Marco
Grrrrrrr!
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Apologies. This isn't news just some musings of my own and I didn't know where else to post it.
I've not been following ME/CFS research for many years. The XMRV thing brought me back in and I've been trying to get up to speed. One of the PR library papers (Broderick et al) got me doing a little reading on the TH1/TH2 immune imbalance theory which also got me doing a little thinking.
This is a beautiful paper. If anyone is interested in science for the sake of it this is a peach.
http://www.forums.aboutmecfs.org/showthread.php?4812-Broderick-2010-A-Formal-Analysis-of-Cytokine-Networks-in-CFS
I won't even try to explain the basic theory. Others are well versed, in fact its probably old hat to most people. For people like me, this provides a good accessible overview and critique of the limitations of the theory (can't unfortunately vouch for its accuracy) :
http://docs.google.com/viewer?a=v&q=cache:jE2nP3U1F6gJ:www.adltests.com/assets/files/pdf/Cytokines_Th1_Th2_Kidd.pdf+low+TH1+high+TH2&hl=en&gl=uk&pid=bl&srcid=ADGEESjglKiokexKb0qfb95NbDGM5EHSFmwnPGkq7_Jmetv_dPl7TGcXnw0IBPmnD83fzcMNMz_narNeWq9msAQTFQ1Yu1P1nZ34LMU0pRUlpQMrHPrOxO6c-45uhGKIP-_Z92X8eFih&sig=AHIEtbTOnIk8Qo3930pJJDJFMf-UcdcTCA
Anyway, we are all too painfully aware that ME/CFS is dogged by the issue of heterogeneity. On one hand there's the 'stating the bleedin' obvious' heterogeneity resulting from loose diagnostic criteria that allow anyone who is frequently tired to be labelled as CFS.
More substantively, we are all aware that those with 'true' ME/CFS often differ in many ways. Some have sudden onset, some gradual. Some can point to a viral onset, some not. Some cite vaccinations, heavy metals, organophosphates, (the gulf war?) as precipitating factors and some point to overexercise, diet, or stress. While viruses (and retroviruses) have long been proposed as pathogens, none to date have been found in all those diagnosed with ME/CFS. While XMRV may turn out to be the key, PWCs have already been tested negative and it is possible that many of those diagnosed with ME/CFS will be found not to have an active XMRV infection. Some people reportedly make a quick spontaneous recovery while others become chronically ill for many years and fluctuations/relapses are common. Some report that fatigue, the central and sometimes only symptom considered important in CFS, was not a factor in at least a stage of their illness. Finally, regardless of how we view 'therapies' such as CBT/GET or the Gupta Programme, they are reported to be of some help to some people (bear with me of the last point).
I would like to propose that ME/CFS, in ALL CASES, is caused by a dysregulation of the immune system leading to TH2 dominance. For want of a better title I'll call it Type 2 Immune Dysfunction Syndrome (syndrome to distinguish it from other specific illnesses caused by TH2 dominance).
Taking this approach I believe avoids the 'problem' of searching for a single etiology, improves diagnosis and clarifies the treatment options.
I've not been following ME/CFS research for many years. The XMRV thing brought me back in and I've been trying to get up to speed. One of the PR library papers (Broderick et al) got me doing a little reading on the TH1/TH2 immune imbalance theory which also got me doing a little thinking.
This is a beautiful paper. If anyone is interested in science for the sake of it this is a peach.
http://www.forums.aboutmecfs.org/showthread.php?4812-Broderick-2010-A-Formal-Analysis-of-Cytokine-Networks-in-CFS
I won't even try to explain the basic theory. Others are well versed, in fact its probably old hat to most people. For people like me, this provides a good accessible overview and critique of the limitations of the theory (can't unfortunately vouch for its accuracy) :
http://docs.google.com/viewer?a=v&q=cache:jE2nP3U1F6gJ:www.adltests.com/assets/files/pdf/Cytokines_Th1_Th2_Kidd.pdf+low+TH1+high+TH2&hl=en&gl=uk&pid=bl&srcid=ADGEESjglKiokexKb0qfb95NbDGM5EHSFmwnPGkq7_Jmetv_dPl7TGcXnw0IBPmnD83fzcMNMz_narNeWq9msAQTFQ1Yu1P1nZ34LMU0pRUlpQMrHPrOxO6c-45uhGKIP-_Z92X8eFih&sig=AHIEtbTOnIk8Qo3930pJJDJFMf-UcdcTCA
Anyway, we are all too painfully aware that ME/CFS is dogged by the issue of heterogeneity. On one hand there's the 'stating the bleedin' obvious' heterogeneity resulting from loose diagnostic criteria that allow anyone who is frequently tired to be labelled as CFS.
More substantively, we are all aware that those with 'true' ME/CFS often differ in many ways. Some have sudden onset, some gradual. Some can point to a viral onset, some not. Some cite vaccinations, heavy metals, organophosphates, (the gulf war?) as precipitating factors and some point to overexercise, diet, or stress. While viruses (and retroviruses) have long been proposed as pathogens, none to date have been found in all those diagnosed with ME/CFS. While XMRV may turn out to be the key, PWCs have already been tested negative and it is possible that many of those diagnosed with ME/CFS will be found not to have an active XMRV infection. Some people reportedly make a quick spontaneous recovery while others become chronically ill for many years and fluctuations/relapses are common. Some report that fatigue, the central and sometimes only symptom considered important in CFS, was not a factor in at least a stage of their illness. Finally, regardless of how we view 'therapies' such as CBT/GET or the Gupta Programme, they are reported to be of some help to some people (bear with me of the last point).
I would like to propose that ME/CFS, in ALL CASES, is caused by a dysregulation of the immune system leading to TH2 dominance. For want of a better title I'll call it Type 2 Immune Dysfunction Syndrome (syndrome to distinguish it from other specific illnesses caused by TH2 dominance).
Taking this approach I believe avoids the 'problem' of searching for a single etiology, improves diagnosis and clarifies the treatment options.