I"m quite taken with this hypothesis. I've been a doubter of Robert Phair's but it seems he didn't give up after the IDO1 metabolic trap and is now looking at this, so credit to him for continuing to work for us.
What's good about itaconate is it can really link the metabolic and immune aspects of the disease, which are both definitely present but are hard to grasp. Itaconate is famous for rewiring metabolism,
as explained here.
https://portlandpress.com/biochemso...964/Itaconate-as-an-inflammatory-mediator-and
But that's not all. it can also give us a link to the blood flow aspects of the disease, because itaconate is able to affect nitric oxide production, and one of the important roles nitric oxide plays is regulating dilation nd contraction of blood vessels.
(of course, the body uses some systems and molecules for many things. mTorc is an exmaple, it seems to be involved in everything and it doesn't mean it is key to this disease, it's just a key part of the body. The fact itaconate is involved in several me/cfs disease processes could just mean it's one of those molecules that is up and involved in every process. i.e. it could be a red herring.)
Ron says at the end of the video that he thinks one cause of itaconate activation could be lingering infection. I've come around to the idea of lingering infection, and the possibility that it interacts with blood flow issues.
My idea is that possibly a virus has developed a survival strategy where it survives in peripheral tissues (e.g. muscle) and limits the ability of the immune system to detect it by physically reducing the amount of blood flow to the tissues where it sits. A strategy so simple as to be both unexpected and cunning!
Inflammation makes you red, that's your immune system dilating blood vessels to let things through. If in me/cfs dilation is impaired (perhaps the virus lingers in the endothelium, or can disrupt nictric oxide production via mitochondria, or is even in the parts of the nervous system that control vasodilation) then might immune function be imparied, not at a deep, clever, chemical way, but in a really simple mechanistic way where large immune cells can't get through to where the virus is hiding. Notably robert phair was in these pages no so long ago and when someone described how they don't go red, he said "There's also the question of how you can sweat without flushing since both are mediated, at least in part, by vasodilation. I'll look into that too. This feels like a productive line of investigation."
https://forums.phoenixrising.me/thr...nd-body-temperature.82073/page-3#post-2311336