Do you believe ME/CFS is an immune mediated disease?

Please include/consider auto-immune disease as a subset of immune mediated disease.


From the MS society



Immune-Mediated Disease vs. Autoimmune Disease
Scientists believe that one or more environmental factors trigger MS in a genetically susceptible individual. These environmental factors include an unknown foreign substance, called an antigen, such as a virus or toxin. In autoimmune diseases, researchers have identified the specific antigen that is responsible. But researchers have not yet identified specific antigens that trigger MS. Despite this, most experts believe MS is an autoimmune disease.

 

I didn't answer the poll. I think all the answers are wrong to some extent.

I strongly suspect ME is an immune initiated disease. However its unclear to what extent it has ongoing immune issues as a driving force. I think its likely the immune system is perturbed, but that may be secondary. Or not. We do not know. Yet due to this immune initiation, most often a viral infection, I also cannot say we do not know as an absolute.

Poisoning, other pathogens, and in rare cases injury, all seem to be able to trigger ME or some variation of ME. So the immune system is most likely integral to the start of ME. But how much is it involved in the perpetuation of ME? We need research to give us those answers.

Serious immune challenges set in play a multitude of secondary events. This includes major epigenetic changes. So the alternative, which is not conclusive, is that these changes persist. They do not have to be immunological. We lack any firm evidence of what might cause such changes to persist. Its all hypotheses at this point.

 

Maybe I should have phrased it as an “active” immune mediated disease?

 

My reply then would be "no idea", though really its "evidence pending". Something is wrong with our immune systems, but is it causal, a consequence, or part of a vicious loop with other things?

 

To further complicate the question, which immune system? The brain's immune system is separate from the rest of the body, but interacts with that. I think the brain's immune system is involved with ME, but I don't know to what extent. I don't think the body's immune system initially triggers the ME state, and can influence its severity, but isn't maintaining the ME state and isn't responsible for most of the symptoms.

If the purpose of the question is whether research and treatment experiments should focus on the body's immune system, I'm firmly in the "no" category.

 

I feel all we can say is that currently it is looking very much like everyone with ME has abnormalities in their immune system, but we don’t know if there is a causal relationship or if both the ‘ME’ or ‘ME symptoms’ and the immune issues arise from something else. Even if there is a causal relationship we don’t know which direction it goes. Obviously it may turn out to make no sense to talk about ME and immune issues as distinct entities rather it may be that both the immune issues and the other ME symptoms are part of a single process.

I answered the poll ‘no idea’ as I feel to do otherwise is to go well beyond our current knowledge, though I do have the belief that understanding more about the immune issues associated with ME will be a big step nearer to understanding its aetiology.