Stress-Induced Transcriptomic Changes in Females with ME/CFS Reveal Disrupted Immune Signatures, 2023, van Booven et al.

The abstract is very short though. They could have given some specific findings. I don't think the abstract serves the readers or the researchers well. It seems to lurch from generality to specificity in a way that is odd for a trial that only had female participants.

The conclusion is oddly written too:

It says that the study helps advance the understanding of ME/CFS, which is reasonable. It then suggests that the goal of such an understanding is to identify 'more targeted therapeutic options', but only for female ME/CFS patients. It's an unnecessary specificity when surely the goal is therapeutic options for all people with ME/CFS. It also suggests that there are existing untargeted therapeutic options for female ME/CFS patients.

That raises questions in my mind - did they do this study with men also, but not include those results? The methods section isn't at all reassuring (it's also not in the usual place, after the introduction, but tucked away after the discussion). No where does it tell us how many people underwent the exercise challenge.

Part of the discussion suggests that previous studies have found different results in men and women:

And, that's fair enough, but I really want to know that the decision to focus on 20 particular women with ME/CFS was made before the women were recruited and the data was examined, and that they weren't a cherry-picked sample of a larger study. I find the concept of this study (proteomics and cell types before and after an exercise challenge) very good, and the results are very interesting. But, I don't like seeing these indications of possible bias.

 

Yes, although presumably it's still a choice. I just wonder if that structuring was used for a reason in this paper.

Thanks SNT Gatchaman.

It's hard to know what is going on when they don't give us baseline concentrations.

CD8+ T cells

The tables suggest that CD8+ T cell numbers changed -13.444 fold from peak exercise (T1) to 4 hours after exercise (T2) in healthy controls. That's a huge decrease in the healthy controls - if the T1 value was 100, the T2 value would be 7. The tables present no figures for CD8+ cells in the ME/CFS participants, and no values for CD8+ cells at T0 for the healthy controls. Presumably that's because the only statistically significant change over time was that massive reduction from peak exercise to 4 hours afterwards in the healthy controls.

The paper suggests that this shows that people with ME/CFS aren't able to reduce inflammation after an exercise challenge.

The problem is, this paper gives us no evidence for the levels of CD8+ T cells being higher at rest in people with ME/CFS, and it doesn't report any absolute values at any time. A straightforward table with the values at T0, T1 and T2 for the ME/CFS and healthy controls for each cell type would have been very useful. I think there could be important findings here, but the presentation isn't giving us solid data.