Just FYI, multiple groups have reported sharply elevated inflammatory cytokines in major depression. One was a quite convincing study from Harvard. This is a mainstream hypothesis, though multiple other groups have not found this connection
Interesting, however anyone with a chronic disease would be expected to have increased rates of depression, and these diseases would include inflammatory disorders. Failing that un-diagnosed immune disorders also - namely ME (CFIDS) could masquerade as depression, as there is no diagnostic test and many patients doctors refuse to diagnose ME (CFIDS) and tell people they're depressed.
Failing that. Severe pain leading to disablity, wheelchair use etc - is not a symptom of depression. Inflammatory cytokines are off the scale in ME (CFIDS) and not in depression - most importantly post exercise. People with depression do not report flu like feelings at baseline (flaring on exertion), or burning pain at all.
To compare the two is interesting, e.g. to note that psychological states (a state of low mood) may share common features of disease, yet the levels of what is being compared are different.
In depression one's blood sugar raises after a meal.
In diabetics with pancreas damage one's blood sugar raises after a meal.
This could be then stated that 'raised' blood glucose after a meal in diabetics
is found in depressed people also and both conditions share a common feature.
Yet without insulin a diabetics blood sugar may hit 50, and a non diabetic 9 - which is normal.
Inflammation
at rest to a damaging level to endothelial tissue through oxidative stress (as report by ME Research UK) is a feature of ME (CFIDS) XMRV? that is unique to this condition.
The report I read from ME Research UK showed it is so bad in ME (CFIDS) that patients at rest doing nothing, have more oxidative stress/inflammation than those without ME (CFIDS) post work out on an exercise bike. I've got a transcript of my notes of a presentation I've got that youtube deleted, so for that reason I've deleted the names below. It was published though as somewhere in a pile
of papers I have the magazine with the same study available to the public! Silly youtube, or should I say silly MERGE who claimed copyright after giving away a FREE DVD.
Here we go:
Vascular & Inflammatory aspects of chronic fatigue syndrome
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*CFS/ME patients form a part of 'connective tissue' disorders. Of the people seen in clinic - a Seminal 72% of *censored by youtube* referrals were ME/CFS patients. *censored by youtube* decided to find out why in the early 1990's - as there was no education about ME/CFS patients as undergraduates and no diagnostic test or treatment for this disease. ME/CFS is still under recognised, under diagnosed, under investigated & under trained all these years later. Patients pushed themselves (as they weren't aware they had ME/CFS) and become more unwell - and prolong their incapacity.
2) Iontophorisis test has been developed (safe & painless) to investigate cholinergic induced pathological dilatation of blood vessels. Blood flow measured using Lazer Doppler flowmetry (LDF).
This shows how quickly the blood is flowing, and how 'open' the blood vessels are.
3) Iontophorisis test shows enhanced vasodilation of blood vessels (too open) in ME/CFS. This is the exact REVERSE of Coronary heart disease. Explains circulatory symptoms of dizziness/flushing/swelling of ankles & feet when upright.
Trying drugs to combat this (that vasoconstrict blood vessles) cause side effects and beta blockers simply increase tiredness. Compression stockings are thus the only current recommended therapy.
4) Oxidised lipids (rusted by free radicals) in ME/CFS are raised. *Isoprostanes*. Free Radicals - enhanced oxidising 'rusting' of the body in ME/CFS. Free Radicals cause inflammation in ME/CFS. Free Radicals promote production of prostocyclines.
5) If you oxidise lipids the long terms risks are 'increased coronary risk' - e.g heart attack/stroke. Lipids are fats. If you oxidise fats (rust it) you produce atheroma plaques. Atheroma's are dangerous. Patients with long term disease may be at increased risk of cardiovascular disorders. For this reason in the *censored by youtube* where *censored by youtube* works (Only *censored by youtube* clinic, not nationally), ME/CFS patients are screened for 'cardiovascular risk factors'.
6) One of the key triggers of oxidative stress is exercise - because exercise causes oxidative stress. ME/CFS post infective group (FUKUDA CFS Criteria) had very high levels of inflammatory oxidised chemical in their blood after exercise.
7) The level of Isoprostanes (that cause oxidative injury) are so high that ME/CFS patients BEFORE being tested ....are HIGHER than controls - post exercise. 'So no wonder the patients feel unwell.
8) The LEVEL of these oxidised lipid, correlates with the level of 'post exertional myalgia' - in other words you can FINALLY PROVE the amount of PAIN you are in - because the level of oxidised lipid in your blood SHOWS this. Antioxidant therapy does not significantly help the problem.
9) Inflammation also shown in a 'CRP High sensitivity test'. Higher in ME/CFS, genuine abnormality not shown 5/10 years ago in lower sensitivity tests.
10) The effects of all this? The findings mimic the effects of ATHEROSCELROSIS (hardening of the arteries - coronary disease) which is also a vascular and inflammatory disease state. What is the link to ME/CFS? Probably damage to endothelium caused by activated white cells that release chemicals that causes damage to blood vessels and inflammation. Other diseases such as Rheumatoid arthritis (auto immune disease) also have increased cardiac risk - to the extent that 40% of arthritic patients die from cardiac events.
11) The consequence of all this oxidative injury & pro inflammatory state ME/CFS patients bodies are in, is that cells are programmed to die off quicker, a process called apoptosis, and thus as predicted - white cell apoptosis is INCREASED in ME/CFS patients. Proving 'very definite' inflammation, 'allowing us to designate this disorder as truly physical'.
12) The findings in ME/CFS of Vasodilation, Inflammation, Oxidative Stress, Increased Apoptosis - may explain some of the symptoms and give possible targets for intervention, but 'obviously this is a few years away I'm afraid'.
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Depression does not have this, only ME (CFIDS) does. Hence none of us can exercise, or graded exercise our way to increased health as it's pathalogically damaging and the 'pain' we report is very real, and testable.
Unlike in depression, who's sufferers report no pain and who say that exercise lifts their mood and reduces their levels of mental disabilty.
It is quite probable that ME (CFIDS) XMRV? shares some vague immunological features with depression - both share brain dysfunction.
Yet depression brain scans are the reverse of ME (CFIDS), and ME (CFIDS) has increased serotonin levels, and 5HT receptor sensitivity.
