Stomach biopsy testing for other viruses (CMV, EBV, HHV6, etc) in addition to Enterovirus?

[junkcrap50]

I am wondering if there would be any benefit or insight into testing a stomach or other GI biopsy for other CFS linked viruses (CMV, EBV, HHV6) like Dr. Chia does for enterovirus. I am getting a full GI workup and decided to send a stomach biopsy for enterovirus testing (see here:
ENTEROVIRUS VP1 IMMUNOPEROXIDASE STAIN TEST REQUEST FORM). I am waiting to hear back from my CFS & infectious disease doctor.

However, I recently learned that in other settings, such as in transplant cases, stomach biopsies are also used and tested for CMV & EBV. (But, I don't know why they do that vs serology, for example.)

QUESTION: Would there be any point to also test the stomach or GI biopsy for EBV, CMV, & HHV6 of CFS patients?

Other questions:

1. Would this give a clearer answer on chronic viral infection instead of usng elevated IgG titers above an arbitrary level? Latent vs active infections?
2. Would this show intracellular viral infections that is not detectable in serum?
3. Is there any CFS research relating to viral biopsy testing, not including Dr. Chia's enterovirus testing?
4. Do EBV, CMV, HHV6 viruses like to reside in any particular type of tissue, like enterovirus is found in the gut? Or do you have to test every type of tissue or tissue that has a pathology?

Other:
From the HHV-6 Foundation's website:

Elevated antibody titers can only suggest—not prove—that the virus is active. Short of a tissue biopsy, it may be impossible to find direct evidence of chronic HHV-6 infection. Therefore, physicians who suspect active virus, in a chronic case, must usually treat based on clinical judgment of the symptoms, using elevated antibodies as one of several diagnostic “clues.”

Another interesting correlation between HHV-6A and patients with CFS is that a recent study in Europe found that 82% of fine needle biopsy tissue samples from patients with Hashimoto’s thyroiditis were positive for both HHV-6A DNA and messenger RNA, proving that these were active infections (Caselli 2012).

EDIT: Fixed link @Hipsman caught.

 

[Hipsman]

ENTEROVIRUS VP1 IMMUNOPEROXIDASE STAIN TEST REQUEST FORM

it says page not found for some reason...

 

[Hip]

QUESTION: Would there be any point to also test the stomach or GI biopsy for EBV, CMV, & HHV6 of CFS patients?

The trouble with testing the stomach or skeletal muscle tissues for herpesviruses is that (inexplicably) there have been virtually no ME/CFS studies which have done this. Without doing this background research, it's hard to interpret the results of any personal individual test you might make on stomach or muscle tissue biopsies.

In the field of enterovirus ME/CFS research, there is a long history of testing stomach or muscle biopsies, and many studies have shown that enterovirus infection is much more common in the tissues of ME/CFS patients, compared to healthy controls.

But nobody seems to have conducted such biopsy studies on herpesvirus ME/CFS patients. The only one study I know of which did look for herpesvirus was an old British one, which searched for both enterovirus and EBV in the skeletal muscle tissues — and found enterovirus in one subset of patients, and EBV in another subset.

Would this show intracellular viral infections that is not detectable in serum?

There are certain types of intracellular infection which you may only find in the tissues, such as abortive herpesvirus infections, which Dr Lerner posited are the cause of ME/CFS. So as far as I can see, tissue testing ME/CFS patients for herpesviruses would be very interesting.

Do EBV, CMV, HHV6 viruses like to reside in any particular type of tissue, like enterovirus is found in the gut? Or do you have to test every type of tissue or tissue that has a pathology?

Each virus has a set of cell types and specific organs which it may infect. For example, EBV infects the B-cells in the blood, and that is the main reservoir of latent EBV which lives in the body on a long-term basis.

In the stomach, chronic enterovirus lives in the parietal cells (the cells which secrete hydrochloric acid for digestion), and it's this parietal cell infection that Chia's biopsy VP1 staining detects.

it says page not found for some reason...

You can find Dr Chia's stomach tissue VP1 staining test here.

 

[kangaSue]

ENTEROVIRUS VP1 IMMUNOPEROXIDASE STAIN TEST REQUEST FORM

I gather treatment would be the same either way so you probably only really need to know if enterovirus can be implicated in some way with the GI problems and that was the test used by the motility centre doing this gastroparesis study;

https://pubmed.ncbi.nlm.nih.gov/27344315/
Gastric Enterovirus Infection: A Possible Causative Etiology of Gastroparesis
[EV testing was performed using immunoperoxidase staining with an EV-specific murine monoclonal antibody against EV viral capsid protein 1 (vp1) (EV MED Research. Lomita, California, USA) ]