Discussion in 'Latest ME/CFS Research' started by Firestormm, Jun 27, 2013.
I might be wrong - couldn't see it - but haven't we been discussing this somewhere else? Thanks
From the main paper (link above at bottom of abstract). I noticed that Broderick is on this paper - so are we saying that CFS is a 'stress-mediated' condition now then? I mean is this were we are still heading - the interpretation. After all these years, that 'stress' responses are still in the main running for an explanation. Am not entirely naive of course - I realise that this is indeed in the running - but you don't often come across such a 'neat' summation. And of course 'stress responses' are responses to infections as well as responses to being unable to recover from that infection. It was just something that immediately stood out for me. Anyway, back to the paper....
I dare say folk might want to discuss the 'exercise challenge':
Hmm... I wonder if PEM is another characteristic of both illnesses...
Reading the results, let me see if I have this right.
In the Healthy Controls - cytokine expression rose across all time points - i.e. rest and during and after exercise - for females; but not for males (at least not of statistical significance).
That's interesting, in and of itself, don't you think? Leads me to wonder why.... but I don't suppose we need to go there.
Will keep reading. Need a rest now though
I think every ailment is going to involve a "stress response" (presumably they mean a biological one) - to the infection, or the physical trauma, or the immune dysfunction. Stress response is starting to smell like one of those terms that doesn't mean a damn thing, except maybe "something's wrong" and/or "we don't know".
From a biologist's point of view, a stressor is something that purturbs a biological system, so a stress response is a change in a biological system. The vague definition of stress in most places confuses the issue. How if they are talking HPA dysregulation then they should say that and not call it a stress response, and similarly for other specific stressors and biological perturbations. The term "stress response" is starting to smell like a dead rat to me too, and I hated dissecting rats at uni.
This "rat" talk reminds me of a joke:
Sometimes, we need some comic relief...
Its all a bit of a mess really isn't it?
Actually the standout point for me was this from the review of immune findings :
From my latest 'blog' :
You're quite chummy with Julia Newton? Think she'd be interested?
I might like the lady, Marco, but never met her or talked to her, my friend. Give it whirl I'm sure she'd take a look. Seems very receptive to me. Was an interesting blog you wrote. I just got it in my inbox. Thanks
I know you have particular sense of humour and I was just playing on your frequent use of the first names of researchers.
Just a little fun.
Glad you 'liked' the blog - but please read it in context of the series if you haven't already.
Aggressive vaccinations (28 in a day) were linked to gulf war illness
I'm glad to see research actively looking at more than simple single point data under nonstressed (meaning without a change or challenge to the system) conditions. The human body is a sophisticated dynamic system with unbelievably complex control systems helping it adjust to change. My husband and I (engineers that we are) have been saying for years that ME/CFS is a control system problem -- we get an infection and our bodies under-react (or over-react); we change position and our bodies don't adjust vasoconstriction and BP properly; we go out in the heat and our bodies don't adapt correctly; we exercise and all hell breaks loose. It's not the condition, it's the change our bodies are not handling well.
Must get back to this today. I was pondering the above, and read I think on Marco's blog that estrogen might have something to do with this greater expression in females. Will have to read his blog more carefully...
I'd rather they used the term 'challenge' than stress-test, but don't much mind what they call it, so long as they test patients in the context of physical or mental exertion, rather than at rest.
This is unconvincing:
What they mean by 'trend' is that there wasn't a significant difference between patients as a whole and controls. There was among men, though only at p=0.04. Not sure how well patients and controls were matched on activity/deconditioning levels? These are very small samples and I wonder how well they will replicate
Chris Snell's work found no sig difference between CFS patients and controls at the first exercise test (and his latest, soon-to-be published work presented at the FDA workshop found no difference in peak output at the second test either).
Overall, these are very small samples and a '>80%' classification accuracy isn't very impressive (>90% might be), especially as that's specific to this small sample and there's a real danger of 'overfitting' the classification model to this particular set of subjects. Until it's been replicated on an independent sample, it doesn't mean that much, and I like to think the authors say as much in the full paper and are planning a replication.
Have I misunderstood something here, Simon? I thought that Chris Snell was a proponent of the two day VO2 max test for ME patients? Are you saying otherwise?
Exactly SOC, the nervous system, hormones and immune system are all regulatory systems - all control systems.
He is saying otherwise, check out his talk at the FDA, the key slide is near the end.
Or rather what he is now saying is no difference in V02max (the original finding was based on n=6!), though he now finds a decrease in efficiency in at the anaerobic threshold. This could be very interesting, on the other hand it really needs replicating given that the VO2max claim didn't hold up. We should learn a lot more when the paper comes out.
Thanks for that Simon. That's interesting because many ME advocates are heavily promoting the two-day VO2 max test as a definitive biomarker test. I had assumed that there was good evidence behind it. I'll have to have a closer look at it. Thanks for the pointers towards Snell's presentation.
At the CFSAC meeting, they seem to be urging Unger to use day-two 'anaerobic threshold' testing, and not V02 max, so maybe I'm just a bit behind the times...
For anyone interested in what Simon said re V02 max, Dr Snell's presentation is here at @81.55:
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