Immune system involvement

She showed a chart presenting the two different immune response processes (or cascades) that occur following various infections.

The chart showed that the immune sys­tem has two subsystems: TH-l and TH-2. Each is designed to activate according to the type of microorganism or antigen involved. The TH-2 system responds particularly against bacteria and parasites. The system's cytokine patterns activate B-cells to make antibodies. However, if there are too many B-cells, then autoantibodies may be produced, that can trigger autoimmune diseases, or profound allergic reactions. The inflammatory cytokines, such as IL-10 linked to the TH-2 response, are found to be closely linked to ME/CFS.

In ME/CFS the immune response appears to be shifted improperly and persistently to the TH-2 system. The TH-l pattern produces Natural Killer (NK) cells and cytotoxic T-cells that help to clear viruses. The TH-l system is not function­ing well. One form of therapy would be to try to shift the overworking TH-2 response to an improved TH-l response. Dr. Klimas is exploring treatments that would accomplish this shift.

Immune system dysregulation

The evidence, according to Dr. Klimas, is substantial and irrefutable. Hundreds of scientific articles have been published, nationally and internationally, confirming evidence of immune activation, natural killer cell dysfunction, TH-2 cytokine patterns, and the poor functioning of the TH-l system.

Dr. Klimas summarized some of the evidence.

1. Immune dysregulation in ME/CFS:

A. Up-regulation of macrophages

B. CD-4 cell activation, CD-8 activation

C. TH-2 shift, B-cell derived illness (allergy)

D. TH-l-dependent poor function, NK-cell dysfunction

E.  Pro-inflammatory cytokine release

2. Evidence of chronic immune activation

A. Activation markers on cells

B Products of activated cells (cytokines, etc.)

C. Enzyme systems of up-regulation (e.g., interferon, 2,5a-RNaseL activity)

D. Messenger RNA up-regulation of cell products (cytokines)

Dr. Klimas particularly noted the dramatic up-regulation of the anti-viral enzyme systems. The work of Dr. Suhadolnik on the 2,5a-RNaseL pathway in ME/CFS has shown that the cells and the enzymes are so activated that the reaction, instead of taking 1-2 minutes to digest a viral protein, occurs almost instantly, in as few as 3 seconds.

Dr. Klimas praised Dr. Suhadolnik's research. His Ampligen research findings have been confirmed by four other studies. And not only has he been able to discover enzyme system diagnostic markers for ME/CFS, he has even been able to correlate these markers to the severity of illness. Dr. Suhadolnik included other illness subgroups in his research, but found that ME/CFS subjects have the highest level of activation in the antiviral RNaseL pathway ever reported in the medical literature. Fortunately, he has recently received NIH research funding to continue his groundbreaking work.