AIDS and CFS/ME: a tale of two syndromes

Pinching, Anthony J.

doi:10.7861/clinmedicine.3-1-78

Cited by 5 publications

(5 citation statements)

References 9 publications

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“…Access to CFS/ME specialist assessment throughout the UK is variable [ 16 , 17 ]. The five CFS/ME teams contributing data to this study represent areas of the country that currently have higher levels of access.…”

Section: Methodsmentioning

confidence: 99%

“…Access to these services throughout the UK is variable [16,17], and the proportion of people with CFS/ME who are referred to specialist services is unknown. Amongst those who are referred to a specialist service, the impact of their illness on employment and income has not been quantified.…”

Section: Introductionmentioning

confidence: 99%

“…In the UK, specialist CFS/ME clinical teams provide a range of treatments according to National Institute for Health and Clinical Excellence (NICE) guidelines [ 3 ]. Access to these services throughout the UK is variable [ 16 , 17 ], and the proportion of people with CFS/ME who are referred to specialist services is unknown. Amongst those who are referred to a specialist service, the impact of their illness on employment and income has not been quantified.…”

Section: Introductionmentioning

confidence: 99%

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The impact of CFS/ME on employment and productivity in the UK: a cross-sectional study based on the CFS/ME national outcomes database

Collin

Crawley

May³

et al. 2011

BMC Health Serv Res

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BackgroundFew studies have investigated factors associated with discontinuation of employment in patients with CFS/ME or quantified its impact on productivity.MethodsWe used patient-level data from five NHS CFS/ME services during the period 01/04/2006-31/03/2010 collated in the UK CFS/ME National Outcomes Database. We used logistic regression to identify factors associated with discontinuation of employment. We estimated UK-wide productivity costs using patient-level data on duration of illness before assessment by a CFS/ME service, duration of unemployment, age, sex and numbers of patients, in conjunction with Office for National Statistics income and population data.ResultsData were available for 2,170 patients, of whom 1,669 (76.9%) were women. Current employment status was recorded for 1,991 patients (91.8%), of whom 811 patients (40.7%) were currently employed and 998 (50.1%) had discontinued their employment "because of fatigue-related symptoms". Older age, male sex, disability, fatigue, pain, and duration of illness were associated with cessation of employment. In a multivariable model, age, male sex, and disability remained as independent predictors. Total productivity costs among the 2,170 patients due to discontinuation of employment in the years preceding assessment by a specialist CFS/ME service (median duration of illness = 36 months) were £49.2 million. Our sample was equivalent to 4,424 UK adults accessing specialist services each year, representing productivity costs to the UK economy of £102.2 million. Sensitivity analyses suggested a range between £75.5-£128.9 million.ConclusionsCFS/ME incurs huge productivity costs amongst the small fraction of adults with CFS/ME who access specialist services.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The impact of CFS/ME on employment and productivity in the UK: a cross-sectional study based on the CFS/ME national outcomes database

Collin

Crawley

May³

et al. 2011

BMC Health Serv Res

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“…The concept of microbial translocation as a key mechanism of chronic systemic immune activation, and disease was studied extensively in the HIV infection, a condition associated with chronic fatigue and increased prevalence of ME/CFS [294,295]. COVID-19, like HIV, causes intestinal barrier disruption, impaired efferocytosis, and accumulation of senescent, apoptotic, and necrotic cells that were previously associated with dysfunctional immune responses [296,297].…”

Section: Discussionmentioning

confidence: 99%

Long COVID and the Neuroendocrinology of Microbial Translocation Outside the GI Tract: Some Treatment Strategies

Sfera

Osorio

Hazan³

et al. 2022

Endocrines

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Similar to previous pandemics, COVID-19 has been succeeded by well-documented post-infectious sequelae, including chronic fatigue, cough, shortness of breath, myalgia, and concentration difficulties, which may last 5 to 12 weeks or longer after the acute phase of illness. Both the psychological stress of SARS-CoV-2 infection and being diagnosed with COVID-19 can upregulate cortisol, a stress hormone that disrupts the efferocytosis effectors, macrophages, and natural killer cells, leading to the excessive accumulation of senescent cells and disruption of biological barriers. This has been well-established in cancer patients who often experience unrelenting fatigue as well as gut and blood–brain barrier dysfunction upon treatment with senescence-inducing radiation or chemotherapy. In our previous research from 2020 and 2021, we linked COVID-19 to myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) via angiotensin II upregulation, premature endothelial senescence, intestinal barrier dysfunction, and microbial translocation from the gastrointestinal tract into the systemic circulation. In 2021 and 2022, these hypotheses were validated and SARS-CoV-2-induced cellular senescence as well as microbial translocation were documented in both acute SARS-CoV-2 infection, long COVID, and ME/CFS, connecting intestinal barrier dysfunction to disabling fatigue and specific infectious events. The purpose of this narrative review is to summarize what is currently known about host immune responses to translocated gut microbes and how these responses relate to fatiguing illnesses, including long COVID. To accomplish this goal, we examine the role of intestinal and blood–brain barriers in long COVID and other illnesses typified by chronic fatigue, with a special emphasis on commensal microbes functioning as viral reservoirs. Furthermore, we discuss the role of SARS-CoV-2/Mycoplasma coinfection in dysfunctional efferocytosis, emphasizing some potential novel treatment strategies, including the use of senotherapeutic drugs, HMGB1 inhibitors, Toll-like receptor 4 (TLR4) blockers, and membrane lipid replacement.

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“…Professor Pinching observes that biomedical solutions 'provide some anchorage against shifting constructs of illness, of which perhaps CFS/ME is one of the most evident current exemplars' . 4 Thus, whilst perceptions of AIDS have completely changed, medical and social issues around CFS/ME remain unresolved leaving its status unchanged. Similar considerations have applied to other conditions such as Gulf War Syndrome or the association between MMR and autism.…”

Section: Changing Perceptions Of Diseasementioning

confidence: 99%

From the Editor

Watkins¹

2003

Clinical Medicine

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AIDS and CFS/ME: a tale of two syndromes

Cited by 5 publications

References 9 publications

The impact of CFS/ME on employment and productivity in the UK: a cross-sectional study based on the CFS/ME national outcomes database

The impact of CFS/ME on employment and productivity in the UK: a cross-sectional study based on the CFS/ME national outcomes database

Long COVID and the Neuroendocrinology of Microbial Translocation Outside the GI Tract: Some Treatment Strategies

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