Trial Report A multicenter virome analysis of blood, feces, and saliva in myalgic encephalomyelitis/chronic fatigue syndrome, 2023, Briese et al.

A multicenter virome analysis of blood, feces, and saliva in myalgic encephalomyelitis/chronic fatigue syndrome
Thomas Briese; Rafal Tokarz; Lucinda Bateman; Xiaoyu Che; Cheng Guo; Komal Jain; Vishal Kapoor; Susan Levine; Mady Hornig; Alexandra Oleynik; Phenix-Lan Quan; Wai H. Wong; Brent L. Williams; Suzanne D. Vernon; Nancy G. Klimas; Daniel L. Peterson; Jose G. Montoya; Walter Ian Lipkin

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is estimated to affect 0.4%–2.5% of the global population. Most cases are unexplained; however, some patients describe an antecedent viral infection or response to antiviral medications. We report here a multicenter study for the presence of viral nucleic acid in blood, feces, and saliva of patients with ME/CFS using polymerase chain reaction and high‐throughput sequencing. We found no consistent group‐specific differences other than a lower prevalence of anelloviruses in cases compared to healthy controls. Our findings suggest that future investigations into viral infections in ME/CFS should focus on adaptive immune responses rather than surveillance for viral gene products.

Link | PDF (Journal of Medical Virology, paywall)

 

Whilst the study is very much appreciated, to me this doesn't rule out the value of studying a pathogen. Conduct the same study for post-Ebola and your results will also be negative.

 

Tissue.
Most arguments re viral persistence are that it's tissue that provides the reservoir.
Some COVID research has turned up viral evidence in tissues I believe.

Not so easy to look at .

 

Which is why non-invasive strategies, such as [18 F]F-AraG-labelled activated T cell PET imaging, could be really helpful. They can guide focus to biopsy-accessible tissue reservoirs (eg gut) or at least indicate troubled but biopsy-inaccessible regions (eg CNS). See —

Multimodal Molecular Imaging Reveals Tissue-Based T Cell Activation and Viral RNA Persistence for Up to Two Years Following COVID-19 (2023)

and for background on [18 F]F-AraG —

Biodistribution of a Mitochondrial Metabolic Tracer, 18FF-AraG, in Healthy Volunteers (2022, Molecular imaging)
Imaging of Activated T Cells as an Early Predictor of Immune Response to Anti-PD-1 Therapy (2019, Cancer Research)

 

It does make me question the value of ME/CFS patients getting tested for viruses with blood samples in labs like Armin labs. [like I do with their tick-borne infection testing],

 

When someone says not to test for viruses or bacteria or parasites, it makes me want to test for those all the more - especially in tissue, which someone once said not to bother testing.

I wonder how many patients were in this cohort, and what their demographics were.

Did they only test for viruses? No bacteria or parasites or mold?

And btw, cool list of authors - like a Who's Who of US ME/CFS researchers/clinicians.

I have to add that it seems to me highly improbable that NO ME/CFS patients will have active persistent infections, even if immune dysregulation proves to be the main culprit. I have to believe it's just a question of how large a portion can eventually demonstrate those persistent infections.

 

So does this mean that "viral persistence" in ME/CFS most likely does not exist? @Jonathan Edwards could you comment please ?

 

Is this is the study you are referring to? to https://www.medrxiv.org/content/10.1101/2023.07.27.23293177v1.full.pdf+html

From the abstract :

 

Thanks @mariovitali .
I don't know if it is - will read later after some strong coffee.
The T cell activation is a documented COVID consequence - even asymptomatic infections .
Dosnt bode well , especially for kids .

 

Tissue was not tested but I wonder if a virus was there if it would not leave traces in the blood and elsewhere. As somebody noted: "The question is what these viruses can do while replicating at such a low frequency that they are not detected in the blood.

 

I know some viruses have a tropism for tissue, e.g. influenza A toward the lungs, but I'm not sure about traces that serology would detect. I do know, however, that some bacteria are tissue-tropic and traces are next to impossible to find in the blood and waste. PCR is hit or miss. Antibody responses may or may not be there. Etc. etc. That doesn't mean the bacteria aren't causing disease in some area like the brain. Shy of a biopsy, however, or if fortunate, a CSF hit, the patient might never know.

 

Think Jonathan has used the example of shingles --- once your immune system isn't functioning then the virus reappears --- so why hasn't it reappeared in ME/CFS?
Seem to recall Jonathan posting [last few days?] that viral persistence in the gut could explain covid symptoms? So perhaps there's a possibilty that persistence in gut would go unnoticed yet provoke symptoms?

 

“More explorations of viruses in ME/CFS”

@MEResearchUK summary for laypeople of “A multicenter virome analysis of blood, feces, and saliva in #myalgicencephalomyelitis/#chronicfatiguesyndrome”

https://www.meresearch.org.uk/more-explorations-of-viruses-in-me-cfs/

 

Wow!