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Dr. Kerr's 7 Subtypes of CFS

PoetInSF

Senior Member
Messages
167
Location
SF
If stress caused CFIDS then everyone in the world for centuries would have CFIDS.
I think the theory is something like certain people with certain genetic disposition develop CFS after certain viral/physical/emotional stress. Sort of like not all people developing PTSD after a stress. My favorite is a brain/ANS injury from immune distress caused by a viral infection or extreme physical activity. Mind you, it's only one of my idle musings, 'cos I have nothing else better to do. Just in case anyone mistake that for a theory with any scientific basis.

Going back to the topic, I have no idea what Kerr is trying to accomplish with subtypes. I suspect it all goes back to the waste basket theory of CFS. I'd consider CFS as one disease with variable serverity till proven otherwise.
 

cfs since 1998

Senior Member
Messages
603
Going back to the topic, I have no idea what Kerr is trying to accomplish with subtypes. I suspect it all goes back to the waste basket theory of CFS. I'd consider CFS as one disease with variable serverity till proven otherwise.
I'm shocked but I actually agree with this part of your post. I see ME/CFS as defined by the Canadian Consensus critera as a homogenous disease with heterogeneous symptoms, and I don't see much value in Kerr's work. I actually like Gow's gene expression paper better (http://www.ncbi.nlm.nih.gov/pubmed/19555476). Though Gow was responsible for a failed replication attempt of DeFreitas's work as well as a failed replication attempt of the RNase-L work. Gow's and Kerr's motives and goals are confusing.
 

Orla

Senior Member
Messages
708
Location
Ireland
I think the theory is something like certain people with certain genetic disposition develop CFS after certain viral/physical/emotional stress. Sort of like not all people developing PTSD after a stress.

That is Reeves idea, not kerr's. Very weak theory also, basically over extrapulating from the info they had.

I posted this elsewhere:

This is what Kerr wrote regarding the Nice Guideline Development Group (GDG) in the UK:

“The predominance of psychologists / psychiatrists on the GDG is entirely inappropriate and has led to a biased analysis in my opinion. The GDG has placed undue emphasis on a few UK clinical trials which support the use of psychological treatments"

Dr Jonathan Kerr, Hon. Consultant in Microbiology; Consultant Senior Lecturer in Inflammation; Principal Investigator of the CFS Group, St George’s University of London, 11th August 2008

This quote is taken from:

Statements of Concern about Cognitive Behavioural Therapy and Graded Exercise Therapy provided forthe High Court Judicial Review of February 2009, Margaret Williams, 22nd July 2009.

Margaret Williams explained the context of the above comment and others like it: "Over twenty renowned ME/CFS experts provided Statements in support of the Judicial Review of the NICE Guideline on “CFS/ME” heard in February 2009 in the High Court in London. They were specifically written in support of the challenge to the NICE Clinical Guideline on “CFS/ME” and they express concern about the recommendation by NICE that the only management of ME/CFS should be CBT and GET (the same interventions that are the subjects of the Medical Research Council’s PACE Trial)."

http://www.meactionuk.org.uk/JR_Stat...-_extracts.htm


Orla
 

dannybex

Senior Member
Messages
3,561
Location
Seattle
The point is ALL humans live in a stressful environment no matter where they live, how much they have, and even the ones that seem "to have it all". So, stress causing CFIDS? If stress caused CFIDS then everyone in the world for centuries would have CFIDS. Or at least many millions more people would have CFIDS. So that fails the common sense test right there.

You're right Muffin, that if stress caused CFIDS, then everyone i the world would have it. But who is saying stress alone causes CFIDS? Perhaps some pych docs, but I certainly didn't, and I don't think Kerr did either. I think it can be a contributing factor as Cheney and others have seen, especially if it's long term, unending, heavy duty stress, but it certainly doesn't cause CFIDS all by itself.

Stress does exacerbate disease and illness. We KNOW that. It may even kick off some diseases/illnesses off because of a weakend immune system. But that means all other disease and illnesses and not just CFIDS.

Of course. :)
 

starryeyes

Senior Member
Messages
1,558
Location
Bay Area, California
Thanks for posting that Orla. Well, I'm confused about where Kerr stands. It sounds like he's somewhere in the middle on this issue.

Retroviruses can switch genes on and off so XMRV and his gene studies should mesh well. I just don't agree with Kerr's subtyping. I think CFS still manifests similarly yet individually in each of us.
 

usedtobeperkytina

Senior Member
Messages
1,479
Location
Clay, Alabama
Well, I am so glad to see so many agree with me. I had seen so many declare Kerr goes in the "good guy" category that I figured I would be way out of Phoenix Rising mainstream to say I don't agree with the subtypes theory. By the way, Kerr is not the only one saying there are subtypes. CAA is using similar terminology. I'm glad I am not alone in my thoughts on this matter.

Gerwyn and George, you are right in line with what I think. A retrovirus (today's suspect being XMRV) can cause abnormal gene expression. And, it may be location of the virus in the genome, different outside triggers that stimulate XMRV to affect other genes to possible or just genetic differences in people that causes different gene expression.

Now, I guess that doesn't mean that you can't separate people into groupings, but I think we are having too much of the human need to attribute labels being an influence here. I mean, 7 different subsets? I mean, why not nine based on gene expressions. So if there is this person with five genes (that is A, B, C, D and E) abnormal but next patient has same abnormal gene activity (A, B, C, D, and E), but also has F is acting abnormally, that means the two people have different diseases? uh uh, we have a lot more in common than we do different. The thing that makes the difference is that both people have some of the same genes acting abnormal while a healthy person has none of them acting abnormally.

And has been mentioned, there are stages. I ended up "severely" ill. But I only had depression for two months. And that was in response to extreme pain, frustration and loss of hope at not being able to find a doctor, and much worse pain. As soon as I found a doctor that seemed to know what he was doing, my depression lifted. In years, that has been it.

My symptoms come and go. months with this set of symptoms, then months with another. I went almost a year without sharp pains. They just came back two weeks ago.

And I wonder, where is the easy bruising gene? Does that make me a different subtype? oh, and the vertigo gene activation.

Now, I do think listing different symptoms or gene abnormalities will be helpful in treatment. But I don't think you can categorize them into separate groups. As has been said, we are all just one illness with a variety of symptoms (or gene activity abnormalities). So the idea should be that everyone's CFS is unique.

But humans tend to do this with other things to. Race is just a human creation of "subtyping" people according to physical characteristics. The real truth is that we are all humans and we all have a unique mix of physical characteristics.

For example, my brother-in-law is of Sicily descent. He has the Roman nose, the slightly olive skin. But he has hair like an African, true Brillo pad. And just where does Tiger Woods fall?

We are all just human.

As for those of us that spend our time looking at message boards to find out the latest study, I mean all of us, we all just have CFS. Each of us is unique, with our own unique illness, but we all have the same disease.

I am not going to say that grouping together by symptoms for research might not be beneficial. And I don't know if we can rule out multiple causes. But it seems clear to me, we all end up suffering with the same disease.

Now, I have a suggestion, why don't the Lights (at Utah) and Kerr and WPI get together and see if we can put these pieces together to come up with one answer?

Tina
 

Gemini

Senior Member
Messages
1,176
Location
East Coast USA
"Now I have a suggestion, why don't the Lights (at Utah) and Kerr and WPI get together and see if we can put these pieces together to come up with one answer?"

Very good suggestion, Tina. I agree. The Lights' should test their samples for XMRV and expand their comparison groups from normal controls and an autoimmune disease (MS) to include patients with other retroviral diseases (HTLV, HIV), viral diseases (EBV, CMV, HHV-6,HEP-C, etc), and immune deficiency diseases to determine whether those illnesses produce similar biochemical changes after exertion or whether the changes are truly unique to CFS/ME.

Gemini
 

usedtobeperkytina

Senior Member
Messages
1,479
Location
Clay, Alabama
Well, Lights say they show CFS patients with abnormal gene activation after exercise. Kerr says he sees abnormal gene expression. And WPI says XMRV can have an effect on other gene activity.

So, I see a theme here.

Tina