Journal of IiME Volume 3 Issue 1 www.investinme.org P PRROOFFIILLEESS ooff PPRREESSEENNTTEERRSS aatt tthhee IINNVVEESSTT iinn MMEE I INNTTEERRNNAATTIIOONNAALL MMEE//CCFFSS CCOONNFFEERREENNCCEE In contrast to other types of viremic infections, EV RNA levels in whole blood of ME/CFS patients are extremely low, which likely explain the discrepancy of results reported from different research laboratories over the past two decades. Immunoperoxidase staining for viral protein in the stomach biopsies is more sensitive than the neutralizing antibody test or EV RNA detection, and furthermore, demonstrates the antigens in tissues where viruses are expected to replicate and persist based on the route of transmission. The finding of enteroviral RNA and growth of non-cytopathic viruses from the same tissues support the validity of protein staining. As enteroviruses have been largely forgotten since the eradication of poliomyelitis through effective vaccination, there is no specific antiviral therapy for acute or chronic infections. Pleconaril, an anti-capsid agent, showed limited benefit in 1/4 patients with ME/CFS associated with chronic enterovirus infections. Intravenous immunoglobulin, given monthly or every few months, can ameliorate inflammatory symptoms in less than 1/3 of adult patients, but may be more effective in pediatric patients. The combination of alpha and gamma interferon can induce short-term remission in about 45% of ME/CFS patients with debilitating myalgia, but is quite expensive and often poorly tolerated. One of the Chinese herbs, oxymatrine, has beneficial effect in 52% of 300 ME/CFS patients, but transient increase in symptoms are expected in most of the patients. Cytokine gene expression study during therapy demonstrates an increase of IL12/Il10 ration in 7/7 responders but in 0/10 non-responders. A decrease of stainable enteroviral protein is demonstrated in the stomach biopsies of three responders on oxymatrine therapy. Previous evidence for enterovirus infection in ME/CFS from over a decade ago has been confirmed and extended in recent studies. Development of antiviral therapy against enteroviruses is paramount; and the importance of enteroviruses in ME/CFS can be realized with a randomized, placebo-controlled antiviral drug trial. Additional links for Dr Chia: John Chia, Chronic fatigue syndrome is associated with chronic enterovirus infection of the stomach. J Clin Pathol. 2008 Jan;61(1):43-8. Epub 2007 Sep 13. PMID: 17872383 [PubMed - indexed for MEDLINE] Enterovirus infection as a possible cause of pityriasis rosea: demonstration by immunochemical staining. Chia JK, Shitabata P, Wu J, Chia AY. Arch Dermatol. 2006 ul;142(7):942-3. No abstract available. PMID: 16847226 [PubMed - indexed for MEDLINE] Diverse etiologies for chronic fatigue syndrome. Chia JK, Chia A. Clin Infect Dis. 2003 Mar 1;36(5):671-2; author reply 672-3. No abstract available. PMID: 12594650 [PubMed - indexed for MEDLINE] Invest in ME (Charity Nr. 1114035) Page 73/76
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