Journal of IiME Volume 9 Issue 1 Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME). The latter is poorly understood and accompanied by several additional symptoms that suggest a subtle immunoendocrine dysfunction accompanied by viral reactivation and complicated in some cases by alterations in mood and sleep. The differential diagnosis of CFS/ME is large and includes primary sleep problems, endocrine dysfunction, alterations of mood, systemic autoimmunity, certain chronic infections and specific neurological disorders. However, CFS/ME may be confidently diagnosed on the basis of specific clinical criteria combined with normality of specific routine blood tests including those that assess inflammation, autoimmunity, endocrine dysfunction and gluten sensitivity. An early confident diagnosis is important as it can reduce patient anxiety, encourage early intervention and prevent expensive unnecessary investigations. May 2015 Professor Jo Edwards) approximately 10 years ago for the treatment of rheumatoid arthritis), exploring more precisely how the technique works and trying to explain the marked variation in response between different patients Abstract: The newly initiated research into ME/CFS at UCL stemmed from our awareness of the studies of Drs Fluge and Mella showing clinical efficacy of the B cell depleting drug, Rituximab, in a double blind placebo controlled trial in Norway. Rituximab therapy for non-malignant diseases was introduced by Professor Jo Edwards, initially for Rheumatoid arthritis patients at UCL, in 1998. Secondly, Professor Edwards has emphasised the enormous unmet clinical need for patients diagnosed with this condition and encouraged me to become involved in order to explore possible mechanisms underlying ME/CFS which may be modified or even stopped by removing B cells from these patients. Dr Geraldine (Jo) Cambridge B cells, Rituximab and ME/CFS Dr Jo Cambridge is Principal Research Fellow Inflammation, Div of Medicine Faculty of Medical Sciences, UCL Her group focuses its interests on B cell depletion (an idea which they introduced (with the At UCL, I have been conducting clinicallybased research involving patients with a number of different diseases treated with rituximab and other B-cell targeting drugs. Our aim is to maximize the efficiency of their use and to predict imminent relapse in order to allow more rapid intervention before worsening of symptoms. As a newcomer to ME/CFS, the first thing that struck me from published literature and the age and sex distribution of ME/CFS was the hypothesis of an infectious trigger for the condition but with an ‘unbalanced’ response of the immune system which may subsequently not resolve. This does not mean that the infectious agent needs to persist. There are a number of ways that B cells could contribute to this. With the appointment of Fane Mensah, our PhD student in 2014, we have been exploring B cell biology in patients with ME/CFS. His Invest in ME (Charity Nr. 1114035) www.investinme.org Page 48 of 57
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