Is CFS a neuroimmune or autoimmune disorder or both? Can someone give me examples of illness in each catagory.
Also when someone is suffering from an immune disorder is it referring to autoimmune and neuroimmune or are there immune disorders that do not fall into either neuroimmune or autoimmune category.?
People ask me lots of these types of questions when they find out I have CFS and I am never quite sure what to tell them
Hi, juniemarie.
CFS has been called a neuroimmune disorder by some. The reason is that there are abnormalities in cytokine levels in CFS. Cytokines are chemical signalling molecules that are produced by cells of the immune system, and the immune system and the nervous system communicate with each other by means of them. Calling it a neuroimmune disorder doesn't tell us what the cause is, however, so it's a little misleading to call it that, in my opinion. The abnormalities in the immune and nervous systems are only part of the pathophysiology of CFS. There are also problems in other systems as well, and the fundamental cause likely does not lie in the immune or nervous systems. They are just two of the victims, in my opinion.
Autism, Gulf War Illness, and a few others have also been called neuroimmune.
An autoimmune disease is one in which the immune system attacks the body's own molecules. Examples are rheumatoid arthritis and lupus erythematosis. It's likely in these diseases that something is present to provoke the immune response (such as a bacterial or viral infection that hasn't yet been identified), but because of the person's inherited genetics, when the immune system responds to it, there is a cross reaction with one of the body's own molecules, which produces damage.
CFS is not an autoimmune disease per se. However, Hashimoto's autoimmune thyroiditis is very commonly found in CFS, and that is autoimmune. In my hypothesis, this occurs by the Duthoit mechanism. That is, depletion of glutathione removes protection from the thyroid cells, and they are attacked by the hydrogen peroxide that these cells generate in the process of making thyroid hormones. This damages proteins in these cells, and the immune system views them as foreign substances and attacks them, damaging the thyroid cells.
There are immune system disorders that are not referred to as neuroimmune, but probably, strictly speaking, if the cytokine levels are affected, the nervous system experiences changes as well. "Neuroimmune" is really sort of a new buzz word that conveys the understanding that these two systems communicate with each other, but it doesn't tell us what causes the problems initially. I think that when these disorders are better understood, the term "neuroimmune" will probably cease to be used to describe them. But for now, it's a way to group together certain disorders that seem to have something in common, but which aren't well understood yet. It also sounds very technical, which may help to impress people that they are serious disorders, which they are. "Neuroimmune" sounds a lot more serious than "chronic fatigue syndrome," which has unfortunately become a source of jokes for some in the media.
If you want to know what I think is at the basis of CFS, you can read the slides from my recent talk at the Yasko Protocol Confererence. They are the last item at
www.cfsresearch.org that you can find by clicking on CFS/M.E. and then on my name.
Best regards,
Rich
