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Presentatie Lipkin:

inflammatie/

immuunactivatie

in het bloed en

het zenuwstelsel

waarneembaar

 

 

 

 


 

 

 

 

 

In een recente presentatie bracht dr. Ian Lipkin, bekend geworden van dť studie naar XMRV/MLV,

tussentijds verslag uit van zijn onderzoeksresultaten in het kader van het Chronic Fatigue Initiative.

 

Zijn bevindingen, gebaseerd op een groot aantal monsters, zijn opmerkelijk te noemen:

  1. Lipkin en collega's vonden geen virussen/bacteriŽn in het bloed ťn in het ruggenmergvloeistof.
  2. Wel vonden zij in 85% van de monsters tekenen van een retrovirus (!)
  3. Echter, hij schat in dat dat retrovirus waarschijnlijk van geen betekenis is.

  4. In ontlasting-monsters vond hij en zijn collega's het anellovirus,
  5. een virus dat oorspronkelijk geassocieerd werd met bloedtransfusies en hepatitis:

    Torque Teno Virus (TTV), Torque Teno Midi Virus (TTMDV) en Torque Teno Mini Virus (TTMV),

    maar de rol van dit virus en het belang voor ME/CVS is nog onduidelijk en lijkt gering.

  6. Het bloed van patiŽnten vertoont tekenen van immuunactivatie: TNFa, IL-8, IL-2 en IL-17.
  7. ME/CVS-patiŽnten die minder dan 3 jaar ziek zijn en patiŽnten die langer dan 3 jaar ziek zijn, kunnen op basis van subtiele verschillen in cytokine-profielen van elkaar onderscheiden worden.
  8. AllergieŽn lijken vooral in het begin een rol te spelen (eosinofielen-respons, IL-17-concentraties).

    Het immuunsysteem lijkt een (centrale) rol te spelen in de progressieve karakters van de ziekte.

  9. Het onderzoek van het ruggenmergloeistof liet zeer opmerkelijke resultaten zien.
  10. verhoogde hoeveelheden IL-10, IL-5, IL-13, kenmerkend door Th2-immuunactivatie,
  11. verhoogde concentraties IL-1b, illustratief voor inflammatie, en

    een toename van IL-17, een cytokine die een centrale rol speelt in Th17-immuunactivatie.

    Als dit juist is, is de naam (Myalgisch) Encephalomyelitis gerechtvaardigd (zie ook hier).

  12. Ondanks het feit dat Lipkin geen virussen en bacterieen in bloed en ruggenmerg vond,
  13. lijkt hij ervan overtuigd dat een "infectieuze agent" de inflammatie/immuunactivatie veroorzaakt.

  14. Volgens Lipkin speelt het microbioom (de micro-organismen) in de darmen een centrale rol.

 

Voor een ander (ongeverifiŽerd) verslag van de presentatie, klik op onderstaande afbeelding:

 

 

 


 

Kanttekening:

 

Volgens een toelichting van dr. Chia opgetekend door Patrick Calvin

onderzocht Lipkin het bloedplasma op de aanwezigheid van virussen, en

werden de witte bloed-cellen, een aantrekkelijke "schuilplaats" voor virussen, niet onderzocht.

 

 

 

 


 

 

Foremost Virus Hunter Finds Biomarkers,

Few Viruses in Big Chronic Fatigue Syndrome Study

 

Cort Johnson

September 11, 2013

 

 

A Surprise Presentation

 

 

We will publish data very soon on biomarkers of cytokines.

 

Our evidence now suggests

there is ongoing stimulus to the immune system.

 

Dr. Ian Lipkin

 

 

...

 

Virus Study Results Revealed

 

...

 

A special feature of the study involved Simmaron Research's spinal fluid samples.

 

Called a 'unique resource' earlier by Dr. Mady Hornig,

these samples allowed the researchers to get as close to the brain Ė

long thought to be a key area in chronic fatigue syndrome Ė

as they could. And the spinal fluid results were spectacular.

 

 

The Studies

 

...

 

Pathogens

 

First Phase -

 

Screens for 18 specific pathogens already implicated in ME/CFS

(herpesviruses, HTLV, enteroviruses, West Nile Virus, etc.)

were done on blood from Montoya's patients and

the CFI's group (Dr's Peterson, Klimas, Bateman, Levine, etc.).

 

Dr. Lipkin was looking for the virus,

not an indication it was present, but the virus itself.

 

...

 

Immune Response

 

A 'multiplexed immunoassay' looked at

50 proteins associated with immune activation/inflammation and oxidative stress.

 

 

Active Viruses Strike Out

 

Four of the 285 ME/CFS blood samples tested positive for HHV-6B.

 

One of the sixty spinal fluid samples tested positive for a virus (HHV-6B).

 

None of the other viruses commonly associated with ME/CFS

(Epstein Barr-Virus, enteroviruses, the cytomegalovirus, etc.)

showed up in the first pathogen screen.

 

The high throughput screening designed to look for any viruses

including novel viruses drew a blank as well.

 

...

 

With two large sample sets turning up negative

in the lab of one of most acclaimed virus hunters on the planet,

it's probably safe to say that

the hunt for an active infectious agent

in the blood of people with ME/CFS is over.

 

(Lipkin did report 85% of pooled samples

possibly showed evidence of a retrovirus

but believes they will not be related to CFS.

 

He also dismissed earlier rumors

that a novel infectious agent had been found.)

 

Infectious Agent Still Proposed

 

That doesn't mean an infectious agent is not involved.

In fact, Dr. Lipkin stated he didn't doubt that an infectious agent was involved.

He didn't say where and he didn't say it was still present.

 

...

 

Dr. Lipkin specifically alluded to an 'agent'

driving the immune activation he found

in both the blood and spinal fluid of ME/CFS patients

(but not the healthy controls).

 

 

Localized Infections Still Appear to Be a Possibility

 

...

 

The blood is the most convenient place to search for an virus and

active viruses usually do travel through the blood

but central nervous system or localized infections

may not show up in the blood or the spinal fluid.

 

...

 

The Three Year Breakpoint

 

 

Data suggests there may be

substantial differences in biomarkers

in people with less than 3 years of disease

and those with more than 3 years of disease.

 

Dr. Lipkin

 

 

 

Two research groups suggest the immune systems of

people with recent onset and longer duration ME/CFS are significantly different.

 

...

 

Dr. Lipkin's ability to independently

differentiate 'newer' from 'older' patients using cytokine results is pivotal, and

points to the central and progressive role the immune system

may play in this disorder.

 

With Broderick suggesting that two distinct illnesses emerge over time,

and Lipkin proposing treatment options should reflect illness duration,

it was clear these changes were significant indeed.

 

...

 

 

An Early Allergic Response

 

Allergy is not usually mentioned in association with ME/CFS

but eosinophils and other markers suggested to Dr. Lipkin that

the allergic response was enhanced in ME/CFS early on.

 

The cast of immune characters Lipkin's biomarker search fleshed out

was refreshingly familiar with IL-17, IL-2, IL-8 and TNF-a leading the list.

 

Levels of Il-17 were raised in recent onset ME/CFS patients.

Lipkin suggested immunomoculators able to bring IL-17 levels down

might be treatment option at some point.

 

...

 

The spinal fluid, interestingly enough, showed a very different pattern.

 

It showed a consistent profile of

immunological dysregulation in CFS,

regardless of duration of illness.

 

Dr. Lipkin identified

increased IL-10 and IL-13 levels

suggesting enhanced Th2 activation and

increased IL-1B, IL-5 and IL-17

suggesting Th1 (proinflammatory) activation.

 

Dr. Lipkin was obviously intrigued by the differences in

cytokine findings between spinal fluid and blood.

 

 

A Focus on the Gut

 

 

I think the gut microbiome is going to be

where the action is (in chronic fatigue syndrome).

 

Dr. Ian Lipkin

 

 

Lipkin's prime focus at this point is the gut and fecal matter.

 

 

...

 

Unfortunately, the fecal samples originally collected

didn't provide enough material for analysis

so they're restarting that part of the study.

 

Even more unfortunately,

characterizing the bacteria in fecal matter is extremely expensive.

 

...

 

 

Conclusion

 

The Chronic Fatigue Initiative's pathogen study set a benchmark

for rigor and size in the ME/CFS research field,

not the least because of Dr. Lipkin's leadership.

 

Surprisingly few viruses were found in the blood of ME/CFS patients,

yet Lipkin asserted that

an infectious agent was likely driving the immune activation

he found in the blood and spinal samples.

 

Cytokine analyses of the blood suggested

a different pattern of immune dysregulation

was present in newer onset patients (<3 years) and

patients with a longer duration of illness.

 

Dr. Lipkin believes

the "primary cause is likely to be an infectious agent" and

the gut microbiome is where 'the action' will be in ME/CFS.

 

 

http://simmaronresearch.com/2013/09/

foremost-virus-hunter-finds-biomarkers-few-viruses-chronic-fatigue-syndrome

 

 


 

Met dank aan Manja, die mij attendeerde op het aanvullende verslag op Wiki ME/CVS forums