Dr Alan Moreau presented preliminary results of his work on micro-RNAs (miRNA) at the recent Stanford (2:26) and CMRC conferences. Micro-RNAs are small molecules that regulate gene expression by binding to messenger RNA and blocking their translation into proteins. miRNAs might be new to you and me, but it is an ancient system of gene regulation and some of our micro-RNAs are similar to those of fish. Moreau reported significant differences in miRNAs between ME/CFS patients and controls, particularly after a PEM test. However, what really caught my eye about his work was his new, low intensity protocol for provoking PEM, which potentially has wide application in ME/CFS research. It is a deliberately "low stress" approach using a gentle arm massage from an inflatable cuff, similar to a blood pressure cuff but using about a 10th of the pressure. It is hard to imagine this has much effect, but Moreau said "believe me, it works". And he has some data to back up his claim. I'm keen to hear what others make of this approach. Intriguingly, the idea was suggested by the patient he referred to as "Christian". The arm massage is gentle but goes on a bit - 90 minutes. Because it is relatively gentle test it is suitable for more typical patients than the maximal exercise tests used to provoke PEM at the moment. And that means it can be applied to more representative patients than the maximal exercise test. Moreau has recruited over a hundred patients and most of those are housebound, with testing done by a nurse who makes home visits. So far, Moreau's study has preliminary data on 25 patients, just under a quarter of the total cohort. The study measured symptoms experienced following the test (I think perhaps a couple of days) and recorded "post exertional malaise" experiences on the day of the test and the two days that followed it. Importantly, a quarter of patients showed no sign post exertional malaise, or other symptoms. Moreau said he didn't want to make the test more intense because he didn't want to cause harm to the three quarters of patients who did show signs of PEM. So here's the symptom data. To make things a bit more complicated, the results are broken into four subgroups, which emerged from the preliminary micro-RNA data: The next results are specifically for post exertional malaise, though the question wording shown relates to fatigue/tiredness. ______ I am planning to get in touch with Dr Moreau about the test, because I think very interesting approach with great potential. And I was planning to summarise any significant points that emerge here and can pass on any questions as well.