Low NK cells in ME - what is the best published evidence on this?

[Sasha]

At the FDA meeting yesterday, Dr Dan Peterson said: "Worldwide the number one immunological marker is low NK function, found abnormal by everyone who looks at it."

I've read elsewhere that this is not a consistent finding but seem to remember reading yet elsewhere that it is consistent if you look at certain kinds of studies (big ones? ones using more recent, more sensitive technology? can't remember).

I need some evidence on this to take to a consultation with an infectious diseases specialist on Monday. I have a test showing low NK cells.

I need a good-quality, preferably recent review or crucial study published in a peer-reviewed science journal. Does anyone have reference to one?

Please don't post people's opinions or commentary about NK cells - that would be interesting for another thread, perhaps - please just post about published studies, otherwise I think the thread could easily go off-topic and I need this quickly (I'm so demanding! ).

 

[heapsreal]

study comparing nk bright cells and nk dim cells.
http://www.translational-medicine.com/content/pdf/1479-5876-9-81.pdf
Abstract

Background:

Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) is characterised by severe prolonged

fatigue, and decreases in cognition and other physiological functions, resulting in severe loss of quality of life,

difficult clinical management and high costs to the health care system. To date there is no proven

pathomechanism to satisfactorily explain this disorder. Studies have identified abnormalities in immune function

but these data are inconsistent. We investigated the profile of markers of immune function (including novel

markers) in CFS/ME patients.

Methods:
We included 95 CFS/ME patients and 50 healthy controls. All participants were assessed on natural killer

(NK) and CD8
+T cell cytotoxic activities, Th1 and Th2 cytokine profile of CD4+T cells, expression of vasoactive

intestinal peptide receptor 2 (VPACR2), levels of NK phenotypes (CD56
bright and CD56dim) and regulatory T cells

expressing FoxP3 transcription factor.

Results:
Compared to healthy individuals, CFS/ME patients displayed significant increases in IL-10, IFN-g, TNF-a,

CD4
+CD25+ T cells, FoxP3 and VPACR2 expression. Cytotoxic activity of NK and CD8+T cells and NK phenotypes, in

particular the CD56
bright NK cells were significantly decreased in CFS/ME patients. Additionally granzyme A and

granzyme K expression were reduced while expression levels of perforin were significantly increased in the CFS/ME

population relative to the control population. These data suggest significant dysregulation of the immune system

in CFS/ME patients.

Conclusions:
Our study found immunological abnormalities which may serve as biomarkers in CFS/ME patients

with potential for an application as a diagnostic tool.

 

[Sasha]

Thanks, heaps, but what I'm looking for is really a review, or a study so large and using such fabby new technology that it's definitive (which I don't think this is, though I could be wrong!).

There are lots of individual studies but I don't want to seem to be 'cherry-picking' by taking along just one or two where that show an NK problem in CFS. There have also been studies that didn't find that (I gather) so what a clinician will be looking for will be a review paper. I doubt I'll be able to get the guy to read the paper, even - just whatever I've magic-markered in the abstract - so it needs to be something that's clearly a definitive summary of what's gone on or a definitive study.

 

[Sasha]

Weirdly, those same guys seem to have brought out a review study of NK function in ME/CFS that has just appeared on the MEA site but I can only access the abstract:

http://link.springer.com/article/10.1007/s13317-013-0051-x

Natural killer cells in patients with severe chronic fatigue syndrome

• E. W. Brenu,
• S. L. Hardcastle,
• G. M. Atkinson,
• M. L. van Driel,
• S. Kreijkamp-Kaspers,
• K. J. Ashton,
• D. R. Staines,
• S. M. Marshall-Gradisnik

Abstract

Maintenance of health and physiological homeostasis is a synergistic process involving tight regulation of proteins, transcription factors and other molecular processes. The immune system consists of innate and adaptive immune cells that are required to sustain immunity. The presence of pathogens and tumour cells activates innate immune cells, in particular Natural Killer (NK) cells. Stochastic expression of NK receptors activates either inhibitory or activating signals and results in cytokine production and activation of pathways that result in apoptosis of target cells. Thus, NK cells are a necessary component of the immunological process and aberrations in their functional processes, including equivocal levels of NK cells and cytotoxic activity pre-empts recurrent viral infections, autoimmune diseases and altered inflammatory responses. NK cells are implicated in a number of diseases including chronic fatigue syndrome (CFS). The purpose of this review is to highlight the different profiles of NK cells reported in CFS patients and to determine the extent of NK immune dysfunction in subtypes of CFS patients based on severity in symptoms.

 

[Sushi]

Sasha

If you would like that particular article, you could request it from Snow Leopard.

Best,
Sushi

 

[snowathlete]

If snow leapard has it, i'd be interested too. It's probably ideal for what you want Sasha.

 

[Sasha]

I've left it too late to get it, unfortunately - oh well! Will have to go with what I've got.

 

[Ema]

It wasn't available through my university library unfortunately. I'm not sure if it is too new or the journal is obscure.

 

[globalpilot]

I have the pdf for this study. If anyone wants it please email me.