ME/CFS in the Department of Medicine

Background

The study of infection-associated chronic diseases is a relatively new field, and more research is needed. Examples of infection-associated chronic diseases include Chronic Fatigue Syndrome (CFS) and Chronic Lyme Disease (CLD).  CFS and CLD overlap in many aspects; they are multi-system and complex diseases with potentially devastating physical and cognitive symptoms. These diseases can significantly impair the lives of patients and result in substantial reductions in previous levels of occupational, educational, social, or personal activities.  A broad spectrum, innovative approach to discovery surrounding these debilitating diseases is paramount and a priority at Stanford.

It is common for physicians in the United States to take a skeptical position towards these patients’ symptoms, and this skepticism is unfortunately enhanced because most (if not all) results of conventional laboratory and radiological tests are normal.

At Stanford the group of Jose G. Montoya, MD, associate professor of medicine in the division of infectious diseases, has taken the approach of exploring whether infection can be a trigger for these patients’ ailments. Five years ago we postulated that infection, or the body’s immune response to it, can play an etiologic role in CFS, CLD, and other chronic illnesses. We also hypothesized that prolonged and specific antimicrobial interventions could result in partial or complete reversal of patients’ symptoms. Since then, we have been able to successfully identify several subgroups of patients whose lives have been dramatically changed with our approach.1 It is important to emphasize, however, that our approach does not work in all patients. Our hypothesis related to infection has been reinvigorated by the recent publications on the possible association of a relatively unknown infectious agent and CFS, namely the xenotropic murine leukemia virus-related virus (XMRV). 2,3,4,5,6,7

We hope to see our work change the lives of patients suffering from CFS, CLD, and other chronic diseases.  We hope to identify biomarkers and other tests that can be diagnostic of these diseases so that appropriate and specific treatments can finally take place to end these patients’ ailments. We aim to see one day that these patients will be validated by their health care providers and be fully integrated back into mainstream medicine.

Our initiative aims to mobilize and integrate Stanford’s best faculty and resources towards our mission and goals.  We have been fortunate to receive the support of the Department of Medicine, and hope to invite the participation of faculty and researchers from many different areas.

We have assembled a world-class research team, who will work to identify the connection between these patients’ symptoms and infection or immune dysfunction.


CITATIONS:

1 Kogelnik et al. “Use of valganciclovir in patients with elevated antibody titers against Human Herpesvirus-6 (HHV-6) and Epstein-Barr Virus (EBV) who were experiencing central nervous system dysfunction including long-standing fatigue.” J Clin Virol. 2006 Dec; 37 Suppl 1: S33-8.

2 Lombardi et al. “Detection of an infectious retrovirus, XMRV, in blood cells of patients with chronic fatigue syndrome.” Science. 2009 Oct 23;326(5952):585-9. Epub 2009 Oct 8.

3 Erlwein O et al. “Failure to detect the novel retrovirus XMRV in chronic fatigue syndrome.” PLoS One. 2010 Jan 6;5(1):e8519.

4 Groom HC et al. “Absence of xenotropic murine leukaemia virus-related virus in UK patients with chronic fatigue syndrome.” Retrovirology. 2010 Feb 15;7:10.

5 Van Kuppeveld FJM et al. “Prevalence of xenotropic murine leukaemia virus-related virus in patients with chronic fatigue syndrome in the Netherlands: retrospective analysis of samples from an established cohort.” BMJ 2010 Feb 25;340:c1018

6 Switzer et al. “Absence of evidence of Xentropic Murine Leukemia Virus-related virus infection in persons with Chronic Fatigue Syndrome and healthy controls in the United States.” Retrovirology. 2010 Jul 1;7(1):57. [Epub ahead of print]

7 Lo SC et al. “Detection of MLV-related virus gene sequences in blood of patients with chronic fatigue syndrome and healthy blood donors.” Proc Natl Acad Sci U S A. 2010 Sep 7;107(36):15874-9. Epub 2010 Aug 23.

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