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Latest research roundup: Rituximab effects and more

June 07, 2018

Latest research: standing unaided, glucose and muscle cells and more

Supporting you to stay informed about M.E. research, we publish regular round-ups from Action for M.E. volunteer and pharmacist Emily Beardall, covering a selection of papers published in peer-reviewed journals.

Please note this is not an exhaustive list – we have selected to highlight the studies that we think are most likely to resonate with the daily lives of those affected by the condition. We will also report separately on further studies of significance, as and when they are published.

You can search online directory PubMed for most studies about M.E. published in peer-reviewed journals.

The following studies were published online between 17 March 2018 and 16 May 2018. In each case, we have used the same name for the illness as the researchers publishing the paper.

Standing unaided

A study in the Journal of Translational Medicine looked at the length of time someone with M.E./CFS could stand up, and their observed standing difficulty, compared with controls. Combining these two measures to give a weighted standing time, the results were in keeping with illness severity and the pathology seen in the participants’ blood tests, including the cytokine activin B, used as a marker of immune system activity. The authors conclude that weighted standing time could be used as a simple test alongside other criteria for M.E./CFS diagnosis and establishing symptom severity for tailored treatments.

Glucose and muscle cells

A study published in Bioscience Reports built on a previous study in 2015 by the same group of researchers - including one of Action for M.E.’s medical advisers, Professor Julia Newton - and part-funded by the charity. It showed that glucose uptake by muscle cells from people with M.E/CFS is reduced, due to impairment of AMPK receptors. These receptors play a part in energy metabolism and allow glucose to enter cells so that it can be used for energy. The current study used diabetes drugs metformin and compound 991, known to activate AMPK receptors. These drugs improved glucose uptake by the muscle cells, revealing more about the pathology of the illness. The experiment took place with muscle cells in vitro (removed from patients and placed in a petri dish), rather than in vivo (within M.E./CFS patients). Therefore, further studies are needed to discover whether using diabetes drugs to activate the receptors would lead to an improvement in symptoms in people with the illness.

Unwanted effects of rituximab

Natural Killer cells (NK cells) are a type of white blood cell in the immune system which are responsible for locating and attacking viruses and cancerous cells. Previous research has found that there is reduced NK function in CFS/M.E. patients. A study published in BMC Pharmacology and Toxicology examined the effect of the drug rituximab on NK cells taken from CFS/M.E. patients and non-fatigued controls. Rituximab is currently being trialled as a treatment to suppress the production of autoimmunity antibodies by B cells in the immune system. In this new study, the drug was also found to be toxic to NK cells, impeding their functioning further. The authors warn that the drug could have no effect on symptoms and even cause adverse outcomes for CFS/M.E. patients

Blood sample analysis

A study in the Journal of Extracellular Vesicles compared the extracellular vesicles (EVs) in the blood of people with CFS/M.E. and healthy controls. EVs are pinched off from cell membranes and contain some of the proteins, fats and genetic material from the cell. Analysis revealed that, compared with healthy controls, the EVs from patients were smaller, there were more of them and they contained a higher proportion of proteins. The authors comment that this could be a useful avenue for research, with the potential to be used as a biomarker.