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Chronic Fatigue and the Mysterious XMRV Link
Everyone who suffers with this condition and the many thousands of practitioners involved in their health recovery are interested in whether there may be a causal agent identifiable through appropriate tests – not that there is a treatment on offer, but more a case of validation I suspect. This topic has attracted a great deal of attention in the orthodox and alternative medicine world and has some time to go before the explanations become viable treatments. Keeping up to speed with the science will assist all practitioners in their potential application.
The debate over XMRV began back in 2009 when researchers led by Judy Mikovits of the Whittemore Peterson Institute (WPI) for Neuro-Immune Disease in Reno, Nevada, reported in Science: traces of the virus in peripheral blood mononuclear cells, a type of white blood cell, of 67% of CFS patients. By contrast, only 3.4% of healthy controls were found to harbour the virus. The team also showed that XMRV could infect human cells and concluded that the virus—which had previously been linked to prostate cancer—might play a role in causing CFS.
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Healthy Food And Reasonable Body Weight Does Not Prevent Development Of Type 2 Diabetes!
I think we all accept that changes in insulin levels over time predispose people to the development of type II diabetes and that this is often accompanied by the central adiposity that distinguishes the metabolic syndrome morphology we have come to look for.
This study, published in PLOS One this year (2010), suggests that besides these clinical indications another slightly less obvious change to body mass affects insulin resistance and increases risk of diabetes.[1]
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Coeliac Disease 4 Times More Common Than Previously Thought
Examples of macroscopic features of villous atrophy detected by wireless capsule endoscopy in coeliac disease: A) Normal villi, B) scalloping of the mucosa on circular folds, C) fissuring of the mucosa, D) mosaic pattern. © Mayo Clinic
Researchers from the USA, Europe and other research centres are suggesting that Coeliac Disease has increased up to 4 x in the last 30 years.
They suggest that as much as 1% of the adult and child populations may have CD, and as we know there are many others that have yet to have the disease diagnosed, but experience problems with gluten and are diagnosed as being intolerant or sensitive.
Let’s be clear about what gluten intolerance is. ‘It isn’t a food allergy’. It’s a physical condition in your gut. Basically, undigested gluten proteins (prevalent in wheat and other grains) lurk around your intestines and are regarded by your body as a foreign invader, irritating your gut and flattening the essential microvilli along the small intestine wall. This reduces the surface area available to absorb the nutrients from your food. This can result in symptoms of malabsorption, including chronic fatigue, neurological disorders, nutrient deficiencies, anaemia, nausea, skin rashes, depression, and more.
Whilst there are better screening techniques today than there were in the 1980’s, we must also recognise that there are many other factors at work here, one of which is the changing levels of gluten in grains from hybridisation techniques.
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Genes, Viruses, Microbes and IBD
Crohn’s disease is common and miserable to suffer from, yet its actual cause is still under some debate as no clear understanding has yet been fully elucidated. It is known that there are some gene variations and that the environment has an impact. A paper out in Cell suggests, based on a mouse model that it may be a virus that makes the difference between health and inflammation. demonstrate that a viral infection, a toxic insult to the gut, commensal bacteria, and a Crohn’s disease susceptibility gene collude to cause inflammatory disease in the mouse gut.[1]
To be clear, Cadwell and co-workers are not arguing that Crohn’s disease is caused by infection with norovirus (as used in this study) or by any other single microbe. The environmental factors that predispose to and protect from Crohn’s disease remain uncertain, but the balance among commensal and pathogenic gut bacteria and viral infections is likely to be part of the story. These studies make an urgent and compelling case for characterising the human virome as well as the microbiome and defining its effects on physiology and gene expression. In addition, further explanations to help us to understand how the virome interacts with polymorphisms in the host genome and how numerous toxins in the environment alter this complex interplay will need to be unravelled.
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Folic Acid – What Dose is Safe?
The question over fortification and supplementation with the synthetic form – monoglutamate folic acid in isolation has been brought up in context international interest in food fortification and some confusion regarding supplement recommendations.
Folic acid supplementation, the synthetic form of folate has been thrown a curve ball in the last few years because of its apparent association with an increase in colorectal cancer. In particular three papers have been flagged up; the first is by Cole[1] and his colleagues and the second by Mason[2] and the third by Hirsch.[3]
The first paper describes the results of a randomised trial of folic acid in the prevention of colonic adenoma (a type of benign colon tumour that can become malignant), where the subjects had previously had adenomas removed. In this paper the results have been incorrectly interpreted. The study does not show that folic acid supplementation poses a cancer hazard, it relates to adenomas not carcinomas – the malignant form. The actual incidence of adenomas in those who were supplemented vs. those who were not are virtually identical in the following two 3-4 year follow ups. The relative risks were 1.04 (p=0.58) and 1.13 (p=0.23).
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Vitamin E Gains New Credibility
Vitamin E Treats Fatty Liver
The use of single nutrients for health management are often challenged due to lack of randomised controlled trials or small cohort size, or just general reluctance to regard these small molecules as anything other than a constituent of the mythical balanced diet.
There can be no denying that the increase in abdominal mass or obesity is not an imaginary event, even a cursory glance in your office or in the local town will identify significant differences in body mass. One of the consequences of this is the deposition of fats in the liver –an event referred to in simpler times as ‘fatty liver’ and now glorified with the name ‘non alcoholic steatohepatitis’ less comprehendible and definitely scarier.
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LGG Attenuates Barrier Permeability In The Gut
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Increased gut permeability as discussed in other posts has been linked with symptoms far from the gut and include depression, arthritis, diabetes and other conditions in which a pro inflammatory milieu is being maintained. Some immunologists now refer to this low grade inflammation as Para-Inflammation. Locally, the barrier defect can contribute to diahorrhea and chronic inflammatory bowel diseases.
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Is There A Rural/Urban Gradient In The Prevalence Of Eczema? A Systematic Review And What Can Be Done About It?
One in 10 schoolchildren in the western world suffers from eczema and even developing nations have also seen an increasing trend in the last few decades. There are many proposals to explain the increased incidence, one area of relevance is the environmental impact. Falling under the often misused ‘hygeine hypothesis’ title it has been proposed that there is a reflective difference in the gradient between rural and urban children. Implying the environmental impact on the developing immune system of children is different and therefore less protective in the urban setting.
This concept has now been studied in a recent article in the British Journal of Dermatology.[1] By conducting a Medline and Embase data base review studies that compared the incidence between the two environments were reviewed. Some 26 papers were assessed with 19 demonstrating a higher risk for eczema in an urbanised area, of these 11 were regarded as being statistically significant. A further 6 studies showed a lower risk of eczema in an urbanised area, of which just 1 was statistically significant.
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What Do Bacteria Do To Our Immune System?
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The germ theory that has so modernised medicine and driven us, the western world living human to regard all bugs as bad has been undergoing a dramatic rethink over the last few years. Firstly the recognition that your body is teeming with bacteria, providing a warm residence to approximately 10 times as many bacterial cells as human cells. Our mutual inhabitants live on skin, in the respiratory tract and throughout the digestive tract. Your digestive tract alone is home to between 1,000 and 40,000 bacterial species depending on your choice of journal.
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Has The Unravelling Of Human DNA Been A Disappointment?
In an allied review I have discussed the evolving role of epigenetics as the valued mechanism for explaining how gene expression rather than DNA change determines and mediates risk for complex health problems. In addition epigenetics helps to explain cross generational exposure transmission and why despite their being less than 1% variation in human DNA between individuals they can experience significant differences in health and function.
Great hopes were pinned on the discovery of our DNA yet as discussed in a related post we have less DNA than a grape and certainly less than was originally thought, just slightly more than a humble fruit fly in fact – so surely DNA cannot carry all of our aspirations and risk within that elegant double helix.
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