Multiple persistent infections

Introduction

What's old is new again. Long haul syndromes (long COVID and vaccine injury) can be thought of as remixes of health problems that have previously existed. The syndromes heavily overlap with health conditions that have existed in the past.

ME/CFS versus post vaccination syndrome symptoms are compared below:

Data from:

• https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC2429637/pdf/postmedj00163-0031.pdf
• https://www.react19.org/post/persistent-neurological-symptoms-patient-survey

Breast implant illness versus post vaccination symptoms are compared below:

Data from:

• https://www.fda.gov/medical-devices/breast-implants/medical-device-reports-systemic-symptoms-women-breast-implants
• https://www.react19.org/post/persistent-neurological-symptoms-patient-survey

The common denominator

One common thread that runs through long haul, ME/CFS, and breast implant illness (BII) are infectious diseases. Breast implants, while being inorganic and biologically inactive, turn out to be an excellent environment for bacteria. One observational study on BII patients found that BII patients were six times more likely to have culturable bacteria or fungi/yeast growing on their implants compared to healthy controls. Limitations on our current ability to detect microorganisms in biofilm structures may mean that bacterial colonies are more common than what the study detected (36% among BII patients).

ME/CFS is also a condition that has been linked to infectious diseases:

• Various infectious diseases: enteroviruses, herpesviruses including Epstein-Barr virus, Q fever, coxsackie b, and Ross River virus.
• Outbreaks
• Stress, e.g. from a divorce. Stress is thought to weaken the immune system.
• Trauma, e.g. a car accident, head injury, etc.

The data suggests that many different paths can lead to the body being unable to control persistent infections. The diversity of the bacteria, viruses, yeast, parasites, etc. that live inside humans would explain why symptoms vary so much from patient to patient.

The healthy human virome

Kumata and colleagues published the paper A tissue level atlas of the healthy human virome (https://doi.org/10.1186/s12915-020-00785-5). Their study examined the various viruses that live inside health human beings. One of their findings was that viruses don't always live in the same places in the body. One person might have Epstein-Barr virus (EBV) living only in their spleen while another person might have EBV living in multiple organs.

One phenomenon seen in a few long haulers are reactivated infections. Pre-existing viruses such as EBV, shingles / herpes zoster / varicella-zoster virus, etc. turn into more active infections and can be detected in the blood using commercially available tests. This suggests that the immune system is dysfunctional and unable to suppress persistent infections like a healthy immune system would.

The natural variations in the types of microorganisms living in a person and where they reside may explain why there are so many different symptoms and why they vary so much from person to person. A survey of long COVID patients published in The Lancet (https://doi.org/10.1016/j.eclinm.2021.101019) analyzed 203 different symptoms in long COVID sufferers.

Successive infection ("teamwork makes the dream work")

Microorganisms sometimes fight each other, e.g. by producing toxic poisons such as penicillin to kill off competing species fighting for the same resources. However, it is also possible for microorganisms to act synergistically in suppressing the immune system. All microorganisms living in humans tend to be able to do so because they have some mechanism for evading the immune system or suppressing it.

Proal and colleagues (https://doi.org/10.1097/BOR.0b013e32835cedbf) discuss how Epstein-Barr Virus, Borrelia (Lyme), CMV, and other microorganisms all interfere with the immune system by dysregulating the vitamin D receptor pathway. Their paper argues that a greater number of pathogens in the microbiome contributes to greater dysfunction in the immune system, eventually leading to chronic illness. Amy Proal explains these concepts in a Youtube video (https://youtu.be/7yjh04vMe1E).

Autoimmunity

Auto-antibodies are antibodies that engage in 'friendly fire' and stick to the host's proteins/antigens instead of the foreign antigens associated with pathogens. A study by Gerd Wallukat and his team on recovered COVID-19 patients (https://doi.org/10.1016/j.jtauto.2021.100100) found that all had between 2 and 7 different auto-antibodies of the GPCR-fAAB type (g-protein coupled receptor functionally active auto-antibodies). In healthy controls, such auto-antibodies are only found in a small percentage of people.

Proal and colleagues (https://doi.org/10.1097/BOR.0b013e32835cedbf) believe that such autoimmunity processes are being driven by molecular mimicry, a defense strategy where microorganisms evolve their external antigens to be extremely similar to the host's antigens. This strategy makes it difficult for the immune system to eradicate problematic microorganisms without also attacking host tissue.

While many autoimmune conditions are treated by suppressing the immune system and reducing the amount of 'friendly fire' from the immune system, such a strategy does not deal with the root cause: persistent infection. This may explain why immune suppression strategies (e.g. corticosteroids) fail in many patients. The patient's immune system is already unable to contain persistent infections and further suppression of the immune system only makes the underlying problem worse.