Thursday, October 29, 2009

Autonomic Dysregulation Redux - Here we go Again!

This morning I noticed another article seemingly trying to dismiss the findings of the Whittemore Peterson institute by going back to the neuroendocrine model of CFS.  The so called "Paper" titled "How XMRV Retrovirus Findings May Fit With The Amygdala Hyperarousal Model for ME/CFS is written by Ahsok Gupta, a self-proclaimed expert on ME/CFS who states that he cured himself of ME/CFS after being struck by a viral-like illness after his second year of Economics at Cambridge University.  The irony of it is that Mr. Gupta is neither a medical doctor, molecular biologist, or biochemist.

This theory in itself does not seem to hold water - in studies where a drug was injected into the amygdala, the animals had better memory for retaining the task - quite the opposite of memory impairment seen in ME/CFS.  In his paper, he also blames overstimulation of the autonomic nervous system - which would be typically characterized by anxiety, hypertension, and digestive disturbances (Something that occurs with use of cocaine, crystal meth, or even too much caffeine) - quite the opposite of ME/CFS!  He also goes on to theorize that the XMRV virus is simply a passive opportunistic infection which establishes itself due to general suppression and dysfunction of the immune system from autonomic dysregulation and amygdala hyperarousal (Would manifest itself as mania and hypersexuality).  Once again, this theory brings ME/CFS back to the forefront as a fire of unknown origin.

I stand firm that XMRV directly causes the symptoms of ME/CFS, FM, and Gulf War Syndrome - much like HIV causes AIDS.  Gupta quotes "There are two broad aspects to the immune system, Th1 and Th2.  Th1 involves Natural Killed (NK) cells whose job it is to identify and destroy viruses.  The Th2 side of the immune system involves amongst other things antibodies which respond to threats.  There is evidence in the litterature that patients with ME/CFS are Th2 biased..."  Enough said - some of this is partially true, but it does not meet the definition of a cause.  Years of AIDS research has already given us a heads up on what could be happening in XMRV infections.  HIV infects by latching on to the CD4 molecule for entry, much like I postulate that XMRV uses the CD8 Molecule found on NK cells, explaining why NK function is disrupted - saying that if the Th1 arm of the immune system is attacked, the Th2 system is going to be predominant.

To dissect this further, Gupta goes on to state that "The XMRV virus may simply represent one of many viral and bacterial infections present in the blood of ME/CFS patients, and that many of these previous infections (including EBV) have been previously prematurely suspected as the root cause of ME/CFS."  My take on this is look no further than HIV - as the disease progresses to AIDS, titers of CMV, EBV etc. rise dramatically - to the point where some AIDS patients have to take Valcyte to prevent sight-threatening CMV infections.  You also see that RNASE-L is elevated, and the uber-powerful cleaved version is present because RNASE-L functions to keep viral pathogens at bay until NK cells are summoned - unfortunately no one is there to answer the call

I also believe that the autonomic disruption in ME/CFS, FM, and Gulf War Syndrome is a direct result of infection with XMRV.  We've seen this in HIV - AIDS Dementia Complex.  The action of certain cytokines on the nervous system is also of note - anyone who has had the flu can tell you just how tired they are, and feel "spacey" - persons receiving interferon report the same.

I will finish by saying that ME/CFS, Fibromyalgia, and Gulf War Syndrome patients have been bombarded for years with faith healers, alternative/complimentary medicine theories, and psychiatric explanations for their symptoms.  No currently approved treatment has produced any satisfactory improvement in any of this group of patients, although some improvement has been noted with anti-virals targeting herpesviruses such as HHV-6, EBV, CMV lending to the credence that EBV exacerbates symptoms of an XMRV infection.  It will be interesting to see early results of AZT trials, and hopefully more HIV drugs will show efficacy - hopefully the integrase inhibitor Isentress will show efficacy against XMRV due to its lack of delitirious side effects like lipodystrophy, hypercholesterolemia and hyperglycemia found in protease inhibitors and some RTI's.

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