Journal of IiME Volume 7 Issue 1 autoimmunity to non-conventional self proteins has also been demonstrated. We sought evidence for B cell dysregulation as well as T cell dysfunction in 33 well characterised patients with mainly moderate CFS fulfilling all recognised criteria. B, T and NK cell enumeration was assessed using flow cytometry and NK cell cytotoxic function by K562 killing. Cytokines were analysed by multiplex technology. We found a significantly increased number of naïve and transitional B cells in addition to reduced plasmablasts in patients with CFS compared to healthy controls. The numbers of switched memory B cells were also reduced suggesting a dysregulation of B cell checking mechanism. CFS patients had significantly greater numbers of T helper memory effector cells and T helper and cytotoxic effector cells. They also had significantly reduced numbers of CD8+ lymph node homing naïve and memory T-cells suggesting either sequestration within lymph nodes or a reduction overall. While the levels of proinflammatory cytokines were no different between the CFS patients and the HC, the levels of IL12, IL21 and IL27 were reduced. These cytokines are particularly involved in regulating cellular immunity and specific antibody production within lymph node germinal centres. We did not find any significant difference in the circulating levels of NK cells or in NK cytotoxic function between patients with CFS and the HC. Taken as a whole our data suggest a subtle impairment of the immune system with T and B cell dysfunction geared towards autoimmunity and reduced anti-viral immunity. This was accompanied by altered lymph node germinal centre formation that is critical for specific antibody formation and the elimination of B cells with autoimmune tendency. We speculate on the cause of these changes in immune function which are likely to be multifactorial. Immunological Basis of ME Professor Carmen Scheibenbogen Professor for Immunology and Deputy Chair, Institute of Medical Immunology, Berlin Charité, Germany Group leader of a Tumour Immunology Laboratory and Attending Physician at the Dept. of Haematology, Oncology und Transfusionsmedizin, Invest in ME (Charity Nr. 1114035) www.investinme.org Page 30 of 36 (May 2013) CBF, Charité,,2/1997 Venia legendi for Internal Medicine "Habilitation",,1990 - 1998 Residency at the Med. Klinik und Poliklinik V, Hämatologie, Onkologie und Rheumatologie, Universität Heidelberg, 1988 - 1990 Postdoctoral fellowship at the Med. Klinik, Dept. of Hämatologie und, Onkologie, Universität Freiburg,1982 - 88 Medical school at the Universities of Bonn, Marburg and Denver Abstract: Diagnostic Markers in CFS One of the major problems in CFS is that the diagnosis is based on symptoms reported by patients. Diagnostic tests would be of great benefit for improving diagnostic uncertainness and the performance of clinical trials. A hallmark of CFS is immune dysregulation and immune activation. Both T cell activation and a skewed T cell type 1 / 2 profile can be detected in many patients with CFS. Regarding B cell function both diminished and elevated levels of immunoglobulins are found in subsets of patients. Further a skewed immune response against EBV is frequently found. Thus it should be possible to develop reliable diagnostic tests based on immune abnormalities. B-cell Depletion Therapy Using Rituximab in ME/CFS Professor Olav Mella Bergen University Hospital, Norway Professor Mella and Dr Fluge have published a paper "Benefit from B-Lymphocyte Depletion Using the Anti-CD20 Antibody Rituximab in Chronic Fatigue
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