A progress report was issued on two of the three CFIDS research centers that are federally subsidized. Both the Boston and Newark (NJ) sites gave a summary of the year to patients; the Denver center has not issued a report yet.
The Boston center published its second paper on the prevalence of CFIDS, and found nearly as many men as women had CFIDS, with a higher frequency in Black and Latino populations. The Boston group continues to seek infectious agents that may cause or contribute to CFIDS as well as muscle abnormalities found in the metabolism. They are also near completion of a study comparing CFIDS to Multiple Sclerosis and depressed patients. Other studies include the quantified electroencephalograph (QEEG) test to study brain waves and the same type of research on neurally mediated hypotension as Johns Hopkins (and are reaching similar conclusions). They do not, however advocate treatment unless a patient has been formally tested and they do not think this is a cue. The Boston group completed and published paper on balance abnormalities, and has 11 other papers being prepared for publication.
Benjamin Natelson, M.D., director of the Newark Center, finished a drug trial using a low dose of the antidepressant pheneizine after a doctor found CFIDS-like symptoms followed high blood pressure treatment. The trial found that, like other antidepressants, it relieved pain. Results from another trial on a similar drug will announce results soon, and a third trial on DHEA, a human hormone, will commence shortly.
Dr. Natelson will collaborate on tests being done at a new Gulf War center. Cooperative studies with the Gulf War Research center has gained the CFIDS center another million-dollar federal grant. In addition, Multiple Chemical Sensitivity (MCS) and its comparison to CFIDS will be the subject of a pilot study at the Robert Wood Johnson Medical School, A study on breathing showed persons with CFIDSs have lower activity of the nerve that controls heart rate, tying into research by Johns Hopkins. They will now start tilt table testing. A fitness study to compare PWCs to deconditioned, sedentary people is also planned.
Assessing Twins with CFS and FMS
Dedra Buchwald, M.D, from the University of Washington in Seattle, has initiated a study of twins to further explore the influences of nature versus nurture. She hopes the study will clarify the importance of predisposing factors that may trigger or contribute to the onset of Chronic Fatigue Syndrome and Fibromyalgia Syndrome. If you are a twin with either CFS or FMS diagnosis and you wish to be part of the study, please contact Nicollete Vajtay, University of Washington, Harborview Medical Center, 325 Ninth Avenue, Box 359780, Seattle, WA 98104, telephone number (206) 731-2125.
In 1994, Robert Keller, M.D., and Nancy Klinias, M.D., published a report indicating that certain types of HLA (human leukocyte antigen) class II antigens appeared more commonly in the blood samples of 110 CFS patients versus health controls. Normally a multitude of HLA antigens are present in each cell, and are responsible for detecting foreign or infectious agents and activating the immune system to eradicate the unwanted intruders.
Defects in the HLA system are present in auto-immune disorders like lupus and rheumatoid arthritis, diseases in which certain HLA antigens are present in the blood in higher than normal concentrations. Genetic coding for the HLA system can be found on a specific section (or gene locus) of human chromosome number six. Suspecting that CFS might in some way be tied genetically to the HLA system, Keller and Klimas analyzed their small sample of CFS patients for ten different HLADR antigens and three different HLA-DQ antigens. An increase in the presence of HLADR4, DR5, and DQ3 were found in CFS patients. Klimas says this is “soft” data and that more work with larger patient numbers is needed to be done.
At the October 1995 ACR meeting, Muhammad Yunus, M.D., presented data on HLA typing of 40 multi-case families in which at least two members of the same family had FMA. Dr. Yunus and his associates used sophisticated statistical methods, called sibship test, which examine the linkage of FMS with genetically determined HLS types among blood relatives. They found statistically significant genetic linkage of FMS within the HLA system. Dr. Yunus explained that such findings provide stronger evidence for a genetic role in certain HLA antigens. He also speculated that his findings may be related to previous reports of the high incidence of auto-immune diseases (such as lupus and rheumatoid arthritis) among FMS patients. Why? All HLA codings can be tied to the same area on chromosome number six.
Dr. Yunus said that his positive findings provide the first objective and methodologically reliable demonstration of genetic susceptibility in FMS. However, he cautioned that his data needs to be independently corroborated by others.
In 1995, a conference was sponsored by the Karolinska Institute in Stockholm, Sweden. Members from the U.S. centers participated, and welcomed a new CFS research center in that country.