Olav Mella talks autoimmunity and metabolism in ME / CFS

It’s #OMFScienceWednesday! Today we share a video lecture by OMF Scientific Advisory Board member Dr. Olav Mella of the University of Bergen, Norway. In this lecture, Dr. Mella talks about the evidence for autoimmunity and metabolic disturbances in ME / CFS, and what such findings may mean for treatments. The lecture is in Norwegian but there are English subtitles available from the Closed Captions menu.

Dr. Mella made the following points:

• Autoimmunity: It is clear that the immune system is involved in ME / CFS pathology, and he noted that while there is evidence for autoimmunity, ME / CFS does not behave like a ‘classical’ autoimmune disease;
• Genetics: Evidence for genetic predisposition to ME / CFS has been presented in many studies, and his team is currently studying families to understand this better;
• Cytokines: He believes that the many aberrations observed in cytokines – signalling molecules that can indicate inflammation – may reflect an underlying process involved in ME / CFS, but are unlikely to be the cause or hold the answers;
• Rituximab: Dr. Mella’s team has been exploring rituximab as a possible treatment, because of the evidence that B cells are overactive in ME / CFS – depleting them with rituximab could have beneficial effects for patients. His most recent clinical trial with rituximab did not show significant improvements in the patient group he studied. He believes physicians should be cautious about recommending rituximab treatment, but he also believes there is a subgroup of patients in which rituximab would be effective. The challenge is that we have no marker for identifying these patients;
• Cyclophosphamide: Dr. Mella’s most recent clinical trial with cyclophosphamide, which causes a more general immunosuppression, showed more promising preliminary results than that with rituximab. However, patients tolerate it less well – it causes nausea.

For more details, watch the video / read the transcript on YouTube.