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The Emerging Role of Autoimmunity in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/cfs)

  [ 8 votes ]   [ 4 Comments ]
By G. Morris et al. • www.ProHealth.com • October 1, 2013


By G. Morris et al.

Abstract

The World Health Organization classifies myalgic encephalomyelitis/chronic fatigue syndrome (ME/cfs) as a nervous system disease. Together with other diseases under the G93 heading, ME/cfs shares a triad of abnormalities involving elevated oxidative and nitrosative stress (O&NS), activation of immuno-inflammatory pathways, and mitochondrial dysfunctions with depleted levels of adenosine triphosphate (ATP) synthesis.

There is also abundant evidence that many patients with ME/cfs (up to around 60 %) may suffer from autoimmune responses. A wide range of reported abnormalities in ME/cfs are highly pertinent to the generation of autoimmunity. Here we review the potential sources of autoimmunity which are observed in people with ME/cfs.

The increased levels of pro-inflammatory cytokines, e.g., interleukin-1 and tumor necrosis factor-?, and increased levels of nuclear factor-?B predispose to an autoimmune environment. Many cytokine abnormalities conspire to produce a predominance of effector B cells and autoreactive T cells. The common observation of reduced natural killer cell function in ME/cfs is a source of disrupted homeostasis and prolonged effector T cell survival. B cells may be pathogenic by playing a role in autoimmunity independent of their ability to produce antibodies.

The chronic or recurrent viral infections seen in many patients with ME/cfs can induce autoimmunity by mechanisms involving molecular mimicry and bystander activation. Increased bacterial translocation, as observed in ME/cfs, is known to induce chronic inflammation and autoimmunity.

Low ATP production and mitochondrial dysfunction is a source of autoimmunity by inhibiting apoptosis and stimulating necrotic cell death. Self-epitopes may be damaged by exposure to prolonged O&NS, altering their immunogenic profile and become a target for the host's immune system. Nitric oxide may induce many faces of autoimmunity stemming from elevated mitochondrial membrane hyperpolarization and blockade of the methionine cycle with subsequent hypomethylation of DNA.

Here we also outline options for treatment involving rituximab and endotherapia.

Source: Mol Neurobiol. 2013 Sep 26. [Epub ahead of print].Morris G, Berk M, Galecki P, Maes M.




Please Discuss This Article:   Post a Comment 

Autoimmunity and infections
Posted by: neoplus1
Oct 1, 2013
Autoimmunity implies the immune system specifically targets the host tissue. I am not so sure the evidence supports the autoimmune hypothesis.

There is immune dysfunction and the immune system clearly seems to be going and going as if it is fighting infection. But I don't think it is targeting us, we are by-standers.

"The chronic or recurrent viral infections seen in many patients with ME/cfs"

Again, the evidence does not support chronic infections in ME/CFS, we need to move on from this. That recent study looking for infections pretty much confirms this. The "hit and run" theory of infection is more plausible and more likely true.

The study also confirmed the immune dysfunction. Advocacy groups(I'm not talking about all of them) need to stop harping on ideas that are dead and disproved. They will slow progress just like the medical community in which they criticize has in the past.
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Evidence for autoimmune issues
Posted by: ianbarnes
Oct 5, 2013
We have two (or three) choices, either (1) the immune system is "going and going as if it is fighting infection" but there is no infection there, which we would classify as an autoimmune condition. Or (2) the immune system is actually fighting an ongoing infection. Or (3) it is fighting an ongoing infection and there are concurrent autoimmune problems.

For example, see Dr Konstance Knox discuss the viral onset of ME/CFS & auto-immune dysfunction (http://youtu.be/9O2xpW2jzY8). Or look at the high quality research being done by Drs Montoya, Lerner, Chia and others into ongoing viral infections in ME/CFS (http://mecfs.stanford.edu/). Or consider the B-cell abnormalities and the spectacular response to Rituximab in ME/CFS that has been documented by Norwegian researchers.

So we can see that the theories of auto-immune and ongoing viral infection in ME/CFS are far from "dead and disproved", these are very active and productive areas of research.

On the other hand, the "hit and run" theory is still no more than speculation at this stage: no studies have identified the body-system target that has been hit, how it was hit exactly, how the damage is not corrected by homoeostasis, nor how it continues to cause such malign symptoms.

 


Chronic Inflammatory Disease
Posted by: Laehcar
Oct 2, 2013
I believe first you have to have the genetic predisposition to develop ME/CFS, which is an up-regulated (strong, healthy) immune system and that there are many triggers (viruses, chemicals, vaccinations etc), which send the immune system, in some predisposed individuals, into permanent overdrive. I'm quite certain that my hyped-up immune system, that reacts to just about everything, is the culprit for the unrelenting fatigue, flu-like symptoms, insomnia and anxiety/depression I have experienced from this illness.
Reply Reply

Autoimmune Syndrome
Posted by: 23lucy29
Oct 23, 2013
I have suffered for thirty years with an autoimmune problem which is constantly conceived by medical practioners, friends and familiy as in my mind. I was diagnosed by my GP during that time and spent time being put through some unpleasant procedures at a major hospital to find out more about this disease however even then the medical profession still did not acknowledge his belief. As I am aging I find that the symptoms are more constant and I am taking Predisilone on a regular basis. I was diagnosed with Chronic Fatigue Syndrome initially however now I have been advised I have Lupus obviously an autoimmune problem as well. I believe the autoimmune system is hereditary as my dear Dad who is not longer with us suffered similar malaise for years however in those days there was no help. He died quite suddenly of a brain tumour and it was thought all his health problems were linked. He was a very fit person and exercise was his saviour even though some days it was very difficult for him. Thank goodness there is now some help available and I have medical practitioners who have helped me considerably over the past few years.
Kind regards
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