Role of pharmacological activity of autoantibodies in ME/CFS

肌痛性脑脊髓炎/慢性疲劳综合征（ME/CFS）是一种以极度疲劳、记忆障碍、疼痛和其他症状为特征的疾病，这些症状因患者而异。它影响约0.9%的人口，通常由急性病毒或细菌感染引发，如EB病毒。ME/CFS的潜在生理和分子基础尚不清楚，也没有有效的治疗方法。一种提出的机制是，血流被针对参与血流调节的受体的自身抗体改变。抗体是由免疫系统产生的，以识别入侵者，在正常情况下，我们的免疫系统被训练不会攻击我们自己的组织。然而，在严重感染期间，免疫系统采用“所有人都在甲板上”的方法，这导致一些新产生的抗体逃避质量控制并靶向我们自己的组织，即自身抗体。调节血流的受体位于血管壁中，并随着组织（如大脑或肌肉）对氧气和营养物质的需求变化而导致血管扩张或收缩。研究发现ME/CFS患者中这些自身抗体的水平增加，并且使用称为免疫吸附的技术从血液中去除这些自身抗体的初步试验显示症状有所改善。在这个项目中，我们将测试这样一个假设，即自身抗体可以激活或抑制负责血流调节的受体，就像医疗药物用于调节血压一样。我们的目的是分析325名ME/CFS患者和130名健康人的血清样本，以确定是否存在针对所有30种参与血压调节的受体的自身抗体。重要的是，我们将研究在每个样本中检测到的自身抗体激活或抑制这些受体的能力，以检验这些自身抗体的活性是疾病的决定性因素的假设。如果我们的假设是正确的，我们将能够开发一种准确的血液检测，可以更早地检测ME/CFS或独立地确认诊断。最终，我们希望这些结果也可能表明一种可能的治疗干预途径，以抵消自身抗体的影响，并使用现有药物的组合缓解ME/CFS症状，具体针对每个病例。

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a condition characterised by extreme fatigue, memory impairment, pain and other symptoms that vary from patient to patient. It affects about 0.9% of the population and is often triggered by an acute viral or bacterial infection, such as Epstein-Barr virus. The underlying physiological and molecular basis of ME/CFS is unknown, and no effective treatments exist. One proposed mechanism is that the blood flow is altered by autoantibodies against receptors involved in blood flow regulation. Antibodies are generated by the immune system to recognise intruders and under normal conditions, our immune system is trained not to attack our own tissues. However, during a severe infection, the immune system adopts an "all hands on deck" approach, which results in some of the newly-produced antibodies escaping quality control and targeting our own tissues, autoantibodies. Receptors regulation blood flow are located in walls of blood vessels and cause a blood vessel to dilate or contract as the demand for oxygen and nutrients to tissues such as the brain or muscles changes. Research has found increased levels of these autoantibodies in ME/CFS patients and initial trials removing these autoantibodies from the blood using a technique called immunoadsorption have shown improvement in symptoms. In this project, we will test the hypothesis that autoantibodies can activate or inhibit the receptors responsible for the blood flow regulation, in a similar way medical drugs are used to regulate blood pressure. We aim to profile serum samples from 325 ME/CFS patients and 130 healthy individuals to determine the presence of autoantibodies against all thirty receptors involved in blood pressure regulation. Importantly, we will study the ability of autoantibodies detected in each sample to activate or inhibit these receptors in order to test the hypothesis that the activity of these autoantibodies is a decisive factor in the disease. If our hypothesis is correct, we will be able to develop an accurate blood test that may be able to detect ME/CFS earlier or to independently confirm the diagnosis. Ultimately, we hope that these results may also indicate a possible route for therapeutic intervention to counteract the effects of autoantibodies and alleviate the ME/CFS symptoms using a combination of already existing drugs, specific for each individual case.