MAGICAL MEDICINE: HOW TO MAKE AN ILLNESS ... - Invest in ME

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which must mean, for example, in relation to stomach ulcers (which invalidates the work of the 2005 Nobel
prize‐winners Marshall and Warren who discovered H. pylori) and in relation to cancer and to motor
neurone disease, when this is patently untrue.
12. The authors of the Trial information are adamant: “There is no strong evidence that infections are maintaining
factors in CFS/ME”, a statement that is readily disproved by reference to the literature and is therefore
misleading.
13. Even more astonishingly (given the enormous volume of immunological papers showing serious
disruption of the immune system in ME/CFS patients), the Trial information informs participants that:
“Minor abnormalities of the immune system are commonly found in people with CFS/ME” (the implication being
that deconditioning is known to affect the immune system but that any “minor” immune dysfunction is
reversible with CBT and GET). This should be compared with how Nancy Klimas, Professor of Medicine,
University of Miami School of Medicine, Director of Immunology and Director of AIDS Research, and
world‐renowned expert on ME/CFS, described the documented immune abnormalities 18 years ago (quoted
in Section 2 above but repeated because of its importance):
“The NK (natural killer) cell is a very critical cell in (ME)CFS because it is clearly negatively impacted. The most
compelling finding was that the NK cell cytotoxicity in (ME)CFS was as low as we have ever seen it in any
disease. This is very, very significant data. In (ME)CFS the actual function was very, very low ‐‐‐ 9% cytotoxicity:
the mean for the controls was 25, in early HIV and even well into ARC (AIDS related complex, which often precedes
the fully developed condition), NK cytotoxicity might be around 13 or 14 percent. (ME)CFS patients represent the
lowest cytotoxicity of all populations we’ve studied” (Immunological Markers in (ME)CFS. The CFIDS
Association Research Conference, November 1990, Charlotte, North Carolina. Reported in CFIDS Chronicle,
Spring 1991; pp 47‐50)
Attention must be drawn to Klimas’ research 18 years later published in BMC Medical Genomics: 2009:12:
(http://www.biomedcentral.com/1755‐8794/2/12 ), which exposed Gulf War Illness patients and matched
controls to an exercise challenge to explore differences in immune cell function measured by classic immune
assays and gene expression profiling. The study is relevant to the MRC PACE Trial because the authors
state: “The symptom spectrum of (GWI) is similar to (ME)CFS”. The study measured peripheral blood cell
numbers, NK cytotoxicy, cytokines and levels of 20,000 genes immediately before, immediately after and
after four hours following a standard bicycle ergometer exercise challenge.
“GWI patients demonstrated impaired immune function as demonstrated by decreased NK cytotoxicity and altered
gene expression associated with NK cells function. Pro‐inflammatory cytokines, T‐cell ratios, and dysregulated
mediators of the stress response (including salivary cortisol) were also altered in cases compared to control subjects.
“An interesting and potentially important observation was that the exercise challenge augments these
differences, with the most significant effects observed immediately after the stressor. This… provides a
paradigm for exploration of the immuno‐physiological mechanisms that are operating in GWI and similar
complex syndromes (such as ME/CFS).
“Our results mirror what is seen in the literature with regard to (ME)CFS: chronic immune activation, low
cytotoxic immune function, and dysregulated mediators of the stress response with low baseline salivary
cortisol, strongly reflecting the overlap between these two syndromes. Decreased functional capacity of NK
cells is the one consistent finding in (ME)CFS and Siegel et al demonstrated that low NK cell function
defined a more severely ill cohort.
“Our data confirmed reports that the NK cell subsets are more sensitive to exercise stress than any other
cell subtypes.