Two-stage metabolic remodelling in macrophages in response to lipopolysaccharide and interferon-γ stimulation, 2020, Seim et al.

I'm always interested to see theories where LPS can trigger PEM-like symptoms. I have poor digestion and often digestive disturbances can leave me exhausted and very brainfogged.

I've come to think of that as leaky gut pushing LPS into the blood.

Duration is usually not as bad as PEM from exericse. The two can stack though.

 

It might not identify the mechanism, but a reliable response from the majority of PWME would be valuable, if for nothing more than verifying that ME is biological rather than psychological. It needn't be a cytokine; I just think it's likely that a cytokine would affect ME symptoms. That's just my experience with immune activation of various types worsening my ME symptoms.

 

A close relative was having interferon treatment for Hep. C the same year of my very severe ME onset. His symptoms sounded like mine. I remember thinking that his symptoms would be turned off eventually, but mine were uncontrolled and no help in sight. I did post about this year's ago on PR.

 

It was mostly due to the fact that since starting a stimulant, I reliably experience an immediate, primarily muscle pain, stiffness, and feverishness “PEM” that lasts for ~24 hours, and I very rarely experience the typical delayed flu-like PEM. I know that the immediate PEM is at least partially mediated by prostaglandins since NSAIDs have an effect on the muscle pain and stiffness, but very little effect on delayed PEM.

I’ve also read that prostaglandin release inhibits interferon production. I’m definitely not sure it’s TNFa and IL-6, they just happen to fit with the timeline and a study into viral myalgia (unfortunately I can’t find the link now, it was posted by someone else on another thread) reported that injecting a mix of cytokines, including those two, triggered reports of myalgia.

That’s interesting corroboration from your son, thank you!

I haven’t heard of that but thanks for letting me know! That sounds promising. I’ve reached out to Chris a little while ago but haven’t gotten a response, I assume he’s just very busy.

[Edited for grammar]

 

There was a trial by the Fluge/Mella team in Bergen on TNFa inhibition along with Rituximab. It got terminated, and I haven't come across any published data. Might be worth the try reaching out to ask about their experience with it.
( @jnmaciuch )

 

Thanks!

 

The page says this at the top:

 

I've just been talking to my relative who had been on interferon and asked if he could remember whether he had worsening of symptoms while working full time during his treatment. He said he didn't think he did. He said his symptoms had felt just the same, awful. I remember how hard it was for him to be working while on treatment and had wondered recently about whether he experienced PEM. So I had a chance today to ask.

So it sounds like maybe not regarding PEM the way we experience it. So not a definite yes

 

It might depend on which interferon. ME symptoms not responding to IFN-a doesn't mean they don't respond to IFN-g.