Searching for serum antibodies to neuronal proteins in patients with Myalgic Encephalopathy/Chronic Fatigue Syndrome (2019) Giannoccaro et al.

Source: Clinical Therapeutics

Preprint

Date: May 1, 2019

URL:
https://www.sciencedirect.com/science/article/abs/pii/S0149291819301638

Searching for serum antibodies to neuronal proteins in patients with Myalgic Encephalopathy/Chronic Fatigue Syndrome
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Maria Pia Giannoccaro(1), Judith Cossins(1), Kari Sorland(2), Oystein Fluge(2), Angela Vincent(1)

1 Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK

2 Department of Oncology and Medical Physics, Haukeland University Hospital, Bergen, Norway

* Corresposponding author. Pia Giannoccaro, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford OX3 9DU, UK. Email: mpgiannoccaro@gmail.com

Received 12 March 2019

Revised 28 March 2019

Accepted 1 April 2019

Available online 1 May 2019.

Abstract

Purpose

A role for the immune system in causing myalgic encephalopathy/chronic fatigue syndrome (ME/CFS) is long suspected, but few studies have looked for specific autoantibodies that might contribute to the symptoms. Our aim was to look for evidence of antibodies to neuronal proteins in patients with ME/CSF.

Methods

Sera samples from 50 patients and 50 healthy individuals were sent coded to the Neuroimmunology Laboratory in Oxford. Screening for antibody binding to neuronal tissue was performed on brain tissue and neuronal cultures. Specific serum antibodies were assessed by antigen-specific cell-based assays and radioimmunoassays. After antibody testing, the associations between seropositive status and clinical data were investigated.

Findings

Overall, 8 patients and 11 participants were found to have some serum immunoreactivity toward neuronal or neuromuscular junction proteins, but only 1 patient and 2 participants had specific serum antibodies.

Nevertheless, seropositive status in patients with ME was associated with shorter duration since onset and a more severe disease.

Implications

The results indicate no overall increased frequency of antibodies to neuronal proteins in ME/CSF and no evidence of a specific antibody that might be causative or contribute to clinical features in patients.

However, the association of seropositive status with shorter duration of disease and more severe symptoms suggests a possible role of antibodies at onset in some patients and should be the focus of future studies.

Key words: antibodies; chronic fatigue syndrome; LRP4; myalgic encephalopathy; neuronal surface antigens; NMDA receptor

 

Sci hub, https://sci-hub.se/10.1016/j.clinthera.2019.04.001

 

I'm finding the following sentence from the Discussion a bit odd:

The cause of ME/CFS is unclear, although it is likely to be a heterogeneous disorder that covers different causes, pathologic processes, and is often accompanied by neuropsychiatric features.

 

That to me is not an unreasonable summary. Most people agree there is heterogeneity and probably a range of causal factors, at least in initiation. In terms of neuropsychiatric features I think it is worth remembering that Angela Vincent is an authority on autoimmune encephalopathies and these would be considered to have 'neuropsychiatric features'. For instance, coma is a neuropsychiatric feature. What they are meaning are signs of impaired brain function - what usually get referred to as cognitive problems. Neuropsychiatric in this sense means something quite different from psychological or even psychiatric.

 

Thank you. I didn't know that.

 

Patients with MS,SLE, systemic sclerosis can all have neuropsychiatric symptoms caused by the disease process. A friend of ours developed psychosis as the presenting symptom of systemic sclerosis.