Circulating leptin levels in patients with [ME], [CFS] or fibromyalgia a systematic review protocol, 2020, Musker et al

Michael Musker and colleague Tiffany Gill have written an article about their research for The Conversation

Explainer: what is fibromyalgia, the condition Lady Gaga lives with?

It is about fibromyalgia, but the article ends with:

Many of the symptoms of fibromyalgia can be found in people who have a condition known as myalgic encephalomyelitis, or chronic fatigue syndrome. Our research is currently looking at the blood of people with fibromyalgia and chronic fatigue syndrome to see if there are specific inflammatory markers that may help us understand how these illnesses develop.

If we can understand the interaction of the immune system with pain and inflammation, then we can begin to target treatments more effectively for people living with fibromyalgia.
 
Full title: Circulating leptin levels in patients with myalgic encephalomyelitis, chronic fatigue syndrome or fibromyalgia: a systematic review protocol
Objective:
The objective of the review is to evaluate circulating levels of leptin in people diagnosed with myalgic encephalomyelitis chronic fatigue syndrome or fibromyalgia syndrome and to investigate the differences compared with healthy controls.

Introduction:
Myalgic encephalomyelitis chronic fatigue syndrome is a condition that has major symptoms, including self-reported fatigue, post-exertional malaise, and unexplained pain across the body. The widespread pain is measured in a systematic way and is often referred to as fibromyalgia. The two disorders have many similarities, but their association with leptin has indicated that leptin may affect the role of pro-inflammatory cytokines and symptom severity.

Inclusion criteria:
This review will consider observational studies of varying study designs including prospective and retrospective cohort studies, case-control studies, time-series, and analytical cross-sectional studies that include both cases and healthy comparators. Cases will include a diagnosis of myalgic encephalomyelitis, chronic fatigue syndrome, and/or fibromyalgia. Controls are people without this diagnosis, usually healthy participants. Only studies published in English will be included due to limited resources for translation.

Methods:
This protocol will be reported based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) checklist and will follow the JBI methodology for systematic reviews of etiology and risk. A comprehensive search strategy will include PubMed, Embase, Scopus, Science Direct, and PsycINFO. Two reviewers will screen, critically appraise eligible articles, and extract data using a standardized data extraction tool informed by JBI SUMARI. The authors will complete a quantitative analysis that synthesizes findings across studies using pooled effect sizes and confidence intervals of the measures provided.
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Open access, https://journals.lww.com/jbisrir/Ab...in_levels_in_patients_with_myalgic.99794.aspx
 
Cases will include a diagnosis of myalgic encephalomyelitis, chronic fatigue syndrome, and/or fibromyalgia. Controls are people without this diagnosis, usually healthy participants.
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Doesn't say what criteria, so I'm not convinced that all these patients have genuine ME. I think loose criteria leads to problems replicating results.
 
DigitalDrifter said:
Doesn't say what criteria, so I'm not convinced that all these patients have genuine ME. I think loose criteria leads to problems replicating results.
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The review will consider studies that include people of any age diagnosed with MECFS, and/or fibromyalgia. Reference to diagnostic criteria must be detailed; for example, diagnosis by a GP, Fukuda definition, Canadian Consensus Criterion, or other descriptions indicating the method of diagnosis. Attention to the diagnostic method for both MECFS and fibromyalgia is an important factor for heterogeneity. Where no reference or details are provided about diagnostic method, attempts will be made to contact the authors where appropriate. Other language terms for MECFS or fibromyalgia will be included; for example, if it states that there is ‘‘chronic fatigue’’ that lasts for at least six months (see Appendix I for other terms to be searched).

Exposure of interest
The exposure is a diagnosis of MECFS and/or fibromyalgia. The diagnosis will be described by operational criteria such as a diagnosis from a GP or those described by the Fukuda definition, Canadian Consensus Criterion, or American College of Rheumatology (ACR).1
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Authors:
Musker, Michael1,2,3;
McArthur, Alexa2;
Munn, Zachary2;
Wong, Ma-Li1,3,4

1 Mental Health and Wellbeing, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
2 The Centre for Evidence-based Practice South Australia (CEPSA): A JBI Centre of Excellence, Adelaide, SA, Australia
3 Department of Psychiatry, Flinders University, Adelaide, SA, Australia
4 Department of Psychiatry, Upstate University, New York, NY, USA

Corresponding: Dr Michael Musker, michael.musker@sahmri.com

So, a South Australian project. The institutions involved appear to have a mental health focus.
 
MEMarge said:
@Caroline Struthers may know about this.
Though as Hutan states it it comes from a psych base.
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I know a bit about GRADE and consider it pseudoscience along with the Cochrane risk of bias tool. GRADE people really seem to love it though. I guess it must produce very impressive looking tables. I remember one top level GRADE person giving a presentation once about how the GRADE predictions of whether the evidence was reliable or not turned out not to be very reliable! He was very disappointed and surprised, and determined to try and work out why GRADE was not very reliable at detecting the reliability of research. It would be better if such energy could be directed at improving the reliability of research rather than improving tools to detect unreliability. Hey ho.
 
Caroline Struthers said:
I know a bit about GRADE and consider it pseudoscience along with the Cochrane risk of bias tool. GRADE people really seem to love it though. I guess it must produce very impressive looking tables. I remember one top level GRADE person giving a presentation once about how the GRADE predictions of whether the evidence was reliable or not turned out not to be very reliable! He was very disappointed and surprised, and determined to try and work out why GRADE was not very reliable at detecting the reliability of research. It would be better if such energy could be directed at improving the reliability of research rather than improving tools to detect unreliability. Hey ho.
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I found the study Gerald Gartlehner presented. It was about stability not reliability. https://www.ncbi.nlm.nih.gov/books/NBK321518/. I was not a fan of GRADE before...and his presentation of these findings just confirmed my suspicions that it's pretty useless. But all the EBMers use it.
 
comparing leptin levels (as leptin acts immunologically, similar to IL-6, it is theorized) could be of interest in delineating who has ME/CFS vs who has fibro.

Though, I don't know that it is vitally important to know this.
 
Hutan said:
Corresponding: Dr Michael Musker, michael.musker@sahmri.com

So, a South Australian project. The institutions involved appear to have a mental health focus.
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I've met Dr Musker, he didn't actually have strong beliefs about etiology and is leading the team because he has experience as a clinician, skilled with enrolling patients into studies.
The project/team was started under Julio Licinio, a Brazilian with a strong focus on biological-psychiatry, with an interest in leptin. Most of his research involves trying to find biomarkers.

They conducted a study monitoring IL-6 and leptin levels at 7 minute intervals over 8 hours:
http://sacfs.asn.au/news/2016/02/02_13_sahmri_calling_for_research_participants.htm

I guess that paper should be published soon.
 
Biography: Dr Michael Musker Senior Reserach Fellow, RN, DPSN, BA(HON), MSc, PhD.

Biography Mike has 30 years practice experience in mental health and 5 years as Clinical Researcher in Lifelong Health at the South Australian Health and Medical Research Institute. He was the Advanced Clinical Services Coordinator for the South Australian Forensic Mental Health Service.

Mike was the winner of the South Australian Nurse Excellence Awards 2013. He completed his PhD at the University of Adelaide and was awarded the Bellberry Post-Doctoral Research Fellow at the Mind & Brain Theme at the South Australian Health and Medical Research Institute.

The Mason Foundation has supported his current research into Myalgic Encephalomyelitis / Chronic Fatigue Syndrome (ME/CFS) at SAHMRI. His PhD research training focused on Perpetrator Induced Traumatic Stress (PITS) and included interviewing forensic mental health patients and prisoners about Post Traumatic Stress Disorder and other comorbid disorders.

Mike is researching mental health, including bullying, trauma, depression, chronic fatigue syndrome, and many other areas. Most of this research is completed through face to face interview using structured interviews and other diagnostic tools. Mike has helped to develop consumer led practice in South Australia, chairing the Forensic Mental Health Service Lived Experience and Carers group for over 10 years, and has been facilitating the regular meetings of the Consumer (Lived Experience) and Carer Research Consultation Group in the Mind & Brain theme since May 2015.

Mike has been a representative at the SAHMRI Consumer Engagement Group since it’s inception at SAHMRI and been nominated to represent the Lifelong Health Theme as the liaison for Consumer and Community Engagement in SAHMRI at a strategic level. He continues to practice in mental health as a psychiatric nurse.

Working on research in Myalgic Encephalomyelitis / Chronic Fatigue Syndrome, engaging the ME/CFS community in researching this life changing syndrome. Our team has analysed 35 participants, measuring their blood every 7 minutes for eight hours, providing 69 samples of plasma. This was then analysed for 3 pro-inflammatory cytokines Leptin, Interleukin 6 and Interleukin 1 beta. SAHMRI has a multidisciplinary team that is looking at all areas of ME/CFS symptoms. Mike also completed a Masters in Health Promotion, Research and Policy Change at John Moores University in England, and his Master’s thesis was on human aggression. He is a qualified Nurse Tutor following the completion of a Post Graduate Diploma in Education at the University of Manchester. Mike was the South Australian representative for the National Expert Advisory Panel for Forensic Mental Health for 10 years. He has provided lectures at all three universities of South Australia, and is an adjunct senior lecturer in mental health at Adelaide University and Flinders University.
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https://orcid.org/0000-0001-8226-8630
 
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