Friday, May 27, 2011

The Latest XMRV Study

By now, many of you have probably heard about the latest study on XMRV in ME/CFS, conducted by Dr. Singh and published in Journal of Virology a few weeks ago.  I apologize for the late posting on this, but I wanted to gather information and opinions from several sources, especially a response from the Whittemore-Peterson Institute, before attempting to explain it.

So, here's the scoop, in brief:
  • Singh and her colleagues reported in the May 4, 2011, issue of Journal of Virology that they were unable to find any evidence of XMRV in any of the ME/CFS patients they tested.  What sets this study apart from many of the other negative studies is that Dr. Singh expected to find XMRV, consulted with Dr. Mikovitz, author of the original XMRV study at WPI, and used multiple methods to try to detect XMRV.  They analyzed blood samples from 100 ME/CFS patients and 200 healthy controls.  Even Dr. Mikovitz said she was "astounded" that Dr. Singh didn't find XMRV.  Dr. Singh also says she had problems with contamination.  Here is an article from Science that summarizes the study pretty clearly.
  • Though this sounds pretty grim, Dr. Mikovitz issued a response from WPI (to read it, scroll down to May 9 on this News page).  She clarifies some misconceptions about the Singh study and continues to defend her original positive XMRV study, published in Science last October.  She also further explains how WPI has made sure that there are no contamination issues in their lab.
  • Suzanne Vernon, Scientific Director of the CFIDS Association issued a detailed analysis of the Singh paper that explains the methods and approach used, as well as the results.  In her conclusion, she explains that the two huge multi-center studies of XMRV in blood sponsored by the Department of Health & Human Services (DHHS) are still going forward and that no matter how things turn out, WPI has done some amazing work and XMRV has brought much-needed attention to ME/CFS from the scientific community and the general public.
  • The International ME Association also issued its own analysis of the new study.  This is a highly technical document that delves into the details of the methods used in the Singh study.  Its conclusions suggest that the testing methods in this study were not adequate to detect XMRV.
  • While all this arguing is going on, WPI has published a new study that found a unique immune response in ME/CFS patients with XMRV, which would seem to provide new evidence for XMRV's role in ME/CFS.
So, once again, we have an XMRV study with multiple differing views of its outcome.  I'm not a virologist and don't understand the details of all the technical arguments over methodology, but it seems clear to me that these issues are not yet settled.  Certainly, I hope that WPI is right about XMRV - that would mean some answers for us, finally - but they still need to convince the scientific community.  Perhaps this new study on immune response will help.

Bottom Line:  Unfortunately, it seems to be more of the same - wait and see.  WPI continues its work into the role of XMRV in ME/CFS, the DHHS is moving forward (albeit slowly, at the pace of government) on its huge, multi-center studies of XMRV in ME/CFS, and we just have to be patient and wait for the scientific community to work it all out.

6 comments:

  1. Thank you Sue for this info. Good to read such a detailed summary. Thanks!

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  2. Wow. This is really interesting!! I am amazed at the info you find and post here. Thanks so much.

    I tried to reply to your post on my blog and was unable to. I so appreciate your words of encouragement and support. I was having a really bad day and I honestly can't believe I posted all that.... I am much better today. The problems arent gone, but my outlook has certainly improved. And I will ask my doc about being tested. I think I was in 94 but really cant remember now... Thanks so much!!

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  3. Thanks so much for summarizing this, Sue. It's such a service to all of us. Somehow I missed the results of this new study. Now I feel caught up thanks to you!

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  4. You're so good at distilling this confusing information into the most pertinent points. Thank you so much for the analysis. And yep, we'll keep waiting!

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  5. Anonymous3:57 PM

    Why is the CFS community so convinced that Science is wrong in retracting this paper? Dozens of studies have attempted to find XMRV, and almost none of them have found it in even trace amounts. These are big-named, reputable researchers we're talking about. Like the co-discoverer of HIV, for example. Why does one tiny lab at an independent research institute have more credibility to the CFS community than all the other labs in the world?

    It is the responsibility of Science, as a very respected research journal, to retract publications that seem likely to be faulty. If they don't, they will quickly lose their credibility. If 28 studies cannot replicate the original findings of the paper, it is unlikely that the 29th or 30th will. It's not like the journal asked for a retraction after the first few studies failed to duplicate the results - they waited until it started looking a little suspicious. Not to mention the stuff along the way, such as the lack of genetic variability in the XMRV strains 'found' by WPI, suggesting the strain was created in a lab. Or the discovery by other researchers that XMRV is quickly inactivated by the immune system (I know, I know, CFS patients have abnormal immune systems, but it is still incredibly unlikely). I seriously doubt this is a 'conspiracy' towards CFS patients - I think a retraction request would happen to ANY paper in ANY discipline which couldn't be replicated in a reasonable amount of time, especially one like this, with dozens of reputable researchers attempting to do so. Why exactly is this viewed as a personal attack? If it is a government conspiracy, why can't the UK replicate it either?

    It would be great if XMRV was the cause of chronic fatigue syndrome. But it seems pretty unlikely at this point that it is. XMRV is not just lurking around, hiding from all researchers besides the WPI. This isnt the end of XMRV, anyway - there are still a few studies that have yet to be completed. And the WPI should find a way to replicate their study with blinded samples.

    And, in the unlikely event that XMRV is found consistently, I'm sure Science will be happy to admit they were wrong. That is, when one other lab in the world besides WPI is able to find it.

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  6. Anonymous -

    I think the issue isn't whether or not WPI is right about XMRV...the issue is that Science's request to retract the paper is premature and highly unprofessional.

    The only thing completely clear at this point is that there are still a lot of unanswered questions. For instance, if XMRV is all due to contamination, then why are patient samples overwhelmingly positive while control samples show only 4-7% positive?

    In any case, Science's request to retract the paper would cut off the debate before it has been resolved...and that flies in the face of all basic tenets of scientific research. Clearly, this was a move based solely on politics, not on science - and that is a very disturbing thing to see from one of the world's most foremost scientific publications.

    Sue

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