For those considering such a trial, I will mention that the therapeutic effects of CTX in cancer treatment are now thought to be related in part to the induction of intestinal permeability and the attendant translocation of certain microbial organisms. This brings about a robust adaptive immune response that can be abrogated by antibiotic administration. You can read about the specific cellular responses here:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4048947/#SD1
Without getting too much into the biochemical similarities between CA and ME/CFS and the transferability of this research, I would suggest these findings certainly might say something about the pathophysiology of ME/CFS. Translocation of bacteria into the mononuclear phagocyte system is also one of the most promising developments in cancer immunotherapy. Fairly recently it was reported that administering tetanus vaccinations could triple the survival advantage in glioblastoma. They found that a simple tetanus vaccine could stimulate the migration of dendritic cells to these extraintestinal tissues.
I can't say I'm enthralled with the idea of this approach after recently witnessing the effects of this medication, but I can relate with the sentiment. In addition to the problems described above, I think the associated incidence of neutropenia is likely to require more than a handful of participants to treat secondary infections with antimicrobials, which according to the study linked above, may negate the desired cellular response.
I studied the metabolic capacities of the organisms believed to be playing a part in immunomodulation in this study some time ago, and I am interested by the finding that describes an extraintestinal proliferation of L. Johnsonii. This is a fairly unusual Firmicutes organism which is part of the lactic acidophilus group. I seem to recall that it is particularly sensitive to O2. It is effective in counterbalancing pathogenic lactic acid bacteria, i.e. reducing strep/enterococcus overgrowth. Honestly, I don't fully appreciate the significance of the accumulation of this particular organism, but it is a very unusual LAB in that lacks encoding for amino acid synthesis and purine metabolism and it acquires these resources from the environment; some of these resources are all but certainly obtained from the host since it is incapable of de novo synthesis.
I guess the take-away is don't take ABX if you choose to pursue this therapy Also, I would wonder if taurine/glycine might enhance the efficacy of this treatment because I know that this organism correlated to the therapeutic benefits is highly resistant to bile and the provision of bile acid precursors has been shown to enhance to effects of CTX, in vitro, at least.
. I thought they would know by now if the drug works
