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  • exuberant stimulation of cytokine-producing cells seen in the first 3 years of the illness leads to an “exhaustion” of the cytokine-producing cells thereafter
  • We did not pursue proteomic discovery with the goal of identifying noncytokine biomarkers
  • were conducted using only blood samples. Although blood is more easily obtained than cerebrospinal fluid, analysis of the latter may enable unique insights into immune activation in the central nervous system

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  • The new research suggests that these infections throw a wrench in the immune system’s ability to quiet itself after the acute infection, to return to a homeostatic balance; the immune response becomes like a car stuck in high gear. “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,”
  • “Early diagnosis may provide unique opportunities for treatment that likely differ from those that would be appropriate in later phases of the illness.”

  • The new research suggests that these infections throw a wrench in the immune system's ability to quiet itself after the acute infection, to return to a homeostatic balance; the immune response becomes like a car stuck in high gear

  • The research team plans to publish data later this year on changes in individual cytokine profiles over time, tracking more closely how they fluctuate with the reported severity of symptoms and other factors, Dr. Hornig said.

  • Comparison is vs baseline (no control group), on a par with PACE Trial SMC group
     Note that these figures are a before/after comparison, with no control group to allow for any natural improvement or placebo effect. This study uses the same Fatigue and Physical Function measures as the PACE trial, and the patients in this study did about as well as the SMC group ("specialised" medical care, no CBT or GET), and less well than the PACE CBT/GET patients who had the same treatments.
     
     This study vs PACE SMC, baseline to 12 months
     Fatigue: -6.8 vs -4.5 (ie improved more* than PACE SMC)
     Physical Function: +4.4 vs +11.6 (ie improved less* than PACE SMC)
     
     *Physical Function difference between this study and PACE is almost certainly statistically significant due to the very large sample sizes, though the difference in fatigue might not be.
     
     This suggests that 'out in the wild', CBT and GET (and any othr treatment offered) are, overall, no better than SMC. 
     
     
     
         

  • . We conclude that after physically demanding exercise, CFS subjects demonstrated impaired cognitive processing compared with healthy individuals

  • Patients with CFS (n = 32) and age-matched, normal control patients (n = 29) exercised for 20 minutes on a stationary bike at 70% of their predicted max work load (Watt
  • Exercise challenge induced significant increases of the complement split product C4a, but not C3a or C5a, at 6 hours after exercise only in the CFS group (P <.01), regardless of allergy status. Mean symptom scores were significantly increased after exercise through the use of a daily diary (P <.03) and a weekly diary (P <.01) for the CFS group only. Mean scores for the Multidimensional Fatigue Inventory categories "reduced activity" and "mental fatigue" were significantly increased in the CFS group only (P <.04 and P <.02, respectively).

  • Fatigue in CFS patients increased after exercise, but the level of actual physical activity remained unchanged.

  • We conclude that after physically demanding exercise, CFS subjects demonstrated impaired cognitive processing compared with healthy individuals.

  • Individuals with CFS demonstrated significantly lower SF36v2 and MFI-20 sub-scale scores prior to CPET. Between-group differences remained significant post-CPET, however, there were no significant group by test interaction effects
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