Jarred Younger–Daily fluctuations in cytokines in CFS/ME

This is a novel way of looking at the immune system. i.e—tracking symptom variability comparing good days and bad days and cytokine levels. We need to be able to track something in the blood, and this could be a potential target for new drugs. Cytokine levels may correlate with symptoms. Fluctuating levels may influence symptoms. There are now free programmes/apps to track symptoms over 25 days. Blood is then needed for 25 consecutive days, but with tiny needles and skilled phlebotomists, this need not be too difficult. Classic cytokines and chemokines can be measured.

His team had looked at 3 women with fibromyalgia, and found that leptin levels correlated in all three with symptoms. They then looked at 10 women with CFS/ME, and found that leptin levels correlated with fatigue in 6 of the 10. Comparing with 10 healthy women there was minimal correlation. A network analysis of all cytokines relating to fatigue was done, and leptin was the only one that significantly correlated.

Leptin was three times higher in females than males. It comes from the white fat tissue and is increased in stress and is very "inflammatory."

The microglia are the primary defence in the CNS. Firing leads to a pro-inflammatory state, which makes a person feel ill – this is a normal "sickness response." Microglia can be primed by aging, genetics etc and this can lead to over-expression. The astrocytes take over once the microglia are activated. Leptin crosses the blood-brain barrier and primes the microglia (lowers the threshold). If hit by TNFalpha, leptin increases the vulnerability of the microglia.

He then asked the question "What next?"—leptin antagonists—there are many possibilities, but this is not applicable yet. But cardiac hormones and some antihypertensives do have anti-leptin effects. He noted too that leptin suppresses the appetite. Leptin levels decrease with avoidance of stress.

Modulators of leptin include: naltrexone, minomycin, dextromethorphan, rimfampicin, ceftrixone. A number of natural compounds have the potential too such a tumeric, reservatrol and stinging nettle, but none have been tested.

A biobank is needed, so that more analyses can be done. He noted that leptin can be measured in saliva.