Journal of IiME Volume 6 Issue 1 (June 2012) 2011 “Compared to healthy controls (ME)CFS patients displayed significant increases in IL-10, IFNgamma, TNF alpha, CD4+CD25+ T cells, FOXP3 and vasoactive intestinal peptide receptor 2 expression. Cytotoxic activity of NK and CD8+ T cells and NK phenotypes, in particular the CD56 bright NK cells were significantly decreased in (ME)CFS patients. Additionally granzyme A and granzyme K expression were reduced….These data suggest significant dysregulation of the immune system in (ME)CFS patients” (Ekua Brenu, Don R Staines, Nancy G Klimas et al. Journal of Translational Medicine 2011: 9:81doi:10.1186/1479-5876-9-81). 2011 “(ME)CFS is characterised by unexplained fatigue…with a constellation of other symptoms….Recently, the AISA (autoimmune/inflammatory syndrome induced by adjuvants) syndrome was recognised, indicating the possible contribution of adjuvants and vaccines to the development of autoimmunity” (Hemda Rosenblum et al. Infectious Diseases Clinics of North America. Elsevier Inc. doi:10.1016/j.idc.2011.07.012). 2011 The tenth IACFS International Research and Clinical Conference was held on 22nd-25th September 2011 in Ottawa, Canada. It was entitled “Translating Evidence into Practice”. The immunology section (“The Latest Research in Immunology”), chaired by Professor Nancy Klimas, included the following: Ekua Brenu (PhD candidate, Bond University, Queensland, Australia, et al): Cell specific immune investigations have demonstrated a possible link between (ME)CFS and failure to maintain immunological homeostasis. The most common immune cells with known dysfunction in (ME)CFS are cytotoxic cells, NK cells and CD8+T cells. This study examined cytotoxic function and markers in (ME)CFS patients at 6 month intervals to determine the stability of these observations over time. Preliminary results indicated that Invest in ME (Charity Nr. 1114035) compared with healthy controls, (ME)CFS patients demonstrate significant decreases in cytotoxic activity at baseline, at 6 months and at 12 months. Additionally, NK CD56 bright cells remained decreased in (ME)CFS patients. The study demonstrated and confirmed reduced immune function in patients with (ME)CFS and substantiates the use of NK cell cytotoxicity as a biomarker for (ME)CFS. Ekua Brenu presented a further study which suggested that the cytokine profile in (ME)CFS changes during disease progression and that this may be associated with disease severity, hence the need to match laboratory findings with the clinical state of the patient with (ME)CFS. Mangalathu S Rajeevan, Elizabeth Unger et al (CDC, Atlanta) said there is evidence that immune and inflammatory alterations are important in (ME)CFS, so they set out to determine if genetic variants in inflammation and immune pathways could be linked to (ME)CFS. Compared with nonfatigued controls, (ME)CFS was associated with 34 functionally relevant SNPs (single nucleotide polymorphisms). Twelve of these SNPs are genes playing a role in pathways related to complement cascade, chemokines, cytokine/cytokine signalling and Toll-like receptor signalling. The authors concluded that this study identified a number of novel and functionally relevant genetic variants in complement cascade, chemokine and cytokine signalling pathways associated with (ME)CFS. Of note is the rider stating: “The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the funding agency” (i.e. the CDC). Jeanna M Harvey (MD candidate, University of Miami), together with Professors Mary Ann Fletcher and Nancy Klimas, looked at twelve biomarkers that had significant changes as a result of exercise in three groups (Gulf War Syndrome, ME/CFS and healthy controls). Upon exercise, the number of CD26+ lymphocytes was higher for GWS and the healthy controls but lower in patients with (ME)CFS. The authors concluded that biomarker measurement during the course of an aerobic exercise challenge indicates major differences among GWS, (ME)CFS and healthy controls which may help the understanding of these complex disorders. www.investinme.org Page 92 of 108

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