On the questions of the editors responsible doctor of medical Sciences, head.laboratory of immune SSC, research Director of the chronic fatigue syndrome, Professor N. G. The Artsimovich.
Fatigue can get sick
Nellie G., a hundred years ago, people probably had no idea that fatigue may be a disease. When we first started talking about this disease as a disease?
After infectious diseases when the critical period has passed, some time observed weakness: muscle weakness, depression, insomnia, fatigue, headaches. But usually these symptoms disappear within two to three weeks. When a person is in this condition for more than six months, this is alarming. For a long time, this disorder is not considered a disease, not paying attention to them or classify them as unusual forms of other infectious diseases.
It is now clear that the cases are similar to chronic fatigue syndrome, have already met in the mid 30-ies. But then reports of a new disease been overlooked by physicians.
Its modern name "chronic fatigue syndrome" is a disease received after the epidemic in the state of Nevada (USA) in 1984. Dr. Paul Cheney, practicing in the small town of Incline village, located on the shores of lake Tahoe, has registered more than 200 cases of this disease. Patients felt depression, worsening of mood, muscle weakness. They found the virus of Epstein-Barr or antibodies to him and to other viruses are "relatives" of the herpes virus. Was the cause of the disease is a viral infection or something else, such as poor environmental conditions, remained unclear. Colleagues Cheney is generally believed that dealing with mass hysteria. And yet after a few years his opinion prevailed, and now the diagnosis of "chronic fatigue syndrome" is quite "legitimate". In recent years in the United States annually register new cases of the disease, and now the "fatigue syndrome" affects about 10 patients per 100 thousand population. In Australia in 1990, the incidence was higher: 37 people per 100 thousand population.
- What is the incidence? From the circulation of the virus in certain areas of the globe?
- Chronic fatigue syndrome is a multifactorial disease - occurs when a confluence of many factors. Infectious component plays a significant role. Patients found viruses herpes group already mentioned Epstein-Barr, cytomegalovirus, and other varieties. In addition, in the blood is often present Coxsackie viruses that cause polio, myocarditis, myositis, hepatitis a and FMD.
But the herpes virus infected about 90 percent of the world's population. Why all the polls we have not yet contracted chronic fatigue syndrome? Because these viruses from time to time exist in the body in a hidden, latent form. They are embedded in the hereditary substance of the cell and "live" there for many years, does not prove itself. And begin to take action only under the influence of adverse external conditions. At this point in the fight against viruses activates the immune system. If it is strong then the virus can be destroyed. If weak, then no.
- What happens with immunity?
Most researchers believe that the disease is constantly affects the immune system: viruses bear a label - antigens that serve as their "calling card". Antigens constantly stimulate immune cells, causing them to produce large amounts of active substances cytokines. These substances fight infection, causing the patient to feel discomfort: chills, fever, muscle pain. Therefore, when cancer patients inject any cytokine (to increase the strength of the immune response), they may develop symptoms of viral infection.
"Stimulation" of the immune system not only useless but even dangerous. Constant activity of viruses in the body can gradually lead to a complete reduction of immunity. Many patients with chronic fatigue syndrome is the "stimulation " causes allergic reactions and pains in the joints. In addition, by propagating inside the cells, the virus can lead to their destruction and disruption of the whole body.
Details of the scenario of the interaction of the virus with the immune system depend on genetically predisposed STI body of the patient, the state of his immune system, but also on the biological activity of the virus itself.
The immune system is deteriorating, primarily from stress, leading to changes in the quantitative and qualitative composition of immune cells. In particular, when the stress decreases the number of cells - natural killer cells, providing long-lasting protection of the organism against foreign proteins. The resistance of the organism reduces adverse environmental conditions.
- What is the nature of this disease?
On this account there are many controversial opinions. American researcher S. Strauss believes, for example, that chronic fatigue syndrome is similar to allergies. And in fact, 50-80 percent of patients suffer from hay fever and other allergic diseases.
As the leading American psychoneuroimmunology D. Goldstein and D. Solomon proved that patients with chronic fatigue syndrome is a disorder of the regulation of the Central nervous system, mainly its temporo-limbic regions of the brain. This is quite plausible, since we know that herpes viruses infect this part of the brain.
The so-called limbic system or olfactory brain communicates the Central nervous system to autonomic management activities of the internal organs. From the work of the limbic system to a large degree, our memory, performance, emoziii, the alternation of sleep and wakefulness. That is, those functions that are upset in patients with chronic fatigue syndrome.
Interesting hypothesis about the nature of this disease was put forward by researchers one of the clinics in California, examined 900 patients. According to them, the disease is caused by toxin-arabinose. Select the yeast fungi of the genus Candida, dwelling in the body. A healthy person toxin is not harmful, but can be dangerous for those who have a weakened immune system. But many scientists believe this hypothesis is controversial.
Chronic fatigue syndrome - causes and symptoms
- Always whether the disease begins with infection?
The disease may start with the common cold. While the rhinoviruses that cause the common cold, quickly spread in the body. The immune system is fighting the infection. Some time after the disease has passed, usually anyone feels a bit "out of place": concerned about weakness, headaches, fatigue, depressed mood. As I said, healthy people gradually returns to normal, and in patients with chronic fatigue syndrome this condition can last more than six months. So, the doctor has a reason to find out what happens to the immune system.
But usually people, feeling no matter refers to the wrong address: disturbed sleep is a neurologist, upset gut - consult at the gastroenterologist, suffers from eczema is treated by a dermatologist, while first of all, he should seek the advice of Neuroimmunology. And it is not surprising that treatment, as a rule, does not give a good result because the underlying cause is another.
- What personality traits may predispose a person to this disease?
- It is possible to trace the psychological characteristics that serve as a favorable environment for disease development. Women suffer more often than men, and young people more often than older people. The disease usually occurs in workaholics, very energetic, ambitious, responsible, but at the same time sensitive nervous system. They want to feel better all around, to move mountains, to carry out impossible. They have inflated expectations of their capabilities. Such people tend to do what they were asked, and even more than that. They are generally active, business, Preppie marijuana. However, in the past, many of them have experienced abuse, tragedy in the family, divorce or serious trauma. Many patients in childhood suffered from low self-esteem. I guess from here and habit all the time to prove something to yourself and others. On their shoulders too much responsibility, they tend to be indispensable in all areas of life.
Not coincidentally about the disease first began in America. American lifestyle associated with full feedback on their work, to which was added costs of the feminist movement of the early 70-ies, - all this has created fertile ground for the rapid spread of chronic fatigue syndrome in one of the richest countries in the world.
The capabilities of the human nervous system is not unlimited. Sooner or later surge collapse. Patient haunted by the feeling of anxiety, fear, depression, disturbed sleep. Incidentally, these same symptoms felt by people with pathological processes in the limbic system of the brain.
Such symptoms are characteristic of "adult" lifestyle. But lately, chronic fatigue syndrome were diagnosed in children. What could be the reason?
- Experts suggest that the fault is frequent toxicosis of pregnancy, expectant mothers, defects in the placenta, birth trauma and asphyxia in the newborn. All this leads to disruption of adaptation mechanisms from the first days of life.
Children to identify this syndrome is more complex than in adults, because they almost never complain of fatigue and ill know how to describe their experiences. But during epidemics of chronic fatigue syndrome children were among the victims. For example, during an outbreak in Iceland in the years 1949-1950 of 1200 patients were 194 child. This amounted to 7 percent of all children in the region. Ill mostly teenagers 15-19 years. In London every year this diagnosis 10-15 students. In Australia, chronic fatigue syndrome occurs in 31 children per 100 thousand population. There are also cases among children younger than 10 years, but they are rare.
- What symptoms are a hallmark of this disease?
The main symptom is persistent fatigue. Insomnia is also very characteristic of the disease. Sick or not sleeping, or not feeling rested after a long night's sleep. Any failure mode - moving, changing time zones, work before going to sleep, leading to insomnia. Impaired thermoregulation: patients can a long time to be raising or lowering the temperature, which is caused by a breach of certain functions of the limbic system of the brain. Frequent sudden weight loss (up to 10-12 kg in two months), also caused by brain abnormalities.
Can develop photophobia, intestinal disorders, allergic rhinitis, pharyngitis, headache, dizziness, palpitations, dryness of the mucous membranes of the eyes and mouth, soreness of the lymph nodes, aching joints. In women, there is an increasing premenstrual syndrome. Manifestations, as already mentioned, a huge set.
Chronic fatigue syndrome - treatment
- How today treat chronic fatigue syndrome?
- Years of research have led to the development of a new group of medicines, which proved very effective against this disease. Based preparations - hydrocarbon in which the carbon atoms are the same as in the crystal lattice of the diamond. Therefore medicines called "adamantanes" from the Greek word "adamantos" - diamond. This bromantan, Kelantan and others.
Due to the special structure of the product is immersed in the cell membrane, causing it to become more permeable to various biologically active substances, which have a powerful effect on the entire body. Normal functioning of the nervous system, strengthening of the immune system and improving hormonal regulation.
That feel when this patient?
"Humans significantly increases physical and mental performance. Long drugs of this group were classified. They were used by athletes as a stimulant.
Not so long ago, the Newspapers wrote about bromantane, which is found in doping control in the blood of athletes at the Olympics in Atlanta. Actually there was a misunderstanding. Bromantan was included in the list of prohibited items before the start of the Olympics, what sport managers were not warned. Athletes wanted to deprive gold medals, but then reconsidered. Special test proved that bromantan acts as an immunomodulator and a real dope means, essentially, is not relevant. An additional effect is the increased attention, concentration, confidence and used by the athletes. But the inclusion of the drug in the list of doping means is, I believe, simply the consequence of some intrigue.
- Adamantanes are a kind of panacea?
- In any case! Patients receiving drugs from the group of adamantanes, are usually treated not only by them. Therapy is especially effective in combination with other means - reflex and acupuncture, autogenic training, hypnosis. If the patient has depression, he in addition to adamantanes will need tranquilizers, if he is exhausted - the necessary course of vitamins, if disturbed sleep - can't do without sleeping pills, if you have severe shocks - plug hypnosis treatment. All these techniques worked in the Clinic of neurosis, where we have patients, research is also underway in the Institute of immunology.
Patients who have undergone treatment, feel a burst of energy, increased confidence, reduced anxiety, fear, nervousness. Returns to normal and the General condition of body: normal temperature, decreases muscle weakness, getting better sleep.
Recently, we successfully applied the method of the so-called transcranial electrostimulation of the brain. It carries a special device with electrodes that attach to the head. The electrodes send weak currents in certain parts of the brain, and when this effect in the pituitary gland produces protein molecules, whose action is similar to the effect of morphine, is an opioid peptides. They have an analgesic effect, improve the condition of the nervous system, stimulate the production of the body needs hormones.
It turned out that patients with chronic fatigue syndrome such stimulation, if it is combined with other treatments, can be very useful.
But I repeat - panacea this disease does not exist. Each patient requires its own individual treatment. What is effective for one may not work in another. A very important contact with your doctor, trust in him.
Patients with chronic fatigue syndrome are divided into several categories. Some, ill, a strong sense of guilt in front of home and family for what had to drastically change their lifestyle. Others did not consider themselves to be sick and take trouble for their own laziness, trying to "motivate" yourself, to take in hand. Others feel doomed.
All these nuances should consider attending physician to lead the patient through all the shoals and reefs to final recovery. And this is quite possible. Under our control have been cured a lot of people who considered themselves hopelessly ill.
Author:
Kalininskaya E.
Source:
According to the magazine "Science and life"
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