Important Findings from the Columbia Study of ME/CFS

“Distinct plasma immune signatures in ME/CFS are present early in the course of illness.”

Hornig et al Sci. Adv. 2015;1:e1400121 Feb 27, 2015

http://advances.sciencemag.org/content/1/1/e1400121

This study led by Drs. Mady Hornig and Ian Lipkin at Columbia University included carefully screened patients from the practices of Drs. Jose Montoya, Nancy Klimas, Susan Levine, Lucinda Bateman and Dan Peterson. The study combined cases from two research samples: one referred to as the NIH study group and another form the Chronic Fatigue Initiative group (privately funded).

Blood samples were drawn between 10 am and 2 pm. All the participants met BOTH the Fukuda and Canadian criteria. In addition, all had viral infection like symptoms prior to the onset of their illness. Each participant gave a blood sample after filling out the study questionnaires (to serve as a mild stressor). Three groups were included: “short duration illness (52 subjects ill for less than 3 years), long duration illness (246 subjects ill longer than 3 years) and healthy controls (348 subjects). In total, this is the largest sample tested to date.

Analyses were done for a large number of cytokines – the chemicals produced by immune cells to communicate with each other and with the rest of the body. The group used very fancy statistics to compare the short duration vs long duration vs controls for each cytokine and to study the relationships between the cytokines ie. which influence the others and in which direction.

The important finding from this study is that significant differences were found between the short and long duration subjects and between each of these groups and the healthy controls.

• Those with short duration illness had a general upregulation (increase) in most of the cytokine levels compared with healthy controls.
• Those with longer duration illness had a general decrease in cytokine levels. The authors hypothesize that there may be an immune burnout after 3 years of having ME/CFS.
• HOWEVER when short and long duration groups were taken together the combined group didn’t differ from the healthy controls. This is an important finding as it may explain why previous smaller studies have failed to demonstrate consistent findings. ME/CFS (SEID) changes over time and most studies lump everyone together cancelling out differences.
• A major finding in the short duration cases was an elevation of interferon gamma. This has been reported repeatedly by Dr. Kenny De Meirleir and others over the years. This cytokine is activated by viral infection suggesting a viral connection.
• The Columbia group has reported previously that they can’t find evidence of active viral infection in this sample. Therefore ME/CFS (SEID) may be a case of “hit and run”. A virus triggers illness and causes long lasting immune changes even after the virus itself is gone from the body.
• Interferon gamma accelerates the breakdown of tryptophan and melatonin, maybe explaining in part the energy, mood and sleep problems experience by people with ME/CFS (SEID).
• They found an increase in leptin in the long duration illness group, similar to the findings of Dr. Jared Younger in patients with Fibromyalgia. Leptin is involved with metabolism, hunger and satiety.
• Another finding is a deficiency of CD40L. In other research low levels of this cytokine are associated with chronic sinus and lung infections and a pattern of encephalitis unrelated to any known pathogen... very interesting.
• Many other findings...

Author: Eleanor (Ellie) Stein MD FRCP(C)

I am a psychiatrist with a small private practice in Calgary and am an assistant clinical professor in the faculty of medicine at the University of Calgary. Since 2000, I have worked with over 1000 patients, all with ME/CFS, FM and ES. My passion for this field comes from my own struggle with these diseases, my desire to improve my health and then pass on what I learn. My goal is for every patient in Canada to have access to respectful, effective health care within the publicly funded system. 

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