Ten Discoveries
about the Biologyof CFS
12Chronic fatigue syndrome is not a form ofdepression, and many patients with CFS haveno diagnosable psychiatric disorder. As withmost chronic illnesses, some CFS patients
become depressed because of the impact of
the illness on their lives, but most studies findthat the majority haven’t experienced depression before the onset of illness.
There’s a state of chronic, low-grade immune
activation in CFS. There is evidence of activated T cells, activation of genes reflecting
immune activation and increased levels ofimmune system chemicals called cytokines.

3There’s substantial evidence of poorly functioning natural killer (NK) cells—white bloodcells important in fighting viral infections.
Studies differ as to whether there may be
increased numbers of NK cells in CFSpatients.

4Abnormalities in the white matter of thebrain have been found in CFS patients using
magnetic resonance imaging (MRI) scans.
Typically, these are small (fraction of an inch)
areas just below the cerebral cortex, theoutermost area of the brain hemispheres.
Differences in gray matter volume are alsobeing observed.

5

Abnormalities in brain metabolism, as indicated by single photon emission computed
tomography (SPECT) and positron emission
tomography (PET), have been discovered.
Other research suggests there’s something
wrong with energy metabolism and theoxidative electron transport chain in the
mitochondria of CFS patients.

6

CFS patients experience abnormalities in
multiple neuroendocrine systems in thebrain, particularly depression of the
hypothalamic-pituitary-adrenal (HPA) axis,
but also the hypothalamic-prolactin axis
and hypothamalmic-growth hormone axis.

7Cognitive impairment is common in CFS
patients. The most frequently documented
abnormalities are difficulty with information
processing, memory and/or attention.

8

Abnormalities of the autonomic nervous
system have been found by numerous independent researchers. These include a failureof the body to maintain blood pressure after
a person stands up, abnormal responses of
the heart rate to standing and unusual poolingof blood in the veins of the legs. Some studies
also find low levels of blood volume.

9

CFS patients have disordered expression ofgenes that are important in energy metabolism. Energy comes from certain naturalchemicals that are processed by enzymes
inside each cell. These enzymes are controlledby specific genes. Other genomic research isrevealing involvement of genes connected toHPA axis activity, the sympathetic nervous
system and immune function.

10

There’s evidence of more frequent latentactive infection with various herpesviruses
and enteroviruses. The herpesviruses include
Epstein Barr, HHV-6 and cytomegalovirus.
Other infectious agents, like bacterium thatcause Lyme disease, Ross River virus andQ fever, can also trigger CFS.

The above summary of CFS research findings was provided by Anthony Komaroff, MD,a professor of medicine at Harvard Medical School, senior physician at Brigham and Women’s
Hospital in Boston and the editor-in chief of Harvard Health Publications. Dr. Komaroff has an
ongoing research program on chronic fatigue syndrome and has published over 230 research
articles and book chapters.

THE CFIDS ASSOCIATION OF AMERICA

www.cfids.org