UK Study - Pediatric CFS

shannah

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Biochemical and Vascular Aspects of Pediatric Chronic Fatigue Syndrome
Gwen Kennedy, PhD; Faisel Khan, PhD; Alexander Hill, PhD; Christine Underwood, MBBS; Jill J. F. Belch, MD


Arch Pediatr Adolesc Med. 2010;164(9):817-823. doi:10.1001/archpediatrics.2010.157

Objective To evaluate the biochemical and vascular aspects of pediatric chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME).

Design Cross-sectional clinical study.

Setting Tayside, Scotland, United Kingdom.

Participants Twenty-five children with CFS/ME and 23 healthy children recruited from throughout the United Kingdom.

Interventions Participants underwent a full clinical examination to establish a diagnosis of CFS/ME and were asked to describe and score their CFS/ME symptoms. Biochemical markers were measured. Arterial wave reflection was estimated to assess systemic arterial stiffness.

Main Outcome Measures Markers of oxidative stress and free radicals, C-reactive protein level, white blood cell apoptosis, and arterial wave reflection.

Results Children with CFS/ME had increased oxidative stress compared with control individuals (isoprostanes: 252.30 vs 215.60 pg/mL, P = .007; vitamin C, mean [SD]: 0.84 [0.26] vs 1.15 [0.28] mg/dL, P < .001; vitamin E, 8.72 [2.39] vs 10.94 [3.46] g/mL, P = .01) and increased white blood cell apoptosis (neutrophils: 53.7% vs 35.7%, P = .005; lymphocytes: 40.1% vs 24.6%, P = .009). Arterial stiffness variables did not differ significantly between groups (mean augmentation index, 0.57% vs 0.47%, P = .09); however, the derived variables significantly correlated with total (r = 0.543, P = .02) and low-density lipoprotein (r = 0.631, P = .004) cholesterol in patients with CFS/ME but not in controls.

Conclusions Biomedical anomalies seen in adults with CFS/MEincreased oxidative stress and increased white blood cell apoptosiscan also be observed in children with clinically diagnosed CFS/ME compared with matched controls. Unlike in their adult counterparts, however, arterial stiffness remained within the reference range in these pediatric patients.


Author Affiliations: Vascular and Inflammatory Diseases Research Unit, The Institute of Cardiovascular Research, Centre for Cardiovascular and Lung Biology, Division of Medical Sciences, Ninewells Hospital and Medical School, Dundee, Scotland, United Kingdom.


http://archpedi.ama-assn.org/cgi/content/short/164/9/817?rss=1
 

Marco

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Consider me well and truly flabbergasted!

I read this post this morning and thought - nice study - but thought no more of it.


Just 10 minutes ago the story was covered on BBC Breakfast News (THE mainstream TV channel for non-UK forumites).

They interviewed a young Scottish boy and his mother and the gist of the commentary was :

for many years sufferers have been told that its all in their heads;

the study showed white blood cell abnormalities that mirror those seen in adult patients;

this adds to the growing evidence that the illness is caused by a virus;

and all the way through the report they referred to ME - no mention of CFS, chronic fatigue etc.



In the wake of zero coverage of the Alter paper; on the eve of the XMRV conference, I can't help thinking (pardon my French) WTF?

Did this one just slip through or are the times indeed changing?
 

Marco

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My jaw is now literally scraping the floor.


The BBC's tame 'Dr Rosemary' and a ME patient discussing ME on the Breakfast Time couch.

Paraphrasing 'Dr Rosemary' :

There is no cure for ME at present and a cure may be a long way away;

But this study clearly indicates where future research should be targeted;

Unfortunately we don't have many effective treatments for viruses (really? did she mean retroviruses);


Patient :

The only thing that works is pacing.

TWO reports on the BBC in one morning??


I wonder if the BBC would like to consider the ethics of subjecting children with a current inflammatory immune response to CBT aimed at changing illness beliefs and GET that can only aggravate the problem?

The Lightning Process?

Esther, you may be harming children!!
 

busybee

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And on radio 4 this morning.

apparently the changes in the white blood cells indicate there may be a viral component to ME;)
 

Tom

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Local community radio in Grantham 1.30 pm ish retrovirus XMRV will be getting a serious mention.
http://gravityfm.net to listen live , it's only a small server so can't take 100's of connections.

You may need a Scottish translator handy.

Tom
 

alex3619

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Hi, there is another possibility: this coverage is one more step to divorcing ME from CFS and presenting it as something different. Its about time, and makes me wonder even more about what is going to be presented at the workshop tomorrow. I am also pleased that it mentions arterial wave reflection: this is the first time I recall reading a reference to this since the Irish study (vascular biophysics) found it. Bye, Alex
 
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Thanks Shannah I hadn't realised you had already started a thread.
I just posted this on the thread I started and I do think it is worth considering.

Many thanks for the link into BBC news.

How ridiculous that no mention of XMRV and MLV.

However reading the article in your link the researchers only found indications of an on going INFECTION. The jump that it is a virus is only assumption.

Dundee Scotland University did the study - Parts of Scotland are known endemic areas for Lyme Disease and the positive tested cases this year exceeded 600. Dr Ho Yen says the real figures could be 10x that ie 6000 then consider that many of us with lyme are ill 10,20 or more years that is an awful lot of possible cases of Lyme the majority of which will not even know the cause of their illness.

Coming from an ME/CFS diagnosis myself who found eventually that it was Lyme Disease and have recovered on long term antibiotics, I am well aware of the controversy over the diagnosis and treatment of lyme Disease.

Eurolme a chat Line I joined 75 % of members were first diagnosed with ME/CFS before finding they actually have Lyme Disease.

The Lyme Doctors are also finding some Lyme patients to be also positive for XMRV there are so many parrallels with these illnesses politicaly as well as symptoms.

If anyone wants to read more visit UK charity at www.lymediseaseaction.org.uk

PS I see now the study was on children throughout the UK but nevertheless Lyme has been found in all parts of the UK and should be ruled out but not just by blood tests that can miss 50% of cases.
 

Trooper

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BBC News24 has just shown a piece about it (11.20am) too. Managed to refer to ME/CFS as chronic fatigue once but a good piece overall.

They did mention the xmrv debate in passing but didnt refer to it as a retrovirus.

Good stuff - I am sure it will be shown a few times today and they will hopefully link to the video on the website soon. *fingers crossed it will be on the 1 and 6 o'clock news*
 

Dolphin

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Hi, there is another possibility: this coverage is one more step to divorcing ME from CFS and presenting it as something different. Its about time, and makes me wonder even more about what is going to be presented at the workshop tomorrow. I am also pleased that it mentions arterial wave reflection: this is the first time I recall reading a reference to this since the Irish study (vascular biophysics) found it. Bye, Alex
I don't know of any Irish biomedical research on anything to do with ME/CFS (except 15+ years ago) - are you sure it was an Irish study? The Dundee team (in Scotland) have done similar research on adults. Vance Spence is based around there. They get research done quite cheaply.
 

hvs

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Being on BBC Breakfast is a huge breakthrough. Seriously, the professionals who fight to keep ME in the pysch column must be scrambling today.
(Btw, there was no mention of a retrovirus because the study actually wasn't seeking any--just signs of infection.)
 

Sunshine

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This is good news, thanks for posting.

When I was a child I got told my ME was caused by young girls skipping breakfast, periods, and believing in a virus.

What did Psychiatrist Simon Wessely who sees children in his unit in London.....................

http://www.kcl.ac.uk/projects/cfs/

...................... tell the medical profession again?

''Viral Attribution reflects Somatization Par Excellance''.

If children with ME have immune abnormalities why in 2010 was UK pediatrician and CBT fan Esther Crawley given a 0.7 million research grant for the scam cure lightning process? (LP).
If children with ME have immune abnormalities why do the 2009 NICE guidelines recommend a psychiatrist, CBT, exercise and pacing and specifically not allow for viral testing?

 

alex3619

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HI Dolphin

I am pretty sure it was an Irish study, but I can't recall if it was north or south. I know and admire Vance Spence's work, I have known of it since before it was first published, we were communicating back then. He was focussing on vascular chemistry, in particular a prolonged acetylcholine response.

The study I was talking about, that I read most of a decade ago, was from biophysicists. It looked at vascular stiffness and measured shockwaves that eminate from the heart with every beat. Normal vascular systems are flexible (elastin) and so spread the shockwave throughout the body, assisting with circulation. In CFS (I don't think it was called an ME study, but this was a long time ago) the shockwave was absorbed, possibly damaging the arteries.

My working hypothesis is that this is due to elevated elastase activity (with cleaved RNaseL as a marker), the vascular system is busy making lots of elastin but can't keep up (and this would imply that low protein diets in CFS are very dangerous). It might also explain some of the chest pains we experience, but I still favour a neurological explanation of those.

I wish I could recall the name of the study. I will run a few searches later.

Bye
Alex
I don't know of any Irish biomedical research on anything to do with ME/CFS (except 15+ years ago) - are you sure it was an Irish study? The Dundee team (in Scotland) have done similar research on adults. Vance Spence is based around there. They get research done quite cheaply.
 

Dolphin

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HI Dolphin

I am pretty sure it was an Irish study, but I can't recall if it was north or south. I know and admire Vance Spence's work, I have known of it since before it was first published, we were communicating back then. He was focussing on vascular chemistry, in particular a prolonged acetylcholine response.

The study I was talking about, that I read most of a decade ago, was from biophysicists. It looked at vascular stiffness and measured shockwaves that eminate from the heart with every beat. Normal vascular systems are flexible (elastin) and so spread the shockwave throughout the body, assisting with circulation. In CFS (I don't think it was called an ME study, but this was a long time ago) the shockwave was absorbed, possibly damaging the arteries.

My working hypothesis is that this is due to elevated elastase activity (with cleaved RNaseL as a marker), the vascular system is busy making lots of elastin but can't keep up (and this would imply that low protein diets in CFS are very dangerous). It might also explain some of the chest pains we experience, but I still favour a neurological explanation of those.

I wish I could recall the name of the study. I will run a few searches later.

Bye
Alex
Are you thinking of this study?
Vance is originally from N. Ireland but hasn't lived there since the end of school (or was it college?) as far as I know (i.e. many decades ago).

Low-grade inflammation and arterial wave reflection in patients with chronic fatigue syndrome.

Clin Sci (Lond). 2008 Apr;114(8):561-6.

Spence VA, Kennedy G, Belch JJ, Hill A, Khan F.

Vascular and Inflammatory Diseases Research Unit, Institute for Cardiovascular Research, Ninewells Hospital and Medical School, University of Dundee, Dundee DD1 9SY, Scotland, UK.

Abstract
Some of the symptoms reported by people with CFS (chronic fatigue syndrome) are associated with various cardiovascular phenomena.

Markers of cardiovascular risk, including inflammation and oxidative stress, have been demonstrated in some patients with CFS, but little is known about the relationship between these and prognostic indicators of cardiovascular risk in this patient group.

In the present study, we investigated the relationship between inflammation and oxidative stress and augmentation index, a measure of arterial stiffness, in 41 well-characterized patients with CFS and in 30 healthy subjects.

AIx@75 (augmentation index normalized for a heart rate of 75 beats/min) was significantly greater in patients with CFS than in control subjects (22.5+/-1.7 compared with 13.3+/-2.3% respectively; P=0.002).

Patients with CFS also had significantly increased levels of CRP (C-reactive protein) (2.58+/-2.91 compared with 1.07+/-2.16 mug/ml respectively; P<0.01) and 8-iso-prostaglandin F(2alpha) isoprostanes (470.7+/-250.9 compared with 331.1+/-97.6 pg/ml respectively; P<0.005). In patients with CFS, AIx@75 correlated significantly with logCRP (r=0.507, P=0.001), isoprostanes (r=0.366, P=0.026), oxidized LDL (low-density lipoprotein) (r=0.333, P=0.039) and systolic blood pressure (r=0.371, P=0.017).

In a stepwise multiple regression model, including systolic and diastolic blood pressure, body mass index, CRP, tumour necrosis factor-alpha, interleukin-1, oxidized LDL, high-density lipoprotein-cholesterol levels, isoprostanes, age and gender, AIx@75 was independently associated with logCRP (beta=0.385, P=0.006), age (beta=0.363, P=0.022) and female gender (beta=0.302, P=0.03) in patients with CFS.

The combination of increased arterial wave reflection, inflammation and oxidative stress may result in an increased risk of future cardiovascular events.

Assessment of arterial wave reflection might be useful for determining cardiovascular risk in this patient group.

PMID: 18031285 [PubMed - indexed for MEDLINE]
If there is an Irish study I'm unaware of I'd be very interesting in knowing about it.
 

Sunshine

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This information about oxidative stress was known to researchers years ago, but no one acted upon it.

6 positive XMRV/MULV studies later and the tide is turning.

Infected babies and children who become adults with ME/CFS who become the laughing stock of the medical profession and blamed for their illness (some who commit suicide).

Is no laughing matter....