You still hear that chronic fatigue syndrome (ME/CFS) is a “mystery illness,” but the nature and mechanisms of the disease are beginning to take shape, thanks to the ongoing efforts of researchers. Over the years, especially recent ones, we’ve learned a huge amount. Some of that knowledge points to roles that inflammation and autoimmunity may play in this illness.
In autoimmunity, the body is suffering from friendly fire. The immune system has gone haywire and now identifies a part of your body as a foreign invader. It then triggers the inflammatory process and sends in specialized cells to destroy the target and begin the healing process.
Only now, the healing process creates more of whatever body part your immune system doesn’t like, so the process continues indefinitely.
It’s important to note that not all immune-system dysfunction is autoimmune.
Some researchers have found evidence suggesting ME/CFS is, at least in part, an autoimmune disease. A few different targets of a misfiring immune system have been suggested.
In a 2013 study examining the possible relationship of O&NS and autoimmunity, researchers said that the presence of pro-inflammatory cytokines and several other known dysfunctions associated with ME/CFS may predispose you to autoimmunity. That means autoimmune activity may be a consequence of the condition rather than a cause of it. These researchers suspect that constant viral infections may lead to a couple of theoretical processes that may induce autoimmunity: bystander activation and molecular mimicry.
In molecular mimicry, the immune system fights an infectious agent and then begins to confuse it with a similar cell in the body and therefore begins attacking it. Essentially, because both cells look like a duck, the immune system labels them both ducks, when in fact one is a goose, and the goose belongs in that ecosystem.
In bystander activation, the body is attacked by a virus, the immune system responds by activating specialized cells, and, for some reason, that activation mistakenly triggers a different type of specialized cell—an autoimmune cell—that begins attacking the body’s tissues.
In the same study, researchers also list several other methods by which ME/CFS may trigger autoimmunity, including dysfunction of mitochondria, which provide energy to your cells, and cellular damage caused by O&NS that cause your immune system to misidentify them.
A different 2013 study involving many of the same researchers puts forth the possibility of an autoimmune reaction to 5-HT, also known as serotonin. As a hormone and neurotransmitter, serotonin performs several crucial roles in both the gut and the brain. Serotonin dysregulation has long been believed to be involved in ME/CFS.
Researchers say that just over 60 percent of the participants with ME/CFS tested positive for autoimmune activity against 5-HT—more than 10 times the rate of the control group, and quadruple the rate of those with long-lasting fatigue that didn’t meet the critieria for ME/CFS.