The putative role of viruses, bacteria, and chronic fungal biotoxin exposure in the genesis of intractable fatigue accompanied by cognitive and physical disability

Morris, Gerwyn, Berk, Michael, Walder, Ken and Maes, Michael 2015, The putative role of viruses, bacteria, and chronic fungal biotoxin exposure in the genesis of intractable fatigue accompanied by cognitive and physical disability, Molecular neurobiology, vol. 53, no. 4, pp. 2550-2571, doi: 10.1007/s12035-015-9262-7.

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Title The putative role of viruses, bacteria, and chronic fungal biotoxin exposure in the genesis of intractable fatigue accompanied by cognitive and physical disability
Author(s) Morris, Gerwyn
Berk, MichaelORCID iD for Berk, Michael orcid.org/0000-0002-5554-6946
Walder, KenORCID iD for Walder, Ken orcid.org/0000-0002-6758-4763
Maes, Michael
Journal name Molecular neurobiology
Volume number 53
Issue number 4
Start page 2550
End page 2571
Total pages 22
Publisher Humana Press
Place of publication Clifton, N.J.
Publication date 2015-06-17
ISSN 1559-1182
Keyword(s) Chronic fatigue syndrome
Cognition
Depression
Immune
Inflammation
Neurology
Oxidative stress
Psychiatry
Toll-like receptor
Summary Patients who present with severe intractable apparently idiopathic fatigue accompanied by profound physical and or cognitive disability present a significant therapeutic challenge. The effect of psychological counseling is limited, with significant but very slight improvements in psychometric measures of fatigue and disability but no improvement on scientific measures of physical impairment compared to controls. Similarly, exercise regimes either produce significant, but practically unimportant, benefit or provoke symptom exacerbation. Many such patients are afforded the exclusionary, non-specific diagnosis of chronic fatigue syndrome if rudimentary testing fails to discover the cause of their symptoms. More sophisticated investigations often reveal the presence of a range of pathogens capable of establishing life-long infections with sophisticated immune evasion strategies, including Parvoviruses, HHV6, variants of Epstein-Barr, Cytomegalovirus, Mycoplasma, and Borrelia burgdorferi. Other patients have a history of chronic fungal or other biotoxin exposure. Herein, we explain the epigenetic factors that may render such individuals susceptible to the chronic pathology induced by such agents, how such agents induce pathology, and, indeed, how such pathology can persist and even amplify even when infections have cleared or when biotoxin exposure has ceased. The presence of active, reactivated, or even latent Herpes virus could be a potential source of intractable fatigue accompanied by profound physical and or cognitive disability in some patients, and the same may be true of persistent Parvovirus B12 and mycoplasma infection. A history of chronic mold exposure is a feasible explanation for such symptoms, as is the presence of B. burgdorferi. The complex tropism, life cycles, genetic variability, and low titer of many of these pathogens makes their detection in blood a challenge. Examination of lymphoid tissue or CSF in such circumstances may be warranted.
Language eng
DOI 10.1007/s12035-015-9262-7
Field of Research 110899 Medical Microbiology not elsewhere classified
Socio Economic Objective 920111 Nervous System and Disorders
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2015, Humana Press
Persistent URL http://hdl.handle.net/10536/DRO/DU:30074310

Document type: Journal Article
Collection: School of Medicine
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