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Scientists have discovered a potential retroviral link to chronic fatigue syndrome, known
as CFS, a debilitating disease that affects millions of people in the United States.
Researchers from the Whittemore Peterson Institute (WPI), located at the University of
Nevada, Reno, the National Cancer Institute (NCI), part of the National Institutes of
Health, and the Cleveland Clinic, report this finding online in the Oct. 8, 2009, issue of
Science ("Detection of an Infectious Retrovirus, XMRV, in Blood Cells of Patients with
Chronic Fatigue Syndrome").
"We now have evidence that a retrovirus named XMRV is frequently present in the blood of
patients with CFS. This discovery could be a major step in the discovery of vital
treatment options for millions of patients," said Judy Mikovits, PhD, director of research
for WPI and leader of the team that discovered this association.
Researchers cautioned, however, that this finding shows there is an association between
XMRV and CFS but does not prove that XMRV causes CFS.
The scientists provide a new hypothesis for a retrovirus link with CFS. The virus, XMRV,
was first identified by Robert H. Silverman, PhD, professor in the Department of Cancer
Biology at the Cleveland Clinic Lerner Research Institute, in men who had a specific
immune system defect that reduced their ability to fight viral infections.
"The discovery of XMRV in two major diseases, prostate cancer and now chronic fatigue
syndrome, is very exciting. If cause-and-effect is established, there would be a new
opportunity for prevention and treatment of these diseases," said Silverman, a co-author
on the CFS paper.
Commonality of an immune system defect in patients with CFS and prostate cancer led
researchers to look for the virus in their blood samples.
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In this study, WPI scientists identified XMRV in the blood of 68 of 101 (67 percent) of
CFS patients.
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In contrast, they found that eight of 218 healthy people (3.7 percent) contained XMRV DNA.
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The research team not only found that blood cells contained XMRV but also expressed XMRV
proteins at high levels and produced infectious viral particles.
A clinically validated test to detect XMRV antibodies in patients' plasma is currently
under development.
These results were also supported by the observation of retrovirus particles in patient
samples when examined using transmission electron microscopy. The data demonstrate the
first direct isolation of infectious XMRV from humans.
"These compelling data allow the development of a hypothesis concerning a cause of this
complex and misunderstood disease, since retroviruses are a known cause of
neurodegenerative diseases and cancer in man," said Francis Ruscetti, PhD, Laboratory of
Experimental Immunology, NCI.
Retroviruses like XMRV have also been shown to activate a number of other latent
viruses. This could explain why so many different viruses, such as Epstein-Barr virus,
which was causally linked to Burkitt's and other lymphomas in the 1970s, have been
associated with CFS. It is important to note that retroviruses, like XMRV, are not
airborne.
"The scientific evidence that a retrovirus is implicated in CFS opens a new world of
possibilities for so many people," said Annette Whittemore, founder and president of WPI
and mother of a CFS patient. "Scientists can now begin the important work of translating
this discovery into medical care for individuals with XMRV related diseases."
Dan Peterson, MD, medical director of WPI added, "Patients with CFS deal with a myriad of
health issues as their quality of life declines. I'm excited about the possibility of
providing patients, who are positive for XMRV, a definitive diagnosis, and hopefully very
soon, a range of effective treatment options."
The Whittemore Peterson Institute for Neuro Immune Disease exists to bring discovery,
knowledge, and effective treatments to patients with illnesses that are caused by acquired
dysregulation of both the immune system and the nervous system, often resulting in
lifelong disease and disability. (www.wpinstitute.org).
The Lerner Research Institute is home to Cleveland Clinic's laboratory, translational and
clinical research. Its mission: to promote human health by investigating in the laboratory
and the clinic the causes of disease and discovering novel approaches to prevention and
treatments; to train the next generation of biomedical researchers; and to foster
productive collaborations with those providing clinical care. More than 1,200 people in 11
departments work in research programs focusing on cardiovascular, cancer, neurologic,
musculoskeletal, allergic and immunologic, eye, metabolic, and infectious disease. The
Institute also is an integral part of the Cleveland Clinic Lerner College of Medicine of
Case Western Reserve University.
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