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The new research suggests that these infections throw a wrench in the immune system's ability to quiet itself after the acute infection, to return to a homeostatic balance; the immune response becomes like a car stuck in high gear."It appears that ME/CFS patients are flush with cytokines until around the three-year mark, at which point the immune system shows evidence of exhaustion and cytokine levels drop," says Dr. "Early diagnosis may provide unique opportunities for treatment that likely differ from those that would be appropriate in later phases of the illness." The investigators went to great lengths to carefully screen participants to make sure they had the disease.They found specific patterns in patients who had the disease three years or less that were not present in controls or in patients who had the disease for more than three years.Short duration patients had increased amounts of many different types of immune molecules called cytokines.No drugs have been approved for ME/CFS, but Burmeister has found partial relief in recent years with twice-weekly infusions of the drug Ampligen, an unapproved immunomodulator that she can only obtain through an experimental treatment protocol.She blogs extensively about her illness and in 2012 testified before a Food and Drug Administration panel considering whether to recommend approval for Ampligen.Researchers have identified distinct immune changes in patients diagnosed with chronic fatigue syndrome, known medically as myalgic encephalomyelitis or systemic exertion intolerance disease.The findings could help improve diagnosis and identify treatment options for the disabling disorder, in which symptoms range from extreme fatigue and difficulty concentrating to headaches and muscle pain.
Hornig and colleagues hope to replicate the current, cross-sectional results in a longitudinal study that follows patients for a year to see how cytokine levels, including interleukin-17A, differ within individual patients over time, depending on how long they have had the disease.The association was unusually strong with a cytokine called interferon gamma that has been linked to the fatigue that follows many viral infections, including Epstein-Barr virus (the cause of infectious mononucleosis).Cytokine levels were not explained by symptom severity.(The panel voted 8-5 against it, citing insufficient safety and efficacy data.) In recent months, her blog has doggedly tracked the creation of a new, federally commissioned panel charged with reviewing and updating the diagnostic criteria for the disease. 27, Burmeister plans to tell the members of the panel why she thinks their project stinks.The Department of Health and Human Services announced in September that it had requested the Institute of Medicine, an independent, highly regarded affiliate of the National Academy of Sciences, to conduct the study. Few would claim that describing an illness with enough accuracy for clinicians to recognize it and treat it effectively is simple.