New Research Continues Uncertainty About XMRV's Role in CFS

The week held some major highs and lows for researchers at the WPI, which is where the original concept and research suggesting that XMRV virus may play a role in where chronic fatigue syndrome comes from.

Posted on | Jacob Teitelbaum, MD | Comments ()

The week held some major highs and lows for researchers at the WPI, which is where the original concept and research suggesting that XMRV virus may play a role in where chronic fatigue syndrome comes from.

Three new studies[1-3] and an “Expression of Concern[4]” from the editor of the journal Science kicks the debate into high gear.

On the upside, they published an excellent study in the journal In Vivo[3]. They found that in CFS patients whose illness had a sudden flu-like onset, and who had a positive XMRV test in their lab, the cytokine (immune function) lab panel was like a CFS "fingerprint" and was able to distinguish these CFS patients from a healthy group with excellent accuracy.

Though the authors suggest that this supports the presence of XMRV in CFS, I do not believe this to be the case. By my reading, it simply shows that in a CFS patient whose illness began with an acute viral infection, you will see a characteristic pattern in their immune lab tests, offering a promising new test for people whose CFS began with an infection. But this is a lot — especially for those who are working with family members or insurance companies that still don't believe their illness is real. This testing may be helpful when it becomes available.

On the other hand, XMRV research took a major hit. The editor of the journal Science, which published the initial WPI XMRV virus study, added his “Editorial Expression of Concern[4]” letter to the study. As they had two new studies that did not find XMRV virus in CFS patients, they are concerned that the XMRV virus found in the initial WPI study might be a contaminant. This led to some people suggesting that the WPI should retract their study, which I consider to be extreme and inappropriate.

To put it in perspective, over time:

1. Cholesterol medications were shown to be minimally helpful in primary prevention (i.e., for those without known heart disease — they are clearly helpful in those who have known heart disease or stroke).

2. Some antidepressants have been shown to be about as effective as placebo for mild to moderate depression.

3. Some diabetes medications actually are more likely to kill the patient than help them.

And the list goes on and on and on …

Does this mean the journals will soon be requesting retractions and attaching “letters of concern” to thousands of these earlier studies? Unless this becomes their new policy, it is equally inappropriate for them to be doing so here.

I suspect that the XMRV debate has yet to be resolved –  and I have discussed repeatedly what is needed to resolve it, which is fairly simple to do. The WPI needs to be sent blinded blood samples from a mix of patients with CFS (with and without a viral onset) and healthy controls. If, by doing their XMRV test, they can tell which samples came from CFS vs. which came from healthy patients significantly better than chance, then it is worth pursuing. If not, then not. It can be fairly straightforward.

In the meantime, it is okay to ignore the debate, and focus on the wealth of other exciting new research and treatment advances in CFS, so you can get your life back now – while we wait for the XMRV question to sort itself out.


[1] Host Defense against Viral Infection Involves Interferon Mediated Down-Regulation of Sterol Biosynthesis. Mathieu Blanc, et al. PLoS Biology, 2011; 9 (3): e1000598 DOI: 10.1371/journal.pbio.1000598.

[2] Immunological abnormalities as potential biomarkers in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis. Ekua W Brenu, et al. Journal of Translational Medicine. May 28, 2011, 9:81doi:10.1186/1479-5876-9-81.

[3] Xenotropic Murine Leukemia Virus-related Virus-associated Chronic Fatigue Syndrome Reveals a Distinct Inflammatory Signature. VC Lombardi, et al. In Vivo. 2011; 25: 307-314.

[4] Editorial Expression of Concern. Bruce Alberts — Editor-in-Chief, Science. Published in Science: Sciencexpress on, May 31, 2011.


Blog written by Jacob Teitelbaum, MD
Dr. Teitelbaum overcame Chronic Fatigue Syndrome and Fibromyalgia in 1975, and since then has helped hundreds of thousands...