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Altered immune response to exercise in patients with CFS/ME: a systematic literature review

Discussion in 'Latest ME/CFS Research' started by Bob, Jul 1, 2014.

  1. Bob

    Bob

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    I think this is new. Expect some translation peculiarities.

    Altered immune response to exercise in patients with chronic fatigue syndrome/myalgic encephalomyelitis: a systematic literature review.
    Nijs J, Nees A, Paul L, De Kooning M, Ickmans K, Meeus M, Van Oosterwijck J.
    Exerc Immunol Rev. 2014;20:94-116.

    Abstract:
    http://www.ncbi.nlm.nih.gov/pubmed/24974723

    Full PDF:
    http://www.medizin.uni-tuebingen.de/transfusionsmedizin/institut/eir/content/2014/94/article.pdf

     
  2. daisybell

    daisybell Senior Member

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    I like the table showing the research that is needed in this area, and the suggestion that the effect of GET on immune function should be investigated.
     
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  3. A.B.

    A.B. Senior Member

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    This should be cited on Wikipedia. It will look funny among all the psychobabble that tries to insinuate that CFS isn't an illness and can be cured with CBT/GET.
     
  4. Firestormm

    Firestormm Guest

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    Interesting - lesson to learn I guess:
     
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  5. Firestormm

    Firestormm Guest

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  6. Firestormm

    Firestormm Guest

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  7. Firestormm

    Firestormm Guest

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    Complement response? Does that mean symptom exacerbation? Anyone? Thanks.
     
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  8. Firestormm

    Firestormm Guest

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  9. Firestormm

    Firestormm Guest

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  10. Firestormm

    Firestormm Guest

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    I did as well (attached) and...

    I thought this is also important and would have implications for prescribed therapy or management practices:
    Table Three.jpg
     
    Last edited: Jul 2, 2014
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  11. Marco

    Marco Old blackguard

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    @Bob

    Thanks for posting this. A very useful review.
     
  12. Valentijn

    Valentijn Activity Level: 3

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    It looks like a fairly honest review, though I'm not sure I agree with (or understand) some of their criticisms. For example, what sort of randomization are they complaining about a lack of? It's not like there were multiple groups to divide the patients into.
     
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  13. Firestormm

    Firestormm Guest

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    Where they were talking above about perhaps future experiments looking at the effects of 'daily living exercise' (if I might use that term of my own creation), might fit with what Julia Newton is talking about in the latest video (below) - around 4 minutes in - where she says that further experiments are needed to see how certain types of exercise appear to help and other types do not: in relation to muscle abnormalities:

     
  14. Sasha

    Sasha Fine, thank you

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    I've been thinking for some time that we desperately need literature reviews for specific research topics, especially this one. We can't expect most doctors to locate and read a ton of literature and attempt to synthesise it - we need these systematic reviews so that we've got evidence that we can easily point to and that people can easily read.
     
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  15. lansbergen

    lansbergen Senior Member

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    Possible

    http://en.wikipedia.org/wiki/Complement_system
    Decades ago I tried to understand the complement system but it is so complicated I gave up
     
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  16. Simon

    Simon

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    OK, this is a bit weird as all forms of complement response (there are three different types) target "foreign" molecules, eg bacterial cell wall sugars or antibodies bound to pathogens. It's not at al obvious to me how this ties in with exercise, though I can see how activation of the powerful complement system would make you feel lousy.

    C4a is a key of the complement proteins (complement is a protein cascade, much like that involved in blood clotting), and generation of C4a is a key step in activating the complement system.

    Activation of complement leads to:
    • direct destruction of cells through lysis (via the Membrane Attack Complex, which basically stabs holes in target cells)
    • 'opsonisation', which is making target cells 'tastier' to Neutrophils and other phagocytosing cells
    • Attracting immune cells players to the target cells/infected area
    • Clumping together of pathogens, which takes them out of play and makes them easier prey for the immune system.
    Anyway, a surprising but interesting finding.
     
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  17. Bob

    Bob

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    It could perhaps potentially be explained in a number of ways? e.g. If exercise activates a latent virus, or if exercise precipitates an auto-immune response involving the complement response system.


    These are the two references in the paper in relation to the "complement C4a split" (I haven't looked at them yet):

    37. NijsJ, Van Oosterwijck J, Meeus M,LambrechtL, Metzger K, Fremont M, and Paul L.
    Unravelling the nature of postexertional malaise in myalgic encephalomyelitis/chronic fatigue syndrome: the role of elastase, complement C4a and interleukin-1beta.
    Journal of internal medicine 267: 418-435, 2010
    http://www.ncbi.nlm.nih.gov/pubmed/20433584

    47. Sorensen B, Streib JE, Strand M, Make B, Giclas PC, Fleshner M, and Jones JF.
    Complement activation in a model of chronic fatigue syndrome.
    The Journal of allergy and clinical immunology 112: 397-403, 2003.
    http://www.ncbi.nlm.nih.gov/pubmed/12897748
     
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  18. Dolphin

    Dolphin Senior Member

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    What would randomization mean in this case? That they'd have some CFS patients who were measured at various times having not done the exercise? Seems like taking a measurement at baseline would do this just as well (indeed, in some ways better as one sees intra-individual variation). Perhaps optimally would be to take a few measurements in the subject before exercising to get a better baseline score than a single measurement where there may be some variability over time in the test.
     
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  19. Dolphin

    Dolphin Senior Member

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    They didn't search the Journal of Chronic Fatigue Syndrome so this study was missed:

    I wouldn't be surprised if Peter White published this paper in the JoCFS so it would not be seen by that many people.
    He even once jointly signed a letter that said:
    The list didn't contain his own paper (mentioned above)!
     
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  20. Dolphin

    Dolphin Senior Member

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    Minor point:

    This meant a study was considered at risk of bias if it only used men, but not if it only used only women, which seems questionable to me.

    I am left wondering whether the fact that Jo Nijs CFS studies tend to use just female cases may have influenced it.
     
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