Immune system defect may cause ME

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24 October 2011 Last updated at 07:46 GMT By James Gallagher Health reporter, BBC News Chronic fatigue syndrome may be due to the immune system, researchers think. Researchers in Norway believe Chronic Fatigue Syndrome (CFS), also known as ME, may be caused by a wayward immune system attacking the body.

The illness, the cause of which is uncertain and has no known cure, has attracted significant controversy.

A small study, reported in PLoS One, showed a cancer drug, which inhibited the immune system, relieved symptoms in some patients.

The ME Association said the findings were "very encouraging news".

Doctors in Norway stumbled across their first clue in 2004 when treating a patient with both Hodgkin's lymphoma, a cancer of the white blood cells, and CFS.

When she received cancer treatment, her fatigue symptoms improved for five months.

'Dramatic'

The latest study, carried out at the Haukeland University Hospital in Bergen, built on the previous discovery by testing 30 patients with CFS.

Half were given two doses of Rituximab, a cancer drug which eliminates a type of white blood cell, while the other half were given a fake treatment.

In those patients receiving the drug, 67% reported an improvement in a score of their fatigue levels. Just 13% showed any improvement in the sham group.

Øystein Fluge, an oncology consultant at the hospital, told the BBC: "There was a varied response: none, moderate, dramatic relief of all symptoms.

"Two had no recurrence [of their symptoms], their life was turned completely around very dramatically."

Their theory is that a type of white blood cell, B lymphocytes, are producing an antibody which attacks the body.

The drug wipes out the lymphocytes which in some cases may "reset the immune system", however, in other patients the fatigue symptoms would return when more B lymphocytes were made.

Caution Continue reading the main story The disease is thought to affect some 250,000 people in the UKSymptoms include extreme tiredness, problems with memory and concentration, sleep disturbances and mood swingsThere is currently no accepted cure and no universally effective treatmentThe cause is not clear either, with many doctors thinking the term CFS/ME is being used for several different diseases.Some patients have sent death threats to researchers after disagreements over a cause or cureMr Fluge said: "I think the fact that patients responded to treatment, improved cognitive function, fatigue and pain makes us believe we're touching one of the central mechanisms.

"But we're scratching at the surface, I would not characterise this as a major breakthrough."

The researchers are now investigating the effect of giving more doses over a longer period of time.

If their hunch is right it will throw up more questions, such as what is the immune system actually attacking and whether or not an actual test for CFS/ME be developed.

Dr Charles Shepherd, the UK ME Association's medical adviser, said: "The results of this clinical trial are very encouraging news for people with ME.

"Firstly, they help to confirm that there is a significant abnormality in immune system function in this disease.

"Secondly, they indicate that altering the immune system response in ME could be an effective form of treatment for at least a subset of patients.

"We now need further clinical trials of such anti-cancer agents to see if other research groups can replicate these findings."

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HEALTH MANAGEMENT. Protective protein prevents joints ravaged immune system from and bones in rheumatoid arthritis

Researchers at the Northwestern University Feinberg have discovered School of medicine, why the immune cells of patients with rheumatoid arthritis are hyperactive and attack the joints and bones. The immune cells have lost their bouncer, burly protein, which is the same way keeps them in line, that noisy patrons controls a bouncer at a nightclub.
The Feinberg School team has this bouncer, a protein called P21, which prevents the immune cells are start in their destructive rampage through the cartilage and bone. If she developed scientists and injected an imitation of the protein in an animal model of rheumatoid arthritis, the disease process was stopped.
"The doorman molecule immune cells of crazy, not more", said lead author Harris Perlman, Associate Professor of Rheumatology at the Northwestern Feinberg School. "Imagine destructive customers in a bar and Bouncer says: 'You're going to behave!'" P21 is. "This discovery opens up a new avenue for future therapies, heavily used against rheumatoid arthritis."
Feinberg team in P21 showed previous studies on patients with rheumatoid arthritis were low, but the protein role was unknown. The new study, published in the journal Arthritis & rheumatism, shows role crucial protein, to keep the immune cells in check.
Currently said to stop, Perlman hyperactive immune cells can be not effective, non toxic.
To develop the new approach, tested share five different Perlman and his team, peptides, called by P21. He slipped each peptide in a "ghostly" molecule, which he injected into mice with rheumatoid arthritis-like disease. The molecule secretly infiltrated the immune cells. After the seven day trial, one of the tested peptides had reassured the overactive immune cells without toxic effects. Next, Perlman plans a 30-day trial of the same peptide to monitor effectiveness and toxicity over a long period.
Existing treatments for rheumatoid arthritis are low-level chemotherapy and corticosteroids. These are not always effective, however, and they are often accompanied by side effects. A newer class of therapy, sometimes used in combination with chemotherapy and steroids, is a biological response modifier. These are the antibody or other proteins that are produced from the hyperactive immune cells to reduce the inflammation. These Biologics work not for everyone, however, and can be associated with side effects, including the risk of infection.

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