Daily Telegraph’s Sarah Knapton, Science Editor, 27 Feb 2015
Patients suffering from chronic fatigue syndrome show distinct changes in their immune system, scientists have shown for the first time.
Researchers say the immune changes represent ‘the first robust physical evidence’ that ME is a biological illness rather than a psychological disorder.
Until now doctors have only been able to diagnose the condition on reported symptoms alone, a problem which has led some to dismiss the illness.
But now Columbia University has found that there are specific patterns in 51 immune biomarkers for people with ME. The test also shows differences for short and long term sufferers.
Researchers are hopeful that at an immune test could help improve diagnosis of the disabling disorder in which symptoms range from extreme fatigue and difficulty concentrating to headaches and muscle pain.
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The study looked at the immune systems of 298 patients suffering from chronic fatigue syndrome.
People who had the condition for three years or less had increased amounts of immune molecules called cytokines. They had particularly high concentrations of a molecule called interferon gamma which has been linked to the fatigue people feel following a viral infection like flu.
“We now have evidence confirming what millions of people with this disease already know, that ME/CFS isn’t psychological,” said Dr Mady Hornig, director of translational research at the Center for Infection and Immunity at Columbia University.
“Our results should accelerate the process of establishing the diagnosis after individuals first fall ill as well as discovery of new treatment strategies focusing on these early blood markers.”
Crucially there are already drugs on the market which can dampen levels of cytokines and potentially help sufferers, although researchers said their findings would need to be replicated before clinical trials could take place.
The study supports previous suggestions that the condition may be triggered by viruses. It is thought that the immune system may simply fail to switch off.
“It appears that ME/CFS patients are flush with cytokines until around the three-year mark, at which point the immune system shows evidence of exhaustion and cytokine levels drop,” says Dr. Hornig.
The condition, once dismissed as ‘Yuppie Flu’, is now a recognised illness which affects around 250,000 people in Britain.
Sufferers report extreme fatigue, joint pain, headaches and memory problems, but doctors still do not know the cause or how to cure it.
Ian Lipkin, Professor of Epidemiology at Columbira added: “This study delivers what has eluded us for so long: unequivocal evidence of immunological dysfunction in ME/CFS and diagnostic biomarkers for disease.”
Anyone can get CFS, although it is more common in women than in men. It usually develops in the early 20s to mid-40s. Children can also be affected, usually between the ages of 13 and 15.
Most cases of CFS are mild or moderate but some people experience symptoms which are so severe they struggle to do even simple tasks like brushing teeth.
Previously experts have suggested it could be triggered by a viral infection; problems with the immune system; a hormonal imbalance or an emotional trauma.
The findings were welcomed by charities who said it proved that ME was a biological disease.
“We welcome hugely respected scientists such as Dr Mady Hornig and Prof Ian Lipkin contributing to the growing momentum of M.E. research with their interesting and potentially exciting findings,” said Sonya Chowdhury, CEO, Action for ME.
“This peer-reviewed evidence that M.E. has a potentially identifiable biomarker could have significant implications for quicker diagnosis and improved treatments for this neglected patient group.
“As the team itself highlights, these findings are only preliminary. There is much more work to be done and we eagerly await replication of these results as soon as possible.”
However some experts were more sceptical about the findings.
Prof Michael Sharpe, Professor of Psychological Medicine, University of Oxford, said: “Whilst this finding that some patients with CFS/ME have an immune abnormality is potentially interesting, we should treat it with great caution.
“Everyone who has worked clinically with patients with CFS/ME knows this is a real illness; this study neither proves nor disproves that observation.”
Prof Paul Morgan, Professor of Inflammation, Skin and Joint Disease, Institute of Infection and Immunity, Cardiff University, added: A biomarker of CFS has long been sought as a means of adding substance to a difficult and controversial clinical diagnosis. Inflammatory cytokine markers have been described but have failed to replicate.
“Independent verification in larger sample sets is an essential first step, particularly in an area so heavily littered with blind alleys.”
The research was published in the journal Science Advances.