Dr Bansal was very interested in the NK findings and whether the EBV is important in these results. EBV can stop the development of memory function in the immune system which will impact on overall functioning (vaccinations work via this memory function). Therefore, in individuals with CFS/ME the recurrent infections, sore throats, viral-type symptoms may be due to this lack of memory function. Dr. Bansal has carried out some work in the field of infertility and is currently looking at patients with CFS/ME when they are well AND when they are unwell. This design has not been used before and it could lead to some very interesting results. →

Sleep research

Non-restorative sleep is commonly reported by patients but it is still unclear why this happens. Drugs may help in the initiation of sleep but not the maintenance throughout the night. Dr. Bansal applied for a grant to look into this from the MRC but was turned down. The costs of such a study are high as over-night sleep analysis is around £300-500 per patient and each patient would need to be tested on a number of occasions.

Alternative treatments

Dr. Bansal mentioned the Lightening Process and thought that it may only be beneficial to the mild and moderately affected but as there is no research on the topic, no conclusions could be made. He also thought the eye-movement desensitisation technique was interesting but probably only useful for mild/moderate cases. His thoughts on the Gupta methods were along the same lines. His beliefs for how these therapies might work relate to the role of memory and how some people with CFS/ME experienced a stressful event around the time they became ill. This stressful situation would have increased levels of cortisol and adrenaline and this could have increased the perception and memory at the time. Subsequently, intrusive memories could possibly cause symptoms later when the mind goes over the events and this could result in fatigue.

Dr Bansal expressed his concerns over costly treatments and mentioned a recent patient who told him about his experiences with Dr Melier. This patient had a positive urine test but it seems that everyone comes out with a positive result from this test. The clinic seems to encourage patients to pay for many further tests and the benefits of these are unknown (but expensive; this patient spent €1,300 in total).

Other treatments Dr Bansal mentioned included:

Green odor – favoured by Japanese investigators (green leafy vegetables containing hexanol and hexanone).

D-Ribose – 5 carbon sugar required for DNA/RNA synthesis and in energy production.

Carnitine (acetyl-carnitine required for GABA synthesis and for neuronal energy production).

Magnesium-S-adenosylmethionine - some evidence as to its benefit but large DBRCTs lacking.

Proposed in-patient unit

Dr. Bansal is trying to gain approval to set up an in-patient unit similar to the one within the Essex Neurological Centre, Romford. Almost all published research has only looked at mild and moderate cases of CFS/ME even though some of the most important information can be gained by looking at the severely affected. He has been given approval by his line-manager but is waiting for the go-ahead from the hospital manager.

Genomics

Jonathan Kerr at St. Georges Hospital has found differential expression of 88 genes in those with CFS/ME compared with healthy controls and those with depression. 85 genes were increased and 3 genes were reduced and could be clustered into 7 subtypes. These included several genes involved in immune function and these include APP, XCR4, FNTA, IL6ST and TNFR. Further work needs to be done including an assessment of these genes when patients with CFS/ME are well and when they are in a relapse.