#IIMEC Professor Nancy Klimas

Phenotyping study comparing long COVID to
large MCAM data set from pre-pandemic ME/CFS
Klimas et al.,1990: poor antiviral function and EBV reactivation in #MECFS

Impaired NK cell, impaired B cell, T cell function
marked reduction of gamma interferon
elevated B cell, elevated memory T cell

serologic evidence of EBV reactivation
#LongCOVID multiple studies showing people who reactivated EBV during acute infection and more likely to get LC. (Su et al., 2022; Chen et al., 2019)

Pender et al., 2017 (T cell exhaustion EBV study)
Peluso et al. - Chronic viral coinfections differentially affect the likelihood of developing #LongCovid
Polyclonal activators (mostly herpesviruses) turn on background noise of immune system

You can wear out your immune system

Perhaps it's the EBV that triggers the neurocognitive issues in #LongCOVID
HHV-6 and EBV have been hypothesized as etiological pathogens
Virus can make "virus stuff". If that assembly is incomplete you don't make the virus, but parts alone can cause symptoms
herpesviruses are in B cells and epithelial cells

How do they get in your brain?

Gottschalk et al, 2023 - potential molecular mechanisms of chronic fatigue in long haul COVID and other viral diseases

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More from @tessfalor

Jun 2
#IIMEC15 Ron Davis
He's wearing all black, because it's the "uniform of #MECFS". @DafoeWhitney doesn't do well with color, so he's used to wearing black
How do you determine the molecular cause of #MECFS & #LongCOVID?

and how do you treat it?
Read 18 tweets
Jun 2
#IIMEC15 Professor Robert Phair

The Itaconate Shunt Hypothesis for ME/CFS
Start with TCA cycle

NAD is reduced to NADH, used to make ATP

Looking at part of pathway not in the textbooks - The itaconate shunt
starts at cis-Aconitate

itaconate is converted to itaconyl-CoA with STK to

Up until 7 years ago, that was the end, then found CLYBL. Lab discovered what it does
Read 19 tweets
Jun 2
#IIMEC15 Kristian Sommerfelt

Funcap - Functional Capacity Questionnaire in #MECFS
How do you access functional capacity?

5857 responses from #MECFS patients (online anonymous, spread via social media)
Questions like "can you X? How often do you Y?" don't work, because it is context dependent. It depends on what else the patient has decided to do, doesn't take consequences into account
Read 5 tweets
Jun 2
#IIMEC15 Dr Jesper Mehlsen

TREATMENTS - Toward uniform treatment
regimen for ME/CFS
Listen to patients about what works and what doesn't work.
There isn't an approved medication for #MECFS

Symptomatic treatment can be applied to improve quality of life
Read 8 tweets
Jun 2
#IIMEC15 Professor Jonas Bergquist

Visits to severely affected Patients
Andrea affected at 22 after mild infection (maybe EBV)

Extreme progression after a few months

Today fully bedbound
17 year old case study they published in 2022

"When a 17-year old girl is diagnosed..."

Girl had diary showing how severe Sx, which they plotted and showed fluctuations over many different time scales.
Read 15 tweets
Jun 2
#IIMEC15 Professor Maureen Hanson

Immune Abnormalities and Viruses in ME
65 million people world-wide have #MECFS, same number have #LongCOVID now

Has occurred in outbreaks, some with polio outbreaks
#MECFS symptoms: fatigue, unrefreshing sleep, orthostatic intolerance, cognitive impairment, sore throat, fever, muscular pain, etc
Read 10 tweets

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