Columbia University Center for Infection and Immunity (CII) collaborate strongly with Simmaron Research on ME/CFS studies. Recently Dr Hornig gave a presentation at a Simmaron Tea event and Cort Johnson gave a brilliant report of the event and what Dr Hornig discussed. We highly recommend reading this article.
Dr Hornig presented on the work they’ve done regarding their findings of immune exhaustion both in blood and spinal fluid. Cort explains about this so well, writing:
“We now know that the same changes to the immune system that we recently reported in the blood of people with ME/CFS with long-standing disease are also present in the central nervous system,” Dr. Hornig
In her presentation, Dr. Hornig first reviewed the recent finding from the Chronic Fatigue Initiative-funded study run by the Columbia team: massive immune up regulation in short duration ME/CFS patients and immune down regulation in longer duration ME/CFS patients. The same immune factors, interestingly enough, that were upregulated early in the illness were squashed later in the illness. One key viral fighter called IFN-y that was hugely important in early ME/CFS but significantly down regulated in later ME/CFS pointed an arrow at a process called “immune exhaustion”.
The blood and spinal fluid matched.
What could cause this kind of immune exhaustion? Dr. Hornig stated it’s usually associated with chronic infections. In a scenario reminiscent of the wired and tired problem in ME/CFS, the immune system gets revved up, stays revved up and ultimately crashes.”
It is brilliant that Cort was able to report on some preliminary findings from the 50 patient and 50 control gut microbiome work funded by the Chronic Fatigue Initiative. This is important microbiome work that Columbia CII will hopefully publish very soon. Note that it is different from the separate, very much larger 125 patients and 125 control microbiome/immunity study that they have begun collecting samples for; CII do not yet have funding for testing and analysis of this crucial study. The small study is revealing important new clues.
Cort writes:[pullquote align=”full” cite=”” link=”” color=”” class=”” size=””] “They’re finding evidence of significant changes in the gut flora of ME/CFS patients vs healthy controls. For one, altered levels of butyrate producing bacteria have been found in the ME/CFS patients. Noting that similar differences have been found in autoimmune diseases, Dr. Hornig proposed that an autoimmune process may be fueling the symptoms in a subset of patients. Another finding suggests substantial serotonin dysregulation may be present in ME/CFS. (Most of the serotonin in our body is found in our gut.) Dr. Hornig described serotonin as a major immune regulator. Thus far they’ve found that serotonin is more likely to be undetectable in shorter duration patients than longer duration patients, and those reduced serotonin levels are associated with increased immune activity including a very significant increase in interferon-gamma – an important antiviral factor.” [/pullquote]
[pullquote align=”full” cite=”” link=”” color=”” class=”” size=””]“Tryptophan [an amino acid we get in our food] is metabolized to either serotonin or kynurenine. If serotonin levels are low, the levels of kynurenine are likely high. Plentiful serotonin results in feelings of well-being, emotional resilience, and immune balance. High levels of kynurenine, on the other hand, have been associated with a host of neurological and neuropsychiatric disorders. Dr. Hornig has called the kynurenine pathway her favorite pathway because it’s been implicated in so many diseases. “[/pullquote]
CII are working on a test to accurately assess kynurenine-pathway metabolites so they can follow up on their finding of low serotonin in ME/CFS patients.
EDIT: You can also find out more about this pathway and Dr Hornigs thoughts about this by seeing transcripts and slides from Dr Hornig’s talk in Sweden. (Near the end of the presentation)
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Many thanks to Simmaron Research and Cort Johnson for reporting on this event!