Article: Chronic Fatigue Syndrome, Viruses, and the Innate Immune System

John Mac

John Mac

Senior Member (Voting Rights)
An article on Psychiatry Advisor by an MD Theodore Henderson.
He seems convinced that viruses are to blame for CFS/ME but whether he's right or not seeing this published on a psychiatry website is good to see.

Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) is a disorder characterized by marked fatigue, exertion induced malaise, cognitive clouding (or brain fog), impaired academic/work performance, disrupted sleep, and joint/muscle pain. Individually, these symptoms are vague and non-specific; however, in combination the clinical picture is quite reliable. Nevertheless, there is no quantitative test for CFS/ME.

As a result, CFS/ME has been much maligned by the medical community. Patients are often disparaged for being lazy, or dismissed as merely psychosomatic malingerers. As one of my patients said, “The doctor looked at me and said, ‘You’re young! You have no reason to be tired. You just need to exercise more.’ It had taken every bit of strength I had to get out of bed and walk across campus and he wanted me to exercise more. Something was wrong and nobody seemed to care!”
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https://www.psychiatryadvisor.com/h...yndrome-viruses-and-the-innate-immune-system/
 
John Mac said:
He seems convinced that viruses are to blame for CFS/ME but whether he's right or not seeing this published on a psychiatry website is good to see.
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I am less enthusiastic. This looks like a site where doctors advertise for business. The biopsychosocial people are very happy to throw in a bit of bio to spice up the narrative. For my money what matters IS whether he is likely to be right or not and I doubt it.
 
This feels like a paradigm shift is slowing growing. It's also happening on the tail end of a growing evidence base that pathogens may play a far larger role than previously known in all sorts of diseases, psychiatric and otherwise. The only clear thing is that far more research is needed and that medicine has no choice but to finally explore the "Here be dragons" part of the map.

The article touches on many topics, including Prusty's recent paper on HHV-6, but the summary points in the general direction of a need to write a new chapter to the germ theory of disease, which may begin to look more like the germ theory of health, given that germs play both a positive role and a potentially harmful one in a finely tuned balanced that is constantly challenged by exposure to more pathogens.
Herein, I lay out the proof for several important pieces of the CFS/ME puzzle.

1) HHV6 and HSV1 and therefore likely the other neurotrophic herpes family viruses can invade the brain and replicate there, potentially spreading to many neurons

2) HHV6 can integrate into the human genome

3) HHV6 partial reactivation impairs mitochondrial function, including decreased ATP production and induces a pro-inflammatory state

4) Serum from patients with CFS/ME carry the ability to impede mitochondrial function in naïve cells

5) Serum from patients with CFS/ME may carry some factor that can impart protection from viral infection to naïve cells

6) This protective factor raises exciting possibilities for a new approach to protection from COVID-19

7) The protective factor can be developed into a diagnostic assay for CFS/ME giving the first definitive test for this much beleaguered and neglected disease.

8) A definitive test is the first step to better research, more funding, and greater federal attention to CFS/ME, which affects an estimated 24 million worldwide33-35
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Thoughts this was interesting on the broader issue of a potential pathogenic cause to common psychiatric disorders:
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The elephant in the room is only getting larger with time. Turns out it may have been made of quintillions (give or take a few) of tiny germs all along.
 
Infections were downgraded in society for years to the point where people complained about it being someone's fault if a relative became seriously ill with an infection.

This attitude also became prevalent in medicine with teaching about infections making up far less of the curriculum.

Now it is becoming apparent that infections actually are a big deal and we don't have the control over them we thought we did.
 
We don't know what the unknown soluble factor is. Prusty thinks it's a signal for cells to hunker down and protect themselves from viruses and maybe other things. That seems reasonable but there's not good evidence for that yet.

I have to admit I'm fascinated by the explanation Henderson proposes.

Maybe it will turn out to be right. I wish there was a greater effort to identify the unknown soluble factor. We could learn so much from knowing what it is.
 
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