redo
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The GIRA theory is a general theory of autoimmunity, and here I will present the GIRA theory in relation with myalgic encephalitis. No matter what lies behind ME, a theory must explain these three vital questions.
Three big questions in ME
How is the disease transmitted?
Why has it been increasing so much in prevalence in the Western world?
Why can so different things such as EBV or giardia, food poisoning or the flu trigger the disease?
While I don't sit with all the answers yet, I will offer my explanation. First, I'd like to explain what the acronym GIRA stands for.
G - Gut
I - (Temporary) Immune suppressing trigger
R - RNA virus
A - Autoimmunity/autoinflammation
Gut
To understand the chain of events, we'll take them one by one. First out, the gut. The content of the gut consists of more than 200 trillion cells (that is largely microbes, bacteria). It's quite an amazing number. The human body as a whole consists of only a fraction of that number of cells. With that share amount of bacteria, it's of utmost importance which of the bacteria is in a majority, and which is a minority. We know very well what happens when the wrong bacteria becomes a majority in the mouth; we get cavities. And, when the wrong bacteria is in a majority in the gut, we among other things get problems with the immune system. It begins malfunctioning, and especially when it comes to how it is able to handle RNA viruses.
Immune suppressing trigger
EBV, the flu, giardia, food poisoning, a tickbite, severe stress are some of the things which can trigger the very specific condition myalgic encephalitis. "Why", is the most important question to understanding the disease. The only common nominator is that they all suppress the immune system for a short period of time. Just for long enough that it can trigger a latent virus. To be specific, a latent endogenous RNA virus, which brings us to the next point on our list.
RNA virus
All humans have RNA viruses in our bodies. Endogenous RNA viruses. Throughout evolution human bodies have adapted, and we've learned to silence these RNA viruses. But, if the wrong bacteria dominate the gut, the immune system gets distorted, and all we need for the latent RNA viruses to get active is a immune suppressing trigger. That can be anything for EBV to the flu. What happens when the RNA virus becomes active is autoimmunity/autoinflammation. The RNA virus might be one which is identified, and it might be one which isn't known yet. We don't know.
Autoimmunity/autoinflammation
When the latent RNA virus is active, it distort the immune system (like RNA viruses are famous for). What these RNA viruses do, is for the most part to distort the immune system in such a way that autoinflammation/autoimmunity happens, and the myalgic encephalitis patients gets symptomatic, just the same way as RA patients, FMS patients or patients with other autoimmune conditions.
Autoimmunity/autoinflammation causes (among other things) a myriad of symptoms, neurological and non-neurological. Brain fog, joint pain, malaise, insomnia and so forth. And that's what we call ME.
Now that's the GIRA. And now, we'll go over to answering the questions.
How is it transmitted? Endogenous RNA viruses are something we're born with. They are silenced at birth, but may become active sometime throughout life if conditions are "right".
Why is it increasing so very much in prevalence in the Western world? The reason is that a premise for the virus to become active is that the trillions of bacteria in the gut are dominated by the wrong ones. What determines which bacteria dominate the 30 feet long gut is exactly the same as what determines which bacteria dominate the mouth; and that is what we feed the bacteria. So, in laymen's terms, it's the diet. And that's also the reason why people don't have our western autoimmune diseases in poorer countries.
Why can such different things as EBV or the flu trigger the disease? All the endogenous RNA virus needs when they immune system is malfunctioning because of overgrowth of the wrong bacteria in the gut is a trigger.
Other vital questions besides the big three.
Why is it we get somewhat better with probiotics, antibiotics, antivirals and Rituximab? (they are such different things!)
With probiotics, what we do is alleviate the gut problems which have risen. What happens is that if we are able to change the gut flora for the better, the body is more able to handle the RNA virus, as very much of immune functioning lies in the gut. The reason why some of the patients get worse so quickly of sugar (within days) is because it temporary changes the gut flora allowing for the wrong bacteria to get a stronger hold.
With antibiotics, there's more a mixed bag of results. I've heard many stories of people getting worse from certain antibiotics, and what they do is suppress helpful bacteria in the gut, and allows the harmful bacteria to get a stronger hold. But, with other antibiotics, it could really go after the right bacteria, and be very effective at it, doing much more good than harm. What happens than is that patient feels better, because the immune system functions better as a result of less of the wrong bacteria in the 200 trillion cell thing which is our gut content. And on top of that some antibiotics may act as anti inflammatory drugs regardless of the gut pathway of action.
With (normal) antivirals, many have immune modulating properties (such as also Montoya have proposed is the mechanism of action) and it alleviates symptoms. It might do it via going after a somewhat active co-virus, or directly by immune modulation.
With Rituximab and other immune modulators you go more directly at the immune dysfunction caused by the RNA virus. Autoantibodies or cytokines could very well be it. Wiping out the pathogenic ones, could work wonders on the patients.
Why do more women than men get ME? The endogenous RNA virus model would be a parallel to the HERV-W model in MS. While much is uncertain about the gender bias in ME, it seems to affect more women than men. MS affects women two to three times more often than men. The reason for this is the same as what's behind the HERV-W (RNA virus) hypothesis of MS. The genders respond differently, and much of the reason if the differences in the immune system.
Graphical presentation (just click the link, and the image will pop up).
http://i42.tinypic.com/nq39m1.jpg
Note. The links in the text are meant to be sources where one could read more about the general idea of a topic. More like a interesting to read list, than actual sources for evidence.
Further reading:
Microbes which defend and define us
Microbes which may be a reason for disease if they're the wrong ones
Gut Bacteria Lend a Molecular Hand to Viruses, and aids in making viruses pathogenic
Of Bugs and Brains: Gut Bacteria Affect Multiple Sclerosis
Research is actually pointing towards a new gut flora being responsible for giving RNA viruses the possibility to act out.
Endogenous RNA viruses
Human Endogenous Retrovirus W (HERV W), thought to play a role in MS
HERV W and MS, the Perron et al study
Input is very appreciated. Please do tell me why you think I am wrong or why I am right. What doesn't fit the the hypothesis, and what does.
Three big questions in ME
How is the disease transmitted?
Why has it been increasing so much in prevalence in the Western world?
Why can so different things such as EBV or giardia, food poisoning or the flu trigger the disease?
While I don't sit with all the answers yet, I will offer my explanation. First, I'd like to explain what the acronym GIRA stands for.
G - Gut
I - (Temporary) Immune suppressing trigger
R - RNA virus
A - Autoimmunity/autoinflammation
Gut
To understand the chain of events, we'll take them one by one. First out, the gut. The content of the gut consists of more than 200 trillion cells (that is largely microbes, bacteria). It's quite an amazing number. The human body as a whole consists of only a fraction of that number of cells. With that share amount of bacteria, it's of utmost importance which of the bacteria is in a majority, and which is a minority. We know very well what happens when the wrong bacteria becomes a majority in the mouth; we get cavities. And, when the wrong bacteria is in a majority in the gut, we among other things get problems with the immune system. It begins malfunctioning, and especially when it comes to how it is able to handle RNA viruses.
Immune suppressing trigger
EBV, the flu, giardia, food poisoning, a tickbite, severe stress are some of the things which can trigger the very specific condition myalgic encephalitis. "Why", is the most important question to understanding the disease. The only common nominator is that they all suppress the immune system for a short period of time. Just for long enough that it can trigger a latent virus. To be specific, a latent endogenous RNA virus, which brings us to the next point on our list.
RNA virus
All humans have RNA viruses in our bodies. Endogenous RNA viruses. Throughout evolution human bodies have adapted, and we've learned to silence these RNA viruses. But, if the wrong bacteria dominate the gut, the immune system gets distorted, and all we need for the latent RNA viruses to get active is a immune suppressing trigger. That can be anything for EBV to the flu. What happens when the RNA virus becomes active is autoimmunity/autoinflammation. The RNA virus might be one which is identified, and it might be one which isn't known yet. We don't know.
Autoimmunity/autoinflammation
When the latent RNA virus is active, it distort the immune system (like RNA viruses are famous for). What these RNA viruses do, is for the most part to distort the immune system in such a way that autoinflammation/autoimmunity happens, and the myalgic encephalitis patients gets symptomatic, just the same way as RA patients, FMS patients or patients with other autoimmune conditions.
Autoimmunity/autoinflammation causes (among other things) a myriad of symptoms, neurological and non-neurological. Brain fog, joint pain, malaise, insomnia and so forth. And that's what we call ME.
Now that's the GIRA. And now, we'll go over to answering the questions.
How is it transmitted? Endogenous RNA viruses are something we're born with. They are silenced at birth, but may become active sometime throughout life if conditions are "right".
Why is it increasing so very much in prevalence in the Western world? The reason is that a premise for the virus to become active is that the trillions of bacteria in the gut are dominated by the wrong ones. What determines which bacteria dominate the 30 feet long gut is exactly the same as what determines which bacteria dominate the mouth; and that is what we feed the bacteria. So, in laymen's terms, it's the diet. And that's also the reason why people don't have our western autoimmune diseases in poorer countries.
Why can such different things as EBV or the flu trigger the disease? All the endogenous RNA virus needs when they immune system is malfunctioning because of overgrowth of the wrong bacteria in the gut is a trigger.
Other vital questions besides the big three.
Why is it we get somewhat better with probiotics, antibiotics, antivirals and Rituximab? (they are such different things!)
With probiotics, what we do is alleviate the gut problems which have risen. What happens is that if we are able to change the gut flora for the better, the body is more able to handle the RNA virus, as very much of immune functioning lies in the gut. The reason why some of the patients get worse so quickly of sugar (within days) is because it temporary changes the gut flora allowing for the wrong bacteria to get a stronger hold.
With antibiotics, there's more a mixed bag of results. I've heard many stories of people getting worse from certain antibiotics, and what they do is suppress helpful bacteria in the gut, and allows the harmful bacteria to get a stronger hold. But, with other antibiotics, it could really go after the right bacteria, and be very effective at it, doing much more good than harm. What happens than is that patient feels better, because the immune system functions better as a result of less of the wrong bacteria in the 200 trillion cell thing which is our gut content. And on top of that some antibiotics may act as anti inflammatory drugs regardless of the gut pathway of action.
With (normal) antivirals, many have immune modulating properties (such as also Montoya have proposed is the mechanism of action) and it alleviates symptoms. It might do it via going after a somewhat active co-virus, or directly by immune modulation.
With Rituximab and other immune modulators you go more directly at the immune dysfunction caused by the RNA virus. Autoantibodies or cytokines could very well be it. Wiping out the pathogenic ones, could work wonders on the patients.
Why do more women than men get ME? The endogenous RNA virus model would be a parallel to the HERV-W model in MS. While much is uncertain about the gender bias in ME, it seems to affect more women than men. MS affects women two to three times more often than men. The reason for this is the same as what's behind the HERV-W (RNA virus) hypothesis of MS. The genders respond differently, and much of the reason if the differences in the immune system.
Graphical presentation (just click the link, and the image will pop up).
http://i42.tinypic.com/nq39m1.jpg
Note. The links in the text are meant to be sources where one could read more about the general idea of a topic. More like a interesting to read list, than actual sources for evidence.
Further reading:
Microbes which defend and define us
Microbes which may be a reason for disease if they're the wrong ones
Gut Bacteria Lend a Molecular Hand to Viruses, and aids in making viruses pathogenic
Of Bugs and Brains: Gut Bacteria Affect Multiple Sclerosis
Research is actually pointing towards a new gut flora being responsible for giving RNA viruses the possibility to act out.
Endogenous RNA viruses
Human Endogenous Retrovirus W (HERV W), thought to play a role in MS
HERV W and MS, the Perron et al study
Input is very appreciated. Please do tell me why you think I am wrong or why I am right. What doesn't fit the the hypothesis, and what does.