Moderator's note: This post and relevant replies have been copied from this point, https://www.s4me.info/threads/nih-a...h-and-5th-april-2019.7745/page-14#post-161538, in the Accelerating Research on ME/CFS Meeting thread.
"Something in the blood"
It is amazing that four independent groups have now found that a factor in the blood can affect cell metabolism/mitochondria in ME/CFS and transfer the effect to healthy cells. I have tried to summarise what we know about the four different studies. There are holes and no doubt errors as well, so corrections are appreciated.
Fluge & Mella, 2016
SERUM. Cultured muscle cells incubated with serum from patients show increased mitochondrial oxidative metabolism and respiration, versus serum from healthy controls . (Serum is the fluid left over after blood has clotted.)
This is the only published study to date and the only approach with a detailed methodology. Uses the Seahorse analyser to measure oxidative phosphorylation and lactate production (glycolysis).
12 patients, many severely affected; 12 controls.
UNPUBLISHED SO FAR
Ron Davis
PLASMA swap with Nanoneedle using the salt stress test/energy load. (Plasma is the liquid left over when the red and white blood cells, and the platelets have been removed from the blood.)
Plasma from ME/CFS patients makes healthy cells behave like ME/CFS ones. And plasma from healthy controls makes ME/CFS cells behave like healthy ones.
Presumably the cells are PBMCs (white blood cells, separated from plasma).
Sample size for plasma swap study? We should get more detail when the paper comes out in PNAS.
Karl Morton, Oxford
PLASMA. Plasma from healthy controls makes no difference to the internal oxygen level of cultured cells, whereas plasma from ME/CFS patients lowers the intracellular oxygen level.
Sample size?
What's the explanation — is this increased metabolism rate with ME/CFS, or something else?
Bhupesh Prusty, Wuerzburg university
SERUM. Serum from ME/CFS patients causes mitochondrial groupings from cultured cells to fragment, whereas serum from healthy controls does not.
Normally, mitochondria constantly fuse together and separate, but the fact that they are often fused together is important for our ability to fight viruses. Some viruses, including HHV-6, cause mitochondria to fragment, reducing their ability to fight viruses.
Sample: 3 controls, 5 patients.
In a separate experiment, he showed that the effects was reversible (washed away patient serum after three days and mitochondria gradually resumed normal shapes).
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So that's two studies using serum and two using plasma. Fluge’s and Morten’s are directly linked to cell metabolism. Davis's is indirectly: the salt added to the Nanoneedle test forces the cell to use energy pumping sodium out of the cell. The Prusty one is mitochondrial, but the changes in morphology are apparently linked to cell defence rather than to energy production.
Finally, Ron Davis has said that they believe the factor in the blood responsible for all this is exosomes, tiny membrane-boundpackets of biomolecules released by cells. Exosomes are a type of extracellular vesicle, and these vesicles are being studied by Maureen Hanson as part of her collaborative's work.