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Pathogenic tracks in fatigue syndromes

  [ 39 votes ]   [ Discuss This Article ]
www.ProHealth.com • February 3, 1994


This review analyses the recent literature devoted to two related
fatigue syndromes: chronic fatigue syndrome (CFS) and acute
onset postviral fatigue syndrome (PVFS). The articles are
grouped into five pathogenic tracks: infectious agents, immune
system, skeletic muscle, hypothalamo-pituitary-adrenal (HPA)
axis and psychiatric factors. Although a particular infectious
agent is unlikely to be responsible for all CFS cases,
evidence is shown that host-parasite relationships are
modified in a large proportion of patients with chronic
fatigue. Antibody titres against infectious agents are often
elevated and replication of several viruses could be
increased. Chronic activation of the immune system is also
observed and could be due to the reactivation of persistent or
latent infectious agents such as herpes viruses (i.e. HHV-6)
or enteroviruses. It could also be favorised by an impaired
negative feedback of the HPA axis on the immune system. A
model is proposed where the abnormalities of the HPA axis are
primary events and are mainly responsible for a chronic
activation of the immune system which in turn induces an
increased replication of several viruses under the control of
cellular transcription factors. These replicating viruses
together with cytokines such as TNF-alpha would secondarily
induce functional disorders of muscle and several aspects of
asthenia itself.

Moutschen M, Triffaux JM, Demonty J, Legros JJ, Lefebvre PJ




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