Journal of Chronic Fatigue Syndrome: Volume 6, Issue 3-4, 2000

Volume 6, Issue 3-4, 2000

 * Introduction by Kenny De Meirleir & Roberto Patarca-Montero
 * Report on the Second World Congress on Chronic Fatigue Syndrome and Related Disorders: Towards Effective Diagnosis and Treatment in the 21st Century
 * Role of Mycoplasmal Infections in Fatigue Illnesses: Chronic Fatigue and Fibromyalgia Syndromes, Gulf War Illness and Rheumatoid Arthritis"Summary - 'Bacterial and viral infections are purported to be associated with several fatigue illnesses, including Chronic Fatigue Syndrome (CFS), Fibromyalgia Syndrome (FMS), Gulf War Illnesses (GWI) and Rheumatoid Arthritis (RA), as causative agents, cofactors or opportunistic infections. We and others have looked for the presence of invasive pathogenic mycoplasmal infections in patients with CFS, FMS, GWI and RA and have found significantly more mycoplasmal infections in CFS, FMS, GWI and RA patients than in healthy controls. Most patients had multiple mycoplasmal infections (more than one species). Patients with chronic fatigue as a major sign often have different clinical diagnoses but display overlapping signs/symptoms similar to many of those found in CFS/FMS. When a chronic fatigue illness, such as GWI, spreads to immediate family members, they present with similar signs/symptoms and mycoplasmal infections. CFS/FMS/GWI patients with mycoplasmal infections generally respond to particular antibiotics (doxycycline, minocycline, ciprofloxacin, azithromycin and clarithromycin), and their long-term administration plus nutritional support, immune enhancement and other supplements appear to be necessary for recovery. Examination of the efficacy of antibiotics in recovery of chronic illness patients reveals that the majority of myco-plasma-positive patients respond and many eventually recover. Other chronic infections, such as viral infections, may also be involved in various chronic fatigue illnesses with or without mycoplasmal and other bacterial infections, and these multiple infections could be important in causing patient morbidity and difficulties in treating these illnesses.' G. L. Nicolson, M. Y. Nasralla, A. R. Franco, K. De Meirleir, N. L. Nicolson, R. Ngwenya & J. Haier. (2000). Role of Mycoplasmal Infections in Fatigue Illnesses: Chronic Fatigue and Fibromyalgia Syndromes, Gulf War Illness and Rheumatoid Arthritis. Journal of Chronic Fatigue Syndrome, Vol. 6, Iss. 3-4, pp. 23-39. http://dx.doi.org/10.1300/J092v06n03_03"
 * Human Herpes Virus 6 (HHV-6) Infection in Patients with Chronic Fatigue Syndrome and Its Relationship to Activation-Induced Cell Death"Summary - 'Using evidence-based medical research techniques, current knowledge about the presence of active HHV-6 infections, in a sub-population of patients with chronic fatigue syndrome (CFS), has been reviewed and implications to activation-induced cell death are presented. Therapeutic intervention methods are also disclosed with a call for clinical studies to test the hypothesis presented.'"
 * Neurological Dysfunction in Chronic Fatigue Syndrome"Summary - 'Chronic fatigue syndrome (CFS), popularly known in Europe as myalgic encephalomyelitis (ME), is a common but not a new illness. CFS/ME was classified as a neurological disease by the World Health Organisation in 1993. Neurological dysfunction is considered the principal mechanism of both physical and mental fatigue in this condition. This article reviews the neurological symptoms of the epidemic and sporadic forms of the illness. Paroxysmal changes in the severity of symptoms (fatigue and neuropsychiatric) are the hallmark features in the natural history of this disease. Ion channel abnormality leading to neuronal instability in selective anatomical pathways (basal ganglia circuitry) is proposed as the possible mechanism of fluctuating fatigue and related symptoms in CFS.'"
 * Immunology of Chronic Fatigue Syndrome"Summary - 'A review of the literature on the immunology of CFS reveals that people who have Chronic Fatigue Syndrome (CFS) have two basic problems with immune function that have been documented by most research groups: 1. immune activation, as demonstrated by elevation of activated T lymphocytes, including cytotoxic T cells, as well as elevations of circulating cytokines; and 2. poor cellular function, with low natural killer cell cytotoxicity (NKCC), poor lymphocyte response to mitogens in culture, and frequent immunoglobulin deficiencies, most often IgGl and IgG3. These findings have a waxing and waning temporal pattern which is consistent with episodic immune dysfunction (with predominance of so called T-helper type 2 and proinflammatory cytokines and low NKCC and lymphoproliferation) that can be associated as cause or effect of the physiological and psychological function derangement and/or activation of latent viruses or other pathogens. The interplay of these factors can account for the perpetuation of disease with remission/exacerbation cycles. Therapeutic intervention aimed at induction of a more favorable cytokine expression pattern and immune status is discussed.'"
 * The Biorhythm of Fatigue in Chronic Fatigue Syndrome"Summary - 'Evidence is provided for a rhythmic interpretation of fatigue in CFS.'"