Enteroviruses and the Chronic Fatigue Syndrome

Chronic fatiguing illnesses following well-documented infections and acute "infectious-like" illnesses of uncertain cause have been reported for many decades. Chronic fatigue syndrome (CFS) was first formally defined in 1988. There is considerable evidence that CFS is associated with abnormalities of the central and autonomic nervous systems. There also is evidence linking several infectious agents with CFS, although no agent has been proven to be a cause of the illness. Most of the infectious agents that have been linked to CFS are able to produce a persistent, often life-long, infection and thus are a constant incitement to the immune system. Most also have been shown to be neuropathogens. The evidence is consistent with the hypothesis that CFS, in some cases, can be triggered and perpetuated by several chronic infections that directly or indirectly affect the nervous system, and that symptoms are a reflection of the immune response to the infection.

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“…Some investigators have been unable to link enteroviruses to CFS through studies of blood and stool. 177,178 …”

Section: Enteroviral Infectionmentioning

confidence: 99%

Role of Infection and Neurologic Dysfunction in Chronic Fatigue Syndrome

Komaroff

Cho²

2011

Semin Neurol

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“…Evidences for a persistent enterovirus infection in CFS patients come from studies that found RNA copies of enterovirus in muscle biopsies from CFS patients (20% in CFS patients vs. 0% in the control group) [24], and persistent viremia detected by PCR in two serum samples taken at least 5 months apart [25]. In contrast, other studies failed to find an association between enteroviruses and CFS in serological, antigenic tests or PCR tests [26,27].…”

Section: Viral Infectionsmentioning

confidence: 99%

Infection and vaccination in chronic fatigue syndrome: Myth or reality?

Appel

Chapman

Shoenfeld³

2007

Autoimmunity

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Chronic fatigue syndrome (CFS) is characterized by severe disabling fatigue lasting for more than 6 months associated with physical and mental disturbances such as headache, arthralgia, myalgia, memory impairment, sore throat and tender lymph nodes. The exact pathogenesis is still unknown. Several models were proposed to explain its etiology including chronic infection, endocrine dysfunction, autonomic imbalance, depression, decreased immunity states and an aberrant reaction to infection. No convincing evidence was found to support any of the suggested pathogenic mechanisms. The current concept is that CFS pathogenesis is a multi factorial condition in which an infective agent cause an aberrant immune response characterized by a shift to Th-2 dominant response. When the response fails to be switched-off, a chronic immune activation occurs and clinically expressed as the symptomatology of CFS. Vaccinations are used in order to stimulate the immune system to induce a persistent immunity against the favorable antigens. Several syndromes that contain chronic fatigue as one of their symptoms, such as "Gulf war syndrome" and macrophagic myofasciitis were related to vaccinations. Can vaccinations induce the aberrant immune response of CFS? Little is known about this issue. There are some reports on CFS occurring after vaccination, but few prospective and retrospective studies failed to find such an association. A working group of the Canadian Laboratory Center for Disease Control (LCDC) that was founded in order to examine the suspected association between CFS and vaccinations concluded that there is no evidence that relates CFS to vaccination. Further studies are requested to examine this issue since it is very conceivable that if infection can lead to CFS, vaccination may also lead to it in the same immune-mediated pathogenesis.

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“…11 However, Miller et al and others detected no differences between the IgM and IgG seroprevalence rates for these viruses between patients with CFS and controls. [12][13][14][15] These studies used a variety of criteria to select patients with CFS and were carried out at different time points and in different locations. It is possible that different conclusions have been drawn because Coxsackievirus epidemiology varies with time and place.…”

Section: Evidence For Enterovirus Infection In Cfsmentioning

confidence: 99%

The role of enterovirus in chronic fatigue syndrome

Chia

2005

J Clin Pathol

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Two and a half decades after coining of the term chronic fatigue syndrome (CFS), the diagnosis of this illness is still symptom based and the aetiology remains elusive. Enteroviruses are well known causes of acute respiratory and gastrointestinal infections, with tropism for the central nervous system, muscles, and heart. Initial reports of chronic enteroviral infections causing debilitating symptoms in patients with CFS were met with skeptism, and had been largely forgotten for the past decade. Observations from in vitro experiments and from animal models clearly established a state of chronic persistence through the formation of double stranded RNA, similar to findings reported in muscle biopsies of patients with CFS. Recent evidence not only confirmed the earlier studies, but also clarified the pathogenic role of viral RNA through antiviral treatment. This review summarises the available experimental and clinical evidence that supports the role of enterovirus in chronic fatigue syndrome.

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Enteroviruses and the Chronic Fatigue Syndrome

Cited by 55 publications

References 26 publications

Role of Infection and Neurologic Dysfunction in Chronic Fatigue Syndrome

Role of Infection and Neurologic Dysfunction in Chronic Fatigue Syndrome

Infection and vaccination in chronic fatigue syndrome: Myth or reality?

The role of enterovirus in chronic fatigue syndrome

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