
XMRV DNA was found from 68 of 101 patients (67%), and this was in the Science paper. That leaves 33 patients with CFS who were negative. But on further testing 19 of these 33 are XMRV antibody positive, 30 of these 33 had transmissible virus in the plasma, and 10 of these 33 had protein expression. Overall 99 of the 101 patients show evidence of XMRV infection.
These results have interesting implications. The most important is that there is not a simple test now that will tell you if you have XMRV or if the virus is active in your system. And we need a good control study using all three measures to accurately know control presence of the virus. This is not a fly-by-night operation. Right now, it is necessary to do several tests to know the XMRV status:
a) DNA by PCR
b) Viral infectivity
c) Detection of viral proteins
d) Antibody to the XMRV envelope
As time goes on and we learn more, this process will be simplified. What I do not want is poor science that will cast doubts on an illness that already has its fill of doubters. Let's do it right from the beginning. If by doing it right XMRV proves not to be the cause, so be it. Something is the cause.
Dr. Coffin of Tufts University and the National Cancer Institute presented some very interesting observations. He is a true veteran (45 years) of retroviral research. There have been comments from various people saying that there are lots of viruses associated with CFS, so what is the big deal? Among the points raised by Dr. Coffin:
A) it is relatively difficult to isolate live retrovirus from patients with HIV infection, but relatively easy to isolate live XMRV in CFS. There is a high percentage of infected cells.
B) The percentage of positive controls for XMRV not that much different between CFS controls and prostate cancer controls, 4 or 5%. However, much work needs to be done to verify the control incidence. This is particularly true because the nations' blood supply could be contaminated. (By the way, no patient with ME/CFS should donate blood - personal opinion) The Japanese Red Cross has said that there is a "low incidence" of XMRV in their blood supply.
C) Could some mouse have contaminated the tests by shedding some XMRV in the lab? XMRV is a big family of "simple" retroviruses. In the XMRV strains isolated in CFS patients there is a 0.3% diversity from what are carried in mice - a relatively large diversity. This virus does not vary with replication as much as HIV does. In two weeks of HIV replication the diversity is greater than 0.3%. And this is both good and bad news. Good news for the ultimate production of a vaccine. The diversity has been a roadblock in the production of a HIV vaccine. Bad news for the antiviral therapy implications. But that is way down the road.
D) Dr. Coffin presented a slide of the many things we do not know about XMRV. There are lots of things to do.
E) Dr. Coffin mentioned that there is excitement in the retroviral scientific community - very good news for the ME/CFS community. We will get confirmation, or lack of confirmation, from many good scientists. It will be difficult for biased scientists to squelch this, if it is, in fact, true.
The statement that made my socks roll up and down all by themselves was a reply to a question from the committee. Dr. Coffin said "This was as good as it gets for a first paper, but it is still just a first paper."
Theory of Mechanism of XMRV and ME/CFS
Dr. Peterson presented an update of a theory of mechanism that has been circulating for many years. Ironically enough, it was once called the "X factor theory."
Step 1: Infection with XMRV. No idea of how this happens. Could it be that the tiny XMRV piggybacks onto some huge, lumbering herpes virus like EBV, or HHV6. That mechanism is known to occur. Lots of other possibilities
Step 2: Infection of B, T lymphocytes and NK cells. Dr. Klimas has said that up to 70% of lymphocytes are "activated". Something is going on.
Step 3: Impairment of NK cell number and activity. Because of the retroviral infection, the NK cells are impaired. This is parallel to what is known to happen in HIV disease with the CD4 lymphocytes

As a result of poor NK cell and function (and other T & B cell problems) the person now has an immunodeficiency. NK cells are important in the control of herpes viruses and other agents.
Step 4: Reactivation of other agents. Increased viral load of EBV and other agents cause cytokine production, activation of 2'-5'A Synthetase, RNAse L which contribute to symptoms. It is interesting to note that AIDS patients feel better with suppression of secondary infections. This could explain why treatment with antibiotics, antivirals, gamma globulin and other agents make some patients with ME/CFS feel better for a while.
Archived video of Dr. Daniel Peterson's presentation of the CFSAC 10/29/09 should be available at: http://videocast.nih.gov/PastEvents.asp. It is my personal opinion that it is history in the making. Time will tell.
And while I am making rash predictions, let's talk about the name of this illness. It has been a favorite topic of mine since the "Disease of a Thousand Names." Chronic fatigue syndrome is a miserable name. I think that XMRV is going to turn out to be the puppet-master that pulls the strings of illnesses variously called CFS, ME, fibromyalgia, atypical multiple sclerosis, chronic mononucleosis. And if it does, the name should be XAND, for Xmrv Associated Neuroimmune Disease. I heard Mrs. Annette Whittemore use this term and it feels right. History.
FROM DOM: To subscribe to Dr. Bell's excellent Lyndonville News, go to http://www.davidsbell.com/DSBJoin.htm. I really like what he says on his homepage at http://www.davidsbell.com--
"The medical literature on chronic fatigue syndrome and fibromyalgia
has exploded in recent years, but in the process it has become bulky and
difficult to follow. Meanwhile, the decreased public attention paid to
CFS/FM/ME has led patients to feel abandoned and isolated, particularly
since most medical providers are not familiar with the newer developments. Some
patients may feel that there is even a worsening of the medical climate
with increased disdain and neglect for their illness. It is my
hope that the near future will bring dramatic changes to this climate. This
newsletter is an attempt to increase awareness of CFS and FM through information
that is based upon current medical literature....We are not soliciting patients for our medical practice, and would
discourage persons from coming. I currently follow many hundreds of patients
with CFS/FM, and if I ever find a simple cure for them I will publish it in the
Lyndonville News. But CFS/FM/ME is a complex and difficult
illness, and I would not advise people to hold their breath for the simple cure.
It will take time and steady progress. I am convinced that chronic fatigue syndrome and fibromyalgia
are treatable illnesses that can be managed successfully. I believe
that the medical profession will rise to the task of addressing this illness
properly. I also feel that there will be treatments in the future that will
completely reverse the symptoms. I hope that the Lyndonville News will
be of value to the community of those interested in CFS/FM/ME."
"As a Board Certified Chiropractic Neurologist, I take a different approach to the treatment and prevention of Fibromyalgia. After a thorough neurological examination I determine which part of the nervous system is not functioning properly. In many Fibromyalgia patients I may find a high mesencephalic output.
There are three parts to the brain stem: top, middle, and lower. The mesencephalon is the top part of the brain stem. A high output of the mesencephalon will cause an increased pulse and heart rate, inability to sleep or waking up from fitful sleep, urinary tract infection, increase warmth or sweating, and sensitivity to light.
Along with a high mesenphalic output, the Fibromyalgia patient may have a decreased output of the cerebellum. The cerebellum is in the back part of the brain, and it controls all of the involuntary spinal musculature......Since the upper part of the brain stem (mesencephalon) is firing at an abnormally high rate, I will want to utilize modalities that will lower the mesenphalic output."
FROM DOM: I have talked about Dr. Michael Johnson's interesting theory in past newsletters. Try a search at www.fms-help.com/newsletters.htm.
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"Thank you for posting your web site on Fibro www.fms-help.com. I was struck by this
wonderful condition around age 20, before the term existed. I'm now 50 and
after being in 90% remission for about 15 years, it started to come back
and back and wammo, it's hitting hard. Moving from [the Northeast] to [the
West] is what helped the original healing. Now being 50, working is
torture, relationship washed away, living in a friends spare room and
barely able to support myself. Stress sure is a killer. I'm not a
depressive person but boy do I get depressed. I wish I can tell
others what got me into remission, I think I was just lucky. I
was allergic to everything that went in my mouth, food vitamins, meds, you
name it. Now it's back. The interesting thing is how symptoms can change
from week to week. My favorite is the leg pains, the kind you get when you
have the flu. Had those for 10-15 years and now they are back. I
don't even bother going to doctors anymore, can't afford to. Some days I
wanna just crawl up and pass away. The thought of being stuck with
fibro is sickening. I guess I'm coming from a place of having
been there before and having a remission. Anyways, I got good at
complaining again. At least I got to live some active years hiking
and biking and being outdoorsy. Now I feel like a waste. Walking
a mile hurts more than it helps, yet I do it anyway."
FROM DOM: I hear from many men with
fibro - see www.fms-help.com/men.htm for some of their stories. I'm glad this reader
found my site and is now on the newsletter list to get continous
information, research and emotional support.
23. DOM'S UPDATE I have
continued to feel better than usual since I began using the
drops (for
alkalinity and oxygen) & DMSO (for cold sores) 12 weeks ago, although
our School of Music piano recital a few weeks ago really took the stuffing out of me,
which was followed by playing for the revival at church the following week. Evidently I have to
accept the amount of activity and stress that comes into my life - as much
as I can, that is. Of all the useful items on the list of things I need to
stay functional www.fms-help.com/what.htm, the things that are indispensable to me are: #1, 4, 5, 6, 7, 8, 9, 10,
11, 12, 17, 18, 24, 25 and 26. We are all different, but maybe
some of these things can help others regain more of a life too. My
main thing is that I can't travel more than about 30 miles because of
weird things that happen in my brain (too much stimulation). This
travel handicap began after I worked in toxic mold 5 years ago www.fms-help.com/mold.htm.
Before that, I had the FMS/CFIDS fairly well managed. I think the
mold damaged my immune system further. Still, I am very grateful for
all the things I can still do. I had a birthday this weekend -
58! Wow, that sounds old....well, at least I'm getting closer to heaven, and
that is great!
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DOMINIE'S FIBROMYALGIA & CHRONIC
FATIGUE SYNDROME HOMEPAGE
DISCLAIMER: I am not a medical doctor. I am a fibromyalgia / chronic fatigue syndrome survivor. The purpose of this website is not to diagnose or cure any disease or malady, but is presented as food for thought. This information cannot take the place of professional medical advice. Any attempt to diagnose and treat an illness should come under the direction of a physician. No guarantees are made regarding any of the information in this website.