it is very possible that there is a number of subgroups that will in time be better defined, and differentiated via various tests
Aye, although I've a feeling the broad heterogeneity in disease inputs and outputs (triggers/contributory factors and presentations) may all be channelled through similar, or perhaps even the same, core pathophysiological factors
Presently I relate ME/CFS principally to concomitant - plus possibly, over time, synergistic - neuro-glial/lymphocyte factors ~ essentially neuroexcitation/neuroinflammation + a(n interrelated) distortion of normal glial policing of the CNS/lymphocyte policing of the rest of the body (associated with autoimmunity)
This thread discusses work aimed at teasing out subgroups
Interesting. I'm all for rigorous analysis of large datasets, for me large scale/joined up analysis/meta-analysis/multi-stranded investigation and conceptualisation is what's been lacking in the bulk of ME/CFS research to date (hence my own endeavours) and I think he's right that it's highly likely there is more than one "
causal pathway" involved in ME/CFS or M.E. However 'causal pathways' is not the same as 'core, disease facilitating, causal
processes'
if we are to tackle the underlying pathology, we need to look at autoimmune disease generally
Aye
This paper considers leaky gut to be a common factor in both coeliac disease and Type 1 diabetes, including aetiology and the potential for treatment. The same may well apply to other autoimmune diseases, and I would be surprised if it didn't
Thanks, will add it to my extra CFS vs. the gut readings I've got on my desktop! I believe it does in some autoimmune disorders aye. Incidentally, on the subject of GI and autoimmunity, going back to the breast feeding issue I touched on in the thread about whether we can give ME/CFS to loved ones - one study appears to have found that breast fed infants are twice as likely to develop Crohn’s disease (
Baron et al. 2005)
There is a (growing) connection between environmental toxicity and autoimmune/developmental/personality/depressive disorders, with neuro-glial/lymphocyte processes being, for me, key links through which the former may often translate into the later, in the context of genetic vulnerabilities + accruing effects of aggravating factors
It is possible that for some sufferers the main compromised barrier is not the gut mucosa but the blood-brain barrier, for example as a result of head trauma
Funnily enough, at the mo my last entry in
'Extensions', under
'Proposed pathophysiological pathways' in my disease model is a series of relations involving compromised BBB/SBB elements and cerebral infiltration of large molecule toxins
Following that,
'Aggravating factors: Environmental toxins/antigens', in which I outline links between poisoning and elevated lymphocyte activity, nerve growth factor, plus infant BBB developmental abnormalities
Following that, '
'Aggravating factors: GI disorders', in which I outline links between poisoning, a fairly obvious GI risk factor, immunodeficiency, potential for infection, and interaction between certain GI bacteria and neurotropic viral pathogens (both with the potential to elicit autoimmune responses, particularly in those with genetic vulnerabilities and/or conditions of persistent infection in the context of immunodeficiency)
The tendency to define and treat diseases as discrete and different from each other is very much a modern phenomenon
Aye. I don't really care too much how we label the pathways to ME/CFS, or whether to start out thinking of it as a single aetiology jobbie or not, I care most about getting stuck into trying to understand the core mechanism(s) involved in eliciting such symptoms as best we can
My endeavours in the paper I'm putting together
are focused on identifying (common) core mechanism(s), and hopefully a core theme e.g. neuroexcitation and/or gliopathy, but I am not from a scientific background and indeed my broad-conceptual endeavours are in a sense a protest/reaction to narrow, discrete 'modern' scientific/biomedical approaches
That's not to say that Western-style medicine should be dismissed altogether, just that different kinds may have something to tell us
If you've ever had the chance to look at my protocol you'll have noted I am no stranger to the relative merits of alternative/integrative medicine!
Otherwise we have a tendency to treat downstream effects of pathology rather than root causes
Absolutely, hence my proactive 'protestation'
If, as you say, a root cause is abnormal nociception, this must itself have a cause, mustn't it?
Yup, quite possibly relating to the above mix
