Hanson paper

[consuegra]

https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1011523

Maureen Hanson's paper on potential viral cause of ME/CFS.

This seems and has seemed an important viral connection, now for many years. There is a long history that can be accessed.

Hanson's Conclusion
"Ignoring the abundant evidence for EV involvement in ME/CFS has slowed research into the possible dire but hidden consequences of EV infections, including persistence in virus reservoirs. Prior to the SARS-CoV-2 pandemic, the ability of RNA viruses to persist in tissues for long periods was largely ignored. Further, recognizing that EVs are prime candidates for causing ME/CFS suggests how critical it is to pursue a relevant inquiry into this diverse virus family. Do hidden reservoirs harbor these viruses? Have they induced autoimmunity through molecular mimicry? Is it past or current infection that has resulted in the many findings of immune dysfunction in ME/CFS?"

 

[Wishful]

I'm not a fan of the viral cause hypothesis. It doesn't fit my experiences of ME very well. Also, higher levels of viruses detected in PWME could be a result of ME (immune system dysfunction) rather than a cause of it.

 

[consuegra]

I'm not a fan of the viral cause hypothesis. It doesn't fit my experiences of ME very well. Also, higher levels of viruses detected in PWME could be a result of ME (immune system dysfunction) rather than a cause of it.

Thanks. I can understand your point of view.

In this disease, it seems to me that history is important.

When Dr. John Chia's son got sick in the early 2000s, Dr. Chia went back and read the medical literature about enteroviral outbreaks and ME in the UK in the second half of the 20th century, and discovered that ME was associated or connected with enteroviruses. He treated his son for an Coxsackie B4 infection and cured him. Since then Dr. Chia has been a proponent of an Enteroviral connection to ME .

I struck upon Dr. Chia by chance at an InvestinME conference in 2007 and have followed his work closely since then.

In a world where not much is known about what causes ME, Dr Chia's work is of interest, at least to me, and apparently now, to Dr. Maureen Hanson.

Regards,
Chris

 

[Hip]

Maureen Hanson co-authored another great paper on enterovirus in ME/CFS in 2021:

The Enterovirus Theory of Disease Etiology in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Critical Review

 

[Tammy]

Viral cause of ME/CFS is the only thing that really makes sense to me but I believe it is mostly caused from herpetic viruses.

 

[consuegra]

Viral cause of ME/CFS is the only thing that really makes sense to me but I believe it is mostly caused from herpetic viruses.

Yes, that is understandable. In the 22 years I have been around this illness, herpetic viruses have been the most studied or predicted to be involved. I am not saying they are not.

However, there is an older history, from the UK and other places, that points in the direction of Enteroviruses.
With the exception of Dr. John Chia, no one thinks of this.

It is easy to do a enterovirus antibody test (1-6) via neutralization at ARUP labs in Salt Lake. This test gives some indication of activity. For instance, my daughter has had the highest Coxsackie B4 antibodies via this test for 22 years; at least 12 different tests show consistently the highest antibodies (via neutralization) of Coxsackie B4.

As far as I know no other lab in the US does this same antibody test. Labcorp and Quest Coxsackie antibody tests are hopeless.

I have recommended to various doctors and patients over the years, close to 100 people, and I have never gotten anyone to do this test. It is like a dedicated black hole. It makes no sense.

Chris

 

[Wishful]

This thread triggered a thought about viruses and thyroid hormones. I had temporary remissions from T2. I just checked for whether thyroid hormones affected viral activity. I only found one paper about T3 inhibiting HSV reactivation, so there's no obvious "T3 or T2 strongly counters viral symptoms rapidly" connection. I also had temporary remissions from prednisone and cuminaldehyde, neither of which is knows to cause drastic changes in viral activity over the space of less than an hour. When I read about antivirals, what comes to mind is that it is supposed to take ~ 6 months to work.

It's possible that these temporary remission treatments work on some mechanism related to a virus causing symptoms, but it seems just as likely that these molecules work on some other mechanism, unrelated to viral infection.

There's a strong desire to believe that ME is due to a virus. That's a simple answer, with a reasonably simple solution: eliminate the virus and your ME goes away. However, just because it's a desirable outcome doesn't mean that it's the likely one. Add in that antiviral treatments don't seem very successful at even fully treating ME symptoms, much less curing it, and I really believe it's a false trail.

Whenever I ponder a hypothesis for ME, I ask myself whether it fits the observation of temporary remission, where the person can switch from full ME to full non-ME over the space of less than an hour, and then abruptly switch back again. Viral infections don't seem to fit that very well.

 

[Hip]

Add in that antiviral treatments don't seem very successful at even fully treating ME symptoms, much less curing it, and I really believe it's a false trail.

That's not the case with enterovirus ME/CFS. Interferon is a potent antiviral for enteroviruses, and a course of interferon therapy can often allow severe bedbound patients to go back to work.

And if one wants to argue this improvement in ME/CFS might be due to some non-viral effects of interferon in the body, note that interferon does not seem to work for herpesvirus ME/CFS (which it should if its benefits were due to some non-viral action).

Of course, ME/CFS may be more complicated than just an ongoing viral infection. For example, the viral infection may trigger autoimmunity, or some other immune dysfunction, and ME/CFS may be due to this aberrant immune response, rather than directly due to the virus.

Viruses are also known to affect the microbiome in the intestines and elsewhere, so an ongoing viral infection might cause bacterial dysbiosis, which then releases bacterial toxins into the body, and it is these toxins which cause ME/CFS. This presents a more complicated picture than a simple viral infection.

So whilst we know that viral infection usually triggers ME/CFS, and it's possible that ongoing viral infection helps maintain ME/CFS, more may be going on, and so there are likely intervention possibilities for treating ME/CFS that are non-viral, such as correcting immune dysfunction, or addressing the microbiome.

These non-viral interventions may be our best bet, as it is hard to eliminate low-level tissue infections with viruses. Take type 1 diabetes for example: linked to a chronic coxsackievirus B4 infection of the insulin-producing cells. We don't currently have the medical technology to eliminate that virus from the cells. If we did, it might cure T1D.

 

[Wishful]

Interferon is a potent antiviral for enteroviruses, and a course of interferon therapy can often allow severe bedbound patients to go back to work.

Does it result in complete remission of symptoms, or just a reduction? I certainly accept that viral or other microbial infections can worsen ME symptoms. For me, viral infections altered my ME symptoms very similarly to physical exertion (triggers immune response), so I'd expect a chronic infection to chronically add to ME's baseline, and that removal of that infection would reduce the ME symptoms back to baseline.

Different viruses don't trigger exactly the same immune response do they? Some might trigger cell death, while others might reduce TRP availability or produce some other chemical to help cells remove the virus. That means that some viruses might be better at triggering ME, resulting in localized epidemics. That would make it look like ME is caused by the virus, but it's actually caused by the immune response, which can also be triggered by non-viral means.

 

[Hip]

Does it result in complete remission of symptoms, or just a reduction?

If you look at the results of Dr Chia's experiments with interferon in this article, he says:

Eight of 14 severely ill ME/CFS patients with enteroviral RNA in their blood returned to work on a half or full time basis after interferon alpha/delta therapy but most relapsed several months later. Heavy exertion was a common relapse trigger. Some patients responded well to another course of interferon.

ME/CFS patients who can work full or part time are usually mild, so that suggests the interferon moved these patients from severe to mild, a 2-level gain on the ME/CFS scale of very severe, severe, moderate, mild, remission.


This MEpedia article details the outcomes of some other published studies on interferon for ME/CFS.



My view is that ME/CFS research should not be focused exclusively on viruses, though, because even assuming viruses are the cause of ME/CFS, there will likely be a long chain of cause and effect between the viral infection in the body, and the actual symptoms a patient experiences.

We do not currently have the technology to eradicate the viruses linked to ME/CFS, but we might find some way of intervening at points along the chain of cause and effect.

For example, type 1 diabetes might well be caused by a coxsackievirus B4 infection of the insulin cells; but we actually treat T1D by giving insulin injections, which is an intervention further along the chain of cause and effect.