Dr. Rosemary Underhill komt met een interessante hypothese op de proppen:
ME (CVS) is infectieziekte en de ziekteverwekker wordt nimmer uitgeschakeld ("persisteert").
Ik ben zelf al jaren de mening toegedaan dat
als men met een theorie voor ME, zoals autoimmuniteit, géén epidemieen kan verklaren,
dat dat nooit de juiste verklaring kan zijn...
Deze hypothese vormt daarop een welkome uitzondering.
In haar betoog behandelt Underhill zowel ME in epidemische als in geïsoleerde vorm.
Zij draagt voor haar "bewijsvoering" verschillende stukjes "bewijs" aan, onder meer
de observatie dat ME vaker voorkomt bij niet-genetisch verwante contactpersonen van patiënten
en de vaststelling van Suhadolnik dat het afweersysteem van contactpersonen geactiveerd is.
De "hit-en-run"-verklaring wordt door Underhill,
die zich nog steeds bekommert om
Royal Free Hospital-patiënten,
op basis van een aantal argumenten afgewezen.
Myalgic encephalomyelitis, chronic fatigue syndrome: an infectious disease.
Medical Hypotheses. 2015 Dec; 85(6): 765–773. doi: 10.1016/j.mehy.2015.10.011.
Underhill RA.
Abstract
The etiology of myalgic encephalomyelitis also known as chronic fatigue syndrome or ME/CFS
has not been established.
Controversies exist over
whether it is an organic disease or a psychological disorder and
even the existence of ME/CFS as a disease entity is sometimes denied.
Suggested causal hypotheses have included
psychosomatic disorders, infectious agents, immune dysfunctions, autoimmunity, metabolic disturbances, toxins and inherited genetic factors.
Clinical, immunological and epidemiological evidence
supports the hypothesis that:
ME/CFS is endemic globally as sporadic cases and occasional cluster outbreaks (epidemics).
Cluster outbreaks imply an infectious agent.
An abrupt flu-like onset resembling an infectious illness
occurs in outbreak patients and many sporadic patients.
Immune responses in sporadic patients
resemble immune responses in other infectious diseases.
Contagion is shown by finding secondary cases in outbreaks, and
suggested by a higher prevalence of ME/CFS in sporadic patients'
genetically unrelated close contacts (spouses/partners) than the community.
Abortive cases, sub-clinical cases, and carrier state individuals were found in outbreaks.
The chronic phase of ME/CFS does not appear to be particularly infective.
Some healthy patient-contacts show immune responses similar to patients' immune responses,
suggesting exposure to the same antigen (a pathogen).
The chronicity of symptoms and of immune system changes and the occurrence of secondary cases
suggest persistence of a causal pathogen.
Risk factors which predispose to developing ME/CFS are:
- a close family member with ME/CFS;
- inherited genetic factors;
- female gender;
- age;
- rest/activity;
- previous exposure to stress or toxins;
- various infectious diseases preceding the onset of ME/CFS; and
- occupational exposure of health care professionals.
The hypothesis implies that ME/CFS patients should not donate blood or tissue and
usual precautions should be taken when handling patients' blood and tissue.
No known pathogen has been shown to cause ME/CFS.
Confirmation of the hypothesis requires identification of a causal pathogen.
Research should focus on a search for unknown and known pathogens.
Finding a causal pathogen could
- assist with diagnosis;
- help find a biomarker;
- enable the development of anti-microbial treatments;
- suggest preventive measures;
- explain pathophysiological findings; and
- reassure patients about the validity of their symptoms.
http://www.medical-hypotheses.com/article/S0306-9877(15)00382-5/pdf
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