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4.0 out of 5 stars
Somewhat dated, but still a valuable compilation, October 20, 2009
This review is from: Chronic Fatigue Syndrome: Critical Reviews and Clinical Advances (Paperback)
This slim paperback represents a survey of the most significant research compiled on CFS during the late 1990s as well as research reviews and clinical articles on the causes and mechanisms of the disease. Although the information is somewhat dated, the research approach during this decade was more varied and wide-ranging than research performed in subsequent years, making this book an essential tool for anyone interested in serious medical investigations of CFS.
The first section, written by Rosamund Vallings, is a report on the Second World Congress on CFS and Related Disorders, held in Brussels in September 1999. This is, by far, the most valuable section of the volume as it summarizes the bulk of the research performed over the previous decade. All of the major figures in CFS research were present: Neil McGregor, Byron Hyde, G. Moorkens, and Tim Roberts, who spoke on the biochemistry of the illness, as well as Kuratsune and Dunstan, who spoke about cortisol production, endocrine function, cytokine activity and acetylcarnitine metabolism. Suhadolnik and De Meirleir presented papers on RNase L pathway disruptions in CFS, an area of investigation which holds enormous potential for developing a definitive test for CFS. Reports on clinical immunology and concurrent allergy were made by Brostoff, Hyde, Lambrecht and Regland. Garth Nicolson discussed the presence of mycoplasma infections in CFS and Gulf War veterans, and proposed a course of antibiotic treatment which has been successful in this subgroup. Moorkens and his team reported on pituitary function, noting a significant decrease of growth hormone in CFS patients. Bastien, Nix, Hyde and Cabane reported on clinical findings, including motor abnormalities, memory impairment, altered perception, and reduced exercise capacity. Treatment discussions centered largely around Ampligen, an immune modulator, which was about to enter Phase III trials.
The second and third sections of this volume were devoted, respectively, to research and clinical reports:
1) Role of Mycoplasmal Infection in Fatigue Illnesses: Chronic Fatigue and Fibromyalgia Syndrome, Gulf War Illness and Rheumatoid Arthritis by G. Nicolson et al. Nicolson presents compelling evidence of simultaneous infection with mycoplasma infections, but whether the infection is opportunistic or causative is something that remains to be proven. Nicolson's assertions that CFS and GWS symptoms can be reversed through long-term antibiotic therapy have been effective in only a small number of cases. However, for those patients in whom the mycoplasmal infection is causative, antibiotics may be highly beneficial.
2) Human Herpes Virus 6 Infection in Patients with Chronic Fatigue Syndrome and Its Relationship to Activation-Induced Cell Death, by A. Cocchetto et al. HHV-6 has long been associated with CFS, and has been implicated in increased apoptosis observed in CFS patients. HHV-6 is a highly destructive virus whose proliferation in immunocompromised patients has long been documented as the basis for a wide range of symptoms. The authors propose that immune modulators such as NDGA and N-acetyl cysteine might be useful for downregulating the harmful effects of HHV-6 proliferation.
3) Neurological Dysfunction in Chronic Fatigue Syndrome by A Chaudhuri et al. This article presents a useful summary of some of the more significant neurological effects of CFS: vertigo, movement disorders, mental and physical fatigue, sleep disorder, sensory symptoms, autonomic symptoms, and neuroendocrine abnormalities, as well as proposing a mechanism for neurological dysfunction. Chaudhuri also discusses the history of CFS, from epidemic form to sporadic outbreaks. While the claim that evidence for CFS has been found on an ancient Egyptian papyrus must be taken with a grain (or, perhaps, a pound) of salt, there is substantial evidence for the more recent epidemic form.
4) Immunology of Chronic Fatigue Syndrome by Patarco-Montera et al. This is a concise and valuable review of the literature on immune system abnormalities found in CFS grouped according to type. The authors propose that the interplay of cytokine activation, poor cellular function and pro-inflammatory cytokines play an important role in the waxing and waning pattern of CFS symptoms.
5) The Biorhythm of Fatigue in Chronic Fatigue Syndrome, by Carbane et al. This study failed to show any consistent patterns of fatigue in CFS patients.
6) Divalent Cations, Hormones, Psyche and Soma: Four Case Reports by Hock. Four patients with psychiatric diagnoses of depression, secondary depression, CFS and somatoform disorder were tested for vitamin D deficiencies caused by calcium depletion. All four patients were successfully treated with vitamin D and trace minerals. While this study is far from conclusive it reveals that psychiatric diagnoses can hide underlying biological disorders.
7) Common Clinical and Biological Windows on CFS and Rickettsial Diseases, by Jadin. Rickettsial diseases, such as Lyme disease, were found to be underlying causes of 500 patients previously diagnosed with CFS, FM, MS, depression, heart disease, and psychosis. After treatment with tetracyline symptoms were reversed. While this was a fascinating study, it left many questions unanswered. How were the original diagnoses made? While the idea that CFS may be caused by bacterial infections, the study does not explore the possibility that the overlap in diagnoses in these cases may have been due to sheer medical incompetence.
8) Role of Rickettsiae and Chlamydiae in the Psychopathology of CFS Patients, by Bottero. This was an open study conducted by Bottero after he observed that ALL of his CFS patients tested positive for bacterial infections. An impressive 78.5% of Bottero's 98 CFS patients improved significantly after treatment with antibiotics. A second smaller group, composed of patients diagnosed with ADHD, schizophrenia and autism also showed a similar rate of improvement.
9) Chronic Psychopathologies Associated with Persistant Rickettesiae and/or Similar Germs (Chlamydiae) Phillipe Bottero. Due to the long survival of rickettsiae in reticuloendothelial tissues and vascular linings, persistent infection may result in vascular encephalitis, which, in turn, produces numerous psychiatric symptoms. Sixty patients with psychiatric diagnoses, including schizophrenia, delerium, bi-polar disorder, and depression tested positive for the presence of Rickettsial and Chlamydial infections. Fifty-five of the sixty cases were treated with good to excellent results. It is a pity this article was so poorly written, because it clearly demonstrates how psychiatric opinions have superceded medical diagnoses. If Bottero could cure his group of "schizophrenics" with tetracycline, just imagine how many other patients with treatable organic illnesses have been subjected to years of harmful psychoactive drugs, useless therapy and destructive psychiatric interventions because they were dismissed as "mentally ill"?
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