Monday 5 November 2012

Immune System Science

I'd like to thank a friend for pointing out the author of this book:

Recovering from ME:
A Guide to Self-Empowerment

By William Collinge, Ph.D.

It is available to read on the website www.collinge.org/
I have found some fascinating things to read to help with my ME knowledge and have chosen a piece of it to quote in my post today. Knowing how complex the body is and having such proof that we are dealing with physical anomalies is a very empowering thing. By understanding the foe, the fight is easier to win. Some of the neurobiology is a bit beyond me, but just read through the cracks and you'll get the drift!


"CFS: A DISEASE IN SEARCH OF A CATEGORY
Where does CFS fit in? Interestingly, CFS does not fit neatly into any of the above types of illness. Rather, it has some of the qualities of each. This is one of the reasons why mainstream medicine has had such reluctance to acknowledge the syndrome as a distinct disease--it simply does not fit any of our familiar categories.
We now know that CFS involves both brain dysfunction (encephalopathy, lesions, neurological problems) and immune dysfunction. It is not known whether one precedes the other, or whether they develop simultaneously. According to Byron Hyde, M.D., Chair of the Nightingale Research Foundation, brain dysfunction is a requirement in defining the syndrome. The area of the brain affected varies from one person to the next, although almost all are found to have injury to the left frontal lobe. Damage to this area of the brain is responsible for several of the disturbances of memory, concentration, and other cognitive symptoms of CFS.
The involvement of the central nervous system is further supported by Dr. Paul Cheney, who describes CFS as a disease of cognition dysfunction involving such unusual impairments as difficulties with memory sequencing, spatial disorganisation, trouble giving and following directions, processing problems, intellectual speed, and processing visual and auditory information.
While the involvement of the nervous system is a major part of the syndrome, the heart and soul of making a diagnosis, according to Cheney, remain to be immunologic testing. He describes "all manner of unusual phenomena" going on in the great majority of patients. The most common pattern is chronically heightened T-cell activation, elevated levels of cytokines such as interferon and interleukin II, immunoglobulin deficiencies, and severe natural killer (NK) cell functional deficiency. In fact, NK cell dysfunction is so central to the condition that in Japan the disease is called "Low NK Syndrome."
One leading CFS immunologist, Nancy Klimas, M.D., of the University of Miami, believes this NK deficiency is a central feature of CFS, and qualifies the syndrome as an acquired immune deficiency. She states that her findings, based on a patient population of 500, show higher than normal numbers of natural killer cells in CFS, as if the immune system is trying to respond to something, but very low functionality. The ability of those NK cells to kill was the lowest of any group studied, including among people in early stages of HIV infection, people with ARC (AIDS-Related Complex), and in intravenous drug users.
According to Dr. Klimas, "The most compelling finding was that natural killer cell cytotoxicity in chronic fatigue syndrome was as low as we have seen in any disease... These cells seem to feel the way that CFS patients do--they're exhausted." Other researchers have observed that NK cell numbers rise during the acute stage of CFS, and then return to normal after recovery.
These various dysfunctions help explain how the person may have elevated activity levels of viruses such as Epstein-Barr (EBV), cytomegalovirus (CMV), human herpesvirus number 6 (HH6), herpesvirus types I or II, or other viruses.
These immune dysfunctions are part of a broader picture which also includes immune system up-regulation. It is the chronic, high state of immune activation that appears to be the real cause of most of the symptoms. In fact, Dr. Klimas and her colleagues have also identified a cytokine abnormality that has not been sen before in any disease. In about 35% of their patients, they are seeing interleukin-1 (IL-1) levels that are 50 times higher than normal. Klimas reports that in studies of mice with similarly high levels, the mice develop muscle weakness, lassitude, generalised inflammation, cardiac tachycardia, decreases in cardiac output and peripheral neuropathies--all symptoms found in severe cases of CFS.
Dr. Jay Levy of the University of California, San Francisco, considered by many as the first to have actually located and isolated the AIDS virus, has proposed that the syndrome be renamed "Chronic Immune Activation Syndrome." It is indeed unfortunate that the syndrome was named for merely one of its many symptoms, fatigue, rather than being given a name which represents more accurately the disease process itself. Paul Cheney, M.D. has made the comment that this is like calling pneumonia "chronic cough syndrome."
According to Levy: "We believe that there is an infectious agent that enters the host and activates the immune system... some individuals, because of their genetic makeup or because of their state at the time of infection, will not be able to turn off that activated state... (and) the immune system never returns to a normal resting state. So, these people are in a state of chronic immune activation."...
...One theory is that it is some kind of a hit-and-run virus, leaving the immune system firing away at no specific target."

2 comments:

  1. "Recovering from ME: A Guide to Self-Empowerment" by William Collinge is the best book I've read about CFS. And it's free!
    Not new one but really comprehensive.
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    Many research show CFS/ME is about the chronic infection and/or a state of chronic immune activation that can affect the nervous system. But personally I believe it's just a symptom not cause. That's why even long term antibiotics and viral (like VALCYTE) treatments fail.

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    1. Yes Izabela, I agree with you about the symptoms. I now see ME as an illness of the entire autonomic nervous system.
      The quote I chose is a great starting point to show to family and friends who just need to understand the complexity of this illness. It is interesting with this research that such a large majority have this severe problem with the immune system, it maybe could eventually be used as some kind of diagnosis point. Not all patients have the mitochondrial disfunction or the insomnia, but this does seem to be widespread.

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