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

Interesting that there isn't anything on the Science Media Centre website about their briefing.

 

Well done @JohnTheJack !

Very interesting to hear what Carmine Pariante had to say:

And good questioning from John:

 

I’m not sure that’s correct. The paper shows no correlation between pre-illness psychosocial factors and persistent fatigue, but, as far as I understand, it does not specifically refute the notion that a similar immune response could be triggered by acute emotional stress. Participants were not predisposed to persistent fatigue due to psychosocial factors, but that does not rule out the possibility that a normal emotional response to a very stressful event could be a trigger for an immune response which leads to persistent fatigue in patients with predisposed immune systems.

I’m not saying that that is true. I’m just saying that, as far as I understand, such an idea is not specifically refuted by the paper.

However, it is certainly wrong for the report to claim that the study suggests that CFS can be triggered by an out-of-control immune system which overreacts to emotional distress. The study provides no evidence to support or refute this idea – as far as I can see.

 

That may be so. Thanks for the clarification.

 

We all know we are ill despite the absence of obvious biomarkers, as would anyone who had ever listened to us. We have known for decades. Nobody ever had any business putting about a "no abnormalities = no problem" narrative in the first place. And in fact they didn't, they said "no abnormalities = illness perpetuated by biopsychosocial factors following an initial assault on the system". This paper doesn't seem to contradict that, merely that they have identified an initial assault which can result in some participants still feeling "fatigued" six months later.

So what?

The BPS brigade can still argue about why the fatigue is perpetuated, or does this paper suggest a mechanism which disputes the BPS narrative?

What this paper does is position some of the very same BPS quacktards who have been abusing us for decades as saviour scientists, complete with completely over the top media coverage and overuse of words such as "new" and "first time" etc, which is basically an insult to all the biomedical research they have been ignoring or making sure hasn't been funded for the last X years. Having dumped BPS manure on the ME garden for so long, they now feel entitled to come up smelling of roses. Worth a try I suppose, and probably one step up from forcing mice to swim.

Fabulous, just fabulous.

Yes, I thought that they just wanted to get the words "Carol Monaghan" and "emotional" in the same sentence, inviting the reader to think "she's hysterical", but considering how the sentence was constructed I didn't feel I could make such a bold claim. I'm pretty sure it's what was going on though, especially as it was immediately followed by the bare-faced lie:

 

I will delete my tweet then.

 

Very interesting, thanks.

 

Thanks.

Something that didn't make the post: I think there may be a small silver lining here for the ME/CFS patient community. To the extent that, in this study at least, the authors were prepared to entertain the idea that whatever is causing hepatitis C patients to still be fatigued six months after their treatment could be the same thing that is causing ME/CFS patients to be fatigued after many years (even if I don't think they have got remotely close to actually showing that), it suggests that these researchers are open to the idea of a physiological cause. The alternative would be to argue that the hepatitis C patients with persistent fatigue are also (starting to be) affected by whatever psychological factors purportedly cause or reinforce ME/CFS symptoms; however, no such suggestion was made in the article, and indeed in section 3.5 they note that there was no difference between the "persistent" and "resolved" fatigue groups on any of their psychological measures, some of which have been associated with ME/CFS in previous research.

Also, it seems to me (but as a non-patient I'm not the best placed to comment on this) that the message from the press coverage is "ME: It's not just in your head" (e.g., Mail Online here). As my blog suggests, I don't think this study actually tells us anything about that question, but it seems better than the Rod Liddle version ("It's all in your head, snowflakes").

I thought the senior author, Pariante, rather over-egged the pudding in the Radio Wales discussion. See here around 48:10: "What our research shows is that people who go on to develop CFS later on have a hyperactive immune system"... "We have been able to study people at this early stage of the illness". But nobody in the study actually developed CFS, as far as we know.

 

https://www.kcl.ac.uk/ioppn/news/re...e-syndrome-in-overactive-immune-response.aspx

Clues to chronic fatigue syndrome in overactive immune response
Posted on 17/12/2018

 

Having listened to the various parties give opinions I think I en dup with this conclusion:

1. That the research programme is an intelligent attempt to use interferon induced fatigue to inform general approaches to ME.
2. That the current set of results tell us little and probably nothing at all. The correlations found do not allow any sort of prediction that anything similar would apply in ME as such.