Advances in ME/CFS

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http://www.mefmaction.net/default.aspx?page=demeirleirpatients

Advances in ME/CFS

Highlights from Dr. Kenny De Meirleir's Lecture

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Calgary, Alberta, April 2, 2006

Marjorie van de Sande, B Ed, Grad Dip Ed

National ME/FM Action Network, Advisor & Webmaster

Conference Planning Committee

Dr. De Meirleir is a world renowned researcher and is professor

of Physiology and Internal Medicine at Free University of

Brussels in Belgium. Dr. De Meirleir recently published his

600th peer-reviewed paper. He is co-editor of " Chronic Fatigue

Syndrome: A Biological Approach " , co-editor of the Journal of

Chronic Fatigue Syndrome and reviewer for more than ten other

medical journals. Dr. De Meirleir was one of four international

experts on the panel that developed the Canadian Consensus

Document for ME/CFS. He assesses/treats 3,000 to 4,000

ME/CFS patients annually.

Normal Response to Infectious Agents

Numerous infectious agents can trigger ME/CFS. Infectious

agents that invade cells release ribonucleic acid (RNA) or

deoxyribonucleic acid (DNA) when they reproduce. Normally

when a virus infects a cell, an enzyme called Ribonulease L

(RNase L) is activated and cuts the RNA of the infectious agent

so it cannot replicate itself. The RNase L molecule also cuts the

RNA of the infected cell, which triggers the cell's death and

removal. Then the RNase L molecule " switches off " and remains

inactive so that it doesn't damage healthy cells.

Abnormal RNase L Molecule Found in ME/CFS Patients

The normal weight of the RNase L molecule is 80 kilo Daltons

(kDa). In ME/CFS patients, the RNase L molecule is being cut

and weighs 37 kDa - less than half its normal weight. The low

molecular weight (LMW) RNase L molecule can discriminate

ME/CFS patients from healthy people, and illnesses such as

fibromyalgia, multiple sclerosis, cancer, AIDS and depression.

The Centers for Disease Control (USA) sent 100 blood samples

to Dr. De Meirleir. Using the test for LMW RNase L, Dr. De

Meirleir was able to identify which blood samples came from

ME/CFS patients with 99% accuracy. These findings confirm an

organic origin of ME/CFS and validate the diagnosis.

Abnormal RNase L Molecule Causes Chronic Dysfunction

of the Immune System

The damaged RNase L molecule is not able to kill infectious

agents and it keeps damaged cells alive. The body is unable to

" switch off " these abnormal RNase L fragments so they continue

to cut the RNA of normal cells. The destructive RNase L

fragment is six times more active than normal and consumes

approximately 70% of the cells' energy (ATP). RNase L

fragments destroy normal protein synthesis, enzyme production

and other vital cellular functions. They inhibit respiratory muscles,

and cause hyperventilation, metabolic alkalosis, sleep

disturbances, and central fatigue. There is sodium retention, low

magnesium levels and dramatically low levels of potassium.

Natural killer cells, which protect against viruses and intracellular

infections, are also being damaged. Thus, the immune system

is in a state of chronic dysfunction.

Testing for ME/CFS

Dr. De Meirleir is co-founder of REDLABS

www.redlabsusa.com, which recently opened a lab in Nevada,

USA.

This lab offers diagnostic and treatment tests for ME/CFS

patients. Although each patient's profile is unique, patients tend

to fall into three groups with different causes and treatments.

Based on the results of six tests, Dr. De Meirleir was able to

predict patients' symptoms with 95% accuracy while the

remaining 5% had overlap features. Symptom severity rises in

correlation to the rise in the level of LMW RNase L.

Group Profiles

* Group 1: (15-20%) This group has high levels of LMW RNase

L and elastase, low levels of protein kinase (PKR) and uric acid,

and low to normal levels of nitric oxide. Spinal taps indicate

elevated levels of lymphocytes and proteins in the spinal fluid

and there is increased pressure upon opening the lumbar

puncture.

These patients have a chronic low-grade viral infection and

inflammatory reaction in the brain. Many micro-organisms are

associated with this profile. Heavy metals, pesticides and other

triggers may also be involved. Approximately 20% of this group

has low-grade Herpes Virus 6A (HHV6A) encephalitis.

The prominent feature is neurocognitive problems such as

confusion and impaired concentration and memory. Fatigue

originates in the brain. Pain is not prominent. Patients exhibit

symptoms that have some similarities to multiple sclerosis

(MS).

* Group 2: (10-15%) Patients have very high levels of LMW

RNase L and elastase, high protein kinase activity, severely low

natural killer cell activity and very low serum uric acid levels.

This group of severely ill patients has bacterial infections

originating from animals such as pets, rodents, ticks, etc. These

patients have severe bowel problems. The gut is an important

part of the immune system because 70% of immune cells are in

the digestive tract. When a patient has leaky gut syndrome, the

gut has become permeable and foreign proteins enter the blood

and tissues and inflammation results. Dr. De Meirleir tests for 12

pathogenic gut bacteria.

* Group 3: (60-70%) The majority of ME/CFS patients are in

this group. This profile is basically similar to Group 2, but not as

severe. Generalized pain originating from dysfunction in the pain

processing areas of the brain and CNS is a prominent feature.

These patients have gastrointestinal infections and bacteria are

in the blood.

Some Other Areas of Investigation

* Infections: Part of the immune system is activated and part is

suppressed, leaving the patient vulnerable to opportunistic

infections. Patients may have one or a number of infections.

Serum Immunobilan tests are done to identify which ones are

active. Suspect microorganisms include viruses, bacteria, and

mycoplasma. A chlamydia pneumonia infection is often found in

patients with chronic sinus infections. Approximately 8 – 10% of

ME/CFS patients have infections of animal origin such as

Rickettsiae, iella, Bartonella and Borrelia.

* Heavy Metals: Exposure comes from many sources including

food, insulation, air, etc. ME/CFS patients have increased

sensitivity to chemicals, environmental pollutants and heavy

metals, particularly mercury and nickel. Toxins can trigger an

inflammatory response.

One of the RNase L fragments has a structure that is almost

identical to a protein involved in the removal of heavy metals and

toxic chemical from cells. When this protein is blocked by the

RNase L fragments, the cells become more sensitive to

mercury. Now a tiny amount of mercury that would normally kill

10% of the cells can kill 50 to 100% of the cells.

* Mycrotoxins: Fungi such as Aspergillus Niger and Candida

can contribute to ME/CFS symptoms. Candida is a yeast fungal

infection that changes sugars to aldehydes, a toxic form of

alcohol.

* Digestive Tract: Gastrointestinal problems are a serious

concern in ME/CFS patients. 70% of the body's immune cells

are found in the gastrointestinal tract. These immune cells

prevent bacteria and foreign protein from entering the blood

stream. When the gut become permeable and foreign protein

enters the blood stream, elastase is produced. Elastase is the

enzyme that is responsible for cutting the RNase L molecule into

fragments. Elastase breaks down elastin, which gives elasticity

to collagen. As a result, there is pain and a loss of elasticity in

ligaments and tendons.

* Peripheral Resistance to Thyroid Hormone: Most patients

have normal results for common thyroid tests. However,

ME/CFS patients have a much higher level of a protein that is

98% identical to T3, which is the active form of thyroid. Because

this foreign protein can bind to T3 receptors, T3 cannot find

receptors and is therefore ineffective in its role of activating

cellular metabolism.

Treatment Summary

Some psychiatrists advocate that no tests or lab work be done

on ME/CFS patients because testing will reinforce delusions of

physically illness. Given the wealth of confirmed biochemical

abnormalities, such rationale is ludicrous. Dr. De Meirleir

stressed that tests must be done in order to determine the origin

of the problem. Then treatment can be prescribed to eliminate

the cause. A " clean-up " of all the consequences of the problem

must also be undertaken. Therapies and the order of treatments

vary according to the patient's unique test profile. Treatment

includes:

1. Restoring immune competence

2. Removing microorganisms

3. Restoring hormonal balance

4. Restoring intestinal flora

5. Decreasing prostaglandins and protein kinase activity

6. Removing heavy metals and toxic chemicals

Dr. De Meirleir describes various treatment therapies in his

lecture, which is available on DVD.

New ME/CFS DVD Resources – Prices include shipping &

handling:

Dr. Kenny De Meirleir – Physicians' full day

workshop - $80.00

Dr. Kenny De Meirleir - patients'

lecture - $25.00

Dr. Pierre Flor- Henry's lecture – this is very technical (limited

time offer)

qEEG studies (current density source) and psychophysiological

studies - $20.00

Dr. Bell's lecture (ME/CFS - emphasis on chronic

orthostatic intolerance) - $25.00

Note:

* Please send order ASAP so we can determine the number of

DVDs to have made.

* Dr. De Meirleir's DVDs will be delayed until June

* Payment: must be by check or money order payable to

Marjorie van de Sande Mail it to her at

151 Arbour Ridge Circle NW

Calgary AB T3G 3V9.

* Please be sure to indicate which DVDs you would like.

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