More targeted research is needed!
On May 18, a paper was published in the leading journal Nature review on post-infectious complaints Written by Akiko Iwasaki, in collaboration with researcher Jan Choutka and supplemented by Viraj Jansar and Mady Hornig. Iwasaki is Sterling Professor of Immunobiology and of Molecular, Cellular, and Developmental Biology at Yale University and a Principal Investigator at the Howard Hughes Medical Institute.
In this review, parallels are seen between Q fever fatigue syndrome, Long COVID, ME/CFS and other post-infectious conditions. The similarities are considerable: exhaustion, unrefreshing sleep, concentration problems, cognitive problems. Besides the important common denominator, the post-infectious conditions all seem to have their 'own' specific characteristics that are therefore different. Such as the parasite in the intestine after an outbreak of Giardia lamblia, which usually causes acute intestinal disorders. Glandular fever after having had the Epstein-Barr virus. Chronic eye inflammations after Ebola. Motor disorders and muscle weakness after West Nile virus. Pneumonias after Q fever and the loss of smell and taste after COVID.
General persistent post-acute sequelae
These findings suggest that a proportion of the infected group consistently develops general persistent post-acute sequelae of a post-infectious condition. Regardless of whether it is caused by a parasitic, viral or bacterial infection. And that in addition specific features occur due to a particular pathogen.
People with remarkably long complaints have not received attention for far too long. At a scientific level, there has been insufficient attention for these patients with severely disabling complaints for a long time. This review makes it clear that each condition has its specific characteristics, but that they do have the same basis. Although the pathogen in the body is often not (any longer) detectable.
Four theories for complaints
There are four different theories about what causes complaints in the body:
- Persistent infection;
The persistence of remnants of bacteria or viruses, which means that the illness does not stop. - A hyperactive immune system;
The development of antibodies that can attack the body itself - Dysbiosis, disturbed balance in the intestines;
Own bacteria form an important balance in the body. The imbalance indicates previously passed viruses or bacteria that are reactivated by a new parasite, bacteria or virus. - Neuroinflammation;
The permanent damage after you have had an inflammatory disease such as Q fever, COVID or another virus or bacteria that affects the central nervous system.
Choutka and Iwasaki conclude that the potential for treatment of post-infectious diseases by the shared hypotheses is great. This offers an opportunity for accelerated progress in biomedical research into underlying mechanisms of chronic diseases.
More targeted research needed
So we should not see infectious diseases separately. It seems like everything fits together, post-infectious symptoms after a viral infection or bacterial infection, and with this review many pieces of the puzzle fall into place. There is a lack of understanding of this in medicine at the moment. More targeted research is therefore needed.
For both Q fever and Long COVID, VWS has set up an institute in the form of Q-support and C-support to support patients with post-infectious complaints after their infection. More biomedical research is needed and Q-and C-support see it as their task to push for this. That is why a think tank is being set up to jointly make concrete recommendations to VWS for further research with national and international researchers.
