Leslie Simpson

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Leslie O. Simpson is a retired hemorheologist from New Zealand who has researched the red blood cells of patients with myalgic encephalomyelitis (ME). According to Simpson's research in the 1980s and 1990s the red blood cells of ME patients show shape deformities that cause impaired microcirculation of the blood in the capillaries.

Non-deformable erythrocytes[edit | edit source]

Simpson became interested in ME as some of the disease symptoms were suggestive of impaired microcirculation. In 1986 he reported impaired filtration of red blood cells in a sample of ME patients. His pioneering paper suggested ME to be “associated with changes in blood rheology which could impair microcirculatory blood flow.”[1] This study sparked the interest of T.M. Mukherjee and colleagues in Australia. In a letter published in The Lancet, they reported red cell deformities in some ME patients that they had never seen before.[2] The report by Mukherjee was however criticized for not using a proper control group. Lloyd et al. tried to replicate the findings in 12 patients with CFS and 10 healthy controls, but found that most of the cells from patients and controls had normal, smooth biconcave morphology.[3]

Interest in blood cell deformity and impaired circulation in ME patients waned with only Simpson publishing about the topic. In a 1989 study he compared a large sample of patients with (self-reported) ME with multiple sclerosis (MS) patients and healthy controls. Samples from subjects with myalgic encephalomyelitis had the lowest percentages of normal shaped red cells and the highest incidence of cup-shaped forms.[4] Through collaboration with ME organizations in New Zealand, Australia, South Africa and England, Simpson managed to test more than 2000 ME patients. Once again he found red cell shape transformation. “The results reported here, he wrote, “would support a proposal that ME is a hemorrheological disorder in which symptoms are manifestations of the consequences of impaired capillary blood flow.”[5] Because the study was uncontrolled, the British Journal of Haematology refused to publish it.

Ramsay's disease[edit | edit source]

In 2013 Simpson published a book with ME-patients and psychotherapist Nancy Blake called Ramsay’s disease: Myalgic Encephalomyelitis (ME) and the Unfortunate Creation of 'CFS'. In the book Simpson explains his theory of red blood cell deformability and capillary restriction in ME. He thinks this biological mechanism could account for the characteristic relapsing course Melvin Ramsay noted in patients with ME. According to Simpson “It would be very difficult to imagine a disease process caused by a persistent viral infection or a persisting immunological aberration, which allowed a return to normality for hour, days or weeks.”

Although Simpson thinks erythrocyte deformability is a key element of ME he does not see it as something unique to this disease. He wrote that “the changes in red cell shape populations which occur in ME also occur in other chronic disorders so red cell shape analysis alone is not diagnostic for ME. The observed changes are probably of importance in the pathogenesis of tiredness.”[6] Simpson had previously reported about red blood cell changes in multiple sclerosis and other diseases. Simpson does thinks red cell deformity is an important pathological mechanism in ME and he recommended research into treatment, to focus on the issue of blood circulation. Simpson suggested that evening primrose oil could improve the flow properties of blood.[6]

See also[edit | edit source]

References[edit | edit source]

  1. Simpson, L. O.; Shand, B. I.; Olds, R. J. (Apr 1986). "Blood rheology and myalgic encephalomyelitis: a pilot study". Pathology. 18 (2): 190–192. ISSN 0031-3025. PMID 3093959. 
  2. Maros, K.; Smith, K.; Mukherjee, T. M. (Aug 8, 1987). "ABNORMAL RED-BLOOD-CELL MORPHOLOGY IN MYALGIC ENCEPHALOMYELITIS". The Lancet. 330 (8554): 328–329. doi:10.1016/S0140-6736(87)90909-3. ISSN 1474-547X. 
  3. Bajenov, N.; Collings, A.; Mcgrath, M.; Isbister, J.; Smith, L.; Wakefield, D.; Lloyd, A. (Jul 22, 1989). "RED BLOOD CELL MORPHOLOGY IN CHRONIC FATIGUE SYNDROME". The Lancet. 334 (8656): 217. doi:10.1016/S0140-6736(89)90399-1. ISSN 1474-547X. 
  4. Simpson, L. O. (Mar 22, 1989). "Nondiscocytic erythrocytes in myalgic encephalomyelitis". The New Zealand Medical Journal. 102 (864): 126–127. ISSN 0028-8446. PMID 2927808. 
  5. Simpson LO, Herbison GP. The Results from Red Cell Shape Analyses of Blood Samples From Members of Myalgic Encephalomyelitis Organisations in Four Countries. Journal of Orthomolecular Medicine. 1997;12(4):221-226.
  6. 6.06.1 Simpson LO. Myalgic Encephalomyelitis (ME): A Haemorheological Disorder Manifested as Impaired Capillary Blood Flow. Journal of Orthomolecular Medicine. 1997;12(2):69-76. 

myalgic encephalomyelitis (ME) - A disease often marked by neurological symptoms, but fatigue is sometimes a symptom as well. Some diagnostic criteria distinguish it from chronic fatigue syndrome, while other diagnostic criteria consider it to be a synonym for chronic fatigue syndrome. A defining characteristic of ME is post-exertional malaise (PEM), or post-exertional neuroimmune exhaustion (PENE), which is a notable exacerbation of symptoms brought on by small exertions. PEM can last for days or weeks. Symptoms can include cognitive impairments, muscle pain (myalgia), trouble remaining upright (orthostatic intolerance), sleep abnormalities, and gastro-intestinal impairments, among others. An estimated 25% of those suffering from ME are housebound or bedbound. The World Health Organization (WHO) classifies ME as a neurological disease.

myalgic encephalomyelitis (ME) - A disease often marked by neurological symptoms, but fatigue is sometimes a symptom as well. Some diagnostic criteria distinguish it from chronic fatigue syndrome, while other diagnostic criteria consider it to be a synonym for chronic fatigue syndrome. A defining characteristic of ME is post-exertional malaise (PEM), or post-exertional neuroimmune exhaustion (PENE), which is a notable exacerbation of symptoms brought on by small exertions. PEM can last for days or weeks. Symptoms can include cognitive impairments, muscle pain (myalgia), trouble remaining upright (orthostatic intolerance), sleep abnormalities, and gastro-intestinal impairments, among others. An estimated 25% of those suffering from ME are housebound or bedbound. The World Health Organization (WHO) classifies ME as a neurological disease.

myalgic encephalomyelitis (ME) - A disease often marked by neurological symptoms, but fatigue is sometimes a symptom as well. Some diagnostic criteria distinguish it from chronic fatigue syndrome, while other diagnostic criteria consider it to be a synonym for chronic fatigue syndrome. A defining characteristic of ME is post-exertional malaise (PEM), or post-exertional neuroimmune exhaustion (PENE), which is a notable exacerbation of symptoms brought on by small exertions. PEM can last for days or weeks. Symptoms can include cognitive impairments, muscle pain (myalgia), trouble remaining upright (orthostatic intolerance), sleep abnormalities, and gastro-intestinal impairments, among others. An estimated 25% of those suffering from ME are housebound or bedbound. The World Health Organization (WHO) classifies ME as a neurological disease.

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