Notes on Mast Cell Activation Disorder and ME/CFS, by Margaret Williams, 14 April 2017
Few would dispute that the immunology of ME/CFS is complex and that the findings presented in the literature sometimes appear to be inconsistent.
Whilst much has been published about one sub-group of ME/CFS patients with a low T4 (CD4/helper cell) and a high T8 (CD8/suppressor cell) ratio, not as much seems to have been published about people with ME/CFS who have the opposite T-cell ratio (ie. a high T-cell helper/low suppressor T-cell ratio).
Such an increased T4:T8 ratio resulting in a relative suppressor cell lymphopenia is seen in people with allergies and hypersensitivities, both of which are recognised components of well-defined ME/CFS as distinct from other syndromes of chronic fatigue.
It has long been acknowledged that a reduction in functional activity of suppressor Tcells and the loss of suppressor cell influence is implicated in the pathogenesis of autoimmune diseases (1,2,3,4) and evidence is now accumulating in the literature that ME/CFS is an autoimmune disease.
It has also been suggested that there may be an association between ME/CFS and mast cell activation disorder (5).
Evidence has certainly been presented for a causal involvement of pathologically active mast cells in interstitial cystitis, fibromyalgia and irritable bowel syndrome (6) and a link is suggested with POTS and dysautonomia (7), all of which are frequent comorbidities with ME/CFS.
Mast cell activation disorder (MCAD) can cause tremendous suffering and disability: there is no cure for it and management is directed towards symptom control. Read the full article