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What Causes ME/CFS: The Role of the Dysfunctional Immune System and Viral Infections, 2022, Bansal, Carding et al

Discussion in 'ME/CFS research' started by Tom Kindlon, Dec 14, 2022.

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  1. Tom Kindlon

    Tom Kindlon Senior Member (Voting Rights)

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    https://maplespub.com/article/what-...functional-immune-system-and-viral-infections

    Review Article | Open Access2022|Volume 3|Issue 2|
    https://doi.orG/10.37191/Mapsci-2582-6549-3(2)-033
    What Causes ME/CFS: The Role of the Dysfunctional Immune System and Viral Infections
    Amolak S Bansal1*, Aletta D Kraneveld2, Elisa Oltra3 and Simon Carding4

    1Consultant in Immunology, Allergy and CFS/ME, Spire Bushey Hospital, Watford, UK

    2Chair Interdisciplinary Translational Pharmacology, Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht the Netherlands

    3Department of Pathology, Faculty of Medicine and Health Sciences, Catholic University of Valencia, Valencia, Spain

    4Gut Microbes & Health, Quadram Institute Bioscience, Norwich Research Park, Norwich, NR4 7UQ, UK and Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK

    *Corresponding Author: Amolak S Bansal,Consultant in Immunology, Allergy and CFS/ME, Spire Bushey Hospital, Watford, UK.

    ReceivedAug 12, 2022 RevisedAug 22, 2022 AcceptedAug 29, 2022 Published
    Sep 16, 2022

    Abstract

    Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) remains an enigmatic highly disabling and complex long-term condition with a wide range of aetiologies and symptoms.

    A viral onset is commonly mentioned by patients and several bodily systems are ultimately disturbed.

    The parallel with long-covid is clear. However, immune dysregulation with impaired NK cell dysfunction and tendency to novel autoimmunity have been frequently reported.

    These may contribute to reactivation of previous acquired viruses/retrovirusesaccompanied by impaired endocrine regulation and mitochondrial energy generation.

    The unpredictable nature of seemingly unconnected and diverse symptoms that are poorly responsive to several allopathic and alternative therapies then contributes to an escalation of the illness with secondary dysfunction of multiple other systems.

    Treatment of established ME/CFS is therefore difficult and requires multi-specialty input addressing each of the areas affected by the illness.

    Keywords
    Myalgicencephalomyelitis/chronic fatigue syndrome (ME/CFS), Immune system, Viruses, Retroviruses, Cytokines, NK cells, Mitochondria

     
    Tom Kindlon, Dec 14, 2022
    #1
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  2. Hutan

    Hutan Moderator Staff Member

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    It's not the worst review I've seen, but you know that's a very low bar. Sorry, but this is disappointing, it seems superficial. It doesn't change my view of Bansal as teetering on the edge of BPS thinking.

    What is that actually saying? That immune dysfunction might be involved, but it might not? And if we knew what was causing the symptoms, that would help patients understand their illness and might provide clues as to how to treat it? Well, yes...


    There needed to be a lot more critical thinking and analysis, rather than a reporting of results. It's not helpful to mix up results from studies that are clearly flawed with ones that might be useful.


    The reference for this is
    10. Nguyen CB, Alsøe L, Lindvall JM, Sulheim D, Fagermoen E, Winger A, Kaarbø M,et al. Whole blood gene expression in adolescent chronic fatigue syndrome: an exploratory cross-sectional study suggesting altered B cell differentiation and survival. J Transl Med. 2017;15(1):1-21.PubMed | CrossRef
    I'd like to have a look at that study as it's not obvious to me from the paragraph how, collectively, the findings suggest an altered HPA axis.
    Edit to add: forum thread for this paper
    Whole blood gene expression in adolescent CFS: altered B cell differentiation and survival, 2017, Nguyen et al



    I'd like to know if this statement is true too.
    101. Ovejero T, Sadones O, Sánchez-Fito T, Almenar-Pérez E, Espejo JA, Martín-Martínez E, et al. Activation of transposable elements in immune cells of fibromyalgia patients. Int J Mol Sci. 2020;21(4):1366. PubMed | CrossRef

    102. Rodrigues LS, da Silva Nali LH, Leal CO, Sabino EC, Lacerda EM, Kingdon CC, et al. HERV-K and HERV-W transcriptional activity in myalgic encephalomyelitis/chronic fatigue syndrome. Auto Immun Highlights. 2019;10(1):1-5. PubMed | CrossRef


    I'm left wondering what the point of this paper was.
     
    Last edited: Dec 14, 2022
    Hutan, Dec 14, 2022
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  3. Andy

    Andy Committee Member

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    The paper ends with
    "Conclusion
    Is the immune dysregulation hypothesis proven?

    After over 20 year of attempting to identify specific immune defects and infectious agents that cause ME/CFS, clear pathways are still not evident. However, a complex interaction between the immune system and viruses/retroviruses is now emerging and manifesting subtle changes in cytokines, NK cells and T cells which directly or via autoimmunity may be responsible for the plethora of symptoms seen in ME/CFS. Combined with immune and pathogen-induced mitochondrial dysfunction now being dissected by several research groups it is quite possible that it will gain real insight into the cause of this enigmatic and highly disabling illness."

    so the point of the paper seems to be to show why they couldn't live up to the promise of the title?
     
    Andy, Dec 14, 2022
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  4. Hubris

    Hubris Senior Member (Voting Rights)

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    A lot of people have been saying this, for decades, but no study has ever been done where they try, let's say an immune drug, an antiviral drug and a mitochondrial drug(or supplements) together and the patients get better. No evidence whatsoever for this statement.
     
    Hubris, Dec 14, 2022
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  5. Hutan

    Hutan Moderator Staff Member

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    Yes, it's like they don't want to say 'there is no effective treatment'.

    'poorly responsive to several allopathic and alternative therapies'
    Allopathic medicine is
    So, they are saying the symptoms are poorly responsive to several conventional drugs and alternative therapies. It's such an odd way to phrase it. It certainly doesn't rule out BPS therapies. It doesn't even rule out drugs and alternative therapies that aren't those 'several'.
     
    Hutan, Dec 14, 2022
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  6. Sean

    Sean Senior Member (Voting Rights)

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    Sean, Dec 14, 2022
    #6
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  7. Hutan

    Hutan Moderator Staff Member

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    I checked out that reference, my commentary is on that linked thread.

    It most definitely is not evidence for an altered HPA axis. Not even remotely. Unequivocably, not.

    I won't say what I want to say about these authors. But if researchers don't take the time to actually read and think about the papers they cite, then it suggests that 'clear pathways' will still not be evident in another 20 years.
     
    Hutan, Dec 14, 2022
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  8. Milo

    Milo Senior Member (Voting Rights)

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    Retroviruses, really? Please provide proof of this, other than XMRV of course :android:
     
    Milo, Dec 14, 2022
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  9. SNT Gatchaman

    SNT Gatchaman Senior Member (Voting Rights)

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    Expanding the paper's quote up-thread on HERVs:

    Their reference [98] to lymphocytes in COVID is Evidence of the pathogenic HERV-W envelope expression in T lymphocytes in association with the respiratory outcome of COVID-19 patients (2021). I don't think we have a thread on that but its abstract contains:

    The ME and fibromyalgia specific HERV references [101, 102] do have threads (though it doesn't appear we were very impressed with the ME paper, not least with "CFS/MS" which persists in the accepted paper):

     
    Last edited: Dec 14, 2022
    SNT Gatchaman, Dec 14, 2022
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  10. Tom Kindlon

    Tom Kindlon Senior Member (Voting Rights)

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    From Mastodon:


    https://mas.to/@invest_in_me_research/109514264314178437
     
    Tom Kindlon, Dec 15, 2022
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