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What Causes Chronic Fatigue Syndrome?: Immune Activation But No Viruses, Study Finds



White Blood Cells (Leukocytes)Recent research has found that there are specific patterns in 51 immune biomarkers in patients with ME, also known as chronic fatigue syndrome, or simply ME/CFS. Following what may likely turn out to be a 'game changing' study, scientists are already predicting a blood test and possible treatments for the disabling condition may now not be far away.

The large study carried out at Columbia University by a team including leading chronic fatigue syndrome researcher Professor Ian Lipkin provides ‘the first robust physical evidence’ that ME/CFS is a biological illness rather than a psychological disorder.

Prof. Lipkin said of the research: “This study delivers what has eluded us for so long: unequivocal evidence of immunological dysfunction in ME/CFS and diagnostic biomarkers for disease.”

The results are the first to come out of a larger study, the biggest in ME/CFS research history in fact with the involvement of the biggest names in the field involved. Prof. Lipkin and colleague Dr. Mady Hornig were actually hard at work seeking any possible pathogen: viral, bacterial, fungal or parasitic, to see if a chronic infection could explain ME/CFS. Instead, they found what amounts to an 'immune system fingerprint' seen only in chronic fatigue syndrome patients.

As yet the research has not identified any virus or other pathogen that can be unequivocally linked to ME/CFS but the immune biomarkers Prof. Lipkin, Dr. Hornig and their collaborators have unearthed are likely to be just as important in terms of advancing understanding of the disease and paving the way for simple blood tests for diagnosis and options for biomedical treatment.

Indeed, speaking about the study Dr. Hornig stated: "Our results should accelerate the process of establishing the diagnosis after individuals first fall ill as well as discovery of new treatment strategies focusing on these early blood markers."

The study looked at the immune systems of 285 patients suffering from chronic fatigue syndrome and 201 healthy controls using blood plasma. The samples were provided by another key ME/CFS researcher Dr. Jose Montoya of Stanford University. It is worth noting that this sample size is very large when it comes to chronic fatigue syndrome research and provides the numbers needed for the results to be considered accurate and to be taken seriously by other researchers and the medical establishment.

Patients who had suffered from the condition for three years or less had increased amounts of immune molecules called cytokines and their cousins chemokines; both types of molecule communicate messages within the immune system e.g. they instruct it to mobilise white blood cells in the event of infection. The patients had particularly high concentrations of a molecule called interferon gamma which has been linked to the fatigue people feel following a viral infection like flu.

A finding that came as a shock to the whole ME/CFS research community is that after around three years of illness the cytokine profile of patients changed. Dr. Hornig explained: "It appears that ME/CFS patients are flush with cytokines until around the three-year mark, at which point the immune system shows evidence of exhaustion and cytokine levels drop."

Whilst further independent studies will be needed to verify the findings of Prof. Lipkin and Dr. Hornig's work, the magnitude of the discovery is huge for those suffering from chronic fatigue syndrome and particularly those who may develop the condition in the future. It is a big leap forward towards true recognition of the disease as a serious biological disease as well as for developments in diagnosis and treatment. 

Patients can also take hope from the fact there are already drugs on the market which can dampen levels of cytokines which may potentially offer effective treatment, or at least symptom relief. The researchers were careful to state that their findings would need to be replicated before clinical trials of this nature could take place, however.



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