Journal of IiME Volume 3 Issue 1 www.investinme.org Human enteroviruses and chronic infectious disease (continued) diseases, such high correlations have not been observed. Poliovirus caused paralytic disease during epidemics(22) but only about 1 out of every 100-200 infections involved life-threatening paralysis. The HEV, thought to be primarily CVB, which have been closely linked to causing myocarditis, have been detected in about 15-20% of samples in a variety of studies(21). To explain the high number of positive stomach samples with CFS, one must consider the possibility of a continuing process in CFS patients of new infections with different HEV serotypes and/or a significant number of persistent infections in the stomach. The difficulty these workers had in culturing the viruses from stomach tissue, would be consistent with either HEV strains that do not replicate well in standard tissue culture systems and/or the viruses exist in a form that is difficult to detect. While most HEV do replicate in certain cell cultures, others require the use of suckling mice(27). It is interesting to consider that a HEV-TD population would fit such a description of a 'difficult to culture virus". At present, these findings are highly intriguing but need also to be considered with the proverbial 'grain of salt'. It is of the highest and immediate importance to identify the HEV in these stomach biopsies in order to verify and move forward the theory that HEV are involved in the CFS etiology. Are they a specific serotype of HEV or are they many different types? This can be determined without culturing the viruses, by amplification of specific genome regions and determination of the RNA sequence(5, 24-26). Once established which specific HEV are present, relevant model systems might be developed using cell cultures and possibly mice, to study the CFS disease onset process. Summary Basic research into the biology of the HEV has lead to truly fantastic discoveries which Invest in ME (Charity Nr. 1114035) in turn, have lead to 'bench to bedside' advances. Understanding how to culture animal cells in the laboratory, made possible propagation of the agent that causes polio and subsequent studies in primates, work that in turn lead to the development of the successful poliovirus vaccines from which we have all profited. A search for other viral agents that induce polio-like disease lead to the discovery of the coxsackieviruses and indeed many other HEV. The development of a mouse to study retinal disease produced the NOD mouse, a highly useful mouse strain that is regularly used in studies of T1D. We know that serendipity and planning go hand in hand and often in the laboratory, are hard to tell where one begins and the other leaves off. As scientists who focus on all things enteroviral, we are especially interested in the findings of Chia and Chia that suggest the potential for an HEV link in CFS etiology. Our finding that a deletion in the terminal portion of the CVB genome, was the mechanism by which HEV can persist, could not have been predicted based on what was known. This finding has opened a completely new and quite unsuspected chapter in the very well thumbed volume on enterovirus biology. This was elegantly enunciated by Louis Pasteur in his famous quotation: "Where observation is concerned, chance favors the prepared mind." Without the existence of basic science, most of what we know take for granted in medicine would not exist. It is of the greatest importance to keep in mind the goal toward which one works in science, but it is also of equal importance to simply explore and define the 'new' while keeping that mind well prepared for finding new treasures. It is only through such efforts that we believe the etiology of CFS will be finally illuminated. Page 29/76
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