Long Covid and ME/CFS: Autoantibodies, neurotransmitters and autonomic nervous system dysfunction

June 21, 2021

Dr Shepherd Writes

As we keep reporting: 

Research into both the cause and treatment of Long Covid is producing some interesting ideas and results that might also be relevant to ME/CFS in view of the important clinical and pathological overlaps between the two conditions.

At the same time, research findings relating to the cause and treatment of ME/CFS could also be of help to people with Long Covid

Read the new paper on Autoantibodies, neurotransmitters and autonomic nervous system dysfunction

Dr.Shepherd, MEA Hon Medical Adviser
Dr Charles Shepherd

The most recent example of this two way process is publication of some preliminary results into the use of H1 and H2 histamine receptor antagonists as a possible form of treatment for some people with Long Covid as detailed here. This finding is particularly interesting given the overlap between ME/CFS and Mast Cell Activation Disease/Syndrome.

The new paper in Nature looks at the possible role of two specific neurotransmitter receptor autoantibodies in both conditions.

  • Neurotransmitters are chemicals that help to transmit messages throughout the brain and nervous system
  • Autoantibodies are antibodies that are directed against tissues and chemicals in the body – instead of outside invaders

So autoantibodies can produce harmful effects and we already have some evidence to indicate that people with ME/CFS have some types of these autoantibodies and the disease therefore involves an autoimmune component

Key findings from this new research

  • Neurotransmitter receptor antibodies against ß-adrenergic and muscarinic receptors may play a role in both ME/CFS and Long Covid, especially in relation to dysfunction of the autonomic nervous system/dysautonomia – where these autoantibodies have an effect 
  • A technique called extracorporeal apheresis seems to be effective in reducing these antibodies and could be a way of treating ME/CFS 
  • The researchers conclude that a form of neuropheresis may provide a promising therapeutic option for patients with Long Covid 
  • This method could also be effective when other hitherto unknown antibodies and inflammatory mediators are found

Extracorporeal means a medical procedure that is performed outside the body
Apherisis means a technique in which a particular substance or component is removed from the blood, with the main volume of blood then being returned to the body.

This research links in with the research into these autoantibodies in ME/CFS that has been carried out by Dr Carmen Sheibenbogen and her research group in Germany.

At the moment this research has to be regarded as an interesting finding along with a very speculative approach to treatment. On a personal basis I was involved with Professor Peter Behan in Glasgow many years ago involving a very small trial of plasmapheresis. Unfortunately, this intervention failed to produce any benefit

Dr Charles Shepherd
Hon Medical Adviser, MEA

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