Review Chronic inflammatory response syndrome – A review of the evidence of clinical efficacy of treatment, 2024, Dooley

https://journals.lww.com/annals-of-...matory_response_syndrome___a_review.2360.aspx

Chronic Inflammatory Response Syndrome is a multi-symptom, multisystem illness acquired following respiratory exposure to water-damaged buildings.

It is an underrecognized, underdiagnosed dysregulation of the innate immune system that can affect 25% of the population, therefore representing a silent epidemic.

The only treatment in the published literature documenting clinical efficacy for treatment of Chronic Inflammatory Response Syndrome is the Shoemaker Protocol.

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome is a common misdiagnosis for Chronic Inflammatory Response Syndrome but lacks a defined etiology, biomarkers or a treatment protocol that reverses the underlying conditions.

ABSTRACT

Chronic Inflammatory Response Syndrome (CIRS) is an acquired medical condition characterized by innate immune dysregulation following respiratory exposure to water-damaged buildings (WDB).

This chronic syndrome involves a range of symptoms that simultaneously affecting multiple organ systems.

The purpose of this literature review was to search the published literature for successful treatments for Chronic Inflammatory Response Syndrome, an underrecognized, underdiagnosed, multi-symptom multisystem illness that can affect up to 25% of the population, thus representing a silent epidemic.

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), a common misdiagnosis for CIRS, is an entity that has broader awareness within the medical community despite the absence of a defined etiology, biomarkers or a treatment protocol that reverses the underlying conditions.

Therefore, the search also included treatments for ME/CFS and Sick Building Syndrome (SBS). Thirteen articles referenced treatment for CIRS, and 22 articles referenced treatment for CFS.

The only treatment with documented clinical efficacy was the Shoemaker Protocol, which was described in 11 of the 13 articles.

This treatment protocol exhibits superior outcomes compared with the treatment protocols for ME/CFS.

 

From scanning this paper I’m not at all convinced that CIRS is a syndrome which can be differentiated from ME/CFS. However, it is interesting that people with ME/CFS-like symptoms are reported to have improved after courses of colestyramine (or cholestyramine). These are the 2 small RCTs referred in the paper:

1) https://ehp.niehs.nih.gov/doi/abs/10.1289/ehp.01109s5791

2) https://www.sciencedirect.com/science/article/abs/pii/S0892036206000857

According to Wikipedia:

Its medicinal uses include: