Journal of IiME Volume 1 Issue 1 INFORMATION ON ME/CFS (continued) OVERLAP OF ME/CFS WITH POST POLIO SYNDROME Prestigious papers, for example, Annals of the New York Academy of Sciences 1995 (containing 50 papers on clinical neurology, neuroscience, electrophysiology, brain imaging, histology, virology, immunology, epidemiology, with contributors from the US, Australia, Canada, France, Sweden and the UK) point out the similarities between post-polio syndrome and ME/CFS, notably that the mechanism of the extreme fatigue (called “visceral exhaustion”) -- is exactly the same in ME/CFS as in PPS. STRESS ENHANCES SUSCEPTIBILITY TO INFECTION There is substantial evidence that concurrent stress at the time of viral exposure leads to more severe disease. Stress is known to increase susceptibility to those diseases that are immune-related, eg. infectious disease, cancer and autoimmune disorders. PSYCHONEUROIMMUNOLOGY There is a vast literature (from 1884 to date) on the pathway of causation whereby stress, especially traumatic stress, affects the immune system and potentiates disease development. CHEMICAL INJURY TO THE BLOOD BRAIN BARRIER There is published evidence to show that one mechanism of causation is likely to be a combination of stress and chemicals, resulting in chemical trauma to the brain via a breaching of the blood brain barrier (BBB): stress can intensify the effects of some chemicals, making them very harmful to the brain, nervous system, and liver (resulting in congested blood vessels, reduction of an important enzyme and abnormal fatty deposits), leading to cellular death, especially when chemicals are combined. The ability of chemicals to leak from one area of the brain to another holds the potential for much greater damage to occur in the entire brain. IMMUNOLOGY IN ME/CFS The most commonly found immune abnormalities are very low natural killer (NK) cells, with decreased cytolytic activity, and an increased CD4 - CD8 ratio; there is an increase in the CD8+ cytotoxic T cells bearing antigenic markers of activation on their cell surface; there are higher frequencies of low levels of various autoantibodies, especially antinuclear and anti-smooth muscle antibodies; there are low levels of circulating immune complexes; there are increased levels of IgE and decreased levels of IgG3. Low levels of IgG3 have been reported since 1986 in patients with aching muscles. Overall, these abnormalities are consistent with evidence demonstrating chronic, low-grade immune activation in ME/CFS. In 1994, an international ME /CFS expert (Dr Paul Levine of the Viral Epidemiology Branch of the National Cancer Institute, Bethesda, Maryland) stated “ the spectrum of illnesses associated with a dysregulated immune system must now include CFS” (ref: Clin Inf Dis 1994:18 (Suppl 1):S57-S60). Importantly, it has been convincingly demonstrated that changes in different immune parameters correlate with particular aspects of disease symptomatology and severity. ALLERGIES and MULTIPLE CHEMICAL SENSITIVITY (MCS) IN ME/CFS The relationship between viral infections and onset of allergic disease is well-documented in the medical literature. With specific relationship to ME/CFS, there is overwhelming published evidence that allergies, food intolerance and multiple chemical sensitivities (MCS) are very common; an increasing sensitivity and adverse reaction to many drugs / therapeutic substances is widely believed to be virtually pathognomonic of ME/CFS. Cells cannot be attacked by the immune system unless they display on their surfaces complex glycoprotein molecules known as Class II MHC antigens; cells can be induced to do this by gamma-interferon, which is an anti-viral chemical produced by the immune system when under viral attack. Allergies in ME/CFS are thought to be the result of this mechanism, which makes the body cells susceptible to on-going attack by the immune system. Because reference to allergies is so widespread throughout the ME/CFS literature, many of these references are to be found throughout the reference papers, mostly in the sections on General ME /CFS, Immunology, and Neuroendocrinology. More and more patients are presenting with “total allergy syndrome”; this is recognised as part of ME/CFS; whilst some psychiatrists are notoriously dismissive about its existence, the literature (from highly reputable internationally acclaimed experts) clearly shows that it does exist, and that such patients do indeed develop abnormal immune parameters whilst under observation. (continued on page 45) Invest in ME Charity Nr 1114035 www.investinme.org 44
45 Publizr Home