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"Chronic fatigue syndrome and increased susceptibility to upper respiratory tract infections..."

Discussion in 'Latest ME/CFS Research' started by Kyla, May 1, 2015.

  1. Kyla

    Kyla ᴀɴɴɪᴇ ɢꜱᴀᴍᴩᴇʟ

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    Anyone read this?
    http://www.tandfonline.com/doi/abs/10.1080/21641846.2015.1033271?journalCode=rftg20
    It's behind a paywall, so I only have the abstract :

    Chronic fatigue syndrome and increased susceptibility to upper respiratory tract infections and illnesses
    Background: Previous research has suggested that chronic fatigue syndrome (CFS) patients report more upper respiratory tract illnesses (URTIs) than controls. Aims: The present study aimed to replicate and extend this research. Method: A prospective study of the incidence of URTIs was conducted. This was similar to previous work involving diary studies but also included objective measures of illness severity (e.g. nasal secretion; sub-lingual temperature) and infection (virus isolation from nasal swabs and antibody changes). Fifty-seven patients with CFS, diagnosed according to the 1994 CDC criteria, were recruited randomly from a volunteer panel compiled of patients who had attended the Cardiff CFS outpatient clinic. A further 57 individuals without CFS were recruited from a general population research panel. Results: The results confirmed that CFS patients report more upper respiratory virus infections and the virological results showed that this was not due to a reporting bias but reflected greater susceptibility to infection.Conclusions: This increased susceptibility to infection in the CFS group can account for the increased reporting of URTIs found in this and previous studies.


    On a hilarious /horrifying sidenote, while looking to see if there was a free copy of this anywhere, I found a similar study that was trying to prove ME/CFSers have more upper respiratory tract infections...of psychological origins :bang-head:
    Maybe this should have its own thread, but I am not sure it merits one:
    http://www.ncbi.nlm.nih.gov/pubmed/17535488
     
    Last edited: May 1, 2015
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  2. Dolphin

    Dolphin Senior Member

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    Wrong link:
    http://www.tandfonline.com/doi/full/10.1080/21641846.2015.1033271#.VUQizfm4SUk

    For what it's worth, Andrew Smith co-authored both.
     
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  3. Kyla

    Kyla ᴀɴɴɪᴇ ɢꜱᴀᴍᴩᴇʟ

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  4. Rrrr

    Rrrr Senior Member

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    so the author "evolved" -- he first said cfs patients made up their upper respiratory infections (that was in 2008), and then by 2014 he actually did the work of doing swabs, etc, and found that, yes, cfs patient indeed HAD genuine upper respiratory infections. he smartened up. but why oh why did he start with a psychological hypothesis in 2008. it is like a default of all researchers re: cfs, "oh, they are all looney."
     
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  5. Hip

    Hip Senior Member

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    He did not actually say that the ME/CFS patients made up their infections in 2008; the study just found that respiratory infections were preceded by periods of high psychological stress. In fact in the full 2008 paper is here he points out that ME/CFS patients were reliable in reporting real respiratory infections:
    What he did say though in 2008 was:
     
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  6. SOC

    SOC Senior Member

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    my bolding

    So does he say this about all patients suffering from URTIs, or is he just prejudiced against CFS patients in noting a "tendency on the part of CFS patients to make somatic attributions for the symptoms"? If he accepts that virology found that CFS patients were reliable in reporting URTIs, why does he even bring up the stupid idea that they need to control for our supposed tendency to make somatic attributions, presumably for non-somatic symptoms? Doesn't that sentence logically contradict itself?

    "The patients actually do have URTIs according to virology, but since they tend to claim that their real symptoms are, in fact, real, we should nevertheless not believe them and need to check up on their genuine claims of illness." o_O
     
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  7. taniaaust1

    taniaaust1 Senior Member

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    I don't think we'd ever see a quote like that refering to like cancer patients in that sentence. It really shows once again the types of biases we face. The people usually doing our studies are going into them with biases towards us.
     
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  8. Hip

    Hip Senior Member

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    @SOC
    Yeah, I am not entirely sure, but I think the study authors Faulkner and Smith were expressing their concern that the URTIs reported by ME/CFS patients might not be real, because of this widespread but erroneous idea that ME/CFS patients' symptoms are all psychosomatic.

    Nevertheless, they cited a previous study which found that the URTIs reported by ME/CFS patients were indeed real, and so I think these authors assumed that the URTIs reported in their study were real also, even thought they did not perform virus testing.


    It's amazing that once this psychosomatic idea was introduced, it was blindingly accepted without any evidence by so many ME/CFS researchers. This psychosomatic idea, untenable though it is, became a bad "meme" rampantly infecting whole swathes of academia.
     
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  9. Sean

    Sean Senior Member

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    Enough material in this phenomenon to make several careers for medical historians. For those aspiring historians brave and competent enough to confront the medical establishment over it.
     
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  10. SilverbladeTE

    SilverbladeTE Senior Member

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    Psych crap aside, I have had several bouts of bronchitis since I got this damn illness.
    I have little contact with people day to day so I don't get cold/flu so much, now.
     
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  11. Hip

    Hip Senior Member

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    Most (but not all) patients seem to rarely catch colds anymore after developing ME/CFS.

    A poll on this forum found that around 82% of ME/CFS reported less colds since developing their disease, with only around 13% reporting more colds since getting ME/CFS.

    Because lots of ME/CFS patients don't get out and about much, it's possible that this might explain their reduced rate of catching colds. However, I have to say that in my case, I am living with a few people in the same house, and I notice that when one person brings in a cold, it usually quickly spreads to the other household members through normal social contact. Except to me. I typically only get a cold something like once every one or two years.

    So this suggests that it may not just be the lack of getting out and about that explains the reduction in catching colds; there seems to be a genuine increase in immunity to viral infection.



    Rich Van Konynenburg had a hypothesis of how this seemingly increased immunity to viral infection arises: he thought that because some parts of the immune system in ME/CFS were working under par, this resulted in other areas of the immune system getting up-regulated in order to compensate. In particular, Rich though that our first line in immune defense — the interferon alpha and interferon beta response — was ramped up in ME/CFS patients in order to compensate for weaknesses in other areas of the immune system (weaknesses such as natural killer cell and CD8 T cell function).

    If you have your first line in immune defense ramped up 24/7, this would mean that any cold virus that happens to land in you mouth or respiratory tract will tend to get immediately eradicated by the interferon response before it has a chance to take hold in the body.



    How this observation that many ME/CFS patients rarely catch colds squares with this latest study's findings that ME/CFS patients report more upper respiratory virus infections, I really don't know.

    Note that upper respiratory infections include more types of infection that just common colds: URTIs include sinusitis, tonsillitis, laryngitis and influenza. Some ME/CFS patients do suffer from a lot of sinusitis. So this might explain the discrepancy: although ME/CFS may not catch colds that often, they may be more susceptible to other URTIs.

    Also, without seeing the full paper, it's not clear whether these URTIs detected in ME/CFS patients might have been due to catching a new virus, or due to reactivation of an existing virus.
     
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  12. Kyla

    Kyla ᴀɴɴɪᴇ ɢꜱᴀᴍᴩᴇʟ

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    It seems both immune suppression AND an overactive immune system are variously reported. It could be subgroups? Or that some parts of the immune system are down-regulated and others unregulated?

    It would also be interesting if studies started to divide results before/after the three year mark, since the Hornig study seemed to indicate there might be a drastic change in what the immune system is doing later in the illness.

    I know for myself personally I find it hard at this point to even determine when I have caught any kind of virus, due to feeling flue-ish a fair amount of the time anyway, Basically I am only sure if I spike a high fever or have some other symptom that is not part of my usual repertoire.
     
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  13. justy

    justy Donate Advocate Demonstrate

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    Ha! looks like my respiratory consultant was going on the older study when he said my respiratory infections where 'not real' that there was 'no evidence' I was having lung infections, and that just because the antibiotics made me able to breathe, cleared up the green gunk I was coughing up and stopped the cough it didn't mean I had respiratory infections but that the antibiotics were a storng placebo!!

    I hardly ever get common colds, but I do get lots of lung infections, had pneumonia twice and regularly get pharyngitis and laryngitis episodes.
     
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  14. Effi

    Effi Senior Member

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    This makes so much sense to me! I always wondered why I wasn't catching colds and other viruses from people in my house... When they get sick I usually get this 'almost sick' thing, where I feel that my body is fighting off something, without ever actually getting sick.

    I did get a ton of ear infections and very painful sinus infections in the first three years. After that it changed.
    I wonder about these subdivides a lot... Physically I feel like my immune system is in hyper mode all the time now. Could it be both, though, half hyper and half weakened? What a mess!
     
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  15. jimells

    jimells Senior Member

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    Of course, with a Fukuda cohort we don't really know who they were researching. And the researchers don't either.


    So this is a study from a NHS clinic in the UK? Did it include homebound patients? I'm no researcher, but these results seem more suspect than usual to me.
     
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  16. Hip

    Hip Senior Member

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    I have not seen any evidence to suggest the CCC produce a more homogenous cohort than the Fukuda criteria.

    One study found the CCC selected for patients with more severe ME/CFS compared to the Fukuda criteria, and that there was more psychiatric comorbidity in the CCC patients (which perhaps might be expected if you have a more severe level of ME/CFS, a neurological disease).
     
  17. SilverbladeTE

    SilverbladeTE Senior Member

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    Perhaps what is happening is that the body thinks it is facing a viral threat similar to the Flu, and the body has a SPECIFIC response to that, and it gets turned on but never shuts down for some reason. Either there IS still some infection we're not picking up in the labs,

    OR the immune system's "on/off" switch is "broken",

    OR something is giving of particles or toxins the body mistakes for a viral infection
    Which would kind of be likely if it is a retroviral base cause?

    But one thing Science has to accept is always the rare possibility of an infectious agent OR effect of a type we don't as yet know. Bacteria, amoeba, moulds, mycoplasmas, viruses...what if there's something else?

    But other defences get lowered or changed as the emphasis is on Flu-like viral threat

    Plausible?
     
  18. Kati

    Kati Patient in training

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    Never mind that many, many pts with ME haven't had a cold or URTI in years, sometimes decades. He started with the wrong assumption
     
  19. SOC

    SOC Senior Member

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    Well I'm sure as hell not one of the less colds cohort. I catch everything that comes my way and take forever to recover. In fact, I'm currently struggling with the remains of a cold which has settled into my chest with a nasty cough I can't get over.

    I've had pneumonia uncountable times. I caught H1N1 when it was running around and developed pneumonia as a result.

    I suppose this is could be a subset thing. I'm pretty classic ME/CFS with very sudden acute viral onset, viral symptoms with PEM, pretty severe PEM, immune dysfunction, and multiple reactivations of herpes viruses. I have very low IgM and now slightly low IgG. That's a likely reason for reduced ability to handle viruses.

    Maybe we have an autoimmune subset and an immune deficient subset? Perhaps the autoimmune subset is less susceptible to viral infections while the immune deficient subset is more susceptible? If this is the case, I really have to wonder if these aren't two entirely different illnesses with OI the major commonality.
     
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  20. Hip

    Hip Senior Member

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    Could that low IgM just be a comorbid condition that you have alongside ME/CFS, that may be causing increase susceptibility to colds?
     

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