This last week there has been much news about CFS and markers, “Columbia University’s Mailman School of Public Health, looked at 51 proteins, also known as cytokines, released by cells involved in the immune system. Among 646 patients studied, including CFS patients and healthy controls, people who were ill for three years or less had higher protein levels than the others, the researchers found.” Wall Street Journal To me this is just confirmation of a pattern that I have seen reported in related diseases where fatigue persisted after a technical recovery. The typical onset scenario consists of two items: a probable viral infection with stress. This is not only true for CFS but for many co-morbid conditions such as:
- Rheumatic diseases
- Irritable Bowel Syndrome
- 3-36% of enteric infections result in IBS
Going through a series of studies that looked at fatigue after a severe stomach infection, I derived the table below.
|Recover Period||Percentage Remaining that Recover||Patients remaining|
|6 – 12 Months||~ 50%||~ 14%|
|12 – 24 Months (2 yrs)||~ 50%||>~7%|
|24 – 48 Months (4 yrs)||? 50%>||~4%|
|48 96 Months (8 yrs)||
|96-192 Months (16 yrs)||? 50%||~1%|
My take of the mechanism is that infection setups a gut alteration that keeps triggering production of cytokines. The alteration was an appropriate response when the infection occurred. The normal gut flora did not suppress it after the infection was take care of. Recently I had a bug, and after I recovered from it, I found that my psoriasis flared and I had post-infection signs of inflammation. My wife reminded me of a reader reporting that her psoriasis disappeared like magic from taking the probiotic Align (which she tried after I posted about it). I took it, and hit the probiotics hard for 2 weeks (almost all of them were bifidobacterium) and these post-infection symptoms faded. This is echoed in some recent studies:
- Influenza A Virus Infection of Intestinal Epithelial Cells Enhances the Adhesion Ability of Crohn’s Disease Associated Escherichia coli Strains
- Production of immune response mediators by HT-29 intestinal cell-lines in the presence of Bifidobacterium-treated infant microbiota.
- Immunostimulatory effect of faecal Bifidobacterium species of breast-fed and formula-fed infants in a peripheral blood mononuclear cell/Caco-2 co-culture system. 
- “a probiotic strain, Bifidobacterium longum BB536, alleviates symptoms and affects blood parameters in individuals with Japanese cedar pollinosis (JCPsis) during the pollen season.”
- “various isolates of lactobacilli differentially induces the expression of interleukin 10, interferon-gamma and transforming growth factor beta”  – i.e. some lactobacillus (typical yogurt bacteria) increases interferon-gamma making things worst!
Doing a PubMed search for the main cytokine reference and microbiome found over 120 articles.