Joerg Haier, M.D., Ph.D., Marwan Nasralla, Ph.D. and Garth L. Nicolson, Ph.D.
The Institute for Molecular Medicine
15162 Triton Lane
Huntington Beach, CA 92649-1041, USA
Mycoplasmal Infections in Blood from Patients with CFS, Fibromyalgia Syndrome or Gulf War Illness
Background: Mycoplasmal infections are associated with several acute and chronic illnesses. Since we previously found that about one-half of Gulf War Illness (GWI) patients had mycoplasmal infections, such as M. fermentans, patients with Chronic Fatigue Syndrome (CFS) and/or Fibromyalgia Syndrome (FMS) were examined for mycoplasmal infections in blood leukocytes.
Patients: Blood samples from 203 patients (148 female, 55 male) diagnosed with CFS or FMS were investigated for Mycoplasma spp. and M. fermentans infections using forensic Polymerase Chain Reaction. Clinical characteristics of CFS/FMS patients and GWI patients were similar. In particular, major signs and symptoms, such as chronic fatigue, joint/muscle pain, depression, paraesthesia, cognitive and vision problems were found in all of these diagnoses.
PCR Amplification: Genus-specific primers for mycoplasma were selected from 16S mRNA sequences. The universal probes GPO 1 and MGSO were used for the detection of mycoplasmas and the UNI- probe was used as an internal probe for confirmation with cDNA hybridization. Specific primers for M. fermentans (SB1: forward probe, SB2: reverse probe, SB3: internal probe) were selected from the tuf gene sequence.
Using the genus-specific primers positive PCR results were obtained if the PCR product was 717 base pair in size (or 850 bp for M. fermentans-specific primers). The results were confirmed by cDNA hybridization with the specific internal 32P-labeled probe. In the healthy control group (n=32) no PCR product was obtained, and hybridization signals were not observed. The Mycoplasma spp. sequence was amplified from the peripheral blood of 144 patients (71.4 %). No specific PCR product could be detected in the 57 negative patients (28.6 %) and a significant difference (p < 0.001) was found between patients and healthy controls (0/32). Moreover, the incidence rate was similar in female and male patients. The incidence (41.5%) of M.fermentans infection was significantly higher than in healthy controls (p < 0.001).
Systemic mycoplasmal infections can be considered important in causing morbidity in CFS/FMS. These infections can be treated with multiple cycles of the following antibiotics: doxycycline, ciprofloxacin, azithromycin or clarithromycin.
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