Journal of Chronic Fatigue Syndrome: Volume 9, Issue 1-2, 2001

Volume 9, Issue 1-2, 2001

 * Editorial by Roberto Patarca-Montero
 * Concomitant Environmental Chemical Intolerance Modifies the Neurobehavioral Presentation of Women with Fibromyalgia"'Abstract - Background: This study compared personality, dietary, and psychophysiological characteristics of 3 groups of women: fibro-myalgia (FM) with illness from low levels of environmental chemicals (chemical intolerance, CI), FM alone without CI, and normal controls. CI may be a marker for enhanced central nervous system response amplification (sensitization) in limbic and mesolimbic pathways, which play a role in hedonic responses to food and drugs and in pain. Method: Fibromyalgic women with (FM/CI, n = 11) and without CI (FM, n = 10) and normals (NORM, n = 10) participated in the study. Measures included psychological trait questionnaires, a food frequency questionnaire, a taste test for hedonic and sweetness ratings of different sucrose concentrations, pain self-ratings, and resting spectral electro-encephalographic alpha over midline sites, averaged over four separate days. Results: FM with CI had the highest scores on the Harm Avoidance dimension of the Tridimensional Personality Questionnaire, Carbohydrate Addicts Test, Limbic Symptom sensory and behavior subscales, and SCL-90-R somatization and obsessiveness subscales. FM groups both had the highest mean pain ratings for 21 tender point sites. Groups did not differ for macronutrient intake or for sweetness and hedonic ratings for sucrose. The combined FM groups had greater EEG alpha activity towards posterior midline sites than did normals. Conclusion: The pattern of findings may reflect impaired serotonergic function and/or elevated dopaminergic receptor activation by endogenous and/or exogenous agents. The data could have implications for pharmacological and dietary interventions in different subsets of FM patients.'"
 * Increased Eosinophil Protein X Levels in Chronic Fatigue Syndrome"'Abstract - Chronic fatigue syndrome is a condition of unknown etiology characterized by severe fatigue and accompanied by symptoms including cognitive difficulties, myalgias, and headaches. Studies of this illness have found chronic activation of the immune system, including one reporting elevated levels of eosinophil cationic protein, considered an eosinophil activation marker. The aim of this study was to measure serum levels of eosinophil protein X, a cationic protein not measured previously in this illness. Measurements are reported on serum samples from 29 patients meeting the Centers for Disease Control and Prevention criteria for chronic fatigue syndrome, and 30 healthy controls of similar age and gender. The median serum eosinophil protein X level in patients was higher than controls: 37.9 vs. 25.3μg/L (p = 0.037). Forty-eight percent of patients versus 23% of controls had levels above the normal range. The marked increase in serum levels of eosinophil protein X in chronic fatigue syndrome patients could reflect eosinophil activation in this illness.'"
 * Prevalence of IgM and IgG Antibody to HHV-6 and HHV-8 and Results of Plasma PCR to HHV-6 and HHV-7 in a Group of CFS Patients and Healthy Donors"'Abstract - Human herpes virus-6 (HHV-6) is a beta herpes virus that was first described in 1986 and which occurs in the form of at least two variants, A and B. Healthy donors in the general population are carriers for mainly the B variant, in whom 90% harbor the DNA of this type in their peripheral blood mononuclear cells (PBMNC). A higher prevalence of this virus has been detected by testing of plasma and PBMNCs by IFA, ELISA and by the nested PCR technique, in addition to direct culture for HHV-6 in certain groups of immunesuppressed patients such as those with multiple sclerosis and HIV. It has also been isolated to a greater degree using these techniques from patients who meet the case definition for the chronic fatigue syndrome (CFS). We determined IgG and IgM antibody titers to HHV-6; IgG to HHV-8 and performed PCR testing for HHV-6 on the plasma of 46 patients with CFS and on 7 healthy donors (HD). We also performed PCR testing for HHV-7 on 15 CFS patients and on 4 HD(s). We found a higher prevalence of IgM antibody in CFS patients 23/36 (50%) versus 2/7 (28.5%) of HD. The prevalence of IgG antibody to HHV-8 was zero among both CFS patients and HD. Three out of forty six (6.5%) of CFS patients demonstrated a positive plasma by PCR to HHV-6 compared to zero out of 7 HD(s). Finally, four out of fifteen (26.7%) CFS patients and zero out of four HD(s) demonstrated a positive plasma PCR to HHV-7. Our results were influenced by the presence of various subpopulations of CFS patients among our study group, in addition to our reliance on the results of single specimens as opposed to a series of multiple samples over time in individual subjects, and by methodological variability (decreasing our yield because of diminished viral shedding in cell-free samples or increasing it compared to other research groups who failed to co-culture the PBMNCs with indicator cells, e.g., PHA-stimulated human cord blood cells or human fibroblasts for short-term culture [15 day]). Nevertheless, it is clear that the study of plasma and perhaps other tissue samples, such as cerebral spinal fluid and gastric mucosa from patients with CFS in better defined subgroups, as well as defined population of HDs using a variety of methodological techniques will increase our knowledge about the role of HHV-6 in this complex disorder.'"
 * Prevalence in the Cerebrospinal Fluid of the Following Infectious Agents in a Cohort of 12 CFS Subjects: Human Herpes Virus-6 and 8; Chlamydia Species; Mycoplasma Species; EBV; CMV; and Coxsackievirus"'Abstract - Over the last decade a wide variety of infectious agents has been associated with the chronic fatigue syndrome (CFS) as potential etiologies for this disorder by researchers from all over the world. Many of these agents are neurotrophic and have been linked previously to other diseases involving the central nervous system (CNS). Human herpes virus-6 (HHV-6), especially the B variant, has been found in autopsy specimens of patients who suffered from multiple sclerosis. Because patients with CFS manifest a wide range of symptoms involving the CNS as shown by abnormalities on brain MRIs, SPECT scans of the brain and results of tilt table testing we sought to determine the prevalence of HHV-6, HHV-8, Epstein-Barr virus (EBV), cytomegalovirus (CMV), Mycoplasma species, Chlamydia species, and Coxsackie virus in the spinal fluid of a group of 12 patients with CFS. Although we intended to search mainly for evidence of actively replicating HHV-6, a virus that has been associated by several researchers with this disorder, we found evidence of HHV-8, Chlamydia species, CMV and Coxsackie virus in 6/12 samples. Attempts were made to correlate the clinical presentations of each of these patients, especially the neurological exams and results of objective testing of the CNS, with the particular infectious agent isolated. It was also surprising to obtain such a relatively high yield of infectious agents on cell free specimens of spinal fluid that had not been centrifuged. Future research in spinal fluid analysis, in addition to testing tissue samples by polymerase chain reaction (PCR) and other direct viral isolation techniques will be important in characterizing subpopulations of CFS patients, especially those with involvement of the CNS.'"
 * Nevada Chronic Fatigue Syndrome Consensus Conference- Meeting report
 * Fibromyalgia: Literature in Review (1999-2000)by Roberto Patarca-Montero