Book Chapter: Therapeutic Implications of the Microbial Hypothesis of Mental Illness, 2022, Savitz and Yolken

[Andy]

Abstract

There is increasingly compelling evidence that microorganisms may play an etiological role in the emergence of mental illness in a subset of the population. Historically, most work has focused on the neurotrophic herpesviruses, herpes simplex virus type 1 (HSV-1), cytomegalovirus (CMV), and Epstein–Barr virus (EBV) as well as the protozoan, Toxoplasma gondii. In this chapter, we provide an umbrella review of this literature and additionally highlight prospective studies that allow more mechanistic conclusions to be drawn. Next, we focus on clinical trials of anti-microbial medications for the treatment of psychiatric disorders. We critically evaluate six trials that tested the impact of anti-herpes medications on inflammatory outcomes in the context of a medical disorder, nine clinical trials utilizing anti-herpetic medications for the treatment of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) or schizophrenia, and four clinical trials utilizing anti-parasitic medications for the treatment of schizophrenia. We then turn our attention to evidence for a gut dysbiosis and altered microbiome in psychiatric disorders, and the potential therapeutic effects of probiotics, including an analysis of more than 10 randomized controlled trials of probiotics in the context of schizophrenia, bipolar disorder (BD), and major depressive disorder (MDD).

Paywall, https://link.springer.com/chapter/10.1007/7854_2022_368

 

[Mithriel]

So if they find that antimicrobials helped ME/CFS it will be proof that microorganisms can cause mental illness?

 

[Trish]

I was curious about their sources so looked through the reference list. Here are all the papers I could see that referred to ME and or CFS in the title:

Ariza ME (2021) Myalgic encephalomyelitis/chronic fatigue syndrome: the human herpesviruses are Back! Biomol Ther 11(2). https://doi.org/10.3390/biom11020185

Komaroff AL, Cho TA (2011) Role of infection and neurologic dysfunction in chronic fatigue syndrome. Semin Neurol 31(3):325–337. https://doi.org/10.1055/s-0031-1287654

Loebel M, Strohschein K, Giannini C, Koelsch U, Bauer S, Doebis C et al (2014) Deficient EBV-specific B- and T-cell response in patients with chronic fatigue syndrome. PLoS One 9(1):e85387. https://doi.org/10.1371/journal.pone.0085387

Loebel M, Eckey M, Sotzny F, Hahn E, Bauer S, Grabowski P et al (2017) Serological profiling of the EBV immune response in chronic fatigue syndrome using a peptide microarray. PLoS One 12(6):e0179124. https://doi.org/10.1371/journal.pone.0179124

Pedersen M, Asprusten TT, Godang K, Leegaard TM, Osnes LT, Skovlund E et al (2019) Predictors of chronic fatigue in adolescents six months after acute Epstein-Barr virus infection: a prospective cohort study. Brain Behav Immun 75:94–100. https://doi.org/10.1016/j.bbi.2018.09.023

Ruiz-Pablos M, Paiva B, Montero-Mateo R, Garcia N, Zabaleta A (2021) Epstein-Barr virus and the origin of Myalgic encephalomyelitis or chronic fatigue syndrome. Front Immunol 12:656797. https://doi.org/10.3389/fimmu.2021.656797

And the clinical trial ones:

Lerner AM, Beqaj SH, Deeter RG, Fitzgerald JT (2007) Valacyclovir treatment in Epstein-Barr virus subset chronic fatigue syndrome: thirty-six months follow-up. In Vivo 21(5):707–713

Montoya JG, Kogelnik AM, Bhangoo M, Lunn MR, Flamand L, Merrihew LE et al (2013) Randomized clinical trial to evaluate the efficacy and safety of valganciclovir in a subset of patients with chronic fatigue syndrome. J Med Virol 85(12):2101–2109. https://doi.org/10.1002/jmv.23713

Straus SE, Dale JK, Tobi M, Lawley T, Preble O, Blaese RM et al (1988) Acyclovir treatment of the chronic fatigue syndrome. Lack of efficacy in a placebo-controlled trial. N Engl J Med 319(26):1692–1698. https://doi.org/10.1056/NEJM198812293192602