[OT] The reality of chronic fatigue syndrome

[Guest guest]

Blank[While unconnected to CLL and SLL, it's interesting that CFS/ME also

involves the immune system and the lymph glands. - AG]

The reality of chronic fatigue syndrome

a.. 20 May 2006

b.. From New Scientist Print Edition.

c.. Rowan Hooper

IT AFFECTS around one in every 1000 people in the UK, yet it attracts only a

fraction of the cash spent on other diseases such as HIV. Once derided as

" yuppie flu " , the symptoms of chronic fatigue syndrome (CFS), which include

cramps, sleeplessness, weakness and headaches, often go unrelieved. That could

be about to change as physical evidence for CFS, otherwise known as myalgic

encephalomyelitis (ME), begins to stack up.

Last week, a meeting in London of CFS specialists heard from Kerr of St

's, University of London. Kerr and his team used two techniques to look at

differences in the expression of 47,000 genes and their variants in people with

CFS and a group of unaffected people.

They used a DNA microarray chip to examine gene expression in 27 people with CFS

and 54 controls. They also used " massive parallel signature sequencing " to

assess gene activity in 20 people with CFS and 20 without by measuring the

amount of mRNA each gene produces. The team ended up with about 100 genes where

differences in expression between CFS patients and controls were most striking.

Last year a pilot study identified 35 faulty genes (New Scientist, 21 July 2005,

p 9).

" Most of the abnormally expressed genes are involved in the immune system, " says

Kerr, although he points out that the exact pattern of gene expression varies

between sufferers.

Both over and underactive immune expression have been blamed for the symptoms of

CFS in the past, but the lack of a single marker has hampered diagnosis. Kerr's

work, though preliminary, could herald two breakthroughs: a treatment for the

illness based on immune therapy, and a diagnostic test based on a broad spectrum

of proteins.

Kerr is in the process of setting up clinical trials using beta interferon, a

treatment for multiple sclerosis. It boosts the immune system by enhancing the

activity of natural killer cells, which fight viruses. Since viruses are

believed to play a role in triggering CFS in many people, beta interferon might

clear the infection and help them to shake off CFS.

A test for a disease as misunderstood as CFS would also be invaluable. Kerr's

team has developed one that uses mass spectrometry to find proteins that are

present in people with CFS but not healthy controls. A pilot study, currently

being repeated, shows clear differences between the two groups.

Meanwhile, Perrin, an osteopath from Manchester, who also attended the

meeting, says he has identified other physical manifestations of the disease.

Perrin thinks overloading of the lymph ducts can be a factor leading to CFS in

some people. Postural problems, damage to the brain from a bang to the head, for

example, or chemical or emotional trauma, can place extra stress on the

sympathetic nervous system, he says. This can cause the lymph ducts to become

overloaded or engorged, contributing to the fatigue and pain suffered by CFS

patients. In more than 1000 cases of CFS he has seen, all patients appeared to

have problems with their lymphatic glands. " You can't always see the swollen

lymph vessels, but you can feel them under the surface of the skin, " he says.

Perrin uses soft tissue massage to treat CFS, which encourages lymph to drain

back into the bloodstream, and has submitted the results of clinical trials

demonstrating the success of the technique to the journal Clinical

Rehabilitation. " Every little helps, " says Kerr. " There is a rationale for why

it works. It's non-specific, but manual lymphatic drainage is a good thing. "

Other " complementary " techniques may also be helpful, says Basant Puri, a CFS

specialist at Hammersmith Hospital, London. In some sufferers, a deficiency of

fatty acids such as omega-3 and omega-6 has been implicated in the disease. A

poor diet can lead to deficiencies, but crucially, so can viral infection, which

can also depress the immune system. Puri says many patients respond well to a

combination of the fatty acids EPA and evening primrose oil. " Fatty acid

supplements should be available on the National Health Service, " he says.

Yet one of the biggest challenges facing those involved in CFS research is that

the underlying causes may vary from person to person and one solution is

unlikely to fit them all.

What is needed is more funding for further research into the condition, says Ian

Gibson MP, who chairs the UK parliamentary group for scientific research into

CFS/ME. The group is encouraging people who have had CFS to write in with their

stories. " We hope to form a true picture of ME sufferers' hopes and concerns

over the current work being undertaken in the treatment and research of ME, "

says Gibson.

http://www.newscientist.com/article/mg19025524.700;jsessionid=OHKMBBLFEIOM