In a majority of FMS, CFS and GWI patients examined we and others, principally Dr. Daryl See of the University of California College of Medicine, Irvine, are finding strong evidence for mycoplasrnal blood infections that can explain much if not most of their chronic signs and symptoms. In our studies on GWI we have found mycoplasmal infections in about one-half of approximately 200 patients, and these patients were found to have principally one pathogenic species, M. fermentans. Moreover, in over one-half of the 200 civilians with CFS, FMS or arthritis that we have examined, we are finding a variety of pathogenic mycoplasma species in the leukocyte fraction of blood samples. The test that we use to identify mycoplasmal infections, polymerase chain reaction, is very sensitive and highly specific. This test is a dramatic improvement on the relatively insensitive serum antibody tests that are routinely used to assay for systemic mycoplasmal infections.( xvi, xvii)
Before systemic mycoplasmal infections can be considered important in causing disease, certain criteria must be fulfilled: (xviii)The incidence rate among diseased patients must be higher than in those without disease. This has been found. Moreover, in asymptomatic adults mycoplasmal infections have been found in very low incidence. (xvi)
More of the mycoplasma must be recoverable from diseased patients than from those without disease. This has been found. (xvi, xvii)
An antibody response must be found at higher frequency in diseased patients than in those without disease. This has been found with M fermentans, but usually not until the disease has progressed. M. fermentans hides inside cells and does not elicits strong immune response until near death. (xix, xx)
A clinical response must be accompanied by elimination of the mycoplasma. Follow up studies on recovered patients indicate that they reverted to mycoplasma-negative phenotypes.( xvi, xvii)
Clinical response is differential depending on the type of antibiotics. Recovery is achieved only with antibiotics that are effective against the pathogenic mycoplasmas. (xvi, xvii)
The mycoplasma must cause a similar disease in animal models using monkeys. Injection of M. fermentans resulted in development of fulminant disease that leads to death.(xx)
The mycoplasma must cause a similar disease when administered to human subjects. The mycoplasmas were not administered to volunteers because of ethical considerations to investigate if they cause a similar disease.
A specific anti-mycoplasma antibody reagent or immunization protects against disease. To our knowledge this has not been done. Therefore, six out of eight of the above criteria have been fulfilled, at least for M. fernentans, strongly suggesting that certain mycoplasmas can cause human disease. Baseman and Tully(xxi) have reviewed the literature on the role of mycoplasmal infections in human disease and have concluded that they are important factors or cofactors in a variety of chronic illnesses.
NEW TREATMENTS FOR FMS, CFS AND GWI
If such infections are important in these disorders, then appropriate treatment with antibiotics should, result in clinical improvement and even recovery.(xxiii) We have proposed treatment recommendations for mycoplasmal infections that are similar to those used to treat Lyme disease, caused by other slow-growing intracellular bacteria that are difficult to identify and treat. For mycoplasmal blood infections long-term antibiotic therapy, usually multiple 6-week cycles of doxycycline (200-,300 mg/d), ciprofloxacin (1,500 mg/d), azithromycin (500 mg/d) and clarithromycin (800-1,000 mg/d)(xxii,xxiii) are required, possibly because of the intracellular location of mycoplasmas like M. fermentans and M. penetrans, and the slow-growing nature of these microorganisms. Nutritional support is also important, and vitamins (esp. B, C, E, CoQ10), minerals (Zinc, Selenium, Chromium), immunoenhancers, and replacement of gut flora (Lactobacillus acidophillus) are important as well as moderate exercise and dry saunas to remove contaminated chemicals.