Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Efficacy of Repeat Immunoadsorption.

Abstract

(1) Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a complex neuroimmunological disease. There is evidence for an autoimmune mechanism for  ME/CFS with an infection-triggered onset and dysfunction of ß(2)-adrenoreceptor  antibodies (ß(2)AR-AB). In a first proof-of-concept study, we could show that IA  was effective to reduce ß(2)AR-AB and led to improvement of various symptoms. (2)  Five of the ME/CFS patients who had clinical improvement following treatment with  a five-day IA were retreated in the current study about two years later with a  modified IA protocol. The severity of symptoms was assessed by disease specific  scores during a follow-up period of 12 months. The antibodies were determined by  ELISA. (3) The modified IA treatment protocol resulted in a remarkable similar  clinical response. The treatment was well tolerated and 80-90% decline of total  IgG and ß(2)AR-AB was achieved. Four patients showed a rapid improvement in  several clinical symptoms during IA therapy, lasting for six to 12 months. One  patient had no improvement. (4) We could provide further evidence that IA has  clinical efficacy in patients with ME/CFS. Data from our pilot trial warrant  further controlled studies in ME/CFS.