CFS

Immunomodulation May Benefit Patients With Chronic Fatigue

This is really an interesting approach to management of CFS. Immune cells from the patient’s lymph node are removed, treated with interluekin-2 and injected back into the patient. The results are promising. Now, for those of you a little confused as to how this may work. I’ve discussed Th1:Th2 ratios previously (Th1=attack mode, too much linked to autoimmune…Th2=defense, too much linked to allergies and asthma). IL-2 is a cytokine in the body that shifts the balance towards a Th1 response. So, if chronic fatigue is related to the body overreacting to stimuli from the environment (constant, subacute allergic exposure and reaction), switching the balance back towards a Th1 state may help relieve symptoms. The downside to this is its seeming complexity and cost ($5,000). It is possible that zinc and transfer factor are two substances that may also stimulate a Th1 response.

(article) Immunomodulation using lymph node extraction and ex vivo cell culture, followed by autologous cell reinfusion, significantly improves the symptoms of chronic fatigue syndrome, according to the results of a phase 1 trial. The patients studied “had more restorative sleep and woke up rested, and their activity levels improved,” Dr. Nancy G. Klimas, of the University of Miami in Florida, told Reuters Health. She presented the findings here at the American Association for Chronic Fatigue Syndrome Fifth International Conference. Dr. Klimas and colleagues obtained lymph nodes from 13 patients and cultured the cells for 10 to 12 days with anti-CD3 and interleukin-2. The cells were then infused back into the donors, who were monitored for 24 weeks. No adverse effects were noted, the researchers reported. The patients had significant improvement over the 24 weeks in tests of word retrieval fluency, and there was a trend toward significant change in speed of visual scanning. The most pronounced improvements were in cognitive function, but patients also reported less muscle pain, less lymph node pain, fewer sore throats and more physical stamina. Dr. Klimas said that the benefits began immediately and were seen throughout the trial. “Many clinicians are still having trouble even believing that this is an entity that deserves their attention or is ‘real,’” she noted. “Studies like this, I think, should validate the severity of the biologic underpinnings of this illness and that they are amenable to therapy.” Her group hopes to begin expanded clinical trials within the next 12 months. The trials will probably involve about four sites and as many as 100 patients. “I think [immunomodulation] does have the potential to be a new and novel form of therapy,” Dr. Klimas said. She pointed out that it would only involve one injection and that if it proves successful in the long term, it could be cost effective. She estimated that if the therapy is approved for commercial use, it would cost about $5000 per patient. Several physicians attending the conference hailed the report as confirming that the immune system is important in causing the symptoms of chronic fatigue syndrome. Dr. Nelson Gantz, of Pinnacle Health Systems in Harrisburg, Pennsylvania, said, “Possibly by altering the cytokine balance we can decrease symptoms….This suggests that maybe other therapies directed at various cytokines may help some patients.”