dimanche 11 octobre 2009

Putain... j'ai une "vraie" maladie

As my best friend Maureen, who also suffers terribly with me-cfs, said, "What is surprising is not the discovery but the coverage it's getting." / Comme ma meilleure amie Maureen, qui souffre aussi peniblement de sfc-me que moi, a dit, "Ce qui est suprenant n'est pas la découverte mais sa couverture par les journaux."

Les articles en anglais (New York Times) et en français (Le Monde).


October 9, 2009

NY Time: Virus Is Found in Many With Chronic Fatigue Syndrome

Many people with chronic fatigue syndrome are infected with a little known virus that may cause or at least contribute to their illness, researchers are reporting.

The syndrome, which causes prolonged and severe fatigue, body aches and other symptoms, has long been a mystery ailment, and patients have sometimes been suspected of malingering or having psychiatric problems rather than genuine physical ones. Worldwide, 17 million people have the syndrome, including at least one million Americans.

An article published online Thursday in the journal Science reports that 68 of 101 patients with the syndrome, or 67 percent, were infected with an infectious virus, xenotropic murine leukemia virus-related virus, or XMRV. By contrast, only 3.7 percent of 218 healthy people were infected. Continuing work after the paper was published has found the virus in nearly 98 percent of about 300 patients with the syndrome, said Dr. Judy A. Mikovits, the lead author of the paper.

XMRV is a retrovirus, a member of the same family of viruses as the AIDS virus. These viruses carry their genetic information in RNA rather than DNA, and they insert themselves into their hosts’ genetic material and stay for life.

Dr. Mikovits and other scientists cautioned that they had not yet proved that the virus causes the syndrome. In theory, people with the syndrome may have some other, underlying health problem that makes them prone to being infected by the virus, which could be just a bystander. More studies are needed to explain the connection.

But Dr. Mikovits said she thought the virus would turn out to be the cause, not just of chronic fatigue, but of other illnesses as well. Previous studies have found it in cells taken from prostate cancers.

“I think this establishes what had always been considered a psychiatric disease as an infectious disease,” said Dr. Mikovits, who is research director at the Whittemore Peterson Institute in Reno, a nonprofit center created by the parents of a woman who has a severe case of the syndrome. Her co-authors include scientists from the National Cancer Institute and the Cleveland Clinic.

Dr. Mikovits said she and her colleagues were drawing up plans to test antiretroviral drugs — some of the same ones used to treat HIV infection — to see whether they could help patients with chronic fatigue. If the drugs work, that will help prove that the virus is causing the illness. She said patients and doctors should wait for the studies to be finished before trying the drugs.

Dr. William Schaffner, an infectious disease expert at Vanderbilt University, said the discovery was exciting and made sense.

“My first reaction is, ‘At last,’ ” Dr. Schaffner said. “In interacting with patients with chronic fatigue syndrome, you get the distinct impression that there’s got to be something there.”

He said the illness is intensely frustrating to doctors because it is not understood, there is no effective treatment and many patients are sick for a long time.

He added, “This is going to create an avalanche of subsequent studies.”

Le Monde: Un lien entre un virus et la "fatigue chronique

Compte rendu
Un lien entre un virus et la "fatigue chronique"
LE MONDE | 09.10.09 | 15h18 • Mis à jour le 09.10.09 | 15h18

a tentation était forte d'en faire une "fausse maladie". Une invention de laboratoires pharmaceutiques toujours prêts à sacrifier au "disease mongering", exercice de marketing scientifique consistant à formaliser sous un nom médical - pour y proposer un remède - un ensemble de troubles vagues, sans cause organique identifiée.


Le syndrome de fatigue chronique était de ces suspects : sans étiologie connue, il associe une grande lassitude physique à des douleurs articulaires, des troubles de la mémoire et du sommeil, des irritations de la gorge, etc. Le soupçon est-il levé ? Des chercheurs américains dirigés par Vincent Lombardi (Whittemore Peterson Institute, Nevada) et Francis Ruscetti (National Cancer Institute à Frederick, Maryland) viennent en tout cas d'établir un lien très étroit entre cette pathologie et un rétrovirus infectieux.

Leurs travaux, publiés vendredi 9 octobre dans la revue Science, ont consisté à analyser les échantillons sanguins d'un groupe constitué de 218 individus sains, puis d'un autre de 101 personnes souffrant du syndrome de fatigue chronique. Résultat : le rétrovirus XMRV (Xenotropic MLV - Related Virus) a été retrouvé dans 67 % des échantillons sanguins prélevés sur les personnes souffrant de la maladie en question. Et chez seulement 3,7 % des individus ne se plaignant d'aucun trouble.

Le XMRV est la version "humaine" du MLV (Murine Leukemia Virus), un rétrovirus responsable de leucémie chez la souris. "Le XMRV a été mis en évidence dès 2006 dans certaines tumeurs de la prostate, explique le virologue Thierry Heidmann (Institut Gustave-Roussy, CNRS, université Paris-XI), spécialiste du monde rétroviral. Il s'ajoute aux deux autres rétrovirus infectieux humains connus, le VIH, responsable du sida, et le HTLV (Human T-cell Leukemia/lymphoma virus), responsable de certaines leucémies."

Pour autant, si les chercheurs disent avoir découvert "une association hautement significative" entre le XMRV et le syndrome de fatigue chronique, ils n'en sont pas moins très prudents sur les conclusions à en tirer.

"Nos observations soulèvent plusieurs questions importantes", écrivent-ils. En particulier celle de savoir si c'est le virus qui déclenche (ou co-déclenche) le syndrome. Ou si, au contraire, c'est l'état de faiblesse induit par le syndrome chez les individus - d'où l'affaiblissement de leur immunité - qui suscite ou permet la présence du XMRV...

Qui est l'oeuf, qui est la poule ? "Aujourd'hui on l'ignore, tant pour certains cancers de la prostate que pour ce syndrome", dit M. Heidmann, qui ajoute que c'est désormais à l'épidémiologie de prendre le relais pour contribuer à trancher la question. Ce qui sera très ardu pour la "fatigue chronique". Car en poser le diagnostic de manière univoque semble difficile.


Stéphane Foucart

1 commentaire:

Anonyme a dit…

this is such a terrible disease and up until now most of the sufferers have been dismissed because "it is all in your head". i hope that this new research will bring relief in the way of new treatments for all those who are suffering so much. it should have started years ago, when the aids research was started in earnest. thank you laura for bringing this to our attention. r.w.