Get a Ringside Seat for Invest in ME’s 10th International Conference on 29 May

Instant replay:
Dr Jo Cambridge on B cells & Rituximab

not-quite-instant collation of conference tweets from Phoenix Rising

@aboutmecfs said:

> Jo Cambridge will now talk about B-cel biology and B-cell depletion

> Interested in identifying best responders to Rituximab and predicting who is going to relapse.

> B-cell receptor = antibody [membrane bound version of antibody]

> Antibodies come in different shapes and sizes -- IgM, IgA, IgG plus 2 others

> Looking at a slide of a B-cell -- quite complicated.

@sjmnotes > ha ha ha this B & T cell pic from Wikipedia probably oversimplifies
CGLObnmWEAAUNvm.jpg

> Antibodies bind antigens.

> When you encounter a 'bug', IgM is produced and then IgG.

> B-cell recognizes an antigen and shows it to a T-cell. T-cell makes cytokines which helps the B-cell produce antibodies.
[see that picture above]

> Discussing cytokine research and why it is helpful in their research.

> Rituximab affects antibody production, cytokine production, depletes circulating B-cells.

> Treatment with Rituximab is complicated, very complicated.

> ME/CFS and B-cells -- there is no clear picture from research.

new results!

> They compared cohorts from 2 different centers. Measuring B-cell phenotype using flow cytometry.

> Compared controls to ME patients.

> Percentage of B-cells were the same in both groups. Found differences with CD24 and CD38-CD21 between the groups.

> Higher CD24 percentage in patients,

> Working closely with Fluge and Mella.

=== ends
 
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Instant replay!
Profs Oystein Fluge and Olav Mella with the latest from their large Rituximab trial


not-quite-instant collation of conference tweets from Phoenix Rising

@aboutmecfs said:

> Professor Olav Mella -- giving a brief background of the research starting with improvement of ME patient after taking Rituximab

> Patient given the drug -- response after 7 months which lasted for 4-5 months.

> Two more patients responded to Rituximab.

> Decided to do a small study with 30 patients.

> Phase two study to be published in two to three weeks.

> Present Phase 2 study confirmed results from the 2011 study.

> Marked improvement in physical function after 15 months. Transient worsening after Rituximab in about 20 percent of patients.

> ME is caused by a malfunctioning of the immune system if underlying immune defect is corrected.

> Maintenance therapy can give prolonged duration of response -- up to 24 months into the study.

> Next, they want to confirm or refute that B-lymph depletion with Rituximab may result in a clinically significant response in patients

> anywhere from 2 to 15 years in ME patients.

>Talking about recruitment of patients at each of the 5 centres. Blood tests to exclude other conditions. Biobank material ... .

> Double-bind randomized study.

> Summer of 2017 will be when the Phase 3 study will likely be completed.

> Block Randomization to ensure equal number -- treatment vs placebo

> Rituximab 500 mg/m2 given at day 0 and 15, then 500 mg flat dose at 3 mths, 9 mths and 12 mths. Patients will monitor symptoms.

> Blood samples will be drawn for biobank freezing at regular intervals.

> Standardized, self-recorded scoring of fatigue and all major disease symptoms throughout follow-up.

> Measuring changes in quality of life -- measured by SF36.

> Changes in physical performance measured by electronic armbands.

> Sub-study -- to see if there is evidence of endothelial dysfunction in ME patients that they found in earlier studies.

> Is there a correlation between severity of ME and endothelial dysfunction.

> Also will look at GI function as a sub-study.

> Study officially opened in Sept 2014. Two centres have finished recruitment. Infusions should start at all centres by the end of this summer

> What do they expect to find? Goal - a high quality study that gives a true answer to the questions asked.

> The medical community needs to trust the results. There will be a sub-group that responds.

> The response of the placebo group will be very important.


> Talking about political impact of study -- have gotten public financing, hospitals are cooperating -- learning about ME

> Also are getting private financing. Support from the Kavli foundation (their lifeline). A lot of public interest.... Spawning further research.

> Now talking about toxicity of Rituximab. Toxicity needs to be considered.

> Cost is important too.

> These studies are helping to change the public view of ME.

> They are doing other studies that haven't been published yet -- won't say anything about it.

> Looking at the possibility of using cyclophosphamide for those who can't tolerate Rituximab -- 3 patients -- 2 have responded positively.

> Cheaper than Rituximab -- may be the drug of choice -- recently have started a 40 patient study.

> 3 groups -- have had no response to Rituximab, those who haven't been treated with Rituximab, those who Rituximab stopped working.

> Started in March 2015.

> Very sick patients can be included in this trial.

> Olav Mella is now thanking Invest in ME for inviting him as they are 'the best' and is very impressed with IiME.

> And he thanked the patients -- most of their ideas come from listening to what the patients tell them.

Thanks for epic tweeting from Phoenix Rising
 
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What does this mean do you think, my brain is just done in now.

" Marked improvement in physical function after 15 months. Transient worsening after Rituximab in about 20 percent of patients."

Does this mean that after they have been through the process and the b cells come back again 20% got transiently worse or that 20% get transiently worse while receiving treatments? Hopefully someone might be clear on this.
 
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