Immune cell phenotyping of blood obtained from ME/CFS patients (in INMEST trial) using mass cytometry

To understand the underlying immune system perturbation in ME, and investigate any potential changes correlating with treatment response, we collected blood samples at baseline before treatment, after phase 1 (4 weeks), and after phase 2 (8 weeks). To minimize technical variation samples were prepared directly at blood draw and cells frozen in whole blood stabilizer solution (Cytodelics), plasma centrifuged and frozen, and whole blood bulk mRNA stabilized and frozen. We performed immune cell compositional and phenotypic analysis using mass cytometry, plasma protein analysis by Olink assays and mRNA-sequencing to gather different perspectives of the global immune system states in the ME-patients at each time point.
Conclusion:
In a randomized, placebo-controlled trial of intranasal mechanical stimulation (INMEST) that targets the inflammatory reflex, a 30% reduction in symptom severity was achieved in patients with moderate to severe ME. Immunological correlates of improvement was measurable in blood using systems-level monitoring, and reveal immune perturbation in ME as well as an impairment of immune cell metabolism that is also mitigated by INMEST treatment.