B-Lymphocyte Depletion in Patients With Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

@article{Fluge2019BLymphocyteDI,
  title={B-Lymphocyte Depletion in Patients With Myalgic Encephalomyelitis/Chronic Fatigue Syndrome},
  author={ystein Fluge and Ingrid Gurvin Rekeland and Katarina Lien and Hanne Thrmer and Petter Christian Borchgrevink and Christoph Schfer and Kari Srland and Jrg Amus and Irini Ktoridou-Valen and Ingrid Herder and Merethe Eide Gotaas and ivind Kvammen and Katarzyna Anna Baranowska and Louis Mlj Bohnen and Sissel Oksnevad Martinsen and Ann E Lonar and Ann-Elise H Solvang and Arne E S Gya and Ove Bruland and Kristin Risa and Kine Alme and Olav Dahl and Olav Mella},
  journal={Annals of Internal Medicine},
  year={2019},
  volume={170},
  pages={585-593}
}
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a disease of unknown cause that affects approximately 0.2% of the population according to Canadian consensus criteria (1). Characteristic symptoms include postexertional malaise, fatigue, sleep disturbances, cognitive symptoms, sensory hypersensitivity (including pain), and other symptoms related to autonomic or immune function. The disease is associated with greatly reduced quality of life (2, 3). The socioeconomic costs are high… 
Intravenous Cyclophosphamide in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. An Open-Label Phase II Study
TLDR
Intravenous cyclophosphamide treatment was feasible for ME/CFS patients and associated with an acceptable toxicity profile and without a placebo group, clinical response data must be interpreted with caution.
Pathomechanisms and possible interventions in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).
TLDR
This work suggests a framework model for the initiation and treatment of myalgic encephalomyelitis/chronic fatigue syndrome, which is more frequent in women and influenced by genetic predisposition.
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Trial Fails to Confirm Earlier Observations of Rituximab's Effectiveness
  • P. Rowe
  • Medicine, Psychology
    Annals of Internal Medicine
  • 2019
TLDR
A phase 3, multicenter, randomized, double-blind trial comparing rituximab and placebo on the basis of a unified autoimmune hypothesis regarding pathophysiology and treatment of ME/CFS symptoms, greeted with a great deal of interest.
Epstein-Barr Virus and the Origin of Myalgic Encephalomyelitis or Chronic Fatigue Syndrome
TLDR
It is hypothesize that within ME/CFS there is a subgroup of patients with DRB1 and DQB1 alleles that could confer greater susceptibility to EBV, where immune evasion mechanisms generated by cells with latency induce immunodeficiency.
Could Minocycline Be a “Magic Bullet” for the Treatment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome?
TLDR
A clinical trial by Miwa on minocycline, a tetracycline antibiotic for ME/CFS merit attention, despite the fact that it was a prospective open-label study without a comparative control group, and the large number of dropouts due to side effects begs the question of whether the dose was appropriate.
A Comprehensive Examination of Severely Ill ME/CFS Patients
TLDR
A comprehensive examination of the symptoms and clinical laboratory tests of a cohort of severely ill patients and healthy controls found a striking similarity in symptoms between long COVID and ME/CFS, suggesting that studies on the mechanism and treatment of ME/ CFS may help prevent and treat long CO VID and vice versa.
Pathological Mechanisms Underlying Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
TLDR
Patient stratification to account for this heterogeneity is one important consideration during exploration of potential diagnostic developments of myalgic encephalomyelitis/chronic fatigue syndrome.
Human Leukocyte Antigen alleles associated with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)
TLDR
Novel HLA associations pointing toward the involvement of the immune system in ME/CFS pathogenesis are reported, potentially with a substantial heterogeneity.
Reduced Endothelial Function in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome–Results From Open-Label Cyclophosphamide Intervention Study
TLDR
Patients with myalgic encephalomyelitis/chronic fatigue syndrome had reduced endothelial function affecting both large and small vessels compared to healthy controls and no significant associations were found between clinical response to cyclophosphamide intervention and changes in FMD/PORH from baseline to 12 months.
...
1
2
3
...

References

SHOWING 1-10 OF 29 REFERENCES
B-Lymphocyte Depletion in Myalgic Encephalopathy/ Chronic Fatigue Syndrome. An Open-Label Phase II Study with Rituximab Maintenance Treatment
TLDR
The observed patterns of delayed responses and relapse after B-cell depletion and regeneration, a three times higher disease prevalence in women than in men, and a previously demonstrated increase in B- cell lymphoma risk for elderly ME/CFS patients, suggest that ME/ CFS may be a variant of an autoimmune disease.
Clinical impact of B-cell depletion with the anti-CD20 antibody rituximab in chronic fatigue syndrome: a preliminary case series
TLDR
Benefit for all CFS symptoms, the delayed symptom relief following B- cell depletion, the kinetics of relapses, and the effect also from methotrexate treatment, provide suggestive evidence that B-cells play a significant role in the ongoing clinical features, and that CFS may be amenable to therapeutic interventions aimed at modifying B-cell number and function.
Benefit from B-Lymphocyte Depletion Using the Anti-CD20 Antibody Rituximab in Chronic Fatigue Syndrome. A Double-Blind and Placebo-Controlled Study
TLDR
The delayed responses starting from 2–7 months after Rituximab treatment, in spite of rapid B-cell depletion, suggests that CFS is an autoimmune disease and may be consistent with the gradual elimination of autoantibodies preceding clinical responses.
Cytokine Inhibition in Patients With Chronic Fatigue Syndrome
TLDR
It is contended that etanercept, with its large molecular weight, is not a proper drug to inhibit tumor necrosis factor in the brain, and performing such studies using a placebo-controlled design and with inhibitors that access the central nervous system is essential.
The functional status and well being of people with myalgic encephalomyelitis/chronic fatigue syndrome and their carers
TLDR
ME/CFS is disabling and has a greater impact on functional status and well being than other chronic diseases such as cancer, and the use of generic instruments such as SF-36, in combination of other objective outcome measurements, to describe patients and assess treatments is suggested.
Metabolic profiling indicates impaired pyruvate dehydrogenase function in myalgic encephalopathy/chronic fatigue syndrome.
TLDR
Analysis of serum amino acids showed a specific reduction of amino acids that fuel oxidative metabolism via the TCA cycle, mainly in female ME/CFS patients, with inadequate ATP generation by oxidative phosphorylation and excessive lactate generation upon exertion in clinical disease presentation.
The Health-Related Quality of Life for Patients with Myalgic Encephalomyelitis / Chronic Fatigue Syndrome (ME/CFS)
TLDR
The adjusted analysis confirms that poor HRQoL of ME/CFS is distinctly different from and not a proxy of the other included conditions, and further studies are needed to exclude the possible selection bias of the current study.
The Development of a Revised Canadian Myalgic Encephalomyelitis Chronic Fatigue Syndrome Case Definition
Problem statement: Several investigators have indicated that case defi nitions for Chronic Fatigue Syndrome (CFS) are characterized by vaguely worded criteria that lack operational definitions and
Treatment of primary Sjögren syndrome with rituximab: a randomized trial.
TLDR
Rituximab did not alleviate symptoms or disease activity in patients with pSS at week 24, although it alleviated some symptoms at earlier time points and a primary outcome that may have been insensitive to detect clinically important changes.
Effect of galantamine hydrobromide in chronic fatigue syndrome: a randomized controlled trial.
TLDR
This trial did not demonstrate any benefit of galantamine over placebo in the treatment of patients with CFS and failed to detect any consistent prognostic factor that might have influenced the primary or any secondary outcome measures.
...
1
2
3
...