ú From: A2822AK ú Subject: Article found in IHT I found this article in the International Herald Tribune from January 14th 1993. I don't know, if this has already been discussed in this group, so I post it here; maybe someone would like to comment on it. Regards, H. Engelmann ---> Chronic Fatigue: Doctors Find Some Clues to the Mystery New York Times Service New York - Researchers at three medical centers in New Jersey, Massachusetts and Colorado are conducting sophisticated tests on patients with chronic fatigue syndrome and comparing notes in the first consistent, multidisciplinary approach intended to get to the bottom of the disorder. The syndrome, which begins with flu-like symptoms and can lead to exhaustion lasting for years, remains a profound mystery, said Dr. Stephen E. Straus, chief of the medical virology center at the National Institute of Allergy an Infectious Diseases in Bethesda, Maryland, the agency financing the $3 million research program. "Doctors do not know the molecular basis of fatigue in anyone, much less a person with chronic problems," Dr. Straus said. "When people say they feel tired all the time and their doctors can't find anything wrong with them, they're told the problem is in their heads." But many leading researchers are now convinced that patients are telling the truth, Dr. Straus said. One compelling reason stems from recent research on cytokines, cells of the human immune systemthat have been isolated and turned into drugs to fight cancer and other diseases. When healthy volunteers are injected with cytokines, Dr. Straus said, they feel awful and exhausted, exactly as chronic fatigue patients do. A leading hypothesis among researchers is that chronic fatigue results from abnormally activated cytokines. "We can find plenty of things wrong with these patients," he said, including depressed numbers of natural killer cells, elevated antibodies to childhood viruses and signs of hormone complexes that depress the immune system. "But we don't know what to relate these changes to" or how they compare with healthy people and patients with other diseases that involve fatigue. At the Chronic Fatigue Center in the Veterans Affairs Hospital of East Orange, New Jersey, a team led by Dr. Benjamin Natelson is looking for ways to diagnose the disorder in patients. "If most doctors can't find an abnormality in a lab test, they think it's the patient's fault," Dr. Natelson said, "One of the biggest problems with chronic fatigue has been physician arrogance." The New Jersey center has found a possible way to diagnose chronic fatigue patients. Sue Ann Sisto, a physical therapist at the center, noticed that patients breathe from the upper body, rather than from the belly and abdomen as most people do. Further testing showed that chronic fatigue patients have abnormal vagal tone, meaning the major nerve that syncopates their breathing and heart rate is out of sync. Their hearts are not speeding up and slowing down at a normal pace. "This is a solid piece of evidence that something is going on with these patients," Dr. Natelson said. "Their bodies seem to be conserving energy is strange ways." At the Chronic Fatigue Center of Brigham and Women's Hospital in Boston, Dr. Anthony Komaroff is focusing on the cytokine hypothesis. One idea is that the disease stems from the reactivation of childhood viruses. When any virus proliferates, the body responds by releasing a torrent of cytokines, cells that amplify the immune system and wage war against the invading agent, Dr. Komaroff said. "We used to think you felt terrible because the virus was attacking your cells," he said. "But that's not true. You feel terrible because your body is responding and you are caught in the crossfire. As cytokines hit target, they also hit you." During the attack people feel exhausted and conserve energy by crawling into bed, Dr. Komaroff said. Meanwhile, the cytokines alter liver metabolism and lterally break down human muscles to obtain protein. "Recycling your own body is more efficient than getting new food." he said. "You go to sleep. The battle rages. Finally the immune system clears the body of the virus. The attack is shut off." In chronic fatigue patients, this does not happen, Dr. Komaroff said. "You are in permanent crossfire," he said, "perhaps because the immune system cannot clear the virus. Maybe it is a latent virusthat shows just enough of itself to raise an attack but is hiding so well, the body can't kill it." Cytokines are very difficult to measure, Dr Komaroff said. They are short-lived, are made in many tissues and no one understands their natural balance. Sandra Blakeslee ---> --- * PCB/UseNet Gateway from Sparkware #3 ùHEADER:USENET From CFS-L@LIST.NIH.GOV Mon Feb 1 07:56:27 1993 Received: from list.nih.gov by uu.psi.com (5.65b/4.1.031792-PSI/PSINet) via SMTP id AA07677 for eliot.gelwan; Mon, 1 Feb 93 07:56:27 -0500 Message-Id: <9302011256.AA07677@uu.psi.com> Received: from LIST.NIH.GOV by LIST.NIH.GOV (IBM VM SMTP V2R1) with BSMTP id 6804; Mon, 01 Feb 93 07:57:17 EST Received: from NIHLIST.BITNET by LIST.NIH.GOV (Mailer R2.08 PTF008) with BSMTP id 6800; Mon, 01 Feb 93 07:57:09 EST Date: Mon, 1 Feb 1993 12:36:43 GMT Reply-To: Chronic Fatigue Syndrome discussion CFIDS/ME Sender: Chronic Fatigue Syndrome discussion CFIDS/ME Comments: Warning -- original Sender: tag was NETNEWS@AUVM.AMERICAN.EDU From: Herbert Engelmann Subject: Article found in IHT To: Multiple recipients of list CFS-L ============================================================================== Date: 02-01-93 (10:37) Number: 89467 Channel 1(R) Communica To: ELIOT GELWAN Refer#: NONE From: USENET GATEWAY Read: NO Subj: ARTICLE FOUND IN IHT Conf: (700) EMAIL ------------------------------------------------------------------------ ú Newsgroup: Private mail ú From: A2822AK ú Subject: Article found in IHT Path: cd1!a2822ak Date: 1 Feb 93 12:43:08 GMT Message-ID: Newsgroups: alt.med.cfs Subject: Article found in IHT I found this article in the International Herald Tribune from January 14th 1993. I don't know, if this has already been discussed in this group, so I post it here; maybe someone would like to comment on it. Regards, H. Engelmann ---> Chronic Fatigue: Doctors Find Some Clues to the Mystery New York Times Service New York - Researchers at three medical centers in New Jersey, Massachusetts and Colorado are conducting sophisticated tests on patients with chronic fatigue syndrome and comparing notes in the first consistent, multidisciplinary approach intended to get to the bottom of the disorder. The syndrome, which begins with flu-like symptoms and can lead to exhaustion lasting for years, remains a profound mystery, said Dr. Stephen E. Straus, chief of the medical virology center at the National Institute of Allergy an Infectious Diseases in Bethesda, Maryland, the agency financing the $3 million research program. "Doctors do not know the molecular basis of fatigue in anyone, much less a person with chronic problems," Dr. Straus said. "When people say they feel tired all the time and their doctors can't find anything wrong with them, they're told the problem is in their heads." But many leading researchers are now convinced that patients are telling the truth, Dr. Straus said. One compelling reason stems from recent research on cytokines, cells of the human immune systemthat have been isolated and turned into drugs to fight cancer and other diseases. When healthy volunteers are injected with cytokines, Dr. Straus said, they feel awful and exhausted, exactly as chronic fatigue patients do. A leading hypothesis among researchers is that chronic fatigue results from abnormally activated cytokines. "We can find plenty of things wrong with these patients," he said, including depressed numbers of natural killer cells, elevated antibodies to childhood viruses and signs of hormone complexes that depress the immune system. "But we don't know what to relate these changes to" or how they compare with healthy people and patients with other diseases that involve fatigue. At the Chronic Fatigue Center in the Veterans Affairs Hospital of East Orange, New Jersey, a team led by Dr. Benjamin Natelson is looking for ways to diagnose the disorder in patients. "If most doctors can't find an abnormality in a lab test, they think it's the patient's fault," Dr. Natelson said, "One of the biggest problems with chronic fatigue has been physician arrogance." The New Jersey center has found a possible way to diagnose chronic fatigue patients. Sue Ann Sisto, a physical therapist at the center, noticed that patients breathe from the upper body, rather than from the belly and abdomen as most people do. Further testing showed that chronic fatigue patients have abnormal vagal tone, meaning the major nerve that syncopates their breathing and heart rate is out of sync. Their hearts are not speeding up and slowing down at a normal pace. "This is a solid piece of evidence that something is going on with these patients," Dr. Natelson said. "Their bodies seem to be conserving energy is strange ways." At the Chronic Fatigue Center of Brigham and Women's Hospital in Boston, Dr. Anthony Komaroff is focusing on the cytokine hypothesis. One idea is that the disease stems from the reactivation of childhood viruses. When any virus proliferates, the body responds by releasing a torrent of cytokines, cells that amplify the immune system and wage war against the invading agent, Dr. Komaroff said. "We used to think you felt terrible because the virus was attacking your cells," he said. "But that's not true. You feel terrible because your body is responding and you are caught in the crossfire. As cytokines hit target, they also hit you." During the attack people feel exhausted and conserve energy by crawling into bed, Dr. Komaroff said. Meanwhile, the cytokines alter liver metabolism and lterally break down human muscles to obtain protein. "Recycling your own body is more efficient than getting new food." he said. "You go to sleep. The battle rages. Finally the immune system clears the body of the virus. The attack is shut off." In chronic fatigue patients, this does not happen, Dr. Komaroff said. "You are in permanent crossfire," he said, "perhaps because the immune system cannot clear the virus. Maybe it is a latent virusthat shows just enough of itself to raise an attack but is hiding so well, the body can't kill it." Cytokines are very difficult to measure, Dr Komaroff said. They are short-lived, are made in many tissues and no one understands their natural balance. Sandra Blakeslee --->