Interferons as mediators in ME/CFS

Jonathan Edwards

Senior Member (Voting Rights)
I apologise for trying to make sense of all the threads around DecodeME with another thread but I see interest in collecting thoughts on interferons as candidates. This follows on from recent discussion on the Genetics OLFM4 thread but it goes back much further.

"Interferon' was discovered by two people in 1957, one being a close family friend who died in his forties when I was a child (Alick Isaacs, to a child a wonderfully amusing and kind 'uncle'). It turned out to be several things and we are probably mostly interested in alpha and beta (type 1 Ifs) and gamma (type 2). My understanding is that although these are separate molecules and have different repertoires they often up-regulate expression of the same proteins and pathways.

Interest in ME/CFS goes back to the observation that alpha interferon therapy causes fatigue. Robert Phair picked up on alpha interferon as a key mediator in his itaconate shunt idea. @jnmaciuch and I have been discussing the merits of alpha and gamma interferons for some months. Gamma interferon seemed plausible as a T cell signal that might make more sense than some of the cytokines like TNF or IL6 as part of a persisting abnormal immune response. Now @jnmaciuch has pointed out that we might use alpha interferon as a way to tie in several gene variant hits in DecodeME. At least some of those might link to gamma interferon too, but maybe not all.

My sense is that discussion of pooled knowledge on these molecules and pathways would be a good place to start in trying to build ideas around DecodeME results. Key questions are going to be 1. which tissues might specifically be hosting local, maybe hidden, interferon-based signalling and how that might relate to symptoms 2. how to understand time courses for inappropriate interferon signalling over both short and long term in ways that would make biological sense and fit symptomatology.

I think that is about enough for an introductory post but I will add a few quick thoughts.
1. I am coming around to the idea that gamma interferon may be involved early on in disease triggering but that alpha (?+beta) may well take over long term.
2. For me the problem with alpha is how the body 'learns' to overproduce or over-respond with the long term dynamics of ME/CFS but the increased focus on brain (or maybe neurons) from DecodeME might be relevant there. (Learning to make more gamma is the standard job of T cells.)
3. How best do we tie the DecodeME hits together into a story and what awkward questions would that raise.
 
I'm sure we've talked about this before but I forget - Is anything known about the basic biology of why IFN type 1/2 causes fatigue? I seem to recall that it not just causes fatigue acutely but can also lead to an enduring fatigue that last long after IFN therapy ends. Possibly by interacting with the DRGanglia or someway with the more permeable parts of the BBB, or involved in sensitising peripheral neurons directly at their termini. Is there maybe basic biology work that could be done here maybe in mouse models.

Am I right in saying in lupus the inteferon production is driven by taken up nucleic acid immune complexes? - something which would be absent in ME. I'm guessing neurons and glia respond to type 1 IFNs just like any other cell type does - how does it affect the maintainence and function synapses?
 
Hoping this helps in any way :

1) Likely tissues hosting local, semi‑hidden IFN signalling​


Think “hard‑to‑biopsy, richly innervated, barrier or ganglion tissues” where small, persistent triggers can keep IFN circuits smouldering without flooding peripheral blood.


Neuro-immune interfaces


  • Dorsal root & autonomic ganglia (DRG, nodose, sympathetic chain): Latent neurotropic viruses, mitochondrial damage, or sterile nucleic acids can prime cGAS–STING/RIG‑I/MDA5 in satellite glia & resident macrophages → tonic CXCL9/10/11, ISGs, and sensory/autonomic hypersensitivity (pain, orthostatic symptoms, “flare on exertion”).
  • Meninges & choroid plexus: Border-zone immune hubs; low‑level type I IFN here can reshape CSF cytokines and sickness-behaviour circuits with minimal blood signal.
  • Brain microglia/astrocytes (select nuclei): Local IFN can alter sleep–wake, hypothalamic set points, and central autonomic control → non‑restorative sleep, fatigue, thermoregulatory quirks.

Barrier epithelia with dense innervation


  • Olfactory epithelium & nasal mucosa: A classic niche for persistent epithelial ISGs; signals project to limbic/brainstem circuits → sensory intolerance, malaise.
  • Gut mucosa (Peyer’s patches, myenteric plexus): pDC‑rich, microbe‑dense; sustained type I IFN can disturb epithelial energy handling and vagal signalling → post‑exertional malaise (PEM), GI dysautonomia.
  • Lung small airways & marginal alveolar regions: Intermittent epithelial IFN without overt inflammation → exertional breathlessness out of proportion to spirometry.

Endothelium & muscle–tendon units


  • Microvascular endothelium (skeletal muscle, brain): Type I IFN reduces endothelial glycolysis and NO bioavailability → early muscle fatigability, brain fog under load.
  • Myotendinous junctions & fascia: Local macrophage/tenocyte IFN tone could amplify delayed-onset pain and stiffness after exertion without CK spikes.

Secondary lymphoid tissues


  • Draining lymph nodes/tonsils with intermittent plasmacytoid dendritic cell (pDC) activation → sustained “tonic” IFN‑α that imprints circulating cells while staying below detection in plasma most days.
 
I apologise for trying to make sense of all the threads around DecodeME with another thread but I see interest in collecting thoughts on interferons as candidates. This follows on from recent discussion on the Genetics OLFM4 thread but it goes back much further.

"Interferon' was discovered by two people in 1957, one being a close family friend who died in his forties when I was a child (Alick Isaacs, to a child a wonderfully amusing and kind 'uncle'). It turned out to be several things and we are probably mostly interested in alpha and beta (type 1 Ifs) and gamma (type 2). My understanding is that although these are separate molecules and have different repertoires they often up-regulate expression of the same proteins and pathways.

Interest in ME/CFS goes back to the observation that alpha interferon therapy causes fatigue. Robert Phair picked up on alpha interferon as a key mediator in his itaconate shunt idea. @jnmaciuch and I have been discussing the merits of alpha and gamma interferons for some months. Gamma interferon seemed plausible as a T cell signal that might make more sense than some of the cytokines like TNF or IL6 as part of a persisting abnormal immune response. Now @jnmaciuch has pointed out that we might use alpha interferon as a way to tie in several gene variant hits in DecodeME. At least some of those might link to gamma interferon too, but maybe not all.

My sense is that discussion of pooled knowledge on these molecules and pathways would be a good place to start in trying to build ideas around DecodeME results. Key questions are going to be 1. which tissues might specifically be hosting local, maybe hidden, interferon-based signalling and how that might relate to symptoms 2. how to understand time courses for inappropriate interferon signalling over both short and long term in ways that would make biological sense and fit symptomatology.

I think that is about enough for an introductory post but I will add a few quick thoughts.
1. I am coming around to the idea that gamma interferon may be involved early on in disease triggering but that alpha (?+beta) may well take over long term.
2. For me the problem with alpha is how the body 'learns' to overproduce or over-respond with the long term dynamics of ME/CFS but the increased focus on brain (or maybe neurons) from DecodeME might be relevant there. (Learning to make more gamma is the standard job of T cells.)
3. How best do we tie the DecodeME hits together into a story and what awkward questions would that raise.

Alpha interferon is one of the mooted causes of post Lyme in some patients which may mean overlap with ME.
 
I'm sure we've talked about this before but I forget - Is anything known about the basic biology of why IFN type 1/2 causes fatigue?
Looking at the literature it seems that exposure to elevated interferon can lead to lasting changes in parts of the brain (but my impression is the timeframes studied were weeks/months, not years/decades).

A study found ventral striatal/basal ganglia were affected.

A study failed to find clear microglial activation.

PS: cancer-related fatigue could also provide some clues.
 
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I'm sure we've talked about this before but I forget - Is anything known about the basic biology of why IFN type 1/2 causes fatigue? I seem to recall that it not just causes fatigue acutely but can also lead to an enduring fatigue that last long after IFN therapy ends. Possibly by interacting with the DRGanglia or someway with the more permeable parts of the BBB, or involved in sensitising peripheral neurons directly at their termini. Is there maybe basic biology work that could be done here maybe in mouse models.
Type I (or II) interferons don't signal fatigue directly, but besides immune system mediated effects, it does lead to other changes including sensitisation of afferent nerves in both the dorsal horn and dorsal root (which can be due to it being involved in the tissue repair process), metabolic/endocrine effects etc.

Can anyone tell me what ifn gamma and TNF gene expression assays actually measure?

Gene expression focuses on messenger RNA that codes for the particular genes.

The tests tend to focus on specific cell types, eg Peripheral blood mononuclear cells, but keep in mind this assay result isn't the same as the expression of those genes in other (in vivo) tissue environments.
 
Type I (or II) interferons don't signal fatigue directly, but besides immune system mediated effects, it does lead to other changes including sensitisation of afferent nerves in both the dorsal horn and dorsal root (which can be due to it being involved in the tissue repair process), metabolic/endocrine effects etc.



Gene expression focuses on messenger RNA that codes for the particular genes.

The tests tend to focus on specific cell types, eg Peripheral blood mononuclear cells, but keep in mind this assay result isn't the same as the expression of those genes in other (in vivo) tissue environments.
Thanks. I had these tests on blood but I don't know which cells I assume white ones of one sort or another. Routinely elevated but is it an immune marker rather than immune activity? (Hope this is not thread hijacking)
 
2. For me the problem with alpha is how the body 'learns' to overproduce or over-respond with the long term dynamics of ME/CFS

Is there anything to learn from the sort of arms race that can get set up in toxoplasmosis infection in healthy people?

Added: I'm not trying to suggest ME/CFS might be caused by a parasite, just asking whether the dynamics could be similar.

(Might be a ridiculous question, I don't have enough understanding to know!)
 
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What did you think of the KCL paper on persistent fatigue and interferon alpha @Jonathan Edwards ?

I can't remember if I looked at it in detail before. It is interesting in that it suggests that people with persistent fatigue after interferon alpha may have a prior higher responsiveness flagged by IL-10 and IL-6 but that these cytokines are not mediating the fatigue.

I do think it may be useful to check that DecodeME picked up nothing on gene variants that encode higher IL-6 responses to things but maybe from the KCL study we should not necessarily expect it. Maybe the higher IL-6 levels at KCL were an indication of IFN receptor sensitivity with the pathology being through something else being IFN sensitive. It is all rather complicated but maybe tractable.
 
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