Infection and Inflammation, and Chronic Fatigue Syndrome

A theory was published by Dr. Martin L. Pall, a professor of biochemistry and basic medical sciences at Washington State University, in 2001. The theory starts with the observation that infections that precede and may therefore induce Chronic Fatigue Syndrome and related conditions act to induce excessive production of inflammatory cytokines. This initial step activates a series of reactions:

Inflammatory cytokines induce, in turn, nitric oxide synthase (iNOS), which synthesizes excessive amounts of nitric oxide. Nitric oxide reacts with superoxide to produce the potent oxidant peroxynitrite. Peroxynitrite acts via six known biochemical mechanisms to increase the levels of both nitric oxide and superoxide, which react to produce more peroxynitrite. In this way, once peroxynitrite levels are elevated, they may act to continue the elevation, thus producing a self-sustaining vicious cycle. According to the theory, it is this cycle that maintains the chronic symptoms of Chronic Fatigue Syndrome, and it is this cycle, therefore, that must be interrupted to effectively treat this condition (Pall 2001a).

Breaking the chain of inflammation caused by chronic viral infections would require a three-part protocol:

First, the underlying viral infection should be addressed with antiviral supplements (such as ginseng, echinacea, and lactoferrin) and those that shift the Th1:Th2 ratio (such as essential fatty acids and vitamin E).

Second, inflammation should be reduced with anti-inflammatory agents (such as essential fatty acids and curcumin).

Third, the nitric oxide system should be supported with supplements (such as arginine, vitamin B2 [riboflavin], vitamin B3 [niacin], and folate).

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