G
Gerwyn
Guest
Hi, Gerwin.
My responses are at the asterisks below:
I have to disagree Rich.
***Fair enough.
There is no data to support the idea of subsets or any plausible mechanism by which MOLDS can cause multi systemic disease
.The problem we face now, in my view, is that people are assuming subsets based on different people reporting a different symptom pattern.
While it may be a useful metaphor there is no evidence that this is true in any mind independent sense.
Without the construction of explanatory hypotheses to test a cure would seem remote
***I think we actually have quite a bit of agreement on most of this (but see below regarding your first point). I agree that subsets have not been successfully delineated in the published literature. I agree that trying to define subsets of CFS by symptoms is not productive. I agree that the process needs to be hypothesis-driven. In fact, this is the very point I tried to make during the open-mike session that was held at the AACFS conference in Madison, Wisconsin in 2004. The audience of patients applauded, but I don't think the "powers-that-were" in the AACFS accepted my point. What I said at that time, and what I've tried to do since, is that we need to start developing hypotheses that will account for at least some of the patients in the CFS "bucket." When we have one that seems to fit some of them, we take them out of the bucket and then work on developing a hypothesis for another group of them, and so on. Sort of a divide-and-conquer approach. I was fortunately able to develop the GD-MCB hypothesis a few years later, based on research that was done in autism. This is primarily a pathogenesis hypothesis, which allows for a variety of etiologies, and in that sense, I think it takes in the majority of cases of CFS, at least based on the lab testing we have been able to do thus far. Is this in the peer-reviewed literature? Not yet. Is it valid? Well, I believe it is, and I continue to study cases in detail that this hypothesis appears to fit. Of course, everyone is free to make up their own mind about it.
We interpret our observations in line with our cognitive biases.This ,as you well know, is why the often ignored part of the scientific method is so important.Namely the active attempt to disprove an explanatory model.
***I agree with these statements, too. Once in a while, though, someone changes their cognitive bias based on evidence. I like to think that I do that from time to time. -)
I agree completely about the politics and published papers turning out to be false.We have the example of the Dutch study at the moment
Scientific evidence provides the probability of truth and that "truth" will probably change with time such is the nature of the discipline.
I have long cautioned about the naive acceptance of politically motivated studies.
***I think we generally agree on these issues. I'm not sure I have all the facts concerning the Dutch study, so I will reserve judgment on that.
I am all for creating an explanatory hypothesis of how a myriad of different mycotoxins could be causative of a neuroimmune endocrine disorder based on measurable observations and then testing that hypothesis.
***O.K. Me, too. I suspect that a basis for it could be the mechanism or mechanisms by which some mycotoxins have been found to deplete glutathione in cells, as has been reported in the peer-reviewed literature, not only in the thesis that Lisa cited. If this is coupled with an HLA genotype based inability to remove mycotoxins that some people have inherited, so that the mycotoxins build up enough in these people to have a significant impact on their glutathione stores, and if in addition these people are genetically predisposed to developing a partial methylation cycle block if their glutathione drops down enough, then I think we have the makings of a hypothesis that could account for many of the observations, while at the same time being compatible with accepted biochemistry and immunology. Yes, there are several unproven steps in this chain of cause and effect, and yes, a lot of hard work would need to be done to test it, but where there currently is information that can be used to test it, I think it stands up to the test.
Is there any hard evidence of mycological toxicity in patients with Me/cfs sufferers.Either we apply the standards of hard science or we do not.
***I'm not sure what your criteria are for "hard evidence." I've heard from several people whose symptoms would qualify them for CFS who have reported experiences that are pretty convincing to me. Namely, they have the symptoms of CFS, they begin to suspect that their living environment is hosting toxic molds, based on a long-standing water leak, observation of mold growing on a wall, the smell of mold, and sometimes an ERMI test of their home. Some have reported that they feel better if they are out of their home for a while. Some have gone through Dr. Shoemaker's test program where they are tested, move out, are treated and recover, are tested again, then move back in, get sick again, and are tested again. Dr. Shoemaker is careful to note that there can be other components involved in these homes beside molds, but there is pretty good evidence that mold is a major contributor in many cases. I agree that quantitative studies are needed. Dr. Shoemaker has published a couple of papers about his work involving people exposed to water-damaged buildings. The PubMed I.D. numbers are 15681119 and 17010568.
If we don't then we can hardly complain when our opponents do not.We have to apply the same standards or we have no consistent defence against the pseudoscience of the opposition
***I agree with this, too.
At the moment there is no evidence on which even to base that hypothesis on
***If you mean in peer-reviewed publications, I agree that more is needed. From my point of view, though, there is plenty of evidence on which to base more than one hypothesis. I might add that Dr. Shoemaker does not accept my hypothesis, and in fact has his own, but there is a clinical study in the works now that may shed light on this. I might add that it is not easy to get funding for research in this area. Owners of very large buildings are vulnerable to expensive lawsuits if a convincing connection can be made between conditions in a building and the health of its occupants. Dr. Shoemaker has participated in several of these court proceedings on the side of the plaintiffs, and getting research funded and papers published in peer-reviewed journals that would support such a connection is a high-stakes effort. It's also interesting to note that the headquarters buildings of the U.S. Environmental Protection Agency in Washington, D.C. a few years ago had a serious mold problem, and a lawsuit was brought against them by their own employees. Here's a site that reviews some of the history of "sick building syndrome," particularly in the U.S., including mold-related issues: http://www.safeencasement.com/mold_timeline.htm
Best regards,
Rich
I agree that a particular mold infection can lead to glutathione depletion.so can any other chronic infection.I would prefer an objective diagnosis of ME.I am talking about the CCC definition.Anecdotes are not evidence Rich however convincing they are subjective interpretations.I genuinely hope that there is a study that will test the hypothesisTthe sequence of events you describe are more akin to an allergy.Anyone living in these conditions would experience trouble.Mycotoxicity<as you know, would mimic most of the FUKUDA presentations quite easily as would clinical depression and a number of other things.
Mold(just for argument I will reduce the number to just one) can cause symptoms very similar to CFS(Fukuda) but not ME/cfs(CCC) or anything like them.
Sick building syndrome and Fukuda symptoms are identical without the PEM.
Most fukuda presentations dont make pem mandatory.people in water damaged buildings can have severe problems.
That i think is beyond dispute especially if the Aw raises above 0.9.That does not mean that this exposure causes CFS the neuroimmume endocrine disorder.there is no convincing evidence that glutathione depletion on its own could cause the symptom spectrum seen in CCC Me/cfs.
A retrovirus could via insertional mutagenesis into regulatory genes NFAC and CREB.I do think that glutathione depletion is important but can see no plausible mechanism how it cause the multsystemic presentations seen in ME or the gene regulation patterns seen in kerrs work.
There always remains the possibility however that there are seperate illnesses within the cfs banner.CFS is simply a metaphor and does not referr to any mind independent characteristics of the illness.There are many ways to damage mitochondria, for example some mycotoxins would do this at a high enough dosage for long enough