Persistent infection hypothesis

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The persistent infection hypothesis or persistent viral infection theory is that hypothesis that myalgic encephalomyelitis is triggered and/or maintained by one or more persistent viruses or infections. This is in contrast to the "hit and run" hypothesis, which is that the infection triggers a disease process that continues long after the immune system has eradicated the initial infection.

Theory[edit | edit source]

Evidence[edit | edit source]

Treatment[edit | edit source]

Notable studies[edit | edit source]

  • 1992, Epstein-Barr Virus-Related Persistent Erythema Multiforme in Chronic Fatigue Syndrome[1] - (Abstract)
  • 1993, Persistence of enterovirus RNA in muscle biopsy samples suggests that some cases of chronic fatigue syndrome result from a previous, inflammatory viral myopathy[2] - (Abstract)
  • 1999, Persistence of enteroviral RNA in chronic fatigue syndrome is associated with the abnormal production of equal amounts of positive and negative strands of enteroviral RNA[3] - (Full text)
  • 2010, Acute enterovirus infection followed by myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and viral persistence[4] - (Full text)
  • 2012, Can persistent Epstein-Barr virus infection induce chronic fatigue syndrome as a Pavlov reflex of the immune response?[5] - (Full text)
  • 2016, Type I and Type II Interferon Coordinately Regulate Suppressive Dendritic Cell Fate and Function during Viral Persistence[6] - (Full text)
  • 2018, Myalgic Encephalomyelitis/Chronic Fatigue Syndrome in the era of the human microbiome: persistent pathogens drive chronic symptoms by interfering with host metabolism, gene expression and immunity[7] - (Full text)

See also[edit | edit source]

Learn more[edit | edit source]

References[edit | edit source]

  1. Rebora, Alfredo; Loi, Anna; Romagnoli, Marina; Drago, Francesco (Feb 1, 1992). "Epstein-Barr Virus-Related Persistent Erythema Multiforme in Chronic Fatigue Syndrome". Archives of Dermatology. 128 (2): 217–222. doi:10.1001/archderm.1992.01680120089009. ISSN 0003-987X. 
  2. Bowles, N. E.; Bayston, T. A.; Zhang, H. Y.; Doyle, D.; Lane, R. J.; Cunningham, L.; Archard, L. C. (1993). "Persistence of enterovirus RNA in muscle biopsy samples suggests that some cases of chronic fatigue syndrome result from a previous, inflammatory viral myopathy". Journal of Medicine. 24 (2-3): 145–160. ISSN 0025-7850. PMID 8409778. 
  3. Cunningham, Louise; Bowles, N. E.; Lane, R. J. M.; Dubowitz, V.; Archard, L. C. (1990). "Persistence of enteroviral RNA in chronic fatigue syndrome is associated with the abnormal production of equal amounts of positive and negative strands of enteroviral RNA". Journal of General Virology. 71 (6): 1399–1402. doi:10.1099/0022-1317-71-6-1399. 
  4. Chang, R.; Lee, T.; Voeller, M.; Chia, A.; Chia, J. (Feb 1, 2010). "Acute enterovirus infection followed by myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and viral persistence". Journal of Clinical Pathology. 63 (2): 165–168. doi:10.1136/jcp.2009.070466. ISSN 0021-9746. PMID 19828908. 
  5. Agliari, Elena; Barra, Adriano; Vidal, Kristian Gervasi; Guerra, Francesco (Mar 1, 2012). "Can persistent Epstein–Barr virus infection induce chronic fatigue syndrome as a Pavlov reflex of the immune response?". Journal of Biological Dynamics. 6 (2): 740–762. doi:10.1080/17513758.2012.704083. ISSN 1751-3758. PMID 22873615. 
  6. Brooks, David G.; Smale, Stephen T.; Bensinger, Steven J.; Horwitz, Marcus A.; Kitchen, Scott G.; Torre, Juan Carlos de la; Wilson, Elizabeth B.; Snell, Laura M.; Elsaesser, Heidi (Jan 25, 2016). "Type I and Type II Interferon Coordinately Regulate Suppressive Dendritic Cell Fate and Function during Viral Persistence". PLOS Pathogens. 12 (1): e1005356. doi:10.1371/journal.ppat.1005356. ISSN 1553-7374. PMC 4726812Freely accessible. PMID 26808628. 
  7. Proal, Amy; Marshall, Trevor (Nov 2018). "Myalgic Encephalomyelitis/Chronic Fatigue Syndrome in the era of the human microbiome: persistent pathogens drive chronic symptoms by interfering with host metabolism, gene expression and immunity". Frontiers in Pediatrics. doi:10.3389/fped.2018.00373. 

chronic fatigue syndrome (CFS) - A controversial term, invented by the U.S. Centers for Disease Control, that generally refers to a collection of symptoms as “fatigue”. There have been multiple attempts to come up with a set of diagnostic criteria to define this term, but few of those diagnostic criteria are currently in use. Previous attempts to define this term include the Fukuda criteria and the Oxford criteria. Some view the term as a useful diagnostic category for people with long-term fatigue of unexplained origin. Others view the term as a derogatory term borne out of animus towards patients. Some view the term as a synonym of myalgic encephalomyelitis, while others view myalgic encephalomyelitis as a distinct disease.

enterovirus - A genus of RNA viruses which typically enter the body through the respiratory or gastrointestinal systems and sometimes spread to the central nervous system or other parts of the body, causing neurological, cardiac, and other damage. Since the first reports of myalgic encephalomyelitis (ME), enteroviruses have been suspected as a cause of ME. Enteroviruses have also been implicated as the cause of Type I diabetes, congestive heart failure, and other conditions. Enteroviruses include poliovirus, coxsackieviruses, and many others. New enteroviruses and new strains of existing enteroviruses are continuously being discovered. (Learn more: viralzone.expasy.org)

enterovirus - A genus of RNA viruses which typically enter the body through the respiratory or gastrointestinal systems and sometimes spread to the central nervous system or other parts of the body, causing neurological, cardiac, and other damage. Since the first reports of myalgic encephalomyelitis (ME), enteroviruses have been suspected as a cause of ME. Enteroviruses have also been implicated as the cause of Type I diabetes, congestive heart failure, and other conditions. Enteroviruses include poliovirus, coxsackieviruses, and many others. New enteroviruses and new strains of existing enteroviruses are continuously being discovered. (Learn more: viralzone.expasy.org)

myalgic encephalomyelitis (ME) - A disease often marked by neurological symptoms, but fatigue is sometimes a symptom as well. Some diagnostic criteria distinguish it from chronic fatigue syndrome, while other diagnostic criteria consider it to be a synonym for chronic fatigue syndrome. A defining characteristic of ME is post-exertional malaise (PEM), or post-exertional neuroimmune exhaustion (PENE), which is a notable exacerbation of symptoms brought on by small exertions. PEM can last for days or weeks. Symptoms can include cognitive impairments, muscle pain (myalgia), trouble remaining upright (orthostatic intolerance), sleep abnormalities, and gastro-intestinal impairments, among others. An estimated 25% of those suffering from ME are housebound or bedbound. The World Health Organization (WHO) classifies ME as a neurological disease.

ME/CFS - An acronym that combines myalgic encephalomyelitis with chronic fatigue syndrome. Sometimes they are combined because people have trouble distinguishing one from the other. Sometimes they are combined because people see them as synonyms of each other.

myalgic encephalomyelitis (ME) - A disease often marked by neurological symptoms, but fatigue is sometimes a symptom as well. Some diagnostic criteria distinguish it from chronic fatigue syndrome, while other diagnostic criteria consider it to be a synonym for chronic fatigue syndrome. A defining characteristic of ME is post-exertional malaise (PEM), or post-exertional neuroimmune exhaustion (PENE), which is a notable exacerbation of symptoms brought on by small exertions. PEM can last for days or weeks. Symptoms can include cognitive impairments, muscle pain (myalgia), trouble remaining upright (orthostatic intolerance), sleep abnormalities, and gastro-intestinal impairments, among others. An estimated 25% of those suffering from ME are housebound or bedbound. The World Health Organization (WHO) classifies ME as a neurological disease.

microbiome - The full collection of microscopic organisms (especially bacteria and fungi) which are present in a particular environment, particularly inside the human body.

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