Ten Discoveries about the Biology of CFS

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Ten Discoveries about the Biology of CFS

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This summary of important CFS research

findings is reproduced with kind permission from the Summer 2008 issue of The

CFIDS Chronicle, a quarterly publication of the CFIDS Association of America.

by Dr. Komaroff, MD*

December 2, 2008

1. Chronic fatigue

syndrome is not a form of depression, and many patients with CFS have no

diagnosable psychiatric disorder.

As with most chronic illnesses, some CFS

patients become depressed because of the impact of the illness on their lives,

but most studies find that the majority haven’t experienced depression before

the onset of illness.

2. There’s a state of chronic, low-grade immune

activation in CFS.

There is evidence of activated T cells, activation of

genes reflecting immune activation and increased levels of immune system

chemicals called cytokines.

3. There’s substantial evidence of poorly

functioning natural killer (NK) cells—white blood cells important in fighting

viral infections.

Studies differ as to whether there may be increased numbers

of NK cells in CFS patients.

4. Abnormalities in the white matter of the

brain have been found in CFS patients using magnetic resonance imaging (MRI)

scans.

Typically, these are small (fraction of an inch) areas just below the

cerebral cortex, the outermost area of the brain hemispheres. Differences in

gray matter volume are also being observed.

5. Abnormalities in brain

metabolism, as indicated by single photon emission computed tomography (SPECT)

and positron emission tomography (PET), have been discovered.

Other research

suggests there’s something wrong with energy metabolism and the oxidative

electron transport chain in the mitochondria of CFS patients.

6. CFS

patients experience abnormalities in multiple neuroendocrine systems in the

brain, particularly depression of the hypothalamic- pituitary- adrenal (HPA)

axis,

but also the hypothalamic- prolactin axis and hypothamalmic- growth hormone

axis.

7. Cognitive impairment is common in CFS patients. The most

frequently documented abnormalities are difficulty with information processing,

memory and/or attention.

..

8. Abnormalities of the autonomic nervous

system have been found by numerous independent researchers. These include a

failure of the body to maintain blood pressure after a person stands up,

abnormal responses of the heart rate to standing and unusual pooling of blood in

the veins of the legs. Some studies also find low levels of blood

volume.

9. CFS patients have disordered expression of genes that are

important in energy metabolism. Energy comes from certain natural chemicals that

are processed by enzymes inside each cell. These enzymes are controlled by

specific genes. Other genomic research is revealing involvement of genes

connected to HPA axis activity, the sympathetic nervous system and immune

function.

10. There’s evidence of more frequent latent active infection

with various herpesviruses and enteroviruses.

The herpesviruses include

Epstein Barr, HHV-6 and cytomegalovirus. Other infectious agents, like bacterium

that cause Lyme disease, Ross River virus and Q fever, can also trigger

CFS.

[Note: To learn much more about these discoveries and the underlying

research, watch the fascinating video presentation by CFIDS Association

Scientific Director Suzanne Vernon, PhD, assisted by President Kim McCleary, at

http://www.cfids.org/webinar/sciencecfs-video.asp. ]