The chronic fatigue syndrom is similar to other ill-defined disorders like the burn-out syndrome or the fibromyalgia syndrome: There is a lack of objective disease criteria as well as of clear diagnostics and specific therapies. In addition the symptoms of the syndromes overlap which does not exactly make a clarification of the individual clinical patterns easier. There is no shortage of disorder theories: In the past, the psyche of a person, traumata, infections and environmental factors were made responsible. The one thing the professionals agree on in the meantime is the dysregulations of the immune system. But – as always if one knows only little – multifactoral disease genesis sounds like a whole lot.
Is CFS an infectious disease?
A recent study of the US researchers Vincent Lombardi and Judy Mikovits and their team at the Whittemore Peterson Institute in Reno/Nevada points in the same direction – it supports the virus theory. As reported in the journal Science, they were able to prove in 68 of 101 CFS patients (67 percent) virus genes of the retrovirus XMRV (Gammaretrovirus, Xenotropic murine leukemia virus-related virus) on the monocytes of the peripheral blood (Science 2009; doi: 10.1126/science.1179052). In healthy control persons, only 3.7 percent were infected. The virus is member of the same family as the AIDS virus and is associated with lymphomas and leukemias in the animal world. The virus is also found in human cells in prostate carcinomas (PNAS 2009; doi 10.1073/pnas.0906922106), evidence for the association of the virus with malign cells in humans. The infection was also found in particularly malign tumors. After publishing their work, Lombardi and Mikovits found in 300 CFS patients that 95 percent had antibodies against the virus. In addition they verified in cell cultures during their study that the virus is infectious.
Epidemic CFS diseases are known
But the researchers cannot and don’t want to deduce a simple relation cause-effect from the new findings. They consider it a possibility that additional contributing factors might play a role when persons get infected with the virus. This could be fatigue itself or other health disturbances. It is not unlikely that the virus might be found in other patients with for example fibromyalgia and not only in cancer patients. In addition several other viruses are suspected to participate in CFS, like for example the Epstein-Barr-virus and herpes viruses.
The researchers are especially interested in the communication of the virus in the real world like within a family. The known downright onsets of the disease in a symphony orchestra in North Carolina/USA are those “epidemic cases” where scientists were able to prove similar infection rates. But prior to knowing the exact mechanisms additional studies on animals will be required.
Therapy in sight?
Those new findings certainly do have benefits for patients not only fighting against fatigue but also against prejudices. It increases the acceptance of this so far hard-to-grasp disease. More importantly there is hope for effective future drug therapies. Scientists had to check for example the effectiveness of various antiviral drugs like reverse transcriptase inhibitors. If those help it would be another evidence for the infectious genesis of the disease.
In the medium term, i. e. within the next six months, the development of a test is scheduled to help physicians to identify the virus. To make a diagnosis by one test only perhaps seems to be a bit presumptuous though before the relevance of this infection is really clear.