Persistent fatigue induced by interferon-alpha: A novel, inflammation-based, proxy model of Chronic Fatigue Syndrome, 2018, Pariante et al

BBC coverage by Laurel Ives includes mention of Monaghan, so that's a bonus:

In June, Scottish National Party MP Carol Monaghan led an emotional Westminster Hall debate into a common treatment, graded exercise therapy (Get), which is available on the NHS. She argued it was often damaging and in need of revision. Others defended the treatment.
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https://www.bbc.co.uk/news/health-46570494

Edit: I somehow missed the "Others defended the treatment" last night, but as @Sly Saint mentions later on:

"I don't remember any of the other MPs defending the treatment (not even the Minister who spoke at the end). There was a lot of anti-PACE discussion.
Where did the BBC get this from?"
 
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Esther12 said:
the media hype around it is odd and smells to me of the SMC.
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The SMC does not seem to have put anything onto their website on this study so far:

http://www.sciencemediacentre.org/?s=Cfs&cat=

Perhaps King's has borrowed the SMC mailing list and the press are just grateful to have something that is not Brexit related, but superficially at least a positive story about the achievements of British science.
 
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Peter Trewhitt said:
The SMC does not seem to have put anything onto their website on this study so far:

http://www.sciencemediacentre.org/?s=Cfs&cat=
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No, but sometimes they don't until the day after with a midnight embargo.

Also, I get the impression that they don't openly declare all of their involvement with CFS media management.

I could just be wrong about them being involved with this though.
 
Looks like the Guardian's coverage includes comment from Sharpe, but it doesn't seem to be on their website yet:

https://www.pressreader.com/uk/the-guardian/20181217/281775630256669

"It may give us some clue down the line. If the thing is triggered by an abnormal or excessive immune response [and] if we could find a way to reduce that immune response, we might stop incident cases."

So if the thing is triggered by X, then if we found a way of stopping X we might stop the thing? Good to be able to have an expert explain that.

edit thanks to @RuthT: The Guardian article posted on-line is a bit different, with an extra bit of a quote from Sharpe (I think that the press reader version comes from the hard copy?):

Michael Sharpe, professor of psychological medicine at the University of Oxford, said the study added another piece to the puzzle about what might kick off CFS. “It does seem that something to do with the immune system may be a triggering event, [but] it doesn’t actually tell us why, when that trigger seems to have gone away, the person stays fatigued,” he said.

Sharpe acknowledged the study did not shed light on how to treat established cases of CFS. “it may give us some clue down the line,” he said. “If the thing is triggered by an abnormal or excessive immune response, if we could find a way to reduce that immune response, we might stop incident cases.”
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https://www.theguardian.com/society...eractive-immune-system?CMP=Share_iOSApp_Other
 
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It seems like these findings were foreshadowed by the results of the 2006 Dubbo study, which showed a connection between the apparent severity of the initial infection and the later development of ME.
The key risk factor for post-infective fatigue syndrome is the severity of the acute illness and not age, sex, or psychological factors.

Post-infective and chronic fatigue syndromes precipitated by viral and non-viral pathogens: prospective cohort study
https://www.bmj.com/content/333/7568/575.long
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So, the worse/more fatigued you initially feel from the "trigger"/initiation of interferon alpha treatment, the more likely you are to get ME/persistent fatigue.
 
I posted a comment and called it just another paper, and its awaiting approval. I made note of similar and what seem to be better findings from Jared Younger. We do need to read the paper though ... there is an outside chance that its not too bad ... its gotta snow in Equatorial Africa sometime other than mountain peaks, right?
 
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Andy said:
Hmm, "underlying causes", which could very well mean, "wellll, it starts with an overactive immune response, but then it's the unhelpful beliefs of the patient that perpetuate it". As always, the devil will be in the detail.
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A little bit of that with a little bit of - we are really clever and we have found out that in other diseases it causes this sort of thing (they leave this vague so they have wriggle room) so now our friends can go to NICE and say we have found new evidence of this thing (no description given so that they can all put what they want) and we need more money for research as we are the good guys now; pat us on the back and give us a lolly pop?
 
As others have expressed, I do not understand the hype here. However, my eye was drawn to this, which is probably the most interesting thing and not spoken about in the papers:

CFS patients had lower levels of the ratio of kynurenine to tryptophan and 3-hydroxykynurenine than controls.
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More support for the metabolic trap hypothesis?
 
Tilly said:
A little bit of that with a little bit of - we are really clever and we have found out that in other diseases it causes this sort of thing (they leave this vague so they have wriggle room) so now our friends can go to NICE and say we have found new evidence of this thing (no description given so that they can all put what they want) and we need more money for research as we are the good guys now; pat us on the back and give us a lolly pop?
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Just read the Daily Mail posted by Daisy May. It is very much like watching Alice in Wonderland teaparty while they use chocolate teapots and call it wine, has nothing to do with science more to do with they think we are fools
 
Cheesus said:
As others have expressed, I do not understand the hype here. However, my eye was drawn to this, which is probably the most interesting thing and not spoken about in the papers:



More support for the metabolic trap hypothesis?
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They would not know it even if they fell into it? They will turn it their findings into what ever sticks so they can look better than they are
 
Given the level of hype that this study has been awarded, I think this reveals something useful, that Pariante is seen as part of the establishment and worthy of support, and to retain this then he will have to toe the establishment line. So I retain my suspicions that this study will be used to support the 'physical start but maintained by the patients thoughts' pipedream of the BPS crew.

OR it reveals that I have lost my natural tendency to trust and my default state now is suspicion. Though the two things aren't mutually exclusive I guess.
 
Jonathan Edwards said:
I think it my be relevant who funded the study. Does anybody know who?
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Acknowledgements:

This work was supported by the Medical Research Council grant name: Persistent Fatigue Induced by Interferon-alpha: A New Immunological Model for Chronic Fatigue Syndrome (MR/J002739/1). Additional support was given to the study by the National Institute for Health Research Mental Health Biomedical Research Centre in Mental Health at South London and Maudsley NHS Foundation Trust and King’s College London, who also part support TC. AR also received support from the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South London at King's College Hospital NHS Foundation Trust. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.
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Conflicts of interest:

Prof. Foster has received speaker and consultancy fees from companies that market drugs to treat hepatitis C, specifically AbbVie, Gilead, Merck and Roche.

Dr Forton has received speaker consultancy fees from companies that market drugs to treat hepatitis C, including AbbVie, Gilead, BMS and Janssen. He has received funding for trials from Merck.

Dr Kosh Agarwal has received fees from companies that market drugs to treat Hepatitis C, including AbbVie, Gilead, Astellas, Intercept, Janssen, Merck and Achillon, and has received grants from AbbVie, Gileas, BMS and Roche.

Prof. Cleare has in the last three years received honoraria for speaking from Astra Zeneca and Lundbeck, honoraria for consulting from Allergan, Livanova, Lundbeck and Janssen, and research grant support from Lundbeck, the Medical Research Council (UK), Wellcome Trust (UK) and the National Institute for Health Research (UK).

Dr Harrison has grant funding from Wellcome (NIMA), the Medical Research Council (UK), Arthritis Research UK and Action for ME. He has also acted as a consultant for GSK and has received research funding from Janssen.

Prof. Pariante and Dr. Zunszain have received research funding from Johnson & Johnson as part of a program of research on depression and inflammation, and research funding from the Medical Research Council (UK) and the Wellcome Trust for research on depression and inflammation as part of two large consortia that also include Johnson & Johnson, GSK and Lundbeck.
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