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A neuro-inflammatory model can explain the onset, symptoms and flare-ups of ME/CFS, 2019, Mackay

Discussion in 'BioMedical ME/CFS News' started by RoseE, Dec 19, 2019.

  1. RoseE

    RoseE Senior Member (Voting Rights)

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    This research article in the Journal of The Royal New Zealand College of General Practitioners has just been brought to my attention...
    http://www.publish.csiro.au/HC/fulltext/HC19041

    A neuro-inflammatory model can explain the onset, symptoms and flare-ups of myalgic encephalomyelitis/chronic fatigue syndrome
    Angus Mackay 1
    + Author Affiliations
    Journal of Primary Health Care 11(4) 300-307 https://doi.org/10.1071/HC19041
    Published: 29 November 2019
     
    MEMarge, rvallee, Trish and 1 other person like this.
  2. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

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    Although there is not a lot novel in this account it seems a fair and plausible model, described in a clear and sensible way.
     
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  3. Ravn

    Ravn Senior Member (Voting Rights)

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    This sounds similar to a previous paper by the same author discussed here (I haven't read the new one yet so don't know if it adds anything new to the old one):
    https://www.s4me.info/threads/a-com...ry-paradigm-for-me-cfs-2018-mackay-tate.7187/
     
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  4. strategist

    strategist Senior Member (Voting Rights)

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    I agree that I'm sensitive to everything, but different kinds of stressors do not appear to have equal importance. Exertion stands out much more than others. Gut problems related to apparent reactivity to various foods also seem fairly important. I find that I tolerate emotional stress less but it doesn't seem to trigger the relapses that overexertion does.

    It does feel like there is a subtle kind of inflammation involved in the illness. And dysregulation of lots of things in an unpredictable and ever shifting way.

    I agree that the triggers leave a signal that appears to be additive and cumulative, meaning multiple things at once will sum their effects, and that the signal stays around for a while (a few days, maybe longer?). That seems consistent with some central stress register playing a role.
     
    Last edited: Dec 20, 2019
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  5. Snow Leopard

    Snow Leopard Senior Member (Voting Rights)

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    The hypothesis seems rather vague and most researchers who have invoked some kind of dysfunction of the hypothalamus as a model have generally failed to explain why their hypothesis is not consistent with the range of results from neuroendocrine studies.
     
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  6. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

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    I agree it is vague. If the hypothalamus is targeted then I think it would have to be in a rather specific way - rather as for narcolepsy. That may not fit very well with a generic neuroinflammation model. On the other hand neuroinflammatory changes seen in other conditions may be secondary to specific changes - as in Parkinson's for instance.
     
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  7. Snow Leopard

    Snow Leopard Senior Member (Voting Rights)

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    Yes, the problem is that there is no specific dysfunction of the HPA axis and we've known this for many years. The studies of basal CRH, ACTH, Cortisol etc, along with CRH, ACTH and AVP challenges have all been inconsistent. Notably, in a prospective studies of EBV infection, those who were later diagnosed with CFS (Oxford) did not have any difference in cortisol either at onset of infection, nor 6 months after infection.
     
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  8. ladycatlover

    ladycatlover Moderator Staff Member

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    But the Oxford CFS "criteria" were very loose - they'd pick up many people who were depressed and/or "tired all the time" for any reason, once they got the CFS label they were on a hiding to nothing getting more tests to see what was really going on. Unless they had stellar GPs. So anything using Oxford is a waste of time really.
     
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  9. Snow Leopard

    Snow Leopard Senior Member (Voting Rights)

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    But the argument around low basal cortisol by certain unnamed authors is often claimed to be associated with non-specific fatigue and various psychosocial conditions (PTSD, early childhood trauma etc) the fact that they didn't find any sign of this in an Oxford sample is revealing.
     
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  10. lansbergen

    lansbergen Senior Member (Voting Rights)

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    Recently I catched someting from a visitor. Seemed a cold and many cold bugs are going around here but no influenza virus yet.

    It started like a cold but then the immunesystem went after the mysterious chronic infection causing a nasty flare. As always no real fever.

    I am still not fully recovered.

    Luckly the normal pattern occured. So the ME is a little better then before it started.
     
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