UK, The Times, 23 Apr: 'Biological breakthrough offers fresh hope to ME sufferers

Sean

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As to Wessley I wonder if it might be the opposite of what he says - maybe a lot of pople who think they are depressed actually have undiagnosed ME/cfs -
I think that is highly likely to be the case for at least a substantial portion of 'psych' symptoms and diagnoses, such as depression, anxiety, phobia, etc.

One of the reasons the psychs have tried so hard to portray us ME patients as primarily psych cases is because if it is not true, they are in deep shit about a whole lot of stuff beyond just us.
 

clive powney

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I wonder if the Newcastle team have any hypotheses that link these muscle findings with the cognitive deficits in ME/CFS also seen in PBC and PBC's autoimmune etiology?

Cognitive impairment in primary biliary cirrhosis: Symptom impact and potential etiology

http://onlinelibrary.wiley.com/doi/10.1002/hep.22371/full

Autonomic dysfunction leading to hypotension, reduced blood flow in the brain and muscle tissues resulting in ischemia and hence elevated lactate?

I appreciate that this was just a conference presentation but I do wish researchers would go a little way towards speculating how findings might fit within the broader context - just for my benefit if nothing else;) .
The Newcastle team (Julia Newton) are now recruiting for a project titled 'Understanding the pathogenisis of autonomic dysfunction in CFS and its relationship with cognitive impairment '
http://gtr.rcuk.ac.uk/project/C450A957-9885-4E43-AD9D-1E5364BC07AF
 

baccarat

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it's a shame available funds allow such restriction in studies scope and sample sizes.
when i think it would only take a fraction of the annual salary bill of your average premier league football team to have a good study with a properly sized sample etc to finally ridicule any idea that cfs is not a biological illness, my bp tends to rise...
 

MeSci

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Taking a line from the movie Braveheart and William Wallace, I would expect then, that Simon Wessely and all of the UK psychiatrists/clinical psychologists would go throughout the UK and kiss the 'arse' of every ME/CFS patient they come across for the decades of suffering, abuse, neglect and death they caused.

Eco
I wouldn't want them anywhere near mine!
 

MeSci

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The question though is whether we want to do this at all, including taking alkaline substances. Lactate buildup increases muscle oxygenation in the short term (but does the opposite in the long term if its persistent acidity). Its not about preventing it building up, its about preventing it being made in the first place - isolating the cause/s and stopping those. High lactate is often considered a good thing in sports science, but excessive lactate production is definitely a sign something is wrong.
One thing I have always struggled with in chemistry is how to control the processes that can go in both directions, such the oxygenation of lactic acid to lactate and the reduction of lactate to lactic acid. I know that it involves the addition and removal of hydrogen (H+) ions (protons) but can't figure out how to safely improve the balance physiologically, especially in ATP production.

These links provide useful info but I just can't retain it or remember it!

http://fitsweb.uchc.edu/student/selectives/TimurGraham/Lactic_Acidosis.html

http://ceaccp.oxfordjournals.org/content/6/3/128.ful

I do agree about preventing it from building up, but how can we do that other than being slightly more active than a corpse? I am trying to address build-up from all the theoretically (i.e. in the absence of real-life essential activity) effective ways - reducing carb consumption, trying to minimise stress and avoiding over-exertion. But even a visit to the doctor yesterday (unrelated to ME) has worn me out.

All-too-familiar story, I am sure.
 

alex3619

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We probably wont be able to control the acidity until we understand the underlying process. In the meantime I have no doubt we will try lots of things, and maybe we will get lucky and find something that works. Julia Newton's samples can be used to test things: as a test platform it will be invaluable.

One thing that is being missed here is that low pH, and indeed high pH, will modify enzymatic reactions ... a lot of them. Exactly what is being modified? This could get very interesting.
 

Esther12

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This is really interesting work, though obviously using very small numbers. Apparently it will be submitted as a paper in the near future.

But the fact that cultured cells, not just biopsy cells, show differences indicates this involves changes at a deep level. And presumably deconditioning can't explain the findings as controls and patient cells would be cultured the same way (I have a feeling cultured muscle cells have to be electrially stimulated at some point, but not sure about that). The fact that these results fit with the earlier in vivo fMRI studies of muscle functioning makes the finding look more promising (wonder if they took biopsies from the people in that study?).
I don't understand a lot of the specifics with regards to epigenetics, or the way cells were cultured here - but I'd still hope that the control samples came from deconditioned/sedentary non-CFSers. There are so many mechanisms within the human body that we do not understand, that it we are trying to separate causal and secondary changes in CFS it always seems sensible to try to use sedentary controls for these sorts of studies.
 

Simon

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I don't understand a lot of the specifics with regards to epigenetics, or the way cells were cultured here - but I'd still hope that the control samples came from deconditioned/sedentary non-CFSers. There are so many mechanisms within the human body that we do not understand, that it we are trying to separate causal and secondary changes in CFS it always seems sensible to try to use sedentary controls for these sorts of studies.
This group has used sedentary controls in previous studies but I'm not sure there's much point speculating further until it's published.
 

Gijs

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Yes, they used sedentary controls in this study. They take cells from muscle biopsies in patients with CFS/ME and grow those muscle cells in the laboratory. So, these cells aren’t being influenced by anything else within the human. It is not because CFS-patients aren’t exercising and become deconditioned because these laboratory experiments with these cells can't be influenced by deconditioning and the MRI studies show that the severity of the acid accumulation is directly related to the degree of abnormality with the autonomic nervous system
 

Mark

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Yes, the Times article does state that the controls were sedentary, which is of course a very important issue in this particular study. I think this may well be a very significant milestone, politically at least. Is this the first ever government/MRC-funded study to demonstrate biological abnormalities in ME/CFS? Excess lactic acid in ME/CFS patients is not really news, I think, but demonstrating it in vitro is new to me.

It has really got me thinking about where it fits as a link in the chain of symptoms, because it seems to me that it may fit in quite a clear way. Excess lactic acid production will obviously cause much greater pain and fatigue, but I'm interested in how this might fit in with sleep and PEM. PEM symptoms typically come 24-48 hours after exertion - or to put it another way, after 1-2 night's sleep with masses of excess lactic acid. Anybody have any clues on the biology of how excess lactic acid might be expected to produce the other known PEM symptoms, and the inflammatory markers of PEM found by the likes of the Lights' studies? And then, in the other direction, any thoughts on what kind of cell malfunction (eg mitochondria issues) might cause excess lactic acid production?
 

lansbergen

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And then, in the other direction, any thoughts on what kind of cell malfunction (eg mitochondria issues) might cause excess lactic acid production?
Do they mean latic acid? I didnot see it in the press release.

I am thinking of superoxide.
 

beaker

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Does anyone know if the proceedings of the conference where this was presented will be published in a scientific journal ? Most peer review journals don't want to publish something that has been in the media, unless it is proceedings from a conference.
My M.D. is a straight line academic. He will want a published paper to take it seriously. Unfortunately, that is true for most of academia in the US.

ETA: results confirm what my muscles have felt for a long long time. I ( and I know many of you ) have even described it as lactic acid burns. I'm glad they finally came up with a nice way of showing it !
 

Tristen

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Does anyone know if the proceedings of the conference where this was presented will be published in a scientific journal ? Most peer review journals don't want to publish something that has been in the media, unless it is proceedings from a conference.
My M.D. is a straight line academic. He will want a published paper to take it seriously. Unfortunately, that is true for most of academia in the US.

ETA: results confirm what my muscles have felt for a long long time. I ( and I know many of you ) have even described it as lactic acid burns. I'm glad they finally came up with a nice way of showing it !


Me too. Sometimes, even just stretching sets me off. Also agree on it just seems a better way of demonstrating what we already knew. The study should at least get more attention in the research community.