Sunday, October 17, 2010

ILADS conference 2010 - Dr. Jose Montoya

Dr. Jose Montoya of Stanford gave a lecture at the ILADS conference entitled ‘Viral Induced CFS – the Stanford Perspective”.

Dr. Montoya has not been seen on the ME/CFS lecture circuit since the June 2008 HHV-6 conference. Dr. Montoya was “the main squeeze” at that conference when he gave a much anticipated preliminary report on the Roche-sponsored Valcyte trial of 30 patients - 20 treated patients and 10 controls. The report delivered that day was a great disappointment to many of the ME/CFS patients as the trial failed to confirm the previously very positive reports from several smaller pilot studies. In the Roche study preliminary report, fatigue improvement came up short. However the majority of treated patients did have significant cognitive improvement. Dr. Montoya indicated that much more analysis of the results was necessary. As far as the Patient Advocate knows, no update of this study was presented until this ILADS lecture. Through a complex statistical analysis Dr. Montoya seemed to establish that Valcyte treated patients improved in fatigue categories in several categories compared to placebo. Cognitive improvement was also noted.

In these studies Dr. Montoya used elevated IgG antibodies to EBV and HHV-6 as diagnostic markers and also as measures of improvement. The hope was that these elevated antibodies would recede with treatment, and that they could be “read”.
Dr. Montoya presented data of movement, up or down in a predictable fashion, of neutrophils and monocytes with Valcyte treatment in various patient populations.

In a bit of a surprise, Dr. Montoya reported on more recent efforts at Stanford to develop a cytokine profile to be used as both a diagnostic treatment marker and to measure treatment improvement. Dr. Montoya thinks that he is close to publishing this work, but he wants to make sure “that he gets it right”. Dr. Montoya indicated that he was interested to make his raw data available on the Internet (to pre-screened individuals). In other words, Dr. Montoya is willing to share information.

Two other groups, one with Kilmas and one at the WPI, are working on cytokine/chemokine marker/trackers. The Patient Advocate believes that immunological markers for tracking treatment progress will be published in the coming months. Whether these separate efforts have any continuity will be seen. Whether there has been any cooperatation between these three groups is unknown. If not, the Patient Advocate wonders why not?

The Patient Advocate asked Dr. Montoya if he knew Dr. Dale Guyer -and Dr. Montoya said no. The PA asked Dr. Montoya if he worked with Dr. Brewer and he said no. The Patient Advocate thinks this is going to change. Dr. Montoya works at Stanford in virtual isolation. His colleagues at Stanford have never been overly excited about his work in ME/CFS. Recently it has been reported that he is working with Dr. Lerner. Various people are reaching out to Dr. Montoya to get him more tightly involved in future diagnostics and treatment of ME/CFS. This doctor is one of the very best, a real human being. If Dr. Montoya can develop his own cytokine signature, he will most likely begin trials of the most advanced treatment ideas. Dr Montoya is a courageous and humanistic doctor who wants to help patients.

The PA asked Dr. Montoya if he were testing his patients for XMRV. He said no, but that Stanford was developing its own test. The PA asked him why didn’t he just use the one from VIPdx? To the Patient Advocate this seems the most logical solution - to lease the test from VIPdx. Why reinvent the wheel?

The Patient Advocate assumes Dr. Montoya’s work will be published. It was terrific to see this very sympathetic and serious doctor/researcher giving a public lecture again. The Patient Advocate looks forward to a greater role for Dr. Montoya in future diagnostics and treatment. We need this man to take a larger role.

9 comments:

  1. thanks for reporting on dr. montoya.

    did you see dr. kogelnick's presentation also.

    if so, can you share what he said...either here or thru pm
    lgrasso_hawaii@yahoo.com

    thanks soooooo much.

    warmest regards

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  2. I'm pretty sure Dr. Montoya is using VIPDx as I'm one of his patients:) I'll bet he can't say anything for research purposes.

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  3. VIP Dx' test is a commercial test, not a clinical test. After the reports of so many (false) negatives, patients tested with a previous test have to be retested again. So it is no surprise that for research they are looking for more reliable means to test.
    Anyway, right now an immunological signature and/or cytokine signature looks more promising to raise awareness and acceptance in the medical community than a positive XMRV or MLV test.

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  4. Lerner is involved in XMRV research. Unfortunately because of the nature of research, he can't divulge it yet. And neither can his patients. Would have been nice to hear at the CFSAC Science Day. Lerner has also worked closely with Montoya. So I would suspect that Montoya will be involved, if not already.

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  5. Who besides RED Labs to date has used the "WPI-Dx" test? Very few. Not enough money in it. Just like drug companies, to heck with us: it's more profitable to make one's own variant.

    This is great news that Montoya and Lerner are working together; I now hope they're holding ears with Ron Glaser, who showed at CFSAC there may be other testable virus parameters.

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  6. Thanks again, Chris - was this "In a bit of a surprise, Dr. Montoya reported on more recent efforts at Stanford to develop a cytokine profile to be used as both a diagnostic treatment marker and to measure treatment improvement" referring to CFS?

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  7. Cort, Yes this was for CFS. I think Montoya, like others, is looking for a better diagnostic and treatment tracking (improvement) markers for CFS patients. I can only surmise that he found the elevated titers idea for EBV and HHV6 too unreliable and unpredictable. His efforts to develop a cytokine panel is very close to being finalized I believe. This effort parallels efforts of Klimas and Mikovits to get something to track treatment. I see this in all three cases as a necessary step to small treatment trials of antiretrovirals for CFS patients.
    Chris

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  8. consuegra,

    "The report delivered that day was a great disappointment to many of the ME/CFS patients as the trial failed to confirm the previously very positive reports from several smaller pilot studies."

    This is all a bit vague. Can you elaborate a bit on this part or do you know where i can get more specific information on these results ?!

    Thanks
    Aruschima

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  9. Good to hear your report on Montoya....I LOVE IT that he is not on the lecture circuit..forgive me for saying this! but.....he is with his patients and in his lab. If you have been to Stanfords laboratories..where he loves and wants to be..it makes sense to have patients blood drawn right there at Stanford, although they will develop the test with an outside source. The new tests are SO COMPLEX, yet Stanford has the whole patient appointment, customer service, bloodwork ease thing going on.....they have really streamlined medical management and going there is not stressful at all. (I have 4 specialists there as well as Scripps and other facilities) I can only imagine how well WPI will be run...cannot wait to go there....As far as Lerner and Montoya collaborating.....I have papers dating back to 2006 where Montoya was citing lERNERS WORK. tHIS IS NOT A NEW THING.....AND HE IS working with the Columbia University Virus headhunters...closely....looking at tick borne diseases....think Bacterium, micoplasmas, cytokines and TNF.....plus 12-16 other co-infections plus EBV, CMV, HHV-6, XMRV and mold and toxin and nutrient issues.....it is beginning to look like a chess board to me. I have a copy of the 2006 study...I will scan it and insert it into my next Blog Part #2 in the next few days.....that might be valuable for patients to check out. I pray you and yours are well...Best, Julia

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