April 11, 2017
A potential biomarker, and the effect of exercise on the brains and bodies of people with M.E., are the highlights of our monthly research round-up for April. Researched and written by experienced pharmacist and Action for M.E. volunteer Emily Beardall, our round-up explains some of the recently published peer-reviewed studies on M.E.
The following were published online between 22 February and 21 March 2017. In each case, we have used the same name for the illness as the researchers publishing the paper. Please note this is not an exhaustive list: we have chosen 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.
A group of Australian researchers have published a study in the Journal of Translational Medicine investigating a protein present in the blood of people with CFS/M.E. which they say has the potential to become a blood test for the illness.
The levels of the protein activin B, which plays a part in inflammation and muscle mass, was found to be significantly higher than in the healthy controls and the normal range after 20 minutes of standing. A larger study is needed to establish whether this test correctly identifies patients with CFS/M.E. from healthy people and those with other conditions involving fatigue.
A study published in Brain, Behavior, and Immunity looked at the aftereffect of exercise in people with M.E./CFS compared with healthy but inactive controls. Participants performed three simple physical and mental tasks during brain scans and completed symptom questionnaires a week before and 24 hours after exercising on a stationary bike for half an hour.
The people with M.E./CFS were unable to cycle with as much power as the controls and experienced significantly more pain. For the mental tasks during the brain scans, scores in the healthy controls improved after exercise, but the opposite effect occurred in the people with M.E./CFS, along with greater brain activity, which was linked to their increased symptom scores. Scores and brain scans for the simple physical task were similar for both groups before and after exercise.
Although this was a small study it demonstrates very clearly that, for people with M.E./CFS, exercise worsens symptoms and impairs cognitive functioning, as experienced during post-exertional malaise.
A small Dutch trial of the rheumatoid arthritis drug anakinra (brand name Kineret) for CFS was published in Annals of Internal Medicine. Patients with CFS have been found to have higher levels of an inflammation messenger called interleukin-1, suggesting that they would respond to anakinra, which inhibits IL-1 messaging.
They gave daily injections of the drug to 25 women with CFS, while a further 25 women (also with CFS) were given placebo injections. Side effects were more common in those receiving injections of the drug, and two of them had improvements in fatigue scores (as did and five who received the placebo).
Their symptoms and functioning scores were assessed for a further 20 weeks, but the trial found no differences in scores between the patients receiving the drug and those that had placebo injections. The authors concluded that although higher interleukin-1 levels are found in people with CFS, this may not play a significant role in the illness.
A study published in the journal Sociology of health and illness explored what “recovery” means to people who class themselves as having recovered from M.E./CFS. The 16 participants were identified through support groups and online forums, and were interviewed about their experience of the illness, and how they define recovery.
Some compared levels of activity before M.E./CFS, during the illness and at their present health, whereas others described recovery as being able to work part-time, exercise and socialise. The participants were still needing to pace their activity with rests, and some managed employment by planned boom-and-bust. Some of said they had experienced doubts from other members of the M.E. community about the validity of their M.E./CFS diagnosis.
The authors concluded that people identifying themselves as recovered are in an in-between state, or “one foot in the ill world, one foot in the well world.”