Journal of IiME Volume 3 Issue 1 www.investinme.org Similarities of ME/Chronic Fatigue Syndrome (ME/CFS) and Autism Spectrum Disorders (ASD): Comparisons of Co-Infections (continued) INTRODUCTION Although no single underlying cause has been established for CFS, there is growing awareness that CFS can have an infectious nature that is either causative for the illness, a cofactor for the illness or appears as an opportunistic infection(s) that aggravate patient morbidity (1, 2). There are several reasons for this, including the nonrandom or clustered appearance of CFS, sometimes in immediate family members (2-4), the presence of certain signs and symptoms associated with infection, the often cyclic course of the illness and its response to antimicrobial therapies (2, 5, 6). Previously we found that Gulf War veterans with CFS-like illnesses and a positive test for Mycoplasma fermentans transmitted their infections to their spouses and children (4). The adults in these families were diagnosed with CFS (7) but the children were subsequently diagnosed with Autism Spectrum Disorders (ASD) (8). The criteria for diagnosis of ASD are, in general terms, the presence of a triad of impairments in social interaction, communication and imagination (9). Examination of ASD patients in civilian families for the presence of Mycoplasma species infections revealed that the majority of these patients had one or more infections (10). In ASD cases there are reports of nonspecific signs and symptoms similar to those seen in CFS, such as fatigue, headaches, gastrointestinal and vision problems and occasional intermittent low-grade fevers and other signs and symptoms that are generally excluded in the diagnosis of ASD. These suggested to some authors that a subset of ASD patients may suffer from bacterial or viral infections (11). Here we examined three commonly found systemic infections in CFS patients, Mycoplasma species, Chlamydia pneumoniae and HHV-6 (12-14) and compared the incidence to the same infections found in ASD patients (10). Invest in ME (Charity Nr. 1114035) MATERIALS AND METHODS Patients: All CFS patients (North American, n=100) underwent a medical history, completed a sign/symptom illness survey, had routine laboratory tests and met the Fukuda et al. (15) exclusionary criteria. Control subjects (n=100) had to be free of disease for at least three months prior to data collection, and they had to be free of antibiotic treatment for three months prior to blood collection. All ASD patients (N=48) were randomly recruited from patient support groups in California after diagnosis of ASD according to the International Classification of Diseases (ICD-10) and the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). All ASD patients were assessed by the Autism Diagnostic Interview-Revised (ADI-R) (16) and Childhood Autism Rating Scale (CARS) (17, 18). Most (45/48) had a diagnosis of autism, while 6/48 were diagnosed with ADD (three of which were also diagnosed with autism) and nine autism patients with Asperger’s Syndrome. PCR Analysis of Blood: Blood was collected in EDTA-containing tubes and immediately brought to ice bath temperature as described previously (1214). Samples were shipped with wet ice by overnight air courier to the Institute for Molecular Medicine for analysis. All blood samples were blinded. Whole blood (50 µl) was used for preparation of DNA using Chelex (Biorad, Hercules, USA). Aliquots from the centrifuged samples were used immediately for Polymerase Chain Reaction (PCR) as described previously (1214). Statistics: Subjects’ demographic characteristics were assessed using descriptive statistics and students’ t-tests (independent samples test, t-test for equality of means, 2-tailed). The 95% confidence interval was chosen for Page 15/76
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