Prusty talks about his upcoming research on a podcast

Judee

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to retest in patients with "long covid for more than 3 years" to see if it stays that way with longer illness duration
I've been IgM deficient for at least a couple decades. Instead of going to the newer LC group for that 3 year window which would add to the research time, why don't they ask pwME who have been tested already?

I was tested twice at least 10 years apart iirc and was still deficient both times. I think my values were even lower on the second test even.

Anyways... :meh:
 

Tsukareta

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So you could say that ME/CFS is caused by a 'reprogramming' of a component of the immune system by a virus ? because that was one of my earliest impressions of the disease, then we got into many many other theories like stomach microbiome, microclots, metabolic trap ( which I believed was not the cause of ME/CFS ). Based on this research though how would one categorize ME/CFS ? an immune deficiency ? an autoimmune disease, or a mitochrondrial disease ? also can anyone speculate as to what is the cause of PEM ? thats something prusty did not mention but perhaps its just taken as a given that ( abnormal ) autoantibodies against ( fibronectin ? ) which are affecting / attacking endothelial cells would cause problems with blood flow which would cause hypoxia or other limiting factors sort of like an engine running without enough air it creates an improper unclean burn which then the body has to clean up after = PEM ? what does everyone think ?
 

melihtas

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There is one IgM enriched immunoglobulin available called Pentaglobin.

https://www.transmedpharma.com/our_products/pentaglobin/

When I searched PR for Pentaglobin, only 2 messages came up. Two ME patients tried Pentaglobin and both of them responded extremely well. One of them said, it gave him total remission for two months.

https://forums.phoenixrising.me/thr...atment-by-any-doctor.35949/page-3#post-567065

https://forums.phoenixrising.me/threads/what-happens-with-ivig-therapy.78117/#post-2238885
 

Tsukareta

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I hope it won't turn out that CFS only gets treated with invasive and expensive band aid treatments that only help for a short while after each one and doctors make a lot of money out of doing that. I can imagine a situation where it becomes possible to get diagnosed in the UK but then the NHS wont offer any treatment because it would be too expensive.
 

Dude

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There is one IgM enriched immunoglobulin available called Pentaglobin.

https://www.transmedpharma.com/our_products/pentaglobin/

When I searched PR for Pentaglobin, only 2 messages came up. Two ME patients tried Pentaglobin and both of them responded extremely well. One of them said, it gave him total remission for two months.

https://forums.phoenixrising.me/thr...atment-by-any-doctor.35949/page-3#post-567065

https://forums.phoenixrising.me/threads/what-happens-with-ivig-therapy.78117/#post-2238885
In my head I'm already thinking of a scenario how I can convince my family doctor that he will administer it to me :) Joking aside, are there any risks in administering Ivigm to a "healthy" (mecfs sick) person? The price is quite okay at 500 €.
 

Osaca

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In my head I'm already thinking of a scenario how I can convince my family doctor that he will administer it to me :) Joking aside, are there any risks in administering Ivigm to a "healthy" (mecfs sick) person? The price is quite okay at 500 €.
There's the usual risk, which always exists with ME/CFS: The extertion to get the treatment does damage to your body, whilst the treatment does nothing.

At this point in time it's also not clear what the effects of a substance containing IgM would be on natural IgM. Could it possibly even cause the body to produce less natural IgM or will there be a immunomodulatory effect that increases the production of natural IgM? Could there be a negative effect on latent viruses or will it surpess them? Could something like immunadsorption maybe even cause a stronger reactivation of latent viruses and as such cause less production of natural IgM?

People should also not forget that his hypothesis that he presented isn't mutually exclusive from viral persistence, reactivation of latent viruses nor any of the downstream effects. These downstream effects can also have a contraindication with the treatment.

But I'm sure there'll definitely be many people trying IVIG with IgM in the upcoming months. And once I've seen the paper and it's convincing, I'll probably be one of those people.

Immunomodulation also seems to be science of its own, where to much can cause damage and too little isn't enough. You have to hit the sweetspot which is what those trailling BCG are trying to do.

At the end of the day most autoimmune disease are not easily treated or have no treatment at all. We shouldn't expect that things will change overnight for ME/CFS.
 

BrightCandle

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Bhupesh's s work to me this suggests 3 avenues for potential treatments to research.

1) Antivirals - If herpes is at the core of this messing up the B cells and natural IgM then reducing the effect of Herpes ought to work.

2) B cell boosting/IgM - IVIG but basically any treatment that might cause IgM natural to increase or to improve the B cell count or effectiveness.

3) Fibronectin - Its high in the blood but low in the immune complex. Looking into ways to try and reduce it or convert it better into the immune complex.
 

Osaca

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Did any of you get the impression that the majority of his data has come after his initial interview and was not really what was presented in Berlin? Would certainly be positive, because the data presented in Berlin didn't look good to me, but he now seems to have access to a lot of samples. Seems like that made him shift a bit away from Herpesviruses and more towards an acute viral infection causing autoimmunity?

Of course viral persistence and reactivated viruses somehow affecting B-cells still seems extremely plausible, but in the last interview he basically said "it's all because of Herpesviruses that are affecting the mitochondria" and now it was more nuanced and acute Covid was given a greater role.
 

BrightCandle

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Not sure why he was hiding and hyping it, was just weird it's not how research works. The Berlin talk was too short for something this complex and it was a bit garbled as a result but he is saying the same thing just with more of the linking detail needed to put the chain together
 

Osaca

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Not sure why he was hiding and hyping it, was just weird it's not how research works. The Berlin talk was too short for something this complex and it was a bit garbled as a result but he is saying the same thing just with more of the linking detail needed to put the chain together
It's not just that though. He seemingly suddenly went from a small sample size, to a massive one (over a hundred ME/CFS patients, a similar amount of HC, and over a hundred longhaulers). The data in Berlin was not convincing. In his interview he was very convinced, however it was relatively different to his last interview (no focus on Herpesviruses and especially not mitochondria).

Let's see what the paper says. Really strange that he hasn't submitted a pre-print to Arvix, especially considering all the announcements that were made and it being presented at conferences.
 

Tsukareta

Senior Member
Messages
150
Bhupesh's s work to me this suggests 3 avenues for potential treatments to research.

1) Antivirals - If herpes is at the core of this messing up the B cells and natural IgM then reducing the effect of Herpes ought to work.

2) B cell boosting/IgM - IVIG but basically any treatment that might cause IgM natural to increase or to improve the B cell count or effectiveness.

3) Fibronectin - Its high in the blood but low in the immune complex. Looking into ways to try and reduce it or convert it better into the immune complex.
That was my thought, can we 'boost' the B cells ? but he made it sound like the problem viral infection / re-activation there was a one shot sort of affair, not necessarily an ongoing disruption, sounds like that was an aspect he wants to research in future. I listened to the podcast carefully and he said that some people recover their immunoglobulin levels which is why you heard stories about post viral fatigue and ME/CFS only lasting one year. I suspect we are in more trouble because our levels didn't normalize and we went on to develop further problems, in which case restoring those levels might not solve our issue ( but he did seem to say that fibronectin levels are responsible for engaging the CDR / inflammation, and constitute part of that 'something in the blood' that fragments mitochondria downstream. Is our issue CDR / mito / inflammation or autoimmunity ? or complex activation problem ? how does the excessive immune response to a broad range of antigens factor in ? I don't fully understand.
 

Judee

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@Countrygirl did a nice summary of some of the conference info in this thread. Just want to link the two threads together in case anyone is reading this at a later date: https://forums.phoenixrising.me/thr...3-invest-in-me-conference-cambridge-uk.90160/

Edit: I also just found this article: https://www.frontiersin.org/articles/10.3389/fmed.2020.00388/full

Administration of Immunoglobulins in SARS-CoV-2-Positive Patient Is Associated With Fast Clinical and Radiological Healing: Case Report​


"...7 days after the beginning of therapy with PENTAGLOBIN, and then, 10 days after the clinical onset, the patient also had viral clearance: two consecutive nasopharyngeal swab results were negative (Real-time PCR, DiaSorin Molecular Simplexa™ COVID-19 Direct assay, DiaSorin S.p.A., Italy), and so she was dismissed in spontaneous breath without oxygen support and with fine systemic condition; enoxaparin 4,000 U daily was suggested for a further 14 days as home care treatment. A clinical and laboratory follow-up was planned 15 days after hospital discharge, and a further nasopharyngeal swab (Real-time PCR, DiaSorin Molecular Simplexa™ COVID-19 Direct assay, DiaSorin S.p.A., Italy) tested negative; levels of IgG and IgM anti COVID-19 were tested again, and the previous trend was confirmed by results, as IgG anti COVID-19 was increased to 78.50 UI/ml and IgM anti COVID-19 increased to 0.45 UI\ml (Table 1)."

*enoxaparin is an anticoagulant.
 
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I may be interpreting everything wrong but would a monoclonal antibody lowering fibronectin help, while we search for what could be causing the decrease of IgM fibronectin antibodies?

ChatGpt (take with a grain of salt):
Tocilizumab: Tocilizumab, which targets the interleukin-6 receptor (IL-6R), can indirectly impact fibronectin levels. IL-6 is known to stimulate fibronectin production, and by blocking IL-6 signaling, tocilizumab can potentially reduce fibronectin synthesis.

Secondly, another potential treatment could be IvIG, but for that to work, wouldn't it have to have the IgM fibronectin antibodies? Do any current therapies have this? How would you confirm that say PENTAGLOBIN has the correct IgM antibodies>
 

Osaca

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Has anyone tried Pentaglobin and not gotten better?
There was a small study for acute Covid where those patients that received Pentaglobin+normal treatment were actually slighlty worse off then those that only received the normal treatment https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8270756/.

There was also a big Austrian study that compared different IVIGs treatments etc for acute Covid, Pentaglobin was part of the protocol. But they didn’t release data on Pentaglobin so that usually means it didn’t go well, or at least wasn’t the preferred choice for whatever reason https://clinicaltrials.gov/ct2/show/NCT04351724 & https://www.eqs-news.com/news/corpo...-19-am-universitaetsklinikum-akh-wien/1424117.

The study "Intravenous IgM-enriched immunoglobulins in critical COVID-19: a multicentre propensity-weighted cohort study" in detail asses basically what were looking for (just in the acute phase). Very interestingly it states "the general scarcity of IGAMs and the controversial results of recent studies evaluating conventional IVIG preparations [17,18,19]". I'm definitely no IVIG expert, but this definitely means that there is a very controversial side to the whole IVIG story. The study basically came to the conclusion that IgM enrich IVIG's had no effect on acute Covid (the enrichment was 12% so might have been Pentaglobin).

That's all there I found for acute Covid. I think we should also always mention negative study results even though it might not be motivating. However, all of this was for acute Covid and didn't study whether those people ended up developing Long-Covid. One of the more interesting takeways might be (I really haven't looked at the literatute apart from this study) that IGAM's are quite controversial in general (since even IVIGs seem to have some controversy when not used for treating primary immunodeficiencies).
 
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junkcrap50

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Joking aside, are there any risks in administering Ivigm to a "healthy" (mecfs sick) person? The price is quite okay at 500 €.
From the internet: Generally, IVIG infusion can cause migrainelike headaches, nausea, and dizziness. Infusion reactions including severe allergic reactions have been reported especially in patients with IgA deficiency. It may also promote thrombosis and may result in thromboembolic venous or arterial events. Other adverse effects include acute renal failure, aseptic meningitis, hemolysis, transfusion-related acute lung injury, and transmission of blood-borne infections (it's collected from human donors).
Could something like immunadsorption maybe even cause a stronger reactivation of latent viruses and as such cause less production of natural IgM?
Well, several studies of immunoadsorption have been done in ME/CFS patients. Mostly positive results to me/cfs symptoms. Didn't report any adverse effects that I can recall. Other studies of immunoabsorption has measured IgG levels before and after it, and while it decreases IgG it doesn't entirely eliminate it. Sometimes IVIG is given after immunoadsorption (in some studies), other times it's not. I've heard some times it's recommended to limit human contact for 2 weeks afterwards, but that could be just a precaution.

Let's see what the paper says. Really strange that he hasn't submitted a pre-print to Arvix, especially considering all the announcements that were made and it being presented at conferences.
Why is it strange he didn't submit it to Arvix? The traditional route is zero discussion, talk, or release of any info regarding research; write paper; submit paper to peer review; if passes peer review, then submit for publishing; wait until it is published. It appears to me that submitting preprints is a more (and very) modern thing now. If nowadays submission to preprint is done, then that's usually after it's submitted to peer review (either before or after it passes peer review).
 

Osaca

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Why is it strange he didn't submit it to Arvix? The traditional route is zero discussion, talk, or release of any info regarding research; write paper; submit paper to peer review; if passes peer review, then submit for publishing; wait until it is published. It appears to me that submitting preprints is a more (and very) modern thing now. If nowadays submission to preprint is done, then that's usually after it's submitted to peer review (either before or after it passes peer review).
That is not the traditional route. It sometimes depends on the science. In mathematics, physics and other sciences you even submit a preprint to the Arvix even before you submit the paper for peer review. In those sciences virtually every paper is submit to the Arvix before publication. There's several advantages to this. All the world class scientists in these fields do it. If you don't it would even be frowned upon. It also very common to talk about things that aren't even close to being published, just not in interviews to the public, but in seminars, conferences and workshops.

So if you're already going online talking about your research everywhere, including conferences, it is extremely benefical to listeners and yourself, if there's actually a preprint (this doesn't require any extra work, he's already written the preprint). There's not a single downside for him to submit to the Arvix, whilst there are several for not doing so.

People seem to have a strange conception of how important the Arvix is. We complain about things not being open-source, whilst the Arvix is literally the collection of all scientific knowledge accessible to everybody and open source. It is bad practice that some scientists don't submit to the Arvix. It means you haven't understood what science is all about "sharing knowledge and gaining knowledge".
 
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junkcrap50

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That is not the traditional route. It sometimes depends on the science. In mathematics, physics and other sciences you even submit a preprint to the Arvix even before you submit the paper for peer review. In those sciences virtually every paper is submit to the Arvix before publication. There's several advantages to this. All the world class scientists in these fields do it. If you don't it would even be frowned upon. It also very common to talk about things that aren't even close to being published, just not in interviews to the public, but in seminars, conferences and workshops.

So if you're already going online talking about your research everywhere, including conferences, it is extremely benefical to listeners and yourself, if there's actually a preprint (this doesn't require any extra work, he's already written the preprint). There's not a single downside for him to submit to the Arvix, whilst there are several for not doing so.

People seem to have a strange conception of how important the Arvix is. We complain about things not being open-source, whilst the Arvix is literally the collection of all scientific knowledge accessible to everybody and open source. It is bad practice that some scientists don't submit to the Arvix. It means you haven't understood what science is all about "sharing knowledge and gaining knowledge".
Yes, you are correct: in mathematics, physics, computer science. But this is not true for medicine or biological sciences. Medrxiv didn't start until June 2019, and Biorxiv earlier in 2013, but had slow growth until 2017.
 
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