‘Immune system defect may cause ME’, Rituximab report at BBC News, 24 October 2011

October 24, 2011


From BBC News Online, 24 October 2011 (story but James Gallagher)

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

Mr 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.”

4 thoughts on “‘Immune system defect may cause ME’, Rituximab report at BBC News, 24 October 2011”

  1. I will not get my hopes up. They have been raised and dashed so many times. I just hope more research backs this up. Even if it is too late for me, it would be wonderful if future sufferers could have a treatment or, even better, a cure.

  2. I suffered at my worst from CFS for just over a year, in which time i lost my job and worst, the entire life of a 22 year old. Doctors, specialists and my health insurance labeled my CFS as being caused by psycological issues because they had no other cause to offer – despite the fact that there is nothing wrong with my mental state. 2 years later, I have now made a full recovery, and touch wood have not relapsed, however, my medical record is now labled with CFS/Phsycological Issues. Maybe and hopefully these researchers are right and it is an abnormality within the immune system.

  3. Perhaps what is missing in CFS is the signal to switch off the immune system after successfully overcoming a virus. What is interesting is that diseases like Glandular Fever can trigger CFS in adolescence and adulthood, but in pre-adolescents much less so. The immature immune system is different from that of the adult, the thymus shrinks universally in adolescence, and young women’s bodies need to reorder their immune systems to not attack a fetus. Is the child’s immune system designed to overcome some typically childhood diseases, but the adult immune system not necessarily?

  4. Good you were so lucky, Wlle. I think this is a valuable finding (Rituximab), but what “shocked” me a bit was to now read that they first stumbled across the positive effect of Rituximab in ME/CFS in 2004. I understand one can’t do human drug trials just like that, but i don’t think we have so much time to “lose”. These processes must work faster if so many thousands of people are suffering and waiting. Also it doesn’t really boost your trust in the medical system if the knowledge about the potential benefit of this drug has been around for so many years, yet a number of doctors, researchers and also government agencies in different coutries still were acting as if ME/CFS is a total mystery. I am thankful for what now has been done, but do these people (not Fluge and Mella) realize it matters that we get help now and not somewhere many years in the future?

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