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Chronic fatigue focus shifts from viruses to the brain

Immunology researchers have established there’s no evidence of an infectious cause behind the chronic fatigue syndrome (CFS…

Researchers have put to rest links between infectious retroviruses and chronic fatigue syndrome. Flickr/NCReedplayer

Immunology researchers have established there’s no evidence of an infectious cause behind the chronic fatigue syndrome (CFS), prompting warnings an understanding of what triggers the debilitating illness could be a decade away.

In 2009 a paper in the journal Science made a possible connection between chronic fatigue syndrome and the retrovirus XMRV. The paper was later retracted.

This week a study published in mBio, the online journal of the American Society for Microbiology, revealed no evidence of infection with retroviruses XMRV and pMLV in a study of 147 patients with chronic fatigue syndrome.

“We went ahead and set up a study to test this thing once and for all and determine whether we could find footprints of these viruses in people with chronic fatigue syndrome or in healthy controls,” said study co-author Ian Lipkin, from Columbia University’s Centre for Infection and Immunity.

“These results refute any correlation between these agents and disease,” Dr Lipkin said.

Syndromes intrinsically have “woolly boundaries” said Andrew Lloyd, infectious diseases physician and immunology researcher at the UNSW. “Not everybody within the syndrome label will necessarily have the same illness, there may be more than one illness within the label and some people will be mislabelled.”

But Dr Lloyd said the Columbia University study was “the final nail in the coffin” in the link between XMRV and the family of gammaretroviruses and chronic fatigue syndrome.

“Does that mean that viruses don’t have a role? Absolutely not - it’s clear that viral infections act as a trigger.

“The next question is, is persistence of those virus the driver of ongoing illness, and the answer to that is no.”

However Dr Lloyd said it’s still possibile there are viruses not yet discovered that cause chronic fatigue syndrome, and it’s also in theory possible that a virus might act as a co-factor.

“This whole viral XMRV storyline is actually a distraction,” he added, with researchers now moving their focus to the brain.

Dr Lloyd said that the theory of academic research of CFS had already moved on from infectious viruses.

“Finally three decades later the Americans have arrived back where started,” said Ian Hickie, professor of psychiatry at University of Sydney.

“If you had to choose a place in the body where the problem lies we’re already 99.9% confident the problem is in the brain and we already have some ideas about how the brain might be disturbed to generate this illness,“ Dr Lloyd said.

He added that it would be a “minimum of a decade before we really get to the heart of the matter”, adding that those affected by CFS needed to be patient while the scientific process ran its course.

“The tools available to investigate the central nervous system now in this decade are much greater than they were so we need to capitalise on that, reduce the nonsense, and get on with using those tools to try and find solutions that really help people,” Professor Hickie said.

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21 Comments sorted by

  1. Sean Lamb

    Science Denier

    For people interested in the science as human drama there is an fascinating account of this in Science last year
    http://www.sciencemag.org/content/333/6050/1694.full
    I am surprised that no one seems to have tried a deep-sequencing approach to look at the entire virome or microbiome in patients and healthy people (that is look at the entire range and levels of bacteria and viruses present).

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    1. Sean Lamb

      Science Denier

      In reply to Peter Wachtel

      This is what the data output would look like
      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3374612/
      I doubt that it will help isolate a causative agent, but it would reveal if CFS sufferers had an increased overall viral load or not.

      I know when I have a respiratory viral infection I feel quite physically fatigued, so I don't think looking for a brain dysfunction is necessarily the answer.

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    1. Peter Wachtel

      logged in via LinkedIn

      In reply to Buzzy Kerbox

      Buzzy,

      I understand where you're coming from. But I think you've picked the wrong target to vent your frustration.

      Whether you are Montoya, Lipkin, Komaroff, Fluge, Mella or whoever you are going to be looking at the brain. It's the most probably centre-of-gravity for the problem. That's why the word is "neuro-immune".

      And, the point that these gentlemen are making is that you don't need to understand the absolute causes to work out effective treatments. eg. MS. The same applies to your…

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    2. Buzzy Kerbox

      logged in via email @gmail.com

      In reply to Peter Wachtel

      Peter you keep referring to CFS which is nothing but a too hard basket diagnosis which can pile all kinds of conditions into it, which is also one of our biggest problems to begin with. We have had criteria like the CCC around for three decades now and more recently the updated version the ICC to help separate people with 'chronic fatigue' or depression from those with ME but it just another thing continually ignored while the psychs push questionable therapies like CBT and GET as a solution on the…

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    3. Buzzy Kerbox

      logged in via email @gmail.com

      In reply to Peter Wachtel

      Peter here is a recent update from the UK posted by a patient and you wonder why so many people have a problem with the psychs, the situation in the UK is absolutely appalling and this is the exact kind of dismissal I am talking about; god knows how it has leaked over here into Australia but at least it is nowhere near as bad here.

      One simply has to keep asking why the endless denial and refusal to even consider things like this? Reputations? Funding? Maintaining of the model they have built…

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  2. Buzzy Kerbox

    logged in via email @gmail.com

    For anyone interested there is a good interview here covering different aspects of the condition with Dr. Marshall who with a team scientists are looking at ME/CFS but also other conditions with potentially similar underlying pathology,

    http://phoenixrising.me/archives/13315

    Maybe Charis you might also take a look for some perspective or even contact Dr. Marshall for a story which we rarely see in this country, other than brief misinformed headline articles like this. Notice how other news agencies reported it properly by any chance? Without making ridiculous sweeping generalizations.

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  3. Ian Barnes

    logged in via Facebook

    It is correct to report that there is no evidence of a link between XMRV and ME/CFS. It is quite incorrect to report that "there’s no evidence of an infectious cause behind the chronic fatigue syndrome (CFS)".

    For a start, as the Dubbo study by Llloyd showed, 10% of those who got a range of infections went on to get CFS. Clearly, infections are causal in the onset of CFS.

    Furthermore, there have been many studies that show high rates of ongoing infections by various viruses in ME/CFS (see…

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  4. Nicklas Börjesson

    logged in via Facebook

    This is a list of 170(!) peer reviewed articles that significantly show that ME/CFS is a somatic disease: http://mecfs.wikkii.com/wiki/File:Pubmed_MECFS_review.pdf

    Please show me at least ONE that in any *significant* and *objective* way shows a psychiatric etiology that haven't been shot to pieces.

    The focus has in no way shifted to where these people think or tries to make it look like. XMRV was just one of a thousand possible causes to ME/CFS, to based on that would be like saying that HIV is psychological because it isn't caused by mycobacterium tuberculosis.

    They are just after grant money, like they've always been.
    I actually can't believe that they still have their medical licenses after all these years after all the patients they have done so much harm.

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  5. Tom Hennessy

    Retired

    The marker for a virus' destruction is the same marker for another problem , oxidative stress. As an analogy if your were a 'tracker' and you KNOW what a bear track looks like and you ran across ANOTHER animals track which looked just like a bear track , you may believe it to be a bear track , BUT , if you were a GOOD tracker , you KNOW there ARE two tracks veritably the same. It is pretty much as simple as that. One scenario , hypothesis , is the oxidative stress hypothesis , which , can be indistinguishable…

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    1. Tom Hennessy

      Retired

      In reply to Tom Hennessy

      "In vivo magnetic resonance spectroscopy in chronic fatigue syndrome"
      "Oxidative stress may offer a common explanation"
      http://www.ncbi.nlm.nih.gov/pubmed/15253888

      "A hypothesis is proposed that chronic fatigue is a state of accelerated oxidative molecular injury."
      http://www.majidali.com/Hypothesis.htm

      "These findings identify ROS as endogenous mediators of muscle fatigue and highlight the importance of future research to (a) define the cellular
      mechanism of ROS action and (b) develop antioxidants as novel therapeutic interventions for treating fatigue."
      http://www.ncbi.nlm.nih.gov/pubmed/18191753

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  9. Andy G

    Researcher

    Saying the Americans have come back to where they started is absolutely correct. 30 years ago, doctors found chronic fatigue syndromes common after bad bouts of mono. The CDC did a study, and discounted the link: active epstein bar did not cause CFS. They failed to understand that it was not active infection that caused it, but a hit and run.

    Of course, I personally knew this, as well as most CFS patients after mono. I got mono 10 years ago, then felt fatigued since, though the fatigue has improved. All this hopla about active viral infection and CFS could have been prevented simply by asking a post viral fatigue patient. They, like myself, could have explained that it was a hit and run. Now, look at he brain. Careful patient anecdotal evidence can be more powerful than decades of research.

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  10. Gerald Landry

    Bmm

    Ironic that MCS is not mentioned when most suffer Multiple Chemical Sensitivity first. Then Chronic fatigue follows, in close pursuit Fibromyalgia, could it be that cellular respiration is impaired? That the mitochondria, our energy furnace in every cell has suffered a toxicological assault, resulting in a damaged Kreb or Cori Energy cycle.

    Then anaerobic glycolosis takes over, which converts excess carbohydrate intake into Lactic acid further fuelling the brain fog (MELAS) and FM (fibromyalgia…

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