process of ME/CFS patients, contribute to the recognition of the disease and to the search of more specific treatments. However, more studies are needed to corroborate these findings and to contribute to establish a consensus in diagnosis.
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https://www.frontiersin.org/articles/10.3389/fimmu.2018.01028/abstract

Hutan · Apr 26, 2018

The one time my Treg cells were counted, I had a higher than normal number of them. I thought this was typical for PWME. But this study finds that

ME/CFS patients showed significantly lower values of T regulatory cells (CD4+CD25++(high)FOXP3+)
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(that thumbs down emoji has always looked more like a 'huh? head scratch' to me - I use it here to mean that)

I look forward to seeing a scatterplot of the actual results. I guess numbers of cells is one thing, and good on this group for replicating studies, but the activity of the cells seems to be another, and perhaps more important?, thing.

Good on the researchers also for using 'ME/CFS' rather than 'CFS'; an opening sentence with a definition that mentions more than just fatigue; CCC selection criteria; and a reasonable number of participants. (That one is a thumbs up)

Lisa108 · Apr 26, 2018

Hutan said: ↑

The one time my Treg cells were counted, I had a higher than normal number of them.
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Same here. Maybe we are in a different subgroup?

voner · Apr 26, 2018

Lisa108 said: ↑

Same here. Maybe we are in a different subgroup?
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my cd4+ numbers are consistently high and my CD8+ numbers are consistently low.

Hutan · Apr 26, 2018

From Wikipedia:

Regulatory T cells come in many forms with the most well-understood being those that express CD4, CD25, and FOXP3 (CD4+CD25+ regulatory T cells).
...
Additional regulatory T cell populations include Tr1, Th3, CD8+CD28-, and Qa-1 restricted T cells.
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My lab results just had a figure for 'T suppressor total' which is, I believe, the old term for regulatory T cells (Tregs). So it's hard to know what my measurement is of and if we are comparing apples with apples here. The fact that some normal T cells express the same biomarkers (e.g. CD4, CD8) might be a confusing factor too.

Someone who actually knows what they are talking about with T cells - feel free to step in here.

Indigophoton · May 9, 2018

The full paper has now been published,
https://www.frontiersin.org/articles/10.3389/fimmu.2018.01028/full

Andy · May 9, 2018

Anybody want to offer an opinion on how useful/good a study this is?

adambeyoncelowe · May 9, 2018

I'm keen to hear people's thoughts, too. T-cells and NK cells crop up a lot.

Seven · May 9, 2018

Mine were both low Ts and NKs (number and activity) not sure knowing this has helped me at all, since I cannot raise them no matter what I do (prescription drugs and supplements).

Manganus · Jun 14, 2018

Andy said: ↑

Anybody want to offer an opinion on how useful/good a study this is?
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My brain is nothing to trust, etc., etc., but my impression after reading the paper is that it might be of some value. But it's yet one more of these studies that come up with results that are not immediately possible to translate into clinical practice.

It's a good thing they used strict (2010) criteria instead of Fukuda.
It's another good thing they set out to test other groups' reported findings.
It's yet another good thing they had a fairly large group of patients and controls.

But its 70% hit-rate diagnosing patients with a blood test is in no way immediately useful.

This paper may well be considered yet another piece in the puzzle. But many more pieces remain to be laid down, before we see the picture.

wigglethemouse · Feb 27, 2021

ME/CFS patients showed significantly lower values of T regulatory cells (CD4+CD25++(high)FOXP3+) and higher NKT-like cells (CD3+CD16±CD56+) than the healthy individuals.
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Some info from Wikipedia on Natural Tiller T cell (NKT-like). This is a type of T-cell.
https://en.wikipedia.org/wiki/Natural_killer_T_cell

Natural killer T (NKT) cells are a heterogeneous group of T cells that share properties of both T cells and natural killer cells. Many of these cells recognize the non-polymorphic CD1d molecule, an antigen-presenting molecule that binds self and foreign lipids and glycolipids. They constitute only approximately 1% of all peripheral blood T cells.[1] Natural killer T cells should neither be confused with natural killer cells nor killer T cells (cytotoxic T cells).
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Natural killer T cells can share other features with NK cells, as well, such as CD16 and CD56 expression and granzyme production.
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Association of T and NK cell phenotype with the diagnosis of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), Rivas et al, 2018

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Association of T and NK cell phenotype with the diagnosis of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), Rivas et al, 2018

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