XMRV Replication Study
Independent confirmation of the relationship between XMRV and ME/CFS in Sweden
Prof Jonas Blomberg and Prof Carl-Gerhard Gottfries
Sect of Clinical Virology, Uppsala University Hospital, Uppsala, Sweden; Institution for Neuroscience and Physiology at the Sahlgrenska Academy, Gothenburg University, and Gottfries Clinic, Mölndal, Sweden
ME Research UK and the Irish ME Trust are providing joint funding for this important study.
Background and aims
The discovery of a retroviral link to ME/CFS, reported in the major journal Science on 8th October 2009, has the potential to greatly advance diagnosis and treatment of the illness (see MERUK overview essay, XMRV and ME/CFS — A Stunning Find. The major finding was that DNA from the XMRV virus could be detected in the peripheral blood mononuclear cells of over two-thirds of ME/CFS patients’ samples from the blood bank in the Whittemore Peterson Institute Tissue Repository , but in less than 4% of healthy control samples. Also, the researchers reported that XMRV proteins were being expressed in blood cells from ME/CFS patients at very high levels compared with controls, and that patient-derived XMRV was infectious and transmissible.
These findings have caught the attention of the scientific world, but the next steps are equally important. Chief among these is for independent laboratories across the world to replicate these findings in their own local populations of ME/CFS patients – it’s sometimes said that replication studies are where the rubber meets the road in science! Since the WPI researchers used samples selected from several regions in the US where "outbreaks of CFS" had been documented (using patients diagnosed on CDC-1994 and Canadian Clinical Criteria 2003, blood samples from patients in other areas or countries might throw up very different results. Will ME/CFS samples from other regions of the US show similar high rates of positivity? What about European samples?
This replication study is one attempt to answer this question – to establish whether XMRV nucleic acid can be found in peripheral blood mononuclear cells, plasma and serum of Swedish patients and controls. The researchers will retrospectively test previously stored patients’ samples (20 Fukuda-defined ME/CFS, 20 fibromyalgia, 20 irritable bowel), and 20 controls. In addition, they will prospectively test samples from 120 ME/CFS (defined on the Fukuda 1994 and the Canadian 2003 criteria, similar to patients in the original 2009 report in Science) who will also have functional assessments.
The investigators are well-placed to conduct this confirmation study. Prof Jonas Blomberg is head of The Research Group of Clinical Virology at the University of Uppsala, and his research interests include human endogenous retroviruses; the links between endogenous retroviral sequences (ERVs) of the human genome and diseases such as multiple sclerosis and schizophrenia; and the development of real time PCRs for common viral infections.
Professor Carl-Gerhard Gottfries is Professor Emeritus at the Sahlgrenska University Hospital, Mölndal, and founder of the Gottfries Clinic which was formed in Västra Götaland 1998 for patients with fibromyalgia and ME/CFS, and which is now situated in Mölndal. The unit has three doctors, nurses and medical secretaries, and it has also conducted basic clinical research, including trials of immunomodulatory therapy for FM and CFS.
The results of this important replication study should be available in late 2010.