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PLoS ONE: Raltegrevir is a Potent Inhibitor of XMRV...

Angela Kennedy

Senior Member
Messages
1,026
Location
Essex, UK
Great! Nice to see promise in a few anti-retrovirals with a synergistic effect. And the discussion and abstract give more accurate info on ME/CFIDS than the vast majority of articles.

I will be nitpicky here. A quote from the study:


It's nice that he at least qualifies his statement that GET is effective. But there are still problems with this statement.

He says that GET appears to exert a positive treatment effect by improving coping skills rather than reducing symptoms. He sites a 2000 article by Chalder and Wessely. One problem is the Wessely article doesn't support the statement. (It, of course, just says that GET is the greatest thing since sliced bread for reducing "CFS" symptoms).

A second problem is that there is no credible evidence (of which I am aware, pls correct me if mistaken) showing that GET helps Canadian or Fukuda described ME patients. Studies using the "Oxford" definition are patently invalid as this definition merely describes idiopathic chronic fatigue, not the discrete disease ME/CFIDS.

The third problem is that there is good evidence that GET causes substantial iatrogenic morbidity in a large percentage of ME patients.

The fourth problem is that it does not seem even theoretically possible that GET could improve coping skills (well administered CBT could theoretically improve coping skills and this is probably just a sloppy conflation of CBT and GET on the author's part).

Yes - and the 'proven' benefits is a wild claim if ever there was one about CBT/GET. "Proof"? REALLY? I'm always surprised to see that term get past in a 'science' paper. Scientists should know about the problem with that word, let alone in regard to CBT/GET.
 

Abraxas

Senior Member
Messages
129
U.S. study shows anti-HIV drugs inhibit virus linked to prostate cancer & ME

Not sure if this has been posted anywhere yet: http://news.xinhuanet.com/english2010/health/2010-04/02/c_13234873.htm

WASHINGTON, April 1 (Xinhua) -- Four drugs used to treat HIV infection can inhibit a retrovirus recently linked to prostate cancer and chronic fatigue syndrome, researchers at Emory University/Atlanta Veterans Affairs Medical Center and the University of Utah said.

The findings suggest that if XMRV (xenotropic murine leukemia virus-related virus) is proven to be a cause for prostate cancer or chronic fatigue syndrome, those illnesses may be treatable with drugs already approved for treating HIV. The results were published Thursday by the journal PLoS One.

Discovered in 2006, XMRV has been detected in some prostate cancer patients' tumor biopsies by several investigators. However, its precise role in driving prostate cancer is unclear. A recent report detected XMRV in a majority of chronic fatigue syndrome patients, but these results have not been confirmed by other laboratories.

"Not all studies that have looked for XMRV have been able to detect it in prostate cancers or in samples from chronic fatigue syndrome," says Ila Singh, associate professor of pathology at the University of Utah School of Medicine. "We will need to see the results of clinical trials before these drugs can be used in a clinical setting."

Singh and Raymond Schinazi, professor of pediatrics and chemistry at Emory's Center for AIDS Research, and colleagues teamed up to test 45 anti-HIV compounds, some of these discovered by Emory researchers, and other antiviral compounds against XMRV in cell culture.

The most potent drug against XMRV was raltegravir, produced by Merck and sold under the commercial name Isentress. The FDA initially approved raltegravir in 2007 only for persons whose HIV infection was resistant to other drugs, but in 2009 its approval was expanded to all HIV infected persons.

Raltegravir represents a new class of antiretroviral drugs because it inhibits the integrase enzyme, preventing the virus from invading a cell's DNA.

Besides raltegravir, three other compounds -- another integrase inhibitor and AZT and tenofovir DF, two reverse transcriptase inhibitors -- also inhibit XMRV replication. This suggests that these drugs could be used together in combination therapy, a particularly effective tactic against HIV that helps prevent the emergence of drug-resistant forms of the virus.

"Our study showed that these drugs inhibited XMRV at lower concentrations when two of them were used together, suggesting that highly potent 'cocktail' therapies might inhibit the virus from replicating and spreading," Schinazi says. "This combination of therapies might also have the added benefit of delaying or even preventing the virus from mutating into forms that are drug-resistant."

The study has also been covered in a few other articles including:

Prohealth - http://www.prohealth.com/library/sh...ium=SiteTracking&utm_campaign=home_LatestNews

Business Week - http://www.businessweek.com/lifestyle/content/healthday/637521.html

ETA my apologies, just noticed another thread has been started on this study with an article in the Scientific American. Can a mod or admin merge the two? Thanks.
 

Adam

Senior Member
Messages
495
Location
Sheffield UK
Thanks for posting Abraxas ye Gnostic god ye.;)

I looked on Glaxo site and could not decipher whether or not they produce any of the existing antivirals shown to be effective against XMRV.

It would be something else, wouldn't it, if one of the HIV drugs could be trialled for XMRV in CFS?:victory:

Adam (a mere mortal)
 
G

Gerwyn

Guest
Yes - and the 'proven' benefits is a wild claim if ever there was one about CBT/GET. "Proof"? REALLY? I'm always surprised to see that term get past in a 'science' paper. Scientists should know about the problem with that word, let alone in regard to CBT/GET.

I agree proof is a poor word in general connected to CBT and GET it must mean something like the following:

Proving ,the process by which a yeast-leavened dough rises. Presumably powered by hot air,keeping it in the dark and adding several layers of Bullsh*t.

On a more serious note,i have written to Dr Sing:

Dear Dr.Sing,

I have just read your paper in Plos ONE which I enjoyed and thought was absolutely first class

I must point to one error in the discussion however:

There is no scientific evidence whatsoever that CBT or GET has any effect on the core symptoms of ME/cfs.There is, however, a great deal of propaganda circulating regarding the matter.

The "evidence" relates to patients diagnosed according to the notorious "Oxford" criteria with fatigue as the only constant selection criteria.Patients suspected of having a medical cause for their fatigue are excluded.Patients with fatigue of psychological origin are not.The so called evidence even then involves no objectively measured criteria at all but focuses on patients self reporting.Given the power imbalances between Psychiatrist and patient these results could simply be the product of demand characteristics.

I would comment on the evidence, subjective or otherwise, involving patients diagnosed according to the complete FUKUDA definition and the even more stringent CANADIAN CONSENSUS DEFINITIONS but there simply isn,t any to comment on.

Yours Sincerely,
G.J Morris Bsc LLB
 

parvofighter

Senior Member
Messages
440
Location
Canada
Make sure to add comments to PLoS One

Frickly, thanks for posting this. It's such an important article - and it has really gone around the block a couple of times in the media - great leverage for some exciting information!

The Discussion section is especially fascinating.

[FONT=&quot]The finding that RAL, L-000870812, TDF and ZDV have strong synergistic effects when combined in dual combination bodes well for combination therapy in case of XMRV infection. If XMRV infection parallels other retroviral infections, then the use of combination antiretroviral therapy might maintain XMRV suppression, prevent the emergence of resistance to antiretroviral agents and possibly also cause amelioration of disease.

To our surprise, even the two IN inhibitors displayed a synergistic effect.

[/FONT]​
Synergism is good - you get more therapeutic effect with less toxic drug. Now remember it was an issue for some folks that XMRV has so little genetic variation? Might this just be a piece of "junk virus"? Doc Singh doesn't seem worried at all.
It is important to note here, that XMRV differs from HIV-1 in one aspect that is significant for these studies: XMRV isolates show very limited sequence diversity compared to HIV-1 or MLV. Of all the sequenced XMRV isolates that currently exist, both from cases with prostate cancer as well as CFS, obtained from geographically distant parts of the United States, the two least related genomes differ from each other in only 27 out of a total of over 8,100 nucleotides. A similar degree of limited genetic diversity has been found for HTLV-1 [38], another retrovirus implicated in both cancer and neuroimmune illness.
In other words, things still fit conceptually - don't get your knickers in a knot! And a friendly heads-up to those of you who might like to comment on the paper.

You can post comments here: http://www.plosone.org/annotation/getCommentary.action?target=info%3Adoi%2F10.1371%2Fjournal.pone.0009948

I just put in a plug as "Science-Based" for other prostate cancer researchers to cross over to the "dark side", and do research on XMRV, prostate cancer, AND ME/CFS. The early birds get the worms!
 

hvs

Senior Member
Messages
292
Why get worked up about antiretrovirals?

Why get worked up about antiretrovirals when all one would have to do to vaporize the xmrv is make a brief jaunt to England? As everyone knows, it cannot exist there.
 

hvs

Senior Member
Messages
292
What'd they do, peer-review this thing?? "Received: February 18, 2010; Accepted: March 11, 2010; Published: April 1, 2010"
Gee whiz, Wessely didn't have to go through something as plebeian as peer review...
 

Dolphin

Senior Member
Messages
17,567
I agree proof is a poor word in general connected to CBT and GET it must mean something like the following:

Proving ,the process by which a yeast-leavened dough rises. Presumably powered by hot air,keeping it in the dark and adding several layers of Bullsh*t.

On a more serious note,i have written to Dr Sing:

Dear Dr.Sing,

I have just read your paper in Plos ONE which I enjoyed and thought was absolutely first class

I must point to one error in the discussion however:

There is no scientific evidence whatsoever that CBT or GET has any effect on the core symptoms of ME/cfs.There is, however, a great deal of propaganda circulating regarding the matter.

The "evidence" relates to patients diagnosed according to the notorious "Oxford" criteria with fatigue as the only constant selection criteria.Patients suspected of having a medical cause for their fatigue are excluded.Patients with fatigue of psychological origin are not.The so called evidence even then involves no objectively measured criteria at all but focuses on patients self reporting.Given the power imbalances between Psychiatrist and patient these results could simply be the product of demand characteristics.

I would comment on the evidence, subjective or otherwise, involving patients diagnosed according to the complete FUKUDA definition and the even more stringent CANADIAN CONSENSUS DEFINITIONS but there simply isn,t any to comment on.

Yours Sincerely,
G.J Morris Bsc LLB
Don't forget that one can post comments to the article.

And because it's an online journal, a reasonable percentage of the people who read the article will likely read the comments.

Unlike the Erlwein article, there have not been that many comments (3).
 

JPV

ɹǝqɯǝɯ ɹoıuǝs
Messages
858
Now here's the 64,000 question...

Is XMRV the root cause of CFS/FM/ME or just a "passenger" taking advantage of an immune suppressed system that is indicative of a wider syndrome?

http://www.cfids.org/xmrv/default.asp

The authors (researchers at WPI) raise questions about this discovery at the end of the article, including Is XMRV infection a causal factor in the pathogenesis of CFS or a passenger virus in the immunosuppressed CFS patient population?

Sorry to say, but my money is on it being a "passenger".
 

hvs

Senior Member
Messages
292
Sorry to say, but my money is on it being a "passenger".

No need to be sorry: if it's a passenger, we treat it. How much do you want to bet that it restores people's functionality?
 
G

George

Guest
Looking for L-000870812

I went looking for information on L-000870812 all I could find was a bit about it in the "JAID"

With the development of a reliable biochemical screen, selective compounds that act as strand transfer inhibitors with antiviral activity have been identified and tested.8 One of these integrase inhibitors, L-000870812, exhibited highly robust antiviral activity in rhesus macaques infected with an HIV-simian immunodeficiency virus (SIV) chimeric virus, with a reduction in levels of plasma RNA from 107 to <250 copies/mL.9
link to artical

It may be that it hasn't gotten out of animal studies yet. Anyone have any other info??
 

cfs since 1998

Senior Member
Messages
618
I went looking for information on L-000870812 all I could find was a bit about it in the "JAID"

link to artical

It may be that it hasn't gotten out of animal studies yet. Anyone have any other info??

Reference 9 is this:
http://www.ncbi.nlm.nih.gov/pubmed/15247437

Looks like it was published by Merck.

I can only see the abstract but the full text might have more information. As an aside, the CD4 depletion therapy they were using with this sounds interesting. Remember rituximab? Very interesting.
 
G

George

Guest
Reference 9 is this:
http://www.ncbi.nlm.nih.gov/pubmed/15247437

Looks like it was published by Merck.

I can only see the abstract but the full text might have more information. As an aside, the CD4 depletion therapy they were using with this sounds interesting. Remember rituximab? Very interesting.

Yeah, the B cell depletion that made the CFS'ers feel better. (big grins) So I'm wondering we got two by Merck Raltgravier and L-000870812 one by Gilead, that's the Tenofovir so these are different companies who have a horse to enter into this race then. Nice!
 

cfs since 1998

Senior Member
Messages
618
Yeah, the B cell depletion that made the CFS'ers feel better. (big grins)
I realized you can view the full text for free if you register at the website. In doing so I realized I made a mistake, they did not artificially deplete their CD4 cells, they meant they were starting the drug before the CD4 cells were killed off by the virus.

It did say "integrase inhibitors may present a high genetic barrier to resistance development" which I thought was interesting, and also that when treatment is started early the inhibitor can enhance cell-mediated immunity.

George said:
So I'm wondering we got two by Merck Raltgravier and L-000870812 one by Gilead, that's the Tenofovir so these are different companies who have a horse to enter into this race then. Nice!

Yeah, so Merck has two drugs, one approved and one experimental, and Gilead. And we know Glaxo is interested because they are planning a WPI replication study, so maybe they have a drug on the back shelf they think will work too, or that they could develop a new one relatively easily.
 
G

George

Guest
Yeah, and it's only like, what, $180.00 a month times that by ummmm, the rest of your life for like . . . let's see oh 17 million people o.k.. . . .so like 2,160 per person per year, multiply by oh, let round down to an even 10 million so what a paltry 21 million a year. dang I don't think that's enough to pay the pool boy. (grin)
 

rebecca1995

Apple, anyone?
Messages
380
Location
Northeastern US
Now here's the 64,000 question...

Is XMRV the root cause of CFS/FM/ME or just a "passenger" taking advantage of an immune suppressed system that is indicative of a wider syndrome?...

It's possible that XMRV is not the "puppet master" but just another co-infection, like HHV-6, mycoplasma, or the many infections already associated with ME/CFS. In this case, I think it's quite likely that people could improve from treating XMRV in the same way many benefit from treating HHV-6 with antivirals and mycoplasma with antibiotics.

A similar situation: LLMDs universally say that though Bb (the causative agent of Lyme disease) is the main problem in most with Lyme, it's important to treat other tick-borne co-infections like Babesia, Bartonella, and Ehrlichia, if they're present. The belief is that you can't get over Bb if you're fighting any of these.

It's also possible that XMRV may not cause any pathology at all. But if it does, treatments for it could be helpful, whether XMRV is the Mob Boss or just another henchman. (Can't remember who coined that metaphor...thanks for letting me shamelessly steal it! :D)
 

hvs

Senior Member
Messages
292
It's also possible that XMRV may not cause any pathology at all. But if it does, treatments for it could be helpful, whether XMRV is the Mob Boss or just another henchman.

This is a distinct possibility. And of course the experience of Peterson, Klimas, Lerner, et al suggests a possible association between xmrv and herpes family viruses.
 

Doogle

Senior Member
Messages
200
Yeah, and it's only like, what, $180.00 a month times that by ummmm, the rest of your life for like . . . let's see oh 17 million people o.k.. . . .so like 2,160 per person per year, multiply by oh, let round down to an even 10 million so what a paltry 21 million a year. dang I don't think that's enough to pay the pool boy. (grin)
Isn't that 21 billion?