The Enterovirus Theory of Disease Etiology in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Critical Review.
The Enterovirus Theory of Disease Etiology in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Critical Review.
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DOI：
10.3389/fmed.2021.688486
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发表时间：
2021
影响因子：
3.9
通讯作者：
Hanson MR
中科院分区：
文献类型：
--
作者：
O'Neal AJ;Hanson MR
肌痛性脑脊髓炎/慢性疲劳综合征(ME/CFS)是一种复杂、多系统的疾病，其病因学基础尚不明确。肠道病毒(EV)有时被认为是ME/CFS的原因，因为它们是已知的急性呼吸道和胃肠道感染的病原体，可能持续在继发性感染部位，包括中枢神经系统、肌肉和心脏。到目前为止，调查与ME/CFS相关的肠道病毒感染的研究机构支持ME/CFS患者队列中慢性或持续性肠道病毒感染的流行率高于健康人。然而，在过去的二十年里，不一致的结果导致了相关研究的下降。这篇综述涵盖了与慢性肠道病毒感染相一致的ME/CFS病理生理学方面，并对过去EV相关ME/CFS研究中使用的方法和途径进行了严格的综述。我们描述了之前被询问的样本类型、所使用的方法以及所选择的方法的局限性。我们的结论是，有相当多的证据表明，以前的ME/CFS暴发是由一个或多个肠道病毒群引起的。此外，我们发现先前研究中使用的方法不足以排除ME/CFS患者存在慢性肠道病毒感染。鉴于这种感染可能会导致发病率和预防康复，迫切需要利用最新的分子方法对适当的生物样本进行进一步研究。
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a complex, multi-system disease whose etiological basis has not been established. Enteroviruses (EVs) as a cause of ME/CFS have sometimes been proposed, as they are known agents of acute respiratory and gastrointestinal infections that may persist in secondary infection sites, including the central nervous system, muscle, and heart. To date, the body of research that has investigated enterovirus infections in relation to ME/CFS supports an increased prevalence of chronic or persistent enteroviral infections in ME/CFS patient cohorts than in healthy individuals. Nevertheless, inconsistent results have fueled a decline in related studies over the past two decades. This review covers the aspects of ME/CFS pathophysiology that are consistent with a chronic enterovirus infection and critically reviews methodologies and approaches used in past EV-related ME/CFS studies. We describe the prior sample types that were interrogated, the methods used and the limitations to the approaches that were chosen. We conclude that there is considerable evidence that prior outbreaks of ME/CFS were caused by one or more enterovirus groups. Furthermore, we find that the methods used in prior studies were inadequate to rule out the presence of chronic enteroviral infections in individuals with ME/CFS. Given the possibility that such infections could be contributing to morbidity and preventing recovery, further studies of appropriate biological samples with the latest molecular methods are urgently needed.