Myalgic Encephalomyelitis/Chronic Fatigue Syndrome - Evidence for an autoimmune disease

[Daisymay]

https://www.ncbi.nlm.nih.gov/pubmed/29635081

Autoimmun Rev. 2018 Apr 7. pii: S1568-9972(18)30088-0. doi: 10.1016/j.autrev.2018.01.009. [Epub ahead of print]
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome - Evidence for an autoimmune disease.
Sotzny F1, Blanco J2, Capelli E3, Castro-Marrero J4, Steiner S1, Murovska M5, Scheibenbogen C6; European Network on ME/CFS (EUROMENE).
Author information

Abstract
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a frequent and severe chronic disease drastically impairing life quality. The underlying pathomechanism is incompletely understood yet but there is convincing evidence that in at least a subset of patients ME/CFS has an autoimmune etiology. In this review, we will discuss current autoimmune aspects for ME/CFS. Immune dysregulation in ME/CFS has been frequently described including changes in cytokine profiles and immunoglobulin levels, T- and B-cell phenotype and a decrease of natural killer cell cytotoxicity. Moreover, autoantibodies against various antigens including neurotransmitter receptors have been recently identified in ME/CFS individuals by several groups. Consistently, clinical trials from Norway have shown that B-cell depletion with rituximab results in clinical benefits in about half of ME/CFS patients. Furthermore, recent studies have provided evidence for severe metabolic disturbances presumably mediated by serum autoantibodies in ME/CFS. Therefore, further efforts are required to delineate the role of autoantibodies in the onset and pathomechanisms of ME/CFS in order to better understand and properly treat this disease.

KEYWORDS:
Autoantibodies; Autoimmune; Biomarker; Chronic Fatigue Syndrome; Myalgic Encephalomyelitis

PMID:

29635081

DOI:

10.1016/j.autrev.2018.01.009

 

[Hoopoe]

I'm getting the impression that several groups wanted to publish a B cell autoimmunity paper in case of a positive Rituximab trial.

 

[Trish]

Consistently, clinical trials from Norway have shown that B-cell depletion with rituximab results in clinical benefits in about half of ME/CFS patients.

Oh dear, they are out of date already.

 

[Andy]

Oh dear, they are out of date already.

Shouldn't be really. Also, six days seems an incredibly short time for it to be accepted, does this mean it hasn't been peer reviewed? Is it exempt from that?

Received 1 January 2018, Accepted 7 January 2018, Available online 7 April 2018

 

[Trish]

If its an article gathering together evidence from other people's studies, does it need peer review?

 

[BruceInOz]

If its an article gathering together evidence from other people's studies, does it need peer review?

Yes. Although that answer is only based on what would have been the norm in respected physics journals 20 years ago, so in reality I've no idea. Seven days is a very short time, but I would imagine not impossible. Maybe those asked to review it didn't have anything better to do that week and got to it straight away. I would have required more time for procrastinating though.

 

[Lidia]

Duplicate thread merged

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome – Evidence for an autoimmune disease
FranziskaSotznyaon behalf of the European Network on ME/CFS (EUROMENE)
Autoimmunity Reviews
Volume 17, Issue 6, June 2018, Pages 601-609

I couldn’t find this anywhere here. If it already exists, mods please feel free to delete.

I found the conclusion interesting, in that it talks of Rituximab despite the null result (submitted Jan 2018):

There is compelling evidence that autoimmune mechanisms play a role in ME/CFS. However clinical heterogeneity in disease onset (infection versus non-infection triggered), presence of immune-associated symptoms, and divergent immunological alterations point to the existence of subgroups of ME/CFS patients with possibly different pathomechanisms. Therefore, it is important to identify clinically useful diagnostic markers to select patients with autoimmune-mediated disease for clinical trials. The search for autoantibodies is of great importance enabling to develop potential biomarkers for diagnosis and providing a rationale for therapeutic interventions. Encouraging results from first clinical trials warrant larger studies with rituximab and other strategies targeting autoantibodies.

 

[hixxy]

The most recent clinical trial with rituximab wasn't encouraging. Am I missing something?

 

[andypants]

The most recent clinical trial with rituximab wasn't encouraging. Am I missing something?

No, but it’s not published yet, so if you only look at published studies rtx still looks promising. Or they chose to ignore the phase III trial to promote their own view of ME as an autoimmune disease/autoimmune component.

 

[Jonathan Edwards]

The review was accepted on January 7th. So it may now be out of date.

 

[Tom Kindlon]