Attempts to evaluate the relative levels of enteroviral genomic and template RNA strands in small biopsy tissue samples from patients have yielded ambiguous data, largely due to the limited amount of RNA available. A novel semi-nested polymerase chain reaction (PCR) technique was developed to enable RNA levels to be examined more accurately. PCR products were visualised by horizontal agarose gel electrophoresis. This technique was demonstrated on linear single-stranded plasmid DNA; viral RNA isolated from a human rhabdomyosarcoma (RD) cell line persistently infected with a mutated coxsackie B5 virus (piRD) and two cell lines, RD and HEp2 cells, acutely infected with a wild-type clinical isolate of coxsackie B5 virus.

Letters1 June 1994Enterovirus in the Chronic Fatigue SyndromeFrances McGarry, BSc, John Gow, PhD, and Peter O. Behan, MDFrances McGarry, BScSouthern General Hospital; Glasgow G51 4TF; Scotland, John Gow, PhDSouthern General Hospital; Glasgow G51 4TF; Scotland, and Peter O. Behan, MDSouthern General Hospital; Glasgow G51 4TF; ScotlandAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-120-11-199406010-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The chronic fatigue syndrome is a recurring illness of unknown cause characterized by incapacitating fatigue and a range of symptoms and laboratory findings suggestive of hypothalamic dysfunction [1-3]. Rare patients who have died from other acute causes have had cellular infiltrates in the hypothalamus [4]. The syndrome usually follows a flu-like illness, and circumstantial evidence has implicated enteroviruses [1]. We therefore examined the central nervous system of a woman with the syndrome who died from suicide for the presence of enterovirus.In June 1992, a 30-year-old woman who had met all criteria for the syndrome for 5 ...References1. Bakheit AM, Behan PO, Watson WS, Morton JJ. Abnormal arginine-vasopressin secretion and water metabolism in patients with postviral fatigue syndrome. Acta Neurol Scand. 1993; 87:234-8. Google Scholar2. Bakheit AM, Behan PO, Dinan TG, Gray CE, O'Keane V. Possible upregulation of hypothalamic 5-HT receptors in patients with the postviral fatigue syndrome. Br Med J. 1992; 304:1010-2. Google Scholar3. Demitrak MA, Dale JK, Straus SE. Evidence for impaired activation of the hypothalamic-pituitary-adrenal axis in patients with chronic fatigue syndrome. J Clin Endocrinol Metab. 1991; 73:1224-34. Google Scholar4. Crowley N, Nelson M, Stouin S. Epidemiological aspects of an outbreak of encephalomyelitis at the Royal Free in the summer of 1955. J Hygiene. 1957; 55:116. Google Scholar Author, Article, and Disclosure InformationAffiliations: Southern General Hospital; Glasgow G51 4TF; Scotland PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByAutoimmune complications of COVID‐19Long COVID or Post-acute Sequelae of COVID-19 (PASC): An Overview of Biological Factors That May Contribute to Persistent SymptomsThe Enterovirus Theory of Disease Etiology in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Critical ReviewChronic viral infections in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)Enteroviruses and Human Neuromuscular DiseasesPacing as a strategy to improve energy management in myalgic encephalomyelitis/chronic fatigue syndrome: a consensus documentRéactivité microbienne lymphocytaire dans le syndrome de fatigue chronique et la fibromyalgieLearning to cope with chronic illness. Efficacy of a multi-component treatment for people with chronic fatigue syndromeThe Enteroviruses: An Emerging Infectious Disease? The Real, the Speculative and the Really SpeculativeImmunoglobulin subclass levels in chronic fatigue syndromeViruses and Chronic Fatigue SyndromeViral illness and chronic fatigue (syndrome) 1 June 1994Volume 120, Issue 11Page: 972-973KeywordsBrainChronic fatigue syndromeEnterovirusHypothalamusMyocardiumPolymerase chain reactionRNASequence analysisSpleenSuicide Issue Published: 1 June 1994 CopyrightCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...

A large study on 121 patients with the chronic fatigue syndrome (CFS) that examined muscle biopsy samples for enterovirus by means of polymerase chain reaction analysis was carried out. The results were compared with those obtained from 101 muscle biopsy specimens from patients with a variety of other neuromuscular disorders (OND), including neurogenic atrophies, dystrophies, and mitochondrial, metabolic, and endocrine myopathies. Thirty-two (26.4%) of the biopsy specimens from the group of patients with CFS were positive, compared with 20 (19.8%) from the group of patients with OND, a difference that was not significant. This finding is in contrast to those of our previous smaller study in which significantly more patients with CFS than control subjects (53% [32 of 60] vs. 15% [6 of 41]) had enterovirus RNA sequences in their muscle. It was concluded that it is unlikely that persistent enterovirus infection plays a pathogenetic role in CFS, although an effect in initiating the disease process cannot be excluded.

An animal model of chronic enteroviral infection was established by using PCR to detect viral genomes in animal tissues and to compare levels of transcription of a variety of cytokines in the brain. Chronic coxsackie-virus B1 infection was found in both brain and skeletal muscle of mice infected as neonates. The viral infection cleared by 240 days post-infection. Elevated levels of tumour necrosis factor alpha and interleukin-6 (IL-6) would appear to be linked to acute and chronic infection respectively. Levels of IL-6 return to normal upon clearance of the virus.