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New CFS and inflammation paper

Firestormm

Senior Member
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I noticed that this author was also responsible (in part) for the following paper of aetiology also from 2011:

Chronic fatigue syndrome--a neuroimmunological model.

Arnett SV, Alleva LM, Korossy-Horwood R, Clark IA.
Source

Research School of Biology, Australian National University, Australia. simon.arnett@anu.edu.au
Abstract

The aetiological and pathophysiological basis of chronic fatigue syndrome (CFS) remains a controversial field of inquiry in the research community.

While CFS and similar disease conditions such as fibromyalgia (FM) and post-infectious encephalopathy have been the focus of intense scrutiny for the past 20 years, results of research were often contradictory and a cohesive pathological model has remained elusive.

However, recent developments in understanding the unique immunophysiology of the brain may provide important clues for the development of a truly comprehensive explanation of the pathology of CFS.

We argue that CFS pathogenesis lies in the influence of peripheral inflammatory events on the brain and the unique immunophysiology of the central nervous system.

There is also evidence that CFS patients have a relative immunodeficiency that predisposes to poor early control of infection that leads to chronic inflammatory responses to infectious insults.

The neurological and endocrine changes have been described in CFS patients support the view that CFS has an inflammatory pathogenesis when considered as a whole.

An inflammatory model of disease also provides an explanation for the marked female sex bias associated with CFS.

This review therefore posits the hypothesis that CFS as a disease of long-term inflammatory processes of the brain. We will also provide an investigative framework that could be used to justify the use of anti-TNF biological agents as a reliable and effective treatment approach to CFS, a syndrome that to date remains frustratingly difficult for both patients and health care professionals to manage.

Copyright © 2011 Elsevier Ltd. All rights reserved.

http://www.ncbi.nlm.nih.gov/pubmed/21474251

I don't know how or why the (bolded) female factor should be inherently possible in this model; but if so then it is the first time I have seen this important aspect taken into account in such an hypothesis.

Will have to dig deeper unless someone can help me out? Thanks.
 

Firestormm

Senior Member
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5,055
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Cornwall England
I've seen it reported many times that there are more cases of CFS in females than males. Are you questioning this or something else?

No Roxie. And yes - something else :)

What has always been lacking in any 'model' for our condition has been an explanation for the predominance of ME in females. Why do more females get ME than males? And how can a biological process or failing, possibly explain that - beyond or perhaps including something genetic?

It was something that didn't 'fit' with the XMRV hypothesis. There may be no explanation - but I think that's a bit weak. For some reason more females (like 3 times as many I believe) get ME than males. Can this all be explained through misdiagnosis - more females being diagnosed than males? No. I don't think it can.

I also think we need to place greater faith in the diagnostic capability of the various criteria but this can be a moot point. Maybe we will never get an answer - or better explanation - until such time as a biomarker is developed into a test and we can really get to work on these criteria.

Anyway, that's why I focused on that part of the paper. How can they explain away this dichotomy? I need to read more (as per usual) :)
 

heapsreal

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No Roxie. And yes - something else :)

What has always been lacking in any 'model' for our condition has been an explanation for the predominance of ME in females. Why do more females get ME than males? And how can a biological process or failing, possibly explain that - beyond or perhaps including something genetic?

It was something that didn't 'fit' with the XMRV hypothesis. There may be no explanation - but I think that's a bit weak. For some reason more females (like 3 times as many I believe) get ME than males. Can this all be explained through misdiagnosis - more females being diagnosed than males? No. I don't think it can.

I also think we need to place greater faith in the diagnostic capability of the various criteria but this can be a moot point. Maybe we will never get an answer - or better explanation - until such time as a biomarker is developed into a test and we can really get to work on these criteria.

Anyway, that's why I focused on that part of the paper. How can they explain away this dichotomy? I need to read more (as per usual) :)

Im not really sure if there is that great a difference in males vs females who get cfs/me, its just always been mentioned in common info on this subject but never really seen any figures, they cant even really figure out who has it and who hasnt. Theres too many grey areas that cant be worked out until there is some descent diagnostic markers.

What would be interesting would be a count of males and females from this site, i wonder if a moderate could find those figures for us?
 

Firestormm

Senior Member
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Cornwall England
Yeah it's not clear-cut Heaps by any stretch of the imagination. Trouble with any survey on here is of course the assumption we all have a similarly valid diagnosis :) Still, you could always set one up.

This lack of clarity is why the claim drew my attention.
 

heapsreal

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Yeah it's not clear-cut Heaps by any stretch of the imagination. Trouble with any survey on here is of course the assumption we all have a similarly valid diagnosis :) Still, you could always set one up.

This lack of clarity is why the claim drew my attention.
i wasnt thinking of a survey as such but someone with access to the data on all the members here and just doing a gender count. A survey is reliant on people doing it, which myself being a boy would probably be to lazy to do, lol??
 

Firestormm

Senior Member
Messages
5,055
Location
Cornwall England
i wasnt thinking of a survey as such but someone with access to the data on all the members here and just doing a gender count. A survey is reliant on people doing it, which myself being a boy would probably be to lazy to do, lol??

Would you know who was a patient though Heaps if the mods (assuming they could) trolled through the details? Probably not. There have been studies published that contain this ratio data. We can never be 100% sure of course but they have evaluated the prevalence of female dominance.

Lol. Now THAT phrase should come with a caution :)
 
Messages
57
Trouble with any survey on here is of course the assumption we all have a similarly valid diagnosis

Plus other factors, such as any possible gender imbalance in tendency to use internet, use forums etc. Don't want to be mr negative but I don't think that figure would have enough validity to improve our understanding. I can't provide any citations but I did get the impression that the imbalance (if not exact proportion) was quite widely documented. I think that included tighter definitions, not just broad ones that may bring in an excess of other diagnoses with their own gender imbalance. I really want to try to find the answer but I'm afraid in my current slump I probably won't.
 
Messages
57
Thanks Firestormm, I have been lurking and reading with interest in between I promise :) I think I am less inclined to post when I am feeling better as I am focused more on "Real life", whereas in a slump I tend to become more laptop focused . Not sure that is a good thing, just an observation, maybe I need the therapy of sharing, not sure.
 

Firestormm

Senior Member
Messages
5,055
Location
Cornwall England
Thanks Firestormm, I have been lurking and reading with interest in between I promise :) I think I am less inclined to post when I am feeling better as I am focused more on "Real life", whereas in a slump I tend to become more laptop focused . Not sure that is a good thing, just an observation, maybe I need the therapy of sharing, not sure.

Nope. I think it is a fair reflection of how we cope when we can of course :) Achieving that balance is the hardest thing in my life sometimes. I'm in need of an internet break. :)
 

user9876

Senior Member
Messages
4,556
No Roxie. And yes - something else :)

What has always been lacking in any 'model' for our condition has been an explanation for the predominance of ME in females. Why do more females get ME than males? And how can a biological process or failing, possibly explain that - beyond or perhaps including something genetic?

It was something that didn't 'fit' with the XMRV hypothesis. There may be no explanation - but I think that's a bit weak. For some reason more females (like 3 times as many I believe) get ME than males. Can this all be explained through misdiagnosis - more females being diagnosed than males? No. I don't think it can.

I also think we need to place greater faith in the diagnostic capability of the various criteria but this can be a moot point. Maybe we will never get an answer - or better explanation - until such time as a biomarker is developed into a test and we can really get to work on these criteria.

Anyway, that's why I focused on that part of the paper. How can they explain away this dichotomy? I need to read more (as per usual) :)


I believe that females generally have stronger immune systems and hence are more likely to suffer from autoimmune diseases. Hence it fits quite well with the Rituximab story.
 

urbantravels

disjecta membra
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Los Angeles, CA
There is a higher prevalence of women among patients that suffer from known autoimmune diseases:

Lupus - 90%
MS - 70% - 80%
Rheumatoid arthritis - 70%
Sjogren's - 90%
Hashimoto's thyroiditis - 80-95%

and so on. This is just what I get from a quick Google from reputable medical sites. Among ME/CFS patients, the percentage is thought to be about 70% female (per Leonard Jason) - it's doubtful we can get very exact owing to the problems with case definition and underdiagnosis, but the percentage seems in line with other autoimmune diseases.

"Stronger immune systems" is a meaningless statement. And wouldn't necessarily be a benefit anyway, since the pathology in autommune diseases has to do with immune over-reaction/inappropriate reaction to a threat that isn't really there (i.e. attacking the body's own cells and tissues.) Nobody really knows exactly why women get autoimmune diseases way more often than men, but it could be genetic (disease-linked genes passing down in the female line) or a result of women's more complex immune situation - i.e., women's bodies have to be able to carry a fetus without the immune system attacking it, even though it's definitely non-self. (A high percentage of miscarriages are caused by various immune attacks on the fetus that normally are not supposed to happen.)

In ME/CFS it appears that some components of the immune system are upregulated and others are downregulated, so go figure. There is never any simple answer when it comes to the immune system, it's got more moving parts than a space shuttle.

As for whether it seems like there are a lot of men on this forum, it *does* seem like there are more than 30% men on this forum. But my view of the forum may be biased because I don't hang out on "emotional support" type topics. Those who like wrangling about the mechanisms of the disease may be disproportionately male; who can say? This forum is not a representative sample of all people with ME/CFS.
 

roxie60

Senior Member
Messages
1,791
Location
Central Illinois, USA
Would you know who was a patient though Heaps if the mods (assuming they could) trolled through the details? Probably not. There have been studies published that contain this ratio data. We can never be 100% sure of course but they have evaluated the prevalence of female dominance.

Lol. Now THAT phrase should come with a caution :)
:lol: :lol::rofl:
 
Messages
15,786
As for whether it seems like there are a lot of men on this forum, it *does* seem like there are more than 30% men on this forum.

Some of us have user names that seem masculine (mine is a male name in Dutch), and a lot of our avatars don't offer any clues. There are at least a few people I assumed were male without even thinking about it, then realized were female :p
 

urbantravels

disjecta membra
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1,333
Location
Los Angeles, CA
Yeah, my username and avatar don't really offer lots of gender hints either. I do get mistaken for male on message boards where my real name isn't visible. I don't think this happens on Twitter since my real name is present too.

(My avatar is a sculpture from one of the sculpture gardens at the Getty Center. To my own embarassment, I can't remember the title and artist. It's not one of the really famous artists. Not knowing the title and artist, I can't retrieve the information from the Internet, even though I remember its exact location. Would it KILL the Getty to post a complete list of outdoor works indexed by location? grumble grumble)
 

Firestormm

Senior Member
Messages
5,055
Location
Cornwall England
Here's a much more nuanced discussion of various theories regarding why women are disproportionately attacked by most autoimmune diseases - but not all; there appear to be a few that are more prevalent in men.

http://www.hss.edu/conditions_autoimmune-disease-sex.asp

Urban, is that then the theory behind this Thread's author's contention? That their model is essentially one of ME being an autoimmune disease? Thanks.

I've yet to read the damn paper in full. Will get there though...!
 

urbantravels

disjecta membra
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Location
Los Angeles, CA
I don't believe so. This paper is discussing inflammation and not directly hypothesizing about the causes of said inflammation. The conversation here kind of worked its way around to autoimmune diseases because you asked why more women having CFS supports the idea that there is inflammation involved.

To be clear, more women than men get (most) autoimmune diseases.

Women are ALSO more prone than men to have inflammation, whether from an autoimmune disease or not.

Inflammation, by definition, is the result of an immune reaction.

It appears to be that something about female immune systems makes them more prone to go out of whack. The immune systems, I mean, not the women. SHUT UP

The immune system is NOT exactly the same in both genders. The basic "design" is the same but there are a lot of subtle differences, most of which aren't well understood. The interactions between the immune system and gender differences in genetics, hormones, etc make an already fantastically complex system even more difficult to understand.