Failure to Detect XMRV = Failure to use good science
Written by Andrea Pring 6th January 2010
A study co-authored by psychiatrist, Professor Simon Wessely, investigating the possibility of XMRV infection in CFS patients in the UK, has reported negative results.
The study is the first since the groundbreaking news publicised by scientists at the Whittemore Peterson Institute, the National Cancer Institute and Cleveland Clinic of the incidence of a retrovirus known as XMRV in 67% of their CFS patient sample. The results were published in the prestigious journal Science in October 9th 2009 to worldwide critical acclaim.
The new study conducted by British psychiatrist, Simon Wessely, published on Jan. 6 2010 in the open access online journal PLos ONE, tested 186 patients - all referrals to the CFS clinic at King’s College Hospital, London - who had undergone minimal medical screening to exclude them from other illnesses. The patients were also given the Chalder Fatigue Questionnaire to determine their level of disability.
According to the study, “The patient set studied is a well-characterised and representative sample of CFS patients who have been described previously: all were routine clinic attendees, referred within the UK National Health Service, who had taken part in prior studies of neuroendocrine functioning and/or of cognitive behaviour therapy.”
DNA extracted from the blood of 186 CFS patients was “screened for XMRV provirus and for the closely related murine leukaemia virus”.
Although the study did use positive and negative controls it did not follow the lead of the initial Lombardi et al. study and test the blood of healthy individuals as a clinical control. Other pertinent differences include the use of different blood sample volumes and processing, patient selection criteria, number and type of tests completed and the use of disparate primer sequences that amplified different regions of the XMRV proviral DNA.
The ‘tick-sheet’ style Chalder Fatigue Questionnaire used to garner samples that met the ‘international consensus criteria for CFS’ consisted of questions such as Do you have problems with tiredness? Do you feel sleepy or drowsy? Do you have problems starting things? This type of tiredness has no relevance to the true disabling nature of ME/CFS but is likely to relate to those who suffer from depression-related tiredness or those with undetected thyroid and adrenal issues which often elude the minimal testing given to UK patients. The structure of the questionnaire undoubtedly allowed the inclusion of individuals suffering with clinical depression. Severely ill patients (25% of all patients) are not factored in due to their severity and lack of physical mobility making it difficult to reach one of the NHS Specialist ME/CFS centres. This exclusion of the very ill will skew the results.
Those involved in the Lombardi et al. study had previously called for restraint and the need for tightly regulated studies that replicate the work of the initial study with exactness in order to ensure accuracy.
The way in which the Wessely study was executed would indicate that it did not seek to replicate the Lombardi et al. study in line with other studies currently being conducted, but would seem to have been done simply to confound the results and attempt to deflect positive public opinion and funding.
A statement from the Whittemore Peterson Institute sums up the Wessely study by saying “The WPI study was published after six months of rigorous review and three independent lab confirmations, proving that contamination had not taken place and that infectious XMRV was present in 67 percent of CFS patients diagnosed according to the Canadian and Fukuda criteria. In contrast, this latest study was published online after only three days of review. Significant and critical questions remain as to the status of patient samples used in the UK study as those samples may have been confused with fatigued psychiatric patients, since the UK has relegated “CFS” patients to psychiatric care and not traditional medical practices.”
The initial findings by those of the Whittemore Peterson Institute and collaborators are likely to have a profound effect on the understanding of the nature of this illness and bring hope to millions worldwide. The psychiatric health procedures used in the UK to ‘cure’ sufferers of their abnormal illness beliefs will doubtless to be seen as outdated and unscientific in comparison to the work currently being conducted in the US and Europe. In my opinion, the direct comparisons highlight the need to bring an end to two decades of corrupt and harmful medical care in the UK; Wessely and his fellow psychiatrists who have consistently denied the illness and oftentimes derided sufferers, calling them such names as 'the undeserving sick of our society', may well face a bleak future if they don't embrace the true nature and magnitude of this illness.
Erlwein O, Kaye S, McClure MO, Weber J, Willis G, Collier D, Wessely S, Cleare A. (2010) Failure to detect the novel retrovirus XMRV in chronic fatigue syndrome. PLoS ONE 5(1):e8519. doi:10.1371/ journal.pone. 0008519