PATHOGENIC TRACKS IN FATIGUE SYNDROMES

Citation
M. Moutschen et al., PATHOGENIC TRACKS IN FATIGUE SYNDROMES, Acta Clinica Belgica, 49(6), 1994, pp. 274-289
Citations number
NO
Categorie Soggetti
Medicine, General & Internal
Journal title
ISSN journal
00015512
Volume
49
Issue
6
Year of publication
1994
Pages
274 - 289
Database
ISI
SICI code
0001-5512(1994)49:6<274:PTIFS>2.0.ZU;2-T
Abstract
This review analyses the recent literature devoted to two related fati gue syndromes: chronic fatigue syndrome (CFS) and acute onset postvira l fatigue syndrome (PVFS). The articles are grouped into five pathogen ic tracks: infectious agents, immune system, skeletic muscle, hypothal amo-pituitary-adrenal (HPA) axis and psychiatric factors. Although a p articular infectious agent is unlikely to be responsible for all CFS c ases, evidence is shown that host-parasite relationships are modified in a large proportion of patients with chronic fatigue, Antibody titre s against infectious agents are often elevated and replication of seve ral viruses could be increased. Chronic activation of the immune syste m is also observed and could be due to the reactivation of persistent br latent infectious agents such as heroes viruses (i.e. HHV-6) or ent eroviruses. It could also be favorised by an impaired negative feedbac k of the HPA axis on the immune system, A model is proposed where the abnormalities of the HPA axis are primary events and are mainly respon sible for a chronic activation of the immune system which in turn indu ces an increased replication of several viruses under the control of c ellular transcription factors, These replicating viruses together with cytokines such as TNF-alpha would secondarily induce functional disor ders of muscle and several aspects of asthenia itself.