Review Immunological associations in post-infective fatigue syndromes including Long COVID, Raijmakers, Wyller, Knoop, Lloyd et al, 2025
Kalliope
Senior Member (Voting Rights)
Just adding the conclusion where it says something about "functional brain alterations": One of the authors, Wyller, is pushing "Pain Reprocessing Therapy" hard these days and recently got a whole day in the spotlight at the Norwegian broadcaster via radio, the evening news and a news debate programme about this as a cure for LC and fatigue.
Conclusion
The immunologic hypothesis for PIFS has gained cautious support from this metanalysis. PIFS may also be driven by other disease mechanisms, such as metabolic processes and/or functional brain alterations.7,83 The current surge in PIFS research due to Long COVID holds potential to finally understand the pathophysiology of PIFS. Future studies should adhere to the high-quality standards for which this paper provides a benchmark, including careful documentation of the acute infection and the strict application of at least one PIFS research case definition.
Jonathan Edwards
Senior Member (Voting Rights)
The level of ignorance displayed is striking.
The author list is quite a roll call of BPS proponents.
It's a bit hard to understand why they are going out of their way to suggest PIFS is an immune issue, given the stories they have committed themselves to in the past.
Increased white cell counts and higher levels of RANTES and TNFa? I don't think it's terribly compelling. 30 studies were included, but by my rough skim only 4 studies measured RANTES.
Many of these authors have ridden the gravy train of helping to deny people with ME/CFS proper financial and medical support for years. If I was cynical, I might think that they are realising that their funders are starting to think that this is a problem that needs to be properly solved. They might even be realising that it is a problem that can be solved, and they are keen to protect their reputations as PIFS experts.
It's a bit hard to understand why they are going out of their way to suggest PIFS is an immune issue, given the stories they have committed themselves to in the past.
Increased white cell counts and higher levels of RANTES and TNFa? I don't think it's terribly compelling. 30 studies were included, but by my rough skim only 4 studies measured RANTES.
Many of these authors have ridden the gravy train of helping to deny people with ME/CFS proper financial and medical support for years. If I was cynical, I might think that they are realising that their funders are starting to think that this is a problem that needs to be properly solved. They might even be realising that it is a problem that can be solved, and they are keen to protect their reputations as PIFS experts.
Kalliope
Senior Member (Voting Rights)
I think that sounds quite possible. Wyller says the immune system is influenced by stress, so as long as the answer is some kind of CBT, he seems happy enough with the question.
In one of the TV programmes he was in the other day, he said straight out that his approach is most cost effective, so I guess the health authorities are happy too.
Can you be specific about the level of ignorance? I mean, I haven't read it, but it does seem from a glance at the abstract that, as is suggested, they're changing or at least shifting their tune. Doesn't pointing to immune activation undermine their persistent insistence that there's nothing pathophysiological going wrong in people with "functional" disorders? Or is the idea still that it is all from "psychosocial stress" or pandemic-related anxiety/depression, and that's causing the immune problems?
Jonathan Edwards
Senior Member (Voting Rights)
There is a vast literature, including multiple previous reviews of a far wider range of measures that they appear not to have noticed. White cell counts are not even worth remarking on, they are so non-specific. The most important information we have lies with negative data that they say nothing about. And what are 'PIFS' anyway?
These people have always written about 'bio' things as well as psychosocial. One of the earliest reviews on cytokines in ME/CFS is from Peter White. Knoop has been involved in all sort of bio studies. It means they can claim to know all about all the aspects and mix and match. As others have said, they will no doubt try and link in with 'stress'. There may be some political footwork going on in Holland (I have reason to think so) but there always was political footwork with this lot.
rvallee
Senior Member (Voting Rights)
I doubt it. Most of the BPS quacks have done some low quality studies like this, usually useless reviews like this. Just enough to point at so they can pretend they are not zealots pushing their harmful nonsense. It's not as if this study adds anything, but it is an easy citation on their academic record.
Plus, there is value to their BS to pretend to do 'research' trying to understand the immunological whatever of psychosomatic bullshit. They're just buying years of relevance, by trading millions of our lives for it. They've always done that. Every oil company has some BS renewable energy and "we're all in this together, take shorter showers to conserve energy" bullshit programs.
Bullshit works. Always does. Imagine being producers of some of the weakest most harmful pseudoscience in history admonishing research for being low quality. The key to bullshit is to be brazen and never give any ground, to be so shameless that people don't even dare call it out because it's so ostentatious, so obviously in-your-face insulting that no one would dare admit they were conned more easily than a toddler.
rvallee
Senior Member (Voting Rights)
I assume this is the angle they are pursuing. They will pretend to accept that the immune system is relevant, but that it's dysfunctional because of stress, whatever that means anymore. It's been extremely popular all over again with Long Covid, so easier to sell than cold water in a desert.
There's probably a few decades to waste on that. Medicine has become obsessed with blaming everything on the vague notion of 'stress'. I even noticed some weird quote by a researcher, I think it was on here, who did a LC study and concluded that reducing stress must be the solution for LC, saying something like stress is the biggest factor affecting the immune system.
Imagine saying something like that just a few years after the most deadly pandemic in decades, one that isn't even over, added a larger burden of illness than flu, but has been entirely memory-holed instead. Especially when research keeps pointing at infections being a likely cause in many diseases that are preferred to be thought of as being about lifestyle choices. The regression is so pathetic to watch, everything truly is enshittifying.
They want CBT and mindfulness and other junk pseudoscience to have this major effect on physiology, and the immune system being so complicated is such a perfect target. Especially when you add the equally complicated impacts on neurology, which is about just as poorly understood. They can make 'stress' appearing to be the main factor in immune system function and have several years of being lauded as geniuses for it. Or whatever. They have a good scam going, they're not about to stop when it takes zero effort from them.
Always assume bad faith with these people, it literally never fails.
Sly Saint
Senior Member (Voting Rights)
post-infective fatigue syndromes widely used by bps lot in earlier 'research' (as per thread title) first seemed to crop up with Oxford criteria.
see tag 'pifs'
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Utsikt
Senior Member (Voting Rights)
I have no doubt this will be used to argue that there is nothing obviously wrong with patients that present with these symptoms, so there is no need to do tests on them because testing can be harmful. Besides, we have effective treatments that are cost effective, so please give us more money.
Utsikt
Senior Member (Voting Rights)
Can’t say I’m looking forward to that publication. At least they give us a heads up.
There is nothing in these two references about «functional» brain alterations, at least not using that word and I didn’t find anything when skimming the papers. Lloyd and Raijmakers were authors, so they should know what they wrote.
7 is about the acute sickness response to infection, while this papers is about the non-acute response.
Genetic associations of fatigue and other symptom domains of the acute sickness response to infection - PMC
► The sickness response to acute infection has discrete symptom domains including fatigue, which have unique genetic associations. Keywords: Acute sickness response, Fatigue, Genetic association, Cytokine, Polymorphisms
pmc.ncbi.nlm.nih.gov
83 is an omics paper and Q-sever fatigue syndrome and CFS.
Multi-omics examination of Q fever fatigue syndrome identifies similarities with chronic fatigue syndrome - Journal of Translational Medicine
Background Q fever fatigue syndrome (QFS) is characterised by a state of prolonged fatigue that is seen in 20% of acute Q fever infections and has major health-related consequences. The molecular mechanisms underlying QFS are largely unclear. In order to better understand its pathogenesis, we...
translational-medicine.biomedcentral.com
It’s also very telling that they just happen to mention functional brain alterations for the first time in passing in the conclusion.
How this got past peer review and editors is beyond me, but I guess we can’t expect too much from the Lancet..
Of course they end with a bit of self-gratification. Maybe they are just practicing their beliefs that if you say something enough times it will eventually become true.
What is the equivalent term to 'green washing' for what they are doing? Bio-washing?