Date: Tue, 27 Oct 1998 20:47:35 -0500
Subject: Primer on the CAUSE of CFS

I've finally gotten around to reading the work of Temple University's
Dr. Robert Sudolnick and I thought I would try to summarize it, both
to help clarify it for myself and other sufferers, and to help educate
any CFS skeptics that are still on this list.

Various people had told me that CFS was primarily due to a persistent 
low grade viral infection but I couldn't quite accept that I had that,
even though that's what it feels like.  Especially since the Chronic
Epstein Barr Virus (EBV) theory had been disproven because even though
CFS patients have higher levels of ANTIBODIES to EBV than the normal
population, they did not prove to have higher levels of active VIRUS.

There is another virus though where several investigators are proving
evidence of ACTIVE or REACTIVE infection in CFS patients that is NOT
present in control normals.  This is the Human Herpesvirus 6 (HHV-6)
Virus.

This is NOT Herpes Simplex, the cause of genital herpes.  HHV-6 actually 
a common virus, like Ebstein-Barr which causes mono, and the Chicken Pox
virus, which in IT'S reactivated form causes shingles.

So apparently most of the population is exposed to HHV-6, just as we are
exposed to these other common viruses.  Some become acutely ill and
recover
because their body's virus fighting cells destroy the virus. But in some
of us the virus remains in a low-grade infection.

What Dr. Sudolnick found is that there is a certain chemicals (enzymes)
in the immune system, called 2-5A and RNaseL which increase when a person
is fighting off any viral infection.  He has consistently found elevations
in almost all of his CFS patients of these enzymes, indicating that the
immune system is abnormally activated.  He has also been able to decrease this
activity by using a chemical called poly(I)-poly(C12U) and found both decreased
enzyme activity AND increased health directly related.  There was also
decreased measurements of the HHV-6 activity that correlated with these other
factors.

The drawbacks in Dr. Sudolnick's work were that these are preliminary 
studies and so he was treating very small numbers of patients and only
the most seriously ill and incapacitated.

What needs to be done is more research of this kind. Not more
psychological tests.

So my summation of this data is that CFS may be CAUSED by a low grade HHV-6
infection causing increased immune activation which causes the symptoms of CFS. 
Dr. Nancy Klimas and others have found decreased levels of Natural
Killer (NK) Cell Activity in her CFS patient populations.  

NK Cells are part of the body's virus defense system.  So the question is which
came first:  the low grade HHV-6 infection or the Natural Killer Cell
dysfunction?

Interestingly HHV-6 is gaining great interest as a possible CAUSE of Multiple
Sclerosis as well.  My theory is that Multiple Sclerosis is in fact a different
manifestation of CFS.  It is interesting to note that for Multiple Sclerosis
patients fatigue is frequently 
a greater disability than their neurological problems, at least in early
cases before the neurologic abnormalities become overwhelming.

I wonder if Multiple Sclerosis patients also show decreased NK Killer
Cell activity. 
Anybody know the answer to this question?

OK, now you know everything I know.

Judydoc

PS:  Dr. Klimas just told me that Dr. Sudolnick's work HAS been replicated
in other studies and with larger numbers of patients AND that Multiple
Sclerosis patients do also show low levels of NK Killer Cell activity and
other immunologic similarities to CFS.