Category: History

False Alarm: XMRV, Cancer, and Chronic Fatigue Syndrome

Abstract:

Xenotropic murine leukemia virus (MLV)-related virus (XMRV) was first described in 2006 in some human prostate cancers. But it drew little attention until 2009, when it was also found, as infectious virus and as MLV-related DNA, in samples from people suffering from myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). This discovery was rapidly followed by efforts of the international research community to understand the significance of the association and its potential to spread widely as an important human pathogen.

Within a few years, efforts by researchers worldwide failed to repeat these findings, and mounting evidence for laboratory contamination with mouse-derived virus and viral DNA sequences became accepted as the explanation for the initial findings. As researchers engaged in these studies, we present here a historical review of the rise and fall of XMRV as a human pathogen, and we discuss the lessons learned from these events.

Source: Coffin JM, Kearney MF. False Alarm: XMRV, Cancer, and Chronic Fatigue Syndrome. Annu Rev Virol. 2024 Jul 8. doi: 10.1146/annurev-virology-111821-125122. Epub ahead of print. PMID: 38976866. https://pubmed.ncbi.nlm.nih.gov/38976866/

An Unwanted but Long-Known Company: Post-Viral Symptoms in the Context of Past Pandemics in Switzerland (and Beyond)

Abstract:

Objectives: Some people do not fully recover from an acute viral infection and experience persistent symptoms or incomplete recovery for months or even years. This is not unique to the SARS-CoV-2 virus and history shows that post-viral conditions like post COVID-19 condition, also referred to as Long Covid, are not new. In particular, during and after pandemics caused by respiratory viruses in which large parts of the population were infected or exposed, professional and public attention was increased, not least because of the large number of people affected.

Methods: Given the current relevance of the topic, this article aims to narratively review and summarize the literature on post-viral symptoms during past pandemics and to supplement and illustrate it with Swiss examples from the pandemics of 1890, 1918–1920 and later.

Results: Post-viral diseases were an increasingly emphasised health topic during and after past pandemics triggered by respiratory infections over the last 150 years.

Conclusion: In the next pandemic, it should not be surprising that post-viral conditions will again play a role, and pandemic plans should reflect this.

Source: Staub, Kaspar; Ballouz, Tala; Puhan, Milo (2024). An Unwanted but Long-Known Company: Post-Viral Symptoms in the Context of Past Pandemics in Switzerland (and Beyond). Public Health Reviews, 45:1606966. https://www.ssph-journal.org/articles/10.3389/phrs.2024.1606966/full (Full text)

A Natural History of Disease Framework for Improving the Prevention, Management, and Research on Post-viral Fatigue Syndrome and Other Forms of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

Abstract:

We propose a framework for the treatment, rehabilitation, and research into Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) using a natural history of disease approach to outline the distinct disease stages, with an emphasis on cases following infection to provide insights into prevention.

Moving away from the method of subtyping patients based on the various phenotypic presentations and instead reframing along the lines of disease progression could help with defining the distinct stages of disease, each of which would benefit from large prospective cohort studies to accurately describe the pathological mechanisms taking place therein. With a better understanding of these mechanisms, management and research can be tailored specifically for each disease stage.

Pre-disease and early disease stages call for management strategies that may decrease the risk of long-term morbidity, by focusing on avoidance of further insults, adequate rest to enable recovery, and pacing of activities.

Later disease stages require a more holistic and tailored management approach, with treatment—as this becomes available—targeting the alleviation of symptoms and multi-systemic dysfunction.

More stringent and standardised use of case definitions in research is critical to improve generalisability of results and to create the strong evidence-based policies for management that are currently lacking in ME/CFS.

Source: O’Boyle S, Nacul L, Nacul FE, Mudie K, Kingdon CC, Cliff JM, Clark TG, Dockrell HM and Lacerda EM. A Natural History of Disease Framework for Improving the Prevention, Management, and Research on Post-viral Fatigue Syndrome and Other Forms of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Front. Med. 8:688159. https://www.frontiersin.org/articles/10.3389/fmed.2021.688159/full (Full text)

The 1918 Influenza Pandemic: Back to the Future?

Abstract:

Background: It is just over a century since the 1918 flu pandemic, sometimes referred to as the “mother” of pandemics. This brief retrospective of the 1918 pandemic is taken from the viewpoint of the current SARS-CoV-2/COVID-19 pandemic and is based on a short lecture given during the 2021 Virtual Congress of the ERA-EDTA.

Summary: This review summarizes and highlights some of the earlier pandemic’s salient features, some parallels with today, and some potential learnings, bearing in mind that the flu pandemic occurred over 100 years ago at a time of major turmoil during the climax to WWl, and with limited medical expertise and knowledge, research facilities, or well-structured and resourced healthcare services. While there is little or no information on renal complications at the time, or an effective treatment, some observations in relation to COVID-19 and vaccination are included.

Key Messages: Lessons are difficult to draw from 1918 other than the importance and value of non-pharmaceutical measures to limit viral transmission. While the economic impact of the 1918 pandemic was significant, as it is now with COVID-19, subsequent economic analysis has shown that protecting public health and preserving economic activity are not mutually exclusive. Both H1N1 and SARS-CoV-2 viruses are neurotropic and may cause chronically debilitating neurological diseases, including conditions such as encephalitis lethargica (still debated) and myalgic encephalomyelitis (chronic fatigue syndrome), respectively. Although coronavirus and influenza viral infections have some similarities, they are certainly not the same, as we are realising, and future infectious pandemics may still surprise us, but being “forewarned is forearmed.”

Source: Unwin RJ. The 1918 Influenza Pandemic: Back to the Future? Kidney Blood Press Res. 2021 Oct 18:1-8. doi: 10.1159/000519288. Epub ahead of print. PMID: 34662882. https://pubmed.ncbi.nlm.nih.gov/34662882/ 

ME/CFS: Past, Present and Future

Abstract:

This review raises a number of compelling issues related to the condition of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). Some historical perspective is necessary in order to highlight the nature of the controversy concerning its causation. Throughout history, a pattern tends to repeat itself when natural phenomena require explanation. Dogma usually arrives first, then it is eventually replaced by scientific understanding. The same pattern is unfolding in relation to ME/CFS, but supporters of the psychological dogma surrounding its causation remain stubbornly resistant, even in the face of compelling scientific evidence to the contrary. Acceptance of the latter is not just an academic issue; the route to proper understanding and treatment of ME/CFS is through further scientific research rather than psychological theorisation. Only then will a long-suffering patient group benefit.

Source: Weir, William, and Nigel Speight. 2021. “ME/CFS: Past, Present and Future” Healthcare 9, no. 8: 984. https://doi.org/10.3390/healthcare9080984 https://www.mdpi.com/2227-9032/9/8/984/htm (Full text)

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Organic Disease or Psychosomatic Illness? A Re-Examination of the Royal Free Epidemic of 1955

Abstract:

Background and Objectives: Controversy exists over whether myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is an organic disease or a psychosomatic illness. ME/CFS usually occurs as sporadic cases, but epidemics (outbreaks) have occurred worldwide. Myalgic encephalomyelitis was named to describe an outbreak affecting the lymphatic, muscular, and nervous systems that closed the Royal Free hospital for three months in 1955. Fifteen years later, two psychiatrists concluded that epidemic hysteria was the likely cause. ME/CFS research studies show multiple pathophysiological differences between patients and controls and a possible etiological role for infectious organisms, but the belief that ME/CFS is psychosomatic is widespread and has been specifically supported by the epidemic hysteria hypothesis for the Royal Free outbreak. Our objective was to obtain accounts from ex-Royal Free hospital staff who personally experienced the 1955 outbreak and evaluate evidence for it being an infectious illness versus epidemic hysteria.

Materials and Methods: Statements in the newsletters of two organizations for staff who had worked at the Royal Free hospital invited anyone who had experienced the 1955 Royal Free outbreak to contact the authors. Accounts of the outbreak from telephone interviews and letters were evaluated against the “epidemic hysteria hypothesis” paper and original medical staff reports.

Results: Twenty-seven ex-Royal Free hospital staff, including six who had developed ME, provided descriptions typical of an infectious illness affecting the lymphatic, muscular, and nervous systems, and were not consistent with epidemic hysteria.

Conclusions: The 1955 Royal Free hospital epidemic of myalgic encephalomyelitis was an organic infectious disease, not psychogenic epidemic hysteria.

Source: Underhill R, Baillod R. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Organic Disease or Psychosomatic Illness? A Re-Examination of the Royal Free Epidemic of 1955. Medicina (Kaunas). 2020 Dec 26;57(1):E12. doi: 10.3390/medicina57010012. PMID: 33375343. https://www.mdpi.com/1010-660X/57/1/12  (Full text)

Legitimizing myalgic encephalomyelitis/chronic fatigue syndrome: Indications of change over a decade

Abstract:

This commentary identifies recent scientific and clinical milestones that appear to have increased legitimization of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). These milestones include government-funded reports recognizing the seriousness of ME/CFS, new initiatives for biomedical research sponsored by the US National Institutes of Health, official endorsement of the ME/CFS name, publication of practitioner primers, and the launch of a new peer-review fatigue journal. These positive developments are tempered by ongoing illness challenges including patient stigma, absence of diagnostic markers, a lack of established treatments, and a dearth of researchers and knowledgeable, interested clinicians.

Source: Fred Friedberg (2020) Legitimizing myalgic encephalomyelitis/chronic fatigue syndrome: indications of change over a decade, Fatigue: Biomedicine, Health & Behavior, DOI: 10.1080/21641846.2020.1718292

Neurasthenia: Modern Malady or Historical Relic?

Abstract:

Neurasthenia was a popular diagnosis from 1869 through 1930. Despite being discarded, the core symptoms of neurasthenia can still be found throughout modern society. The present article reviews the symptoms, common course, proposed causes, and common treatments for neurasthenia. Similarities are seen in several familiar diagnoses, including depression, chronic fatigue syndrome, and fibromyalgia. Through reviewing the trends of neurasthenia, modern doctors may learn more about the subtleties of the diagnostic process, as well as the patient-physician relationship. The goal is to learn from the past as it relates to current problems that may be related to the stress of modern living. The history of neurasthenia is presented as it relates to problems that may remain today.

Source: Overholser JC, Beale EE. Neurasthenia: Modern Malady or Historical Relic? J Nerv Ment Dis. 2019 Sep;207(9):731-739. doi: 10.1097/NMD.0000000000000943. https://www.ncbi.nlm.nih.gov/pubmed/31464984

Advances in ME/CFS: Past, Present, and Future

Abstract:

The forerunner of what is today termed myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) was described by the U.S. Public Health Service in 1934. At the present time, we still do not know its cause and/or how to detect it by routine clinical laboratory tests. In consequence, the pathological nature of ME/CFS has been overlooked and the disease has been stigmatized by being mislabeled as psychosomatic or somatoform illness. Such misperceptions of the disease have led to insufficient research exploration of the disease and minimal to absent patient care.

A 2015 Institute of Medicine report on the illness declared ME/CFS a disease affecting up to 2.5 million Americans and chastised the U.S. government for doing little to research the disease and to support its patients. Clinicians who currently treat this disease declare it to be more devastating than HIV/AIDS. A comparison of the histories of the two diseases, an examination of the current status of the two diseases, and a listing of the accomplishments that would be needed for ME/CFS to achieve the same level of treatment and care as currently experienced by patients with HIV/AIDS is provided.

Source: Friedman KJ. Advances in ME/CFS: Past, Present, and Future. Front Pediatr. 2019 Apr 18;7:131. doi: 10.3389/fped.2019.00131. eCollection 2019. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6482157/ (Full article)

History of Researches on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

Abstract:

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a disease characterized by chronic, profound, disabling, and unexplained fatigue. The first patient with ME/CFS in Japan was identified and described in 1990 by Prof. Teruo Kitani and Dr. Hirohiko Kuratsune of the Research Institute for Microbial Diseases, Osaka University. Since then, a variety of studies have been performed to determine the objective biomarkers of the disease. Although it is hypothesized that brain inflammation is involved in the pathophysiology of ME/CFS, there is to date no direct evidence of neuroinflammation in patients with ME/CFS. Our recent positron emission tomography study successfully demonstrated that microglial activation, which is linked to neuroinflammation, occurs in widespread brain areas in patients with ME/CFS, and is associated with the severity of the neuropsychological symptoms. Thus, evaluation of neuroinflammation in patients with ME/CFS may be essential for understanding the core pathophysiology of the disease, and for developing objective diagnostic criteria and effective medical treatments for ME/CFS. Here, we describe disease-related pathophysiological findings and topics, and discuss the history of the diagnostic and therapeutic attempts based on previous findings in Japan.

Source: Watanabe Y, Kuratsune H. History of Researches on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Brain Nerve. 2018 Jan;70(1):5-9. doi: 10.11477/mf.1416200943. [Article in Japanese] https://www.ncbi.nlm.nih.gov/pubmed/29348369