Re: Understanding the contact electrode pads

[Guest guest]

Just to verify, I'm using the Godzilla for microscopic parasites. Is the

preferred protocol to use one electrode on each wrist? I have tens pads so

I could use those, or I could do it the old way.

I have been at this almost two weeks now and I notice a herx which has

evolved into wanting to sleep 15 hours a day and enjoying it.

I was in one of several double blind studies carried out at Harvard

University. I tested positive for c. pulmoni. I believe that c. pulmoni is

responsible for my illness because my symptoms match the ones described

below exactly. There is no known treatment for c. pulmoni. Maybe Godzilla

will work.

CFS Radio Program

Jan. 16th, 2000

G. Mazlen, M.D. Host

with

Dr. Larry Klapow

----------------------------------------------------------------------------

----

Dr. Mazlen

To kick off the new millennium with a good show that you'll find of

great interest and great importance, I'm talking today with Dr. Larry

Klapow, a Ph.D. in Invertebrate Biology who's in Burlingame, California near

San Francisco. Good morning Larry, welcome to our show.

Dr. Klapow

Good morning, , I'm glad to be here.

Dr. Mazlen

Can you tell our audience something about the this suspected new

parasite that you've found in a percentage of patients with Chronic Fatigue

Syndrome? How'd you find it?

Dr. Klapow

Well, , it came about as a result of a conversation I was having

with an immunologist friend of mine, Dr. Marinkovich, here in

Redwood City, California. He was treating a CFS patient we thought might

have a roundworm infection. The patient had a low grade eosinophilia and

some unusual rashes on the torso that suggested the possibility of

threadworm disease. Antibody tests and stool tests were negative. I thought

about this for a while and I know that some chronic parasites migrate

between the digestive tract and the respiratory tract and some of them are

coughed up in sputum. So I looked at the sputum and that's where I found it.

I called the new parasite " Cryptostrongylus pulmoni " , that's a provisional

name and it means " the hidden lung worm " .

Dr. Mazlen

That's pretty appropriate in terms of what you say.

Dr. Klapow

It definitely is, . It's very difficult to find. And I hope other

people will start looking for it. In fact, I've put together some material

that I think can help them.

Dr. Mazlen

You recently completed a small blinded study in cooperation with a

small number of CFS doctors including Dr. Komaroff in Harvard.

You're now doing a larger blinded trial and you're also trying to develop a

clinical test for the parasite. But for these other investigators and

clinicians, can you tell us what does the parasite look like and how can

they find it?

Dr. Klapow

You can identify the parasite, the female by its mouth parts and the

male by its very intricate reproductive structure. This parasite is very

small. The female is less than a millimeter long and the male is about a

third that length. So, in addition to being small there's also a lot of

difficulties. The specimens I usually pick up are naturally expelled in

sputum and they're usually very decayed and rare and because of this you

need very specialized imaging techniques to find them. They're not expensive

techniques, they're just specialized. In any case I wanted to help people

look for this parasite and so I put together a website which describes how

to find it in great detail. It also includes anatomical drawings. I can give

you the website address if you like.

Dr. Mazlen

Yes, give us the address right now, that'll be great.

Dr. Klapow

OK, I'll give you my own email address and then I can post the other

rather longer address for people who contact me. My email address is

lak123@....

Dr. Mazlen

Now, this is really important because this introduces a whole new

dimension about Chronic Fatigue Syndrome and its possible relationship to

roundworm infestation. Can you tell us so far, at least, as you've been

looking, what percentages of Chronic Fatigue Syndrome patients are turning

out to be positive for this worm?

Dr. Klapow

Yes, I find the parasites in about 40% of three-day sputum samples

from CFS patients. However, I have to tell you that yields are very low. In

fact, they're so low that I think I'm probably missing as many positive

patients as I'm finding. The problem here is that over 80% of the positives

I get are represented by only one identifiable specimen. So just by chance

it looks like I'm missing a fairly high percentage.

Dr. Mazlen

So, the prevalence can be a lot higher and this, of course, stirs some

very great interest in terms of causation and etiology which we'll go into

later. Can you tell us anything about the blinded trials so far?

Dr. Klapow

Yes, I did a small blinded trial in cooperation with a number of

doctors including Dr. Komaroff at Harvard and here are the results.

I think they're interesting but you judge for yourself. 5 of the 11 patients

were positive while all 6 controls were negative. Now, it's a small trial

but if you were trying to do as well by guessing, say by just tossing a

coin, you'd only do as well as I report here in about 1 in a 100 tests, so

it's a very hard thing to do by just guessing. The results of this small

trial can be used to devise an experimental design for a large trial that

could give a statistically significant result and going through that

exercise suggests that between 50 and 80 samples will be needed. Now, it may

take some time to process these samples microscopically. It's now taking me

somewhere between 50 and 100 hours to find a single positive patient so I

think the progress will be slow, that is unless we can get something more

rapid going in the form of a PCR test.

Dr. Mazlen

Well, I certainly congratulate you though for the effort that you're

making because this is totally important to patients for their prognosis and

recovery ultimately. There's a lot more to learn and, of course, we're going

to go into that and you mentioned the PCR test and that you have some

arrangements whereby this can be developed and hopefully you'll get some

funding to help this along soon. If anybody in the audience is interested in

helping in this regard they can reach me at rgm1@... which is my email

address and I'll forward it on to Dr. Klapow. Larry where do you think these

parasites might be coming from?

Dr. Klapow

Well, , they have some specialized anatomical structures that

suggest that they're related to parasites of animals that live in the

jungles of Southeast Asia. In fact, there's been somewhat of a history of

hard to diagnose parasites coming out of that area and being brought back to

" Western " countries after periods of warfare. It happened in the n

era when French soldiers were returning from this area and brought back the

chronic parasite Strongyloides stercoralis to Europe where it was first

diagnosed in 1894. It also happened again in World War II. This time British

soldiers became infected while they were imprisoned in Burma returned to

England and 30 years later, in 1974 they were diagnosed with chronic

parasites they had gotten while they were in prison. It's kind of a

testament to how difficult some of these parasites are to find and treat. I

would like to look at people who've been to Southeast Asia and I think I

plan to do that as soon as I finish with the large trial I'm doing on CFS

patients now.

Dr. Mazlen

It's a natural sequitur because you're going to be having a chance to

look at all of the veterans of the Viet Nam era who either served in Viet

Nam or Cambodia or neighboring areas.

Dr. Klapow

That will happen, I think, rather quickly if I can get the PCR test

going.

Dr. Mazlen

You say it might be coming from this source and that's a possibility.

How is it contracted? How do you get it then?

Dr. Klapow

I'm really not sure. What I can tell you is this. I've never seen a

fresh transmissible stage of the parasite in any sputum sample I've seen so

far. I've done a couple of hundred samples at this point. So I don't think

there's any evidence right now of casual transmission. But roundworm

parasites are typically acquired by eating contaminated food, but an

outbreak of Cryptostrongylus infection, if it were transmitted in this way,

would look very different then a typical food poisoning incident where

people get sick within a couple of hours after eating.

Dr. Mazlen

That's due to the long latency that you mentioned.

Dr. Klapow

Cryptostrongylus is very small but it produces a larvae which is very

large so there's an implication here that it must be reproducing very slowly

and possibly has a very long latency time. Of course, we know that the

outbreak of Chronic Fatigue Syndrome usually take place over several months

and in some cases a couple of years and that I think would be consistent

with the possibility of a food borne infection with a very long latency

period.

Dr. Mazlen

Well, now we're going to turn to the clinical side. Most of the time

that doctors are looking for parasitosis, they look to see elevated

eosinophil and serum IgE, or immunoglobulin E, levels in patients. Isn't

this usually the case?

Dr. Klapow

Yes, but that's the first question that I get from doctors when I tell

them that I found what I think is a new species of roundworm parasite.

Where's the elevated IgE? And the answer is elevated IgE is mainly apparent

in acute roundworm infections. With time, the chronic parasites are able to

suppress the IgE response and many of them produce a clinical picture where

the patients either have normal or lower than the normal average level of

IgE and, in fact, that's the picture you see in CFS and in all the studies

I've reviewed, IgE is lower in CFS patients than in healthy control

populations.

Dr. Mazlen

Here I want to interject that I'm part of the new study looking into

C.pulmoni in CFS patients and one of the things that prompted me to call you

and talk to you about getting involved is the fact that I had been seeing

low IgE levels, low eosinophile counts in patients that I thought were

inappropriate.

Dr. Klapow

In fact, there was a paper that's a few years old in the Journal of

Chronic Fatigue Syndrome that indicates that if you correlate IgE and

eosinophil levels with the number of symptoms the patients report, the

sicker they are the lower the IgE and eosinophil counts and that's a

statistically significant relationship.

Dr. Mazlen

And I see it and it seems to be borne out. Now, what do you think is

suppressing IgE in this CFS or Chronic Fatigue Syndrome patients? What's the

mechanism?

Dr. Klapow

Well, I think the mechanism may involve the cell marker CD23 which

suppresses IgE. There are a couple of other things that activate CD23, the

IgE suppresser and those are active herpes viruses and some of the TH1

cytokines, particularly interferon-gamma and the 2'-5'A, the activator of

the latent RNase enzyme. Both herpes viruses and 2'-5'A, as you know, are

highly elevated in CFS patients. In fact, it looks like some roundworms may

be using chronic viruses as cofactors to help perpetuate their own survival.

Dr. Mazlen

That certainly rings true from what I've seen clinically and that

leads us to another question. If a lot of Chronic Fatigue Syndrome patients

have allergies, they should have elevated IgE levels but a lot of them, as

we were just saying, don't. It seems to fit the model you propose of a

suppresser.

Dr. Klapow

Yes, there are some doctors, in fact, that think allergy is a risk

factor for getting a roundworm infection and that's because patients who

tend to produce too much IgE to non-specific stimuli, harmless things, may

not have enough reserves left over to fight off the parasites so they get a

foothold, and in fact, initially, you can even see patients who report

increased allergies, but later on when they're diagnosed with CFS and the

presumptive parasite, if we may go so far and speculate, has suppressed

their IgE response and the values come out clinically low.

Dr. Mazlen

Now, this brings us to a leading question, which, obviously is a

speculation, but that's all right because that's what this show is about. We

want to raise issues and have other people contribute to answering them as

well. There seem to be many infectious agents that have been proposed as

being possible etiological agents for Chronic Fatigue Syndrome. None of them

have held up specifically as a single causative agent. What do you think

about this roundworm infection, c.pulmoni, is it a primary infection or is

it just another opportunistic organism?

Dr. Klapow

Well, I don't know if it's a primary cause of CFS. We'll just have to

have to go through the rules of Koch's postulates and see how far we can

get. I think it's an interesting candidate for a possible primary agent. I

don't think it's an opportunistic infection. Opportunistic infections are

usually airborne and are present everywhere. They're just waiting for our

immune systems to be weakened before they establish a chronic infection.

Cryptostrongylus doesn't seem to be ubiquitous. If I'm right about the

taxonomy, it looks like it's coming out of a particular geographic area.

They're are also a number of things that I think can connect roundworm

infection to the major physiological systems that malfunction in CFS. And

they have to do with the wide variety of physiologically active agents

roundworms are able to secrete.

Dr. Mazlen

We're going back now and talking about the hormones that these

roundworms secrete, namely vasoactive intestinal polypeptide, which is known

as VIP, and hippocampal cholinergic neurostimulatory peptide which is known

as HCNP, and what they do and Larry, what do these hormones cause? What do

they do?

Dr. Klapow

Well, VIP is involved in regulating blood pressure and blood flow.

It's important in regulating blood flow to the brain. It's believed to be

implicated in orthostatic intolerance from which a number of CFS patients

suffer. And, it also controls hypothalmic CRH, a hormone that's ultimately

responsible for the level of cortisol in the blood which is suppressed in

CFS and it's also suppressed in chronic roundworm infections. And the other

one, HCNP, is a limbic system neuropeptide and it's believed to be involved

in memory and immune function. When it goes wrong in areas that have

Alzheimer's lesions, there are cognitive symptoms. In fact, some doctors

have suggested that CFS looks in some respects like a reversible form of

Alzheimer's.

Dr. Mazlen

It seems like that sometimes.

Dr. Klapow

Well, the bad news is that it bare's any resemblance to that disease.

*What good news there is, is that the cognitive symptoms come and go,

without apparently doing permanent damage. I think it is a reasonable hope

that increasingly effective treatments for CFS will be found in time to

substantially help most of those who now suffer from this difficult and

often misunderstood disease.

*Added to transcript by Dr. Klapow after the show.

Transcribed by

Carolyn Viviani

carolynv@...

Permission is given to repost, copy and distribute this transcript as

long as my name is not removed from it.

© 2000 G. Mazlen, M.D.

[Guest guest]

We use " Vital Gel " on our pads after the adhesive quits working. It is a

" Non-irritating Conductive Gel " made for TENS, EMS and ultrasound

applications. We use it mostly with our F-Scan. You should be able to buy

it at a Medical supply store.

jra

25 : 14 - 30 KJV

Understanding the contact electrode

pads

> Thank you for your messages about making or re-using the contact electrode

> pads. As I mentioned, I go thru a new set every couple days!

>

> I am not sure if I understood the info correctly. So,

>

> Is the glue substance ONLY on the pad to keep it adhered to my skin? If

> that glue comes off, if I keep the pad strapped to my skin will the

> electrical current will still be fine?

>

> It sounds like I should apply conductive gel to increase the

> conductivity. I suppose that means that I can apply the conductive gel

> whether or not the pad still has any gluey substance on it ?

>

> In summary, it sounds like the black TENS pad will always remain

> conductive. It is just a matter of maybe adding conductive gel and making

> sure it stays on my skin somehow. Is that a reasonable summary?

>

> Thank you.

>

>

>

>

> The group's main page has a menu to the left, with photos of Godzilla

devices and other things useful in research. These are free to members.

Membership is free, but you agree to be on your own, not take our freedom of

speech as medical advice. We are not doctors! Repeat, we are ordinary lay

people, not experts, not healthy officials, or geniuses of any kind. The

information on this group is not intended as medical advice. Most group

members are NOT doctors or health authorities. Please do not request

medical advice, lest anyone get into trouble out of human compassion. There

are huge fines and issues currently involved with unlicensed medical advice.

The group is only here to share experiences according to the theme of the

group, namely testing if electrical stimulus might inactivate microbes, as

it seems to have done in the Einstein Medical College labs. We are

interested in your results, but cannot say anything about repeatability, or

whether this might have medi

> cal benefits. Thanks, for your understanding, good luck

esearching. --bG

>

[Guest guest]

YOu are doing well, I would think. the Herxes usually do result in

sleep, just be sure to get fluids to clear things out. Do not stop

whatever you are doing, and don't change it. You may wish to add

some more for the liver (large pads on the liver as we've been

saying) and maybe use 2 instead of one wrist. that depends on your

heart and pacemaker, if any.

c.pulmoni depends. what's the pathology of C.pulmoni? where does

the microbe concentrate itself and reproduce?

we know for instance that hepc lives in liver cells. where's

cpulmoni? in the heart arteries? if so, you should know the

answer,,,think how would you reach the pulmonaries using only one

wrist? you need to know that the electricity follows the path from

one electrode to the other, through blood first (700 times more

conductive than tissue) and returns to the second electrode...hint:

2.

bG

> Just to verify, I'm using the Godzilla for microscopic parasites.

Is the

> preferred protocol to use one electrode on each wrist? I have

tens pads so

> I could use those, or I could do it the old way.

>

> I have been at this almost two weeks now and I notice a herx which

has

> evolved into wanting to sleep 15 hours a day and enjoying it.

>

> I was in one of several double blind studies carried out at Harvard

> University. I tested positive for c. pulmoni. I believe that c.

pulmoni is

> responsible for my illness because my symptoms match the ones

described

> below exactly. There is no known treatment for c. pulmoni. Maybe

Godzilla

> will work.

>

>

>

> CFS Radio Program

> Jan. 16th, 2000

> G. Mazlen, M.D. Host

> with

> Dr. Larry Klapow

>

> -------------------------------------------------------------------

---------

> ----

>

> Dr. Mazlen

> To kick off the new millennium with a good show that you'll

find of

> great interest and great importance, I'm talking today with Dr.

Larry

> Klapow, a Ph.D. in Invertebrate Biology who's in Burlingame,

California near

> San Francisco. Good morning Larry, welcome to our show.

> Dr. Klapow

> Good morning, , I'm glad to be here.

>

> Dr. Mazlen

> Can you tell our audience something about the this suspected

new

> parasite that you've found in a percentage of patients with

Chronic Fatigue

> Syndrome? How'd you find it?

>

> Dr. Klapow

> Well, , it came about as a result of a conversation I

was having

> with an immunologist friend of mine, Dr. Marinkovich, here

in

> Redwood City, California. He was treating a CFS patient we thought

might

> have a roundworm infection. The patient had a low grade

eosinophilia and

> some unusual rashes on the torso that suggested the possibility of

> threadworm disease. Antibody tests and stool tests were negative.

I thought

> about this for a while and I know that some chronic parasites

migrate

> between the digestive tract and the respiratory tract and some of

them are

> coughed up in sputum. So I looked at the sputum and that's where I

found it.

> I called the new parasite " Cryptostrongylus pulmoni " , that's a

provisional

> name and it means " the hidden lung worm " .

>

> Dr. Mazlen

> That's pretty appropriate in terms of what you say.

>

> Dr. Klapow

> It definitely is, . It's very difficult to find. And I

hope other

> people will start looking for it. In fact, I've put together some

material

> that I think can help them.

>

> Dr. Mazlen

> You recently completed a small blinded study in cooperation

with a

> small number of CFS doctors including Dr. Komaroff in

Harvard.

> You're now doing a larger blinded trial and you're also trying to

develop a

> clinical test for the parasite. But for these other investigators

and

> clinicians, can you tell us what does the parasite look like and

how can

> they find it?

>

> Dr. Klapow

> You can identify the parasite, the female by its mouth parts

and the

> male by its very intricate reproductive structure. This parasite

is very

> small. The female is less than a millimeter long and the male is

about a

> third that length. So, in addition to being small there's also a

lot of

> difficulties. The specimens I usually pick up are naturally

expelled in

> sputum and they're usually very decayed and rare and because of

this you

> need very specialized imaging techniques to find them. They're not

expensive

> techniques, they're just specialized. In any case I wanted to help

people

> look for this parasite and so I put together a website which

describes how

> to find it in great detail. It also includes anatomical drawings.

I can give

> you the website address if you like.

>

> Dr. Mazlen

> Yes, give us the address right now, that'll be great.

>

> Dr. Klapow

> OK, I'll give you my own email address and then I can post

the other

> rather longer address for people who contact me. My email address

is

> lak123@g...

>

> Dr. Mazlen

> Now, this is really important because this introduces a

whole new

> dimension about Chronic Fatigue Syndrome and its possible

relationship to

> roundworm infestation. Can you tell us so far, at least, as you've

been

> looking, what percentages of Chronic Fatigue Syndrome patients are

turning

> out to be positive for this worm?

>

> Dr. Klapow

> Yes, I find the parasites in about 40% of three-day sputum

samples

> from CFS patients. However, I have to tell you that yields are

very low. In

> fact, they're so low that I think I'm probably missing as many

positive

> patients as I'm finding. The problem here is that over 80% of the

positives

> I get are represented by only one identifiable specimen. So just

by chance

> it looks like I'm missing a fairly high percentage.

>

> Dr. Mazlen

> So, the prevalence can be a lot higher and this, of course,

stirs some

> very great interest in terms of causation and etiology which we'll

go into

> later. Can you tell us anything about the blinded trials so far?

>

> Dr. Klapow

> Yes, I did a small blinded trial in cooperation with a

number of

> doctors including Dr. Komaroff at Harvard and here are the

results.

> I think they're interesting but you judge for yourself. 5 of the

11 patients

> were positive while all 6 controls were negative. Now, it's a

small trial

> but if you were trying to do as well by guessing, say by just

tossing a

> coin, you'd only do as well as I report here in about 1 in a 100

tests, so

> it's a very hard thing to do by just guessing. The results of this

small

> trial can be used to devise an experimental design for a large

trial that

> could give a statistically significant result and going through

that

> exercise suggests that between 50 and 80 samples will be needed.

Now, it may

> take some time to process these samples microscopically. It's now

taking me

> somewhere between 50 and 100 hours to find a single positive

patient so I

> think the progress will be slow, that is unless we can get

something more

> rapid going in the form of a PCR test.

>

> Dr. Mazlen

> Well, I certainly congratulate you though for the effort

that you're

> making because this is totally important to patients for their

prognosis and

> recovery ultimately. There's a lot more to learn and, of course,

we're going

> to go into that and you mentioned the PCR test and that you have

some

> arrangements whereby this can be developed and hopefully you'll

get some

> funding to help this along soon. If anybody in the audience is

interested in

> helping in this regard they can reach me at rgm1@a... which is my

email

> address and I'll forward it on to Dr. Klapow. Larry where do you

think these

> parasites might be coming from?

>

> Dr. Klapow

> Well, , they have some specialized anatomical

structures that

> suggest that they're related to parasites of animals that live in

the

> jungles of Southeast Asia. In fact, there's been somewhat of a

history of

> hard to diagnose parasites coming out of that area and being

brought back to

> " Western " countries after periods of warfare. It happened in the

n

> era when French soldiers were returning from this area and brought

back the

> chronic parasite Strongyloides stercoralis to Europe where it was

first

> diagnosed in 1894. It also happened again in World War II. This

time British

> soldiers became infected while they were imprisoned in Burma

returned to

> England and 30 years later, in 1974 they were diagnosed with

chronic

> parasites they had gotten while they were in prison. It's kind of a

> testament to how difficult some of these parasites are to find and

treat. I

> would like to look at people who've been to Southeast Asia and I

think I

> plan to do that as soon as I finish with the large trial I'm doing

on CFS

> patients now.

>

> Dr. Mazlen

> It's a natural sequitur because you're going to be having a

chance to

> look at all of the veterans of the Viet Nam era who either served

in Viet

> Nam or Cambodia or neighboring areas.

>

> Dr. Klapow

> That will happen, I think, rather quickly if I can get the

PCR test

> going.

>

> Dr. Mazlen

> You say it might be coming from this source and that's a

possibility.

> How is it contracted? How do you get it then?

>

> Dr. Klapow

> I'm really not sure. What I can tell you is this. I've never

seen a

> fresh transmissible stage of the parasite in any sputum sample

I've seen so

> far. I've done a couple of hundred samples at this point. So I

don't think

> there's any evidence right now of casual transmission. But

roundworm

> parasites are typically acquired by eating contaminated food, but

an

> outbreak of Cryptostrongylus infection, if it were transmitted in

this way,

> would look very different then a typical food poisoning incident

where

> people get sick within a couple of hours after eating.

>

> Dr. Mazlen

> That's due to the long latency that you mentioned.

>

> Dr. Klapow

> Cryptostrongylus is very small but it produces a larvae

which is very

> large so there's an implication here that it must be reproducing

very slowly

> and possibly has a very long latency time. Of course, we know that

the

> outbreak of Chronic Fatigue Syndrome usually take place over

several months

> and in some cases a couple of years and that I think would be

consistent

> with the possibility of a food borne infection with a very long

latency

> period.

>

> Dr. Mazlen

> Well, now we're going to turn to the clinical side. Most of

the time

> that doctors are looking for parasitosis, they look to see elevated

> eosinophil and serum IgE, or immunoglobulin E, levels in patients.

Isn't

> this usually the case?

>

> Dr. Klapow

> Yes, but that's the first question that I get from doctors

when I tell

> them that I found what I think is a new species of roundworm

parasite.

> Where's the elevated IgE? And the answer is elevated IgE is mainly

apparent

> in acute roundworm infections. With time, the chronic parasites

are able to

> suppress the IgE response and many of them produce a clinical

picture where

> the patients either have normal or lower than the normal average

level of

> IgE and, in fact, that's the picture you see in CFS and in all the

studies

> I've reviewed, IgE is lower in CFS patients than in healthy control

> populations.

>

> Dr. Mazlen

> Here I want to interject that I'm part of the new study

looking into

> C.pulmoni in CFS patients and one of the things that prompted me

to call you

> and talk to you about getting involved is the fact that I had been

seeing

> low IgE levels, low eosinophile counts in patients that I thought

were

> inappropriate.

>

> Dr. Klapow

> In fact, there was a paper that's a few years old in the

Journal of

> Chronic Fatigue Syndrome that indicates that if you correlate IgE

and

> eosinophil levels with the number of symptoms the patients report,

the

> sicker they are the lower the IgE and eosinophil counts and that's

a

> statistically significant relationship.

>

> Dr. Mazlen

> And I see it and it seems to be borne out. Now, what do you

think is

> suppressing IgE in this CFS or Chronic Fatigue Syndrome patients?

What's the

> mechanism?

>

> Dr. Klapow

> Well, I think the mechanism may involve the cell marker CD23

which

> suppresses IgE. There are a couple of other things that activate

CD23, the

> IgE suppresser and those are active herpes viruses and some of the

TH1

> cytokines, particularly interferon-gamma and the 2'-5'A, the

activator of

> the latent RNase enzyme. Both herpes viruses and 2'-5'A, as you

know, are

> highly elevated in CFS patients. In fact, it looks like some

roundworms may

> be using chronic viruses as cofactors to help perpetuate their own

survival.

>

> Dr. Mazlen

> That certainly rings true from what I've seen clinically and

that

> leads us to another question. If a lot of Chronic Fatigue Syndrome

patients

> have allergies, they should have elevated IgE levels but a lot of

them, as

> we were just saying, don't. It seems to fit the model you propose

of a

> suppresser.

>

> Dr. Klapow

> Yes, there are some doctors, in fact, that think allergy is

a risk

> factor for getting a roundworm infection and that's because

patients who

> tend to produce too much IgE to non-specific stimuli, harmless

things, may

> not have enough reserves left over to fight off the parasites so

they get a

> foothold, and in fact, initially, you can even see patients who

report

> increased allergies, but later on when they're diagnosed with CFS

and the

> presumptive parasite, if we may go so far and speculate, has

suppressed

> their IgE response and the values come out clinically low.

>

> Dr. Mazlen

> Now, this brings us to a leading question, which, obviously

is a

> speculation, but that's all right because that's what this show is

about. We

> want to raise issues and have other people contribute to answering

them as

> well. There seem to be many infectious agents that have been

proposed as

> being possible etiological agents for Chronic Fatigue Syndrome.

None of them

> have held up specifically as a single causative agent. What do you

think

> about this roundworm infection, c.pulmoni, is it a primary

infection or is

> it just another opportunistic organism?

>

> Dr. Klapow

> Well, I don't know if it's a primary cause of CFS. We'll

just have to

> have to go through the rules of Koch's postulates and see how far

we can

> get. I think it's an interesting candidate for a possible primary

agent. I

> don't think it's an opportunistic infection. Opportunistic

infections are

> usually airborne and are present everywhere. They're just waiting

for our

> immune systems to be weakened before they establish a chronic

infection.

> Cryptostrongylus doesn't seem to be ubiquitous. If I'm right about

the

> taxonomy, it looks like it's coming out of a particular geographic

area.

> They're are also a number of things that I think can connect

roundworm

> infection to the major physiological systems that malfunction in

CFS. And

> they have to do with the wide variety of physiologically active

agents

> roundworms are able to secrete.

>

> Dr. Mazlen

> We're going back now and talking about the hormones that

these

> roundworms secrete, namely vasoactive intestinal polypeptide,

which is known

> as VIP, and hippocampal cholinergic neurostimulatory peptide which

is known

> as HCNP, and what they do and Larry, what do these hormones cause?

What do

> they do?

>

> Dr. Klapow

> Well, VIP is involved in regulating blood pressure and blood

flow.

> It's important in regulating blood flow to the brain. It's

believed to be

> implicated in orthostatic intolerance from which a number of CFS

patients

> suffer. And, it also controls hypothalmic CRH, a hormone that's

ultimately

> responsible for the level of cortisol in the blood which is

suppressed in

> CFS and it's also suppressed in chronic roundworm infections. And

the other

> one, HCNP, is a limbic system neuropeptide and it's believed to be

involved

> in memory and immune function. When it goes wrong in areas that

have

> Alzheimer's lesions, there are cognitive symptoms. In fact, some

doctors

> have suggested that CFS looks in some respects like a reversible

form of

> Alzheimer's.

>

> Dr. Mazlen

> It seems like that sometimes.

>

> Dr. Klapow

> Well, the bad news is that it bare's any resemblance to that

disease.

> *What good news there is, is that the cognitive symptoms come and

go,

> without apparently doing permanent damage. I think it is a

reasonable hope

> that increasingly effective treatments for CFS will be found in

time to

> substantially help most of those who now suffer from this

difficult and

> often misunderstood disease.

>

> *Added to transcript by Dr. Klapow after the show.

>

> Transcribed by

>

> Carolyn Viviani

> carolynv@i...

>

> Permission is given to repost, copy and distribute this

transcript as

> long as my name is not removed from it.

>

> © 2000 G. Mazlen, M.D.