Dr Byron Hyde---polio like virus found in subgroup of M.E. patients

CFS Radio Program
January 31st, 1999
http://member.aol.com/rgm1/private/transcr.htm
Roger G. Mazlen, M.D. Host
with
Dr. Byron Hyde

Dr. Mazlen
We're delighted today, we're really please to be able to present on the show live from Canada, Dr. Byron Hyde who will be talking with us in just a minute. Dr. Hyde is a graduate of the University of Ottawa where he received his M.D. degree. Training he did, amongst many places, at the Hotel Du in the University of Montreal and other hospitals in the area. He is a sub specialist in myalgic encephalitis and Chronic Fatigue Syndrome, where, in his words he's treated around or more than 8,000 patients since he started in 1985 and notably also, he's chairman of the Nightingale Research Foundation in Canada where he's been the chairman since 1987 to date. So, obviously have an eminent guest and we need to hear from him and to talk with him about some of the things he's been doing, some exciting new research that's he's involved in. Welcome to the show, Dr. Hyde, we're delighted to have you as our guest and we would like to hear from you about your findings, some of the things you've been doing. 

Dr. Hyde
Hello, Roger, it's a great pleasure to talk to you. 

Dr. Mazlen
We're just thrilled that you could be with us today. 

Dr. Hyde
What would you like to talk about today. This is a vast subject as you know and so little is known about it, even among some of the most eminent physicians, and this isn't a criticism of physicians, it's just that it is a subspecialty and most physicians don't know much about brain surgery and this is as detailed and as vast a subject as brain surgery is, but just totally different. 

Dr. Mazlen
I'm glad you made the analogy to brain surgery because I think most people know how complex that is. You've been doing some research for 16 years into the possible viral etiology of at least some of the cases of Chronic Fatigue Syndrome. What is that work about?

Dr. Hyde
Well, the first thing, Roger, is that we have been working since 1985 and I'm embarrassed to say during the first 4 or 5 years that we worked on this, we didn't find anything. And yet the patients were so terribly, terribly ill and we saw, as in all diseases, enormous variation amongst this type of illness and a lot of physicians said, "Well, if it's so variable, it can't be the same disease." And you have to understand that MS-- multiple sclerosis--is exceedingly variable. If you pick up wild measles you can be ill for an afternoon or you can have major brain injury and become paralyzed, so all diseases have an enormous variable, depending on host resistance, what is causing the illness and what we gradually started to realize when we're looking at these patients is that you could investigate them and we have slowly found a major variable in this disease and that is those individuals who fall ill acutely, and these are the individuals who are absolutely fine at 4 o'clock on a Monday afternoon and at 4:15 they are ill and they're in some kind of great pain, they sometimes have a fever, but the net result is that these individuals fall ill rapidly. Then you have another group of individuals who end up with the same problems of Chronic Fatigue patients and that is, the brain dysfunction, the rapid fatigueability. These people are not tired all the time. What they tend to be is, as soon as they do anything, as soon as anything happens to them, whether it's occupational things such as noise, or too much emotional effort, or too much physical effort, and it doesn't have to be very much, and these people run down rapidly. Well what we've found is that the individuals who fall ill acutely, we've been able to find in about 25% of those individuals, a new virus which resembles a polio virus. It's the same family as the polio virus. It's called enterovirus, but of the some 60 known enterovirus we're actually finding a totally different subgroup of viruses in this individuals and it's very interesting because one of the subgroups of people get better. They stay ill for one, two, three years and they slowly get better and the second subgroup with these polio-like viruses, they don't get better and they resemble almost identically the sequences that you find in paralytic polio but these people are not paralyzed and as everybody out there knows, even though they may not know people anymore, fortunately, with polio, polio didn't just injure the muscles, it injured the spinal chord and it injured in some people the lower part of the brain. And when we look at M.E. patients and Chronic Fatigue patients who fall ill acutely, we always find brain dysfunction and we are able to measure it with a SPECT scan. Now, let's talk a bit about SPECT scans. SPECT scans are not MRIs, they're not like X-rays. What they're looking at is function. And what you can do with a SPECT scan, particularly the new ones like the Picker 3000's with the right kind of heads on them, you can actually look at the functioning of the individual brain cells and in groups, if you will, and what we find is not just the thinking part of the brain is injured, but the subcortical areas of the brain are injured and that's the area of the brain below the thinking part, so these people's memories may be good for a short period of time but the area that allows you to get memories in and out is injured. And also some of the areas which control muscle strength, not the paralytic type of muscle areas, but the areas that coordinate muscle strength and we think that may be one of the reasons why we can actually say that "Yeah, these people have got muscle weakness, very rapid muscle weakness, and we can measure it." And that work was pioneered by Jay Goldstein in California and it's never been taken up seriously by the National Institute of Health--NIH--or the Center for Disease Control. We're at an advantage in Canada that access to these tests are free. We don't have as good as equipment as you have in the states, but the thing we can do all of these tests at no charge, we don't have to worry about whether the patients have insurance or not. 

Dr. Mazlen
Byron, can you comment' as you have to me before the show, with regard to defining vascular disease or vascular type injuries in patients in this group with this type of polio virus or variant enterovirus?

Dr. Hyde
Absolutely, Roger, Now, we went just went rapidly over acute onset and we made the statement that we can diagnose these people on two bases. One is that we are finding that about 25% of them with a polio-like virus and the second is that you can measure all of them, whether we find this virus or not, using a SPECT scan showing difficulty in the brains getting proper nutrition and getting proper blood flow. When you look at the gradual onset group, we find something which sometimes resembles the acute but often is quite different and if you look at our website which is www.nightingale.ca it will give you some more details on this, but basically, we're finding major vascular disease in a good percentage of the slow onset and also the acute onset group and what is nice about this is from a person who doesn't have a great deal of insurance or doesn't have any insurance at all, the testing techniques are very inexpensive and we do echocardiograms and on all of these patients. We also do transcranial Doppler's and carotid Doppler's. Now, this is not invasive. These are just tests that use an echo type of technique to look at the blood vessels and the blood supply going to first to the brain and the blood supply in the brain and in as many as 25% of the gradual onset we find major vascular disease. Some of these people have had strokes that account for their illness. Some of them have obstructions, some of them have malformations. And, I'm just mentioning this as one of many techniques, because it isn't expensive, it isn't invasive, it doesn't hurt, it's fast and it's cheap. And I think one of the problems with people with Chronic Fatigue Syndrome is that it has been treated as one disease or just anxiety neurosis in the past and this is very unfortunate for the patient because a patient will come to one group of doctors and they'll give them tranquilizers or mood elevators, antidepressants, and not really look and say let's do a fairly complete workup on these patients because some of these obstructions, particularly, if the carotid can be corrected and the patients can get back to their lives again and some of these patients have been ill for years, whereas minor--well it's not very minor--but major surgery because it's vascular surgery might correct a few of those people or even a large number of them. The other thing which is not expensive to do and we've found a large number of these patients in both groups, is if you take their blood in a peripheral vein and when you go and get your blood done--everyone's had that--and then take it out of the arm and it comes back, in most of the M.E. and Chronic Fatigue Syndrome patients you'll see they're slightly anemic. But what's really happening is that there is in a large group of these individuals, they don't have enough blood and the entire vascular system, the arteries and the veins somehow go into spasm and so you're getting a concentrated area of blood and it looks like they're just a little bit anemic but when you actually go and do, using the same equipment for the brain scan but using a different process, SPECT scans and do a red blood cell volume, we've seen people with only 50% of their normal circulating red blood cells. Now we don't know what's causing this, because we've just started doing this since Dr. Bell in upper New York State discovered this last year but as many as, I would say, 25% -35% of all the patients we've examined to date are running somewhere between a loss of 20% - 50% of their normal red blood cells. No wonder they're fatigued and exhausted. 

Dr. Mazlen
This is 50% of both groups, acute and gradual onset?

Dr. Hyde
Yes, we find that in both groups. So there's a lot of things here in this type of illness and I think it's worthwhile doing these simple investigations. What has happened with physicians up to now, they've done blood tests, they've done immune tests, they've done tests which really are available to most physicians and you have to look at this group of illnesses as functional illnesses in which they're not functioning and they're not functioning usually because of physical or physiological reasons. 

Dr. Mazlen
Certainly, as you point out, the disease is very real and the deniers of the disease have got to be educated so that they'll stop denying it and insulting people and depriving them of their rightful disability claims. 

Dr. Hyde
This is a very important thing. We actually do in Canada and sometimes in the United States, legal work for these patients. And what we basically do is we investigate these patients first, whether they're in Canada or the United States. We tell them right off, "Look, we haven't found enough to go to court and don't waste your time and energy and money. You may be very very ill." But we only find that in about 20% or less, I'd say closer to 10% that we don't find major illness in these people and in Canada we've probably won 90% of all our court cases. In the United States we've actually won everyone but we've only done a few in the United States. Well, that's not true, we lost one in Pennsylvania, but we didn't have all our information in when it went to court. So, if you can actually show to a judge or a committee or a jury physical basis of illness which is persistent, it's very difficult for them to refuse long term disability.

Dr. Mazlen
I hope that will encourage our audience. I want to mention that you can order a book from the Nightingale Research Foundation which covers the field discussing both Myalgic Encephalitis and Chronic Fatigue Syndrome and this answers the question of our caller, Julie, on line 1. This book has it all in there. It can be ordered through the Nightingale Research Foundation, 121 Iona Street, Ottawa, Canada K1Y 3N1 or through email at the Nightingale site.

Byron, you say you've sequenced this virus, and it's similar to the old polio virus. Are you going to be publishing that eventually? 

Dr. Hyde
We hope to. We've got the paper ready and sometime between now and the summer we'll be submitting it. A lot of this work was fairly expensive and it was done in Glasgow and unfortunately, they've just closed the hospital we were using so we've got a new hospital we're doing the work in in England. We simply can't afford the cost of doing this test in the United States.

Dr. Mazlen
I well know that it's expensive. Now in terms of treating this group that have this new virus, you had mentioned that there's possibly going to be a new treatment available in Canada in September? 

Dr. Hyde
Well there is a new anti-viral which is already available in clinical studies for the polio group of viruses, enteroviruses and we're hoping to start the study in the fall. I can't give you the name of it. I literally do not know what the common name is or even what the medical name is, but it is available and, hopefully, in September, but again you have to realize this is the acute onset group and it's only 25% of them, so it's very worthwhile to do the PCRs for enterovirus and perhaps you can get me back around Christmas time and I'll be able to tell you if it worked or not. So, that's quite interesting. At the moment, you really have to investigate all Chronic Fatigue Syndrome patients in great detail because a lot of them are sitting on very treatable diseases. A lot of them have illnesses that can be corrected by known means and unless these people are properly investigated you can't treat them adequately. However, and I notice that your program is sponsored by Hemispherx, but Hemispherx actually has the only drug that we've seen in the last 15 years that is actually of major assistance to this group of patients. Now, Hemispherx did something that the NIH and CDC did not do. They've actually got a better definition of this illness then the NIH and CDC and basically they say, "Look, you have to have certain things," but the people that went into their study had to have a test done which was done at Temple University in Philadelphia.

Dr. Mazlen
The low molecular weight enzyme test.

Dr. Hyde
Exactly, the 2-5A synthetase RNase pathway that was invented by Dr. Suhadolnik.

<Show ended>

Transcribed by 

Carolyn Viviani
carolynv@inx.net 

Permission is given to repost, copy and distribute this transcript as long as my name is not removed from it.

1999 Roger G. Mazlen, M.D.