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Two Pathogens Implicated In Chronic Fatigue, Multiple Sclerosis and Gulf War Illness.

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Recent research studies are centering on the primitive bacterium known as mycoplasma incognitus (m.i.) and the intracellular pathogen chlamydia pneumoniae (c.p.). In particular, studies have investigated the roles these agents may play in chronic fatigue and immune dysfunction syndrome (CFIDS); fibromyalgia syndrome (FMS), multiple sclerosis (MS), and Gulf War Illness (GWI). These complex, chronic conditions share numerous overlapping symptoms.

According to Garth L. Nicolson, Ph.D., Professor of Internal Medicine at the University of Texas Medical School in Houston, patients suffering from these conditions may be battling chronic infections that can penetrate the central and peripheral nervous system. Moreover, Dr. Nicolson hypothesizes that these infections may also be entering other tissues and organs, possibly causing the signs and symptoms seen in CFIDS, FMS and GWI, including the chronic immune dysfunction. This may partially explain some of the environmentally sensitive responses, but as well as increased virus levels, that are often found in patients with these diseases.

While it appears that few infectious agents can trigger the symptoms presented by the above illnesses, certain infectious organisms, such as mycoplasmas and other primitive bacteria, are considered significant “emerging” pathogens in causing chronic diseases and may also be important co-factors in various illnesses, including AIDS.

While CFIDS is a poorly understood, debilitating disorder, based on the U.S. Centers For Disease Control (CDC), diagnosis requires the presence of a symptom complex including severe fatigue and elements of neurocognitive dysfunction for a minimum of six months (which cannot be explained by any other condition.) As with CFIDS, FMS and GWI are characterized by complex, multi-organ chronic symptoms, including neurological, muscular-skeletal, rheumatic, gastrointestinal and sinopulmonary disorders. Often these patients experience cognitive problems and are diagnosed by psychologists or psychiatrists, who, in the absence of laboratory markers for the above illnesses, decide that these conditions are psychiatric in origin.

Researchers such as infectious disease specialist Darryl See, M.D. of the University of California at Irvine College of Medicine are finding impressive evidence for mycoplasmal blood infections that may help explain chronic CFIDS and FMS conditions. Dr. See and fellow researchers Drs. Winnie Huang and Jeremiah Tilles found that the prevalence of m.i was markedly higher in CFIDS patients than in patient controls. According to the Winter 1997 American Academy of Environmental Medicine Newsletter, Dr. Nicolson’s studies on GWI have identified mycoplasmal infections in approximately one-half of patients.

Dr. Nicolson is also finding a sampling of pathogenic mycoplasmas in the leukocyte fractions of blood samples from approximately one-half of patients with CFIDS, FMS or arthritis. As Dr. Nicolson notes, “The tests that we use to identify mycoplasmal infections, polymerase chain reaction (pcr), and nucleoprotein gene tracking are very sensitive and highly specific. These tests are a dramatic improvement over the relatively insensitive serum antibody tests that are routinely used to assay for systemic mycoplasmal infections.”

The identification of these infections in the blood of a large subset of CFIDS, FMS and arthritis patients suggests that mycoplasmas, and other infections, are an important source of morbidity. Dr. Nicolson reports that antibiotic treatments for mycoplasmal infections in these patients have resulted in improvement and even recovery. This breakthrough is based on preliminary research studies on a relatively small number of patients. Further studies are needed to get a more detailed view of antibiotic treatments for mycoplasmal infections.

According to Dr. Nicolson, recommended treatments for mycoplasmal blood infections require long-term antibiotic therapy. An example would be multiple 6-week cycles of doxycycline at 200 – 300 mg. per day, ciprofloxacin or Cipro at 1,500 mg. per day, azithromycin or Zithromax at 500 mg. per day, and clarithromycin or Biaxin at 500 to 750 mg. per day.

While UC Irvine researchers are unravelling the mysteries of m.i., Vanderbilt University researchers are exploring Chlamydia pneumoniae and its possible role in MS, CFIDS, FMS as well as possible antibiotic treatments. While it is too early to report on these findings, results should be made available in the near future.

(Editor’s Note: The summer 1998 issue of Healthwatch will contain a more detailed article on roles played by mycoplasma incognitus and chlamydia pneumoniae in the pathogenesis of CFIDS, fibromyalgia and GWI.)

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