Dr. De Meirleir's work supports Dr. Marshall's hypothesis - CFS - Th1

26 July 2004

It is my opinion that Dr. Marshall's hypothesis has significant merit for chronic fatigue syndrome. The work and research of Dr. Kenny De Meirleir, who is considered an expert in the CFS community, supports Dr. Marshall's theory quite a bit.

For example, Dr. De Meirleir proposed that mycoplasma infections are capable of causing the 83 kDa RNase L proteolysis and dysfunction which has been consistently found in CFS patients. Mycoplasma can activate monocytes, neutrofils and T-cells. To bring about their phagocytic activity, monocytes, neutrofils and activated T-cells produce elastase which is one of the primary findings by Dr. De Meirleir and was recently revealed by the National CFIDS Foundation. Dr. De Meirleir holds a worldwide patent on his discovery. Subsequently, in the CFS community, patients tested for human leukocyte elastase (HLE) by R.E.D. Laboratories have consistently shown higher levels of elastase corresponding with the RnaseL proteolysis and dysfunction which clearly could be involved in systematic inflamation and numerous symptoms associated with CFS.

Once the 83 kDa RNase L cleavage has occurred, cell apoptosis (programmed cell death) is initiated. Apoptosis in turn enhances the activity of pro-apoptotic and pro-inflammatory proteases including both elastase and calpain, each of which is capable of high molecular weight RNase L proteolysis..

A vicious cycle is initiated by the cell-wall deficient bacteria species (mycoplasma, lyme) and numerous opportunistic infections take advantage of the impaired immune system in CFS patients. Cytokine responses are clearly involved in this process.

Dr. De Meirleir's work defintely supports Dr. Marshall's hypothesis that CFS is indeed a Th1 immune disease most likely caused by "stealth" bacteria without cell walls that can evade and disrupt the immune response. In my opinion it is likely there is a genetic or other co-factor in CFS patients. For example, women have considerably higher rates of CFS in the general population (and other autoimmune diseases) than men. It isn't clear why chronic fatigue syndrome and other autoimmune diseases affect women more than men but the answer could likely lead to a greater understanding of the immune system.

I highly recommend reading Dr. De Meirleir's work and all the research papers that he has been an investigator in. After reading them, along with Dr. Marshall's research papers, it is fairly clear that there is a common factor that almost every CFS researcher has found - and Dr. Marshall's hypothesis brings it together for a clear understanding of the cause and treatment for chronic fatigue syndrome and possibly other autoimmune conditions.

Competing interests: None declared

Competing interests: None declared

Jason L Breckenridge, CFS Researcher / NCF Volunteer

Syracuse New York, 13209

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