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Journal of IiME Volume 6 Issue 1 (June 2012) measure and why to measure them…my suggestion is to include the hormones because of their effect on immune function”. The Immunology Sessions included the following: Theresa L Whiteside, Professor of Pathology at the University of Pittsburgh School of Medicine and Director of the Immunologic Monitoring Laboratory at Pitt’s Cancer Institute, had applied her expertise in natural killer cell biology and immunology to the study of (ME)CFS. She recommended stratifying (ME)CFS patients by immune profile, noting that the immune abnormality that has been most commonly found is low NK cell account and cytotoxic activity (NK cells have a number of roles including defending against viruses, bacteria and tumours and interacting with the central nervous system). She said that in most diseases characterised by low NK cells such as cancer and AIDS, researchers understand the cause, but in (ME)CFS researchers do not know why NK cells are low. She concluded by saying she believes that (ME)CFS is actually a group of immune-mediated diseases and that the immune system may contribute to the pathogenesis. Professor Nancy Klimas reported on her work investigating the role of cytokine abnormalities reported in (ME)CFS; significant elevation of tumour necrosis factor receptor-type 1 (TNF R1) was found in the (ME)CFS samples and the data was also skewed for TNF , IL-5 and IL-10. This pattern is similar to that found in autoimmune diseases and allergy. Dr Eng Tan (from the Autoimmune Disease Centre and Department of Cell Biology, the Scripps institute, La Jolla, California) reported that of 60 (ME)CFS patients, 68% had evidence of antinuclear antibodies, an indication of autoimmune disease. Dr Konstantin N Konstantinov (Albuquerque, New Mexico) reported that his work “provides new laboratory evidence for an autoimmune component in (ME)CFS”. Dr Richard Lanham (State University of New York) noted the incidence of autoimmune or other immunological disease in the families of patients with (ME)CFS, which was reported by 64% of Invest in ME (Charity Nr. 1114035) (ME)CFS patients; Dr Lanham speculated that autoimmune conditions in the family history might be a predisposing factor for (ME)CFS. Dr Edward Barker (University of California, San Francisco) had compared CD+ cell function in patients with (ME)CFS and controls; CD69 expression on CD8+ cells was 58% in (ME)CFS patients whilst it was only 33% in controls. Specific lysis of anti-CD3 antibody-stimulated CD+ 8 cells was 62% in (ME)CFS and 32% in controls. The researchers concluded that “(ME)CFS is associated with an increase in CD8+ cell activity following activation” and that “CD+8 cell dysfunctions can be common findings in individuals with (ME)CFS”. Dr Neil Abbot et al (Scotland) carried out allergy and immune marker testing on patients with (ME)CFS and healthy controls, the (ME)CFS patients being stratified into three groups based on severity of symptoms. When immune activation markers were measured, CD38 levels were elevated in the sickest patients compared with the other two patient groups. Dr Arnold Hilgers (Germany) compared immune panels in 285 (ME)CFS patients, 40 MS patients, 44 rheumatoid disease patients and 100 atopic (allergic) disease patients. 41-88% of (ME)FS patients had functional abnormalities. Food protein hypersensitivity (Type IV) was more common than viral infections in all the patients groups studied. The researchers explained that food protein hypersensitivity might cause chronic immune activation. Dr Adrienne Bennett measured the four subclasses of IgG in a case-control study; levels of IgG1, IgG3 or IgG4, and levels of IgG2 were higher in the (ME)CFS cases than controls. The Immunology Workshop. Professor Nancy Klimas and Dr Jay Levy moderated this 2-hour Workshop, the goal being to improve consistency among (ME)CFS research studies. The Workshop’s conclusions were:  CD4, CD8, and NK cells should be included in the minimum immune panel. The activation markers DR, CD11, CD26, CD38 and CD69 and the cytokines IL-2, IL-4, IL-5, www.investinme.org Page 52 of 108

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