BMSystems were interviewed in
Global Benefits Vision about the risk of post-COVID19 ME/CFS. They provide more information about their upcoming clinical trial and their scientific understanding of the disease,
About ME/CFS itself
Their description of ME/CFS (p. 32) does not include PEM, but the Venn diagram figure underneath the description does and ME/CFS is presented as:
a complex and devastating disease that imposes a burden of illness on millions of people around the world. It is a serious, chronic, and complex systemic disorder
On page 36, they present the context around ME/CFS quite well. They mention important issues such as the different diagnostic criteria, the absence of medical education and of a biomarker, the underdiagnosis of ME/CFS (cites IOM report), and there's also this relieving part:
Alternatively, unconventional medical therapies, counselling and cognitive behavioural therapies (CBT) are frequently implemented, although with little or no evidence of improved symptomatology. These often reflect the mis-conception that CFS/ME is a psychological condition, when in reality it has a clear pathologic immunological basis.
Their understanding of the pathophysiology of ME/CFS (pp. 33-35)
They understand ME/CFS as "an inflammatory disease" caused by "the superposition of humoral and cellular responses" (diagram on p. 35).
Our research shows that CFS/ME is an inflammatory disease, caused by overlapping immune responses that misguide the actions of the immune system.
In a nutshell, this inflammatory condition can occur when a chronic, low-level, and often asymptomatic inflammatory reaction that biases the immune system towards cellular responses is superimposed on an acute infection that triggers a humoral response opposed to the first.
The first condition, which can drive a person’s immune system to adopt a long-lasting strategy (or a polarized/biased response), is often due to a chronic viral infection with a double strand DNA virus such as are HHV, HSV, EBV, CMV, etc. More than 90% of people are exposed to these chronic dsDNA viruses by three years of age. The virus DNA can insert itself into a chromosome and remain latent in just a few cells for years, silently being copied each time the cell divides. Even if for most people this causes no problem, it can set the inflammatory background allowing the occurrence of CFS/ME for some others. This of course depends largely on the genetic and environment factors that shape an individual’s immune system.
[...]
The second condition, which could cause the immune system to adopt an opposing and conflicting strategy, leading to that particular low grade pro-inflammatory tuning, can be triggered by acute infections from positive-sense single-stranded RNA viruses (ssRNA). One of the most common triggers of CFS/ME is acute viral infections such as those provoked by the influenza ssRNA virus. As an example, a Norwegian national study showed that the percentage of CFS/ME occurrence doubled following the 2009 influenza A (H1N1) pandemic.
The clinical trial/treatment: CADI-T1031
A personalized treatment, apparently.
CADI-T1031 is a “disease-centric repositioning” of existing molecules.
BMSystems’ lengthy experience in immunology/inflammation suggests that there may not be a universal treatment for all CFS/ME patients, as immune function varies from person to person depending on genetic, pathologic and environmental backgrounds. Our diagnostic tools are therefore designed to monitor the patient's immune status, and the treatment is then tailored, using standardized pharmaceutical combinations, much like assembling Lego bricks, to match the patient's actual condition.
Two phases: an "immune equilibration" treatment (2-6 months) to resolve immune dysregulation, followed by an "energetic rehabilitation treatment" (6 months - 2 years). A maintenance treatment could be given afterwards.
They say the combination of drugs used is non toxic and has no side effects.
The treatment is divided into 2 main therapeutic phases. The immune equilibration treatment aims to resolve the on-going conflicting immune strategies and phase out the self-propagating inflammatory reaction. This phase is expected to last from 2-6 months depending on patient’s follow-up and evaluation. The second phase is an energetic rehabilitation treatment, which aims to restore the patient’s energy metabolism that is severely deregulated in CFS/ME, while simultaneously supporting the newly reached immune equilibrium. This phase is expected to last anywhere from 6 months to 2 years, depending on patient’s evaluation. Back and forth between Immune and Energetic treatments is not excluded in cases where the patient’s immune system is dysregulated during rehabilitation, due to occurring infections or underlying pathologies. Finally, a maintenance treatment could be administered at will to cover the patient’s fluctuating metabolic needs. It is important to note that all the components in each phases of the CFS/ME treatment have no toxicity and no known side effects, either individually or in combination.
Post-COVID19 risk of ME/CFS
Page 34:
Coronaviruses are all positive sense ssRNA viruses, and among them, Sars-Cov-1, Mers-Cov and Sars-Cov-2 are known to cause very acute infections and inflammatory syndromes.
[...]
It appears therefore quite probable that the current coronavirus epidemic, caused by the positive sense ssRNA SARS-CoV-2 virus, might trigger a worldwide spike in CFS/ME. However, it is far too early to estimate what proportion of the exposed populations may go on to develop CFS/ME as the formal diagnosis requires symptoms that last for at least six months.
They cite the post-SARS studies from Lam & Modolfsky (p. 34), Mady Hornig's report for Solve CFS (p. 31), and a number of articles about the risk of post-COVID19 ME from the New Scientist, the Guardian, ME Association, the Telegraph (p. 40)
[1] Manuel Géa, Dr. Athanasios Beopoulos, Dr. François Iris. "Life after COVID-19: dealing with Chronic Fatigue Syndrome?". Global Benefits Vision, Issue 47 (April 2020).
https://www.bmsystems.net/download/...ssue-047-BMSystems-CFS-Post-Covid-19-2020.pdf
