Saturday, 3 March 2012

Objective Markers in M.E./CFS by Anthony L. Komaroff, MD

This video contains a presentation from Dr. Anthony L. Komaroff, Professor of Internal Medicine at Harvard Medical School. The presentation was given in Stockholm in August 2011.

Summary notes:

In the 1980s, there was a lot of skepticism about M.E. The past 20 years have seen over 5000 CFS studies published and a number of international conferences.

There are scales to measure how badly people are affected. These scales are largely subjective.

Are there biomarkers that can give an objective indication of what is wrong?

MRI studies show abnormalities in the brain. Through spectral coherence technique, disorders in how the cells communicate have been observed. In M.E. patients, these disorders of the brain don't get progressively worse, as in other illnesses that affect the brain.

Spinal fluid can contain chemical markers present in the brain. Mass spectrography analysis can show a core group of proteins in the brains of M.E. sufferers that are absent in normal subjects. It suggests there is low-grade inflammation in the brain that the immune system responds to. Lactic acid levels taken from spinal fluid samples can show elevated levels of 2 to 3 times above those of normal subjects or even a group who were classed with 'high anxiety' disorders. Lactic acid would typically build up if there was something wrong with the energy metabolism in the brain cells.

Another biomarker has been shown in studies that measure blood molecules in M.E. sufferers following a treadmill exercise. Measurements were very different to non-M.E. sufferers.

White blood cell count is higher in M.E. sufferers. Indicates the immune system is active.

Now there is a lot of concrete evidence to prove that M.E. is real. But there is no answer as to HOW/WHY these abnormalities occur.

The usual theories abound: herpes virus, XMRV, enterovirus.

There's only one person who has done a lot of study into enteroviral infections - Dr. John Chia. He found that from biopsies of stomach linings from people with M.E. that the enterovirus is present in higher numbers than with non-M.E. samples.

The human herpes virus can infect brain cells and lays dormant for years. There are parallels to multiple sclerosis patients, but brain scans show very different output readings.

For XMRV, Komaroff cites a study which found proteins from this virus in 63% of the M.E. patients in the study.

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