The Enterovirus Theory of Disease Etiology in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Critical Review
- PMID: 34222292
- PMCID: PMC8253308
- DOI: 10.3389/fmed.2021.688486
The Enterovirus Theory of Disease Etiology in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Critical Review
Abstract
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a complex, multi-system disease whose etiological basis has not been established. Enteroviruses (EVs) as a cause of ME/CFS have sometimes been proposed, as they are known agents of acute respiratory and gastrointestinal infections that may persist in secondary infection sites, including the central nervous system, muscle, and heart. To date, the body of research that has investigated enterovirus infections in relation to ME/CFS supports an increased prevalence of chronic or persistent enteroviral infections in ME/CFS patient cohorts than in healthy individuals. Nevertheless, inconsistent results have fueled a decline in related studies over the past two decades. This review covers the aspects of ME/CFS pathophysiology that are consistent with a chronic enterovirus infection and critically reviews methodologies and approaches used in past EV-related ME/CFS studies. We describe the prior sample types that were interrogated, the methods used and the limitations to the approaches that were chosen. We conclude that there is considerable evidence that prior outbreaks of ME/CFS were caused by one or more enterovirus groups. Furthermore, we find that the methods used in prior studies were inadequate to rule out the presence of chronic enteroviral infections in individuals with ME/CFS. Given the possibility that such infections could be contributing to morbidity and preventing recovery, further studies of appropriate biological samples with the latest molecular methods are urgently needed.
Keywords: RT-PCR; cell culture; chronic fatigue syndrome; chronic infection; enterovirus; immunohistochemistry; myalgic encephalomyelitis; serology.
Copyright © 2021 O'Neal and Hanson.
Conflict of interest statement
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Figures
Similar articles
-
Acute enterovirus infection followed by myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and viral persistence.J Clin Pathol. 2010 Feb;63(2):165-8. doi: 10.1136/jcp.2009.070466. Epub 2009 Oct 14. J Clin Pathol. 2010. PMID: 19828908
-
Circulating extracellular vesicles as potential biomarkers in chronic fatigue syndrome/myalgic encephalomyelitis: an exploratory pilot study.J Extracell Vesicles. 2018 Mar 22;7(1):1453730. doi: 10.1080/20013078.2018.1453730. eCollection 2018. J Extracell Vesicles. 2018. PMID: 29696075 Free PMC article.
-
The persistent viral infections in the development and severity of myalgic encephalomyelitis/chronic fatigue syndrome.J Transl Med. 2023 Jan 18;21(1):33. doi: 10.1186/s12967-023-03887-0. J Transl Med. 2023. PMID: 36653846 Free PMC article.
-
A systematic review of metabolomic dysregulation in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis/Systemic Exertion Intolerance Disease (CFS/ME/SEID).J Transl Med. 2020 May 13;18(1):198. doi: 10.1186/s12967-020-02356-2. J Transl Med. 2020. PMID: 32404171 Free PMC article. Review.
-
Surveying the Metabolic and Dysfunctional Profiles of T Cells and NK Cells in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.Int J Mol Sci. 2023 Jul 26;24(15):11937. doi: 10.3390/ijms241511937. Int J Mol Sci. 2023. PMID: 37569313 Free PMC article. Review.
Cited by
-
Molecular Amplification and Cell Culturing Efficiency for Enteroviruses' Detection in Cerebrospinal Fluids of Algerian Patients Suffering from Meningitis.Viruses. 2024 Jan 23;16(2):170. doi: 10.3390/v16020170. Viruses. 2024. PMID: 38399946 Free PMC article.
-
How does post COVID differ from other post-viral conditions in childhood and adolescence (0-20 years old)? A systematic review.EClinicalMedicine. 2024 Feb 2;68:102436. doi: 10.1016/j.eclinm.2024.102436. eCollection 2024 Feb. EClinicalMedicine. 2024. PMID: 38333536 Free PMC article.
-
Identification of CD8 T-cell dysfunction associated with symptoms in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and Long COVID and treatment with a nebulized antioxidant/anti-pathogen agent in a retrospective case series.Brain Behav Immun Health. 2023 Dec 27;36:100720. doi: 10.1016/j.bbih.2023.100720. eCollection 2024 Mar. Brain Behav Immun Health. 2023. PMID: 38327880 Free PMC article.
-
Single-cell transcriptomics of the immune system in ME/CFS at baseline and following symptom provocation.Cell Rep Med. 2024 Jan 16;5(1):101373. doi: 10.1016/j.xcrm.2023.101373. Cell Rep Med. 2024. PMID: 38232699 Free PMC article.
-
Epstein-Barr virus-acquired immunodeficiency in myalgic encephalomyelitis-Is it present in long COVID?J Transl Med. 2023 Sep 17;21(1):633. doi: 10.1186/s12967-023-04515-7. J Transl Med. 2023. PMID: 37718435 Free PMC article. Review.
References
-
- Hyde B. Understanding Myalgic Encephalomyelitis. Ottawa, Canada: Nightingale Press; (2020) 315 p.
Publication types
Grants and funding
LinkOut - more resources
Full Text Sources
Miscellaneous