I thought it could be interesting to go through Prusty's Twitter profile and there are only two comments relevant for this dicussion that Prusty recently liked:
- “The thing causing mito fragmentation was for a pwME subset the C1q auto abs. So when you showed that in 2019 I ran to get tested & I was positive. So maybe there’s something missing in the complement system (innate immunity), which is the first line of defence, now malfunctioning”
- “Does a MBL2 gene mutation and subsequent mannose-binding lectin deficiency establish a vulnerability/predisposition for disease in your model?”
The first one is about the high levels of anti-C1q aabs we’ve already talked about.
The second one is a comment about a MBL2 gene mutation which leads to a deficiency in the protein mannose-binding lectin (MBL). MBL plays an important role in the immune system by fighting foreign invaders by attaching to them. This attachment then activates the lectin complement system. It is an alternative pathway to the classical complement C1q pathway with a similar mechanism. The clinical significance of MBL-Deficiency is debated and it seems like it only leads to a higher susceptibility to infections (unlike C1q deficiency, which leads to Lupus-like diseases). As of today reduced MBL levels seem to play some role in ME/CFS, but the results aren’t really significant, especially when compared to controls
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8465819/ (funnily enough Prusty was the editor of this paper!). It is something that also sees to play a part in Post-Covid Syndrome (
https://www.nature.com/articles/s41467-022-32507-6) and is something that for example Scheibenbogen tests for in her current IA trial (
https://clinicaltrials.gov/ct2/show/NCT05710770). Both C1q and MBL modulate cytokine production at the mRNA and protein levels and as such play an important role at in the inflammatory response and the avoidance of autoimmunity.
MBL also has a second role, sort of as dirt “cleaner”, in which it binds senescent and apoptotic cells and enhances engulfment of apoptotic cells, as well as cell debris by phagocytes.
MBL is known to bind to SARS-COV-2, HIV, influenza A and seems to play a very small role in HSV-2, HSV-1. The relationship between MBL deficiency and HHV-6 and EBV is not really proven by anything substantial/interesting to us.
Finally there are no treatments at all, or that I could find, that address MBL deficiency. Furthermore it’s mostly produced in the liver and hardly has a connection to the bone marrow.
To summarise: Something to keep an eye on for the future, but probably nothing revolutionary, unless one of you can find out something that I was not able to.