CFIDS ... Autism

[Guest guest]

Dr Goldberg has often said that certain forms of Autism that have the

criteria for

could be called Pediatric CFIDS - hmmm I see alot of familiar

text in this article ....

Doris

Chronic Fatigue's Genetic Component

Study Clarifies Predisposition to Syndrome

By Rick Weiss <http://projects.washingtonpost.com/staff/email/rick+weiss/>

Washington Post Staff Writer

Friday, April 21, 2006; Page A08

An intense battery of medical and psychological tests of people with

chronic fatigue syndrome has strengthened the idea that the mysterious

ailment is actually a collection of five or more conditions with varying

genetic and environmental causes, scientists reported yesterday.

But though the syndrome comes in many flavors, these experts said, the

new work also points to an important common feature: The brains and

immune systems of affected people do not respond normally to physical

and psychological stresses.

The researchers predicted that continued clarification of the precise

genes and hormones involved will lead to better diagnostic tests and

therapies for the ailment, which may affect close to 1 million Americans.

" This is a very important step forward in the field of chronic fatigue

syndrome research, " said L. Gerberding, director of the federal

Centers for Disease Control and Prevention in Atlanta, which sponsored

the project.

The new findings come from the largest clinical trial ever to focus on

people with the syndrome, a debilitating condition accompanied by

unexplained extreme fatigue, memory and concentration problems, sleep

disorders and chronic pain.

Taking a multidisciplinary approach that agency officials said

represents the future of public health, the CDC recruited 20 physicians,

molecular biologists, epidemiologists, computational biologists -- even

physicists and mathematicians -- to collaborate in an effort to tease

apart the syndrome.

The results, published in more than a dozen reports and commentaries in

the April issue of the journal Pharmacogenomics, released yesterday,

suggest that many cases of chronic fatigue have links to a handful of

brain- and immune system-related genes that either harbor small

mutations or are working abnormally for other reasons.

That finding strengthens the case that some people are born with a

predisposition to the condition. But those genetic links remain weak and

incomplete, researchers conceded, leaving most of the syndrome's roots

hidden in a fog of poorly understood physiological, neurological,

psychological and behavioral factors.

" Chronic fatigue syndrome is very heterogeneous. It's not just one

thing, " said C. Reeves, who oversaw the project with CDC

co-worker Suzanne D. Vernon. It will take time to identify all the

biological pathways involved, Reeves said, but the growing evidence of

genetic links should put to rest the idea that the syndrome is a made-up

diagnosis for " a bunch of hysterical, upper-class white women. "

The new study involved 227 residents of Wichita, Kan., who spent two

full days in a hospital undergoing a series of blood tests, hormone

studies, psychological exams and sleep studies.

About one-quarter of them met the formal definition of chronic fatigue

syndrome. A similar number proportion had chronic fatigue but did not

rank as having the full-blown syndrome -- in many cases because their

fatigue was not severe enough. A third group met all of the requirements

of the syndrome but also had melancholic depression, which does not fit

the current diagnostic guidelines for chronic fatigue syndrome. And a

fourth group, for comparison purposes, was healthy.

The CDC, which invested about $2 million in the testing, then made

blood-test results and other data available to researchers, who

performed a wide variety of analyses.

In one set of studies, scientists looked at the activity levels of

20,000 genes known to be involved in the body's response to such

stresses as infections, injuries or emotional trauma. Several hundred

were found to be over- or under-active in various subgroups of fatigued

patients.

Most of those correlations were weak -- that is, the gene expression

patterns alone could not accurately distinguish those whose symptoms had

been diagnosed as the syndrome from those whose symptoms had not. But in

one analysis, the activity of just 26 genes did accurately predict which

of six categories of chronic fatigue a patient had on the basis of

symptoms and other clinical tests. That is a powerful hint that those

genes -- many of them involved in immune system regulation, the adrenal

gland and the brain's hypothalamus and pituitary gland, which are

involved in the body's response to stress -- may hold clues to the

disease variants.

In other analyses, involving 50 genes that some people inherit with

seemingly minor " misspellings, " five of the 500 genetic glitches that

were tracked repeatedly correlated with an apparent susceptibility to

chronic fatigue. Those five include genes that affect levels of

serotonin -- the neurotransmitter whose levels are tweaked by many

antidepressant drugs -- and glutamate, a chemical that excites certain

brain pathways in response to stress.

The specific implications remain uncertain for now, said Vernon, a CDC

molecular biologist. " But everybody's finding the same five genes to be

involved, which is pretty cool. "

Several other studies on the Wichita samples found abnormal levels of

various hormones relating to stress and mood -- additional evidence that

chronic fatigue syndrome patients are genetically and neurologically

" wired " to respond to stress abnormally.

It is already known, Vernon said, that the brain can literally rewire

itself -- breaking old connections between neurons while building new

ones -- in response to various physical or emotional events. Chronic

fatigue syndrome may be the result of a bad rewiring job, she said, in

people genetically predisposed to handle stress poorly.