Sep

29

BunsenBwog: A Sunday Morning Chat with W. Ian Lipkin

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He’s cured three diseases before you even woke up this morning.

Bwog’s avant-garde epidemiologist, Zach Kagan, ventures out on this fine Sunday armed with sleep inertia and a healthy sense of adventure. He discusses recent development in Chronic Fatigue Syndrome (CFS) with our very own Professor Lipkin.

Professor W. Ian Lipkin has been featured in several editions of BunsenBwog, and why wouldn’t he be? As the director of the Center for Infection and Immunity and John Snow Professor of Epidemiology at the Mailman School, Prof. Lipkin has metaphorical fingers in so many metaphorical pies that he ought to get metaphorical carpal tunnel. BunsenBwog has covered his work on the Borna Disease VirusKawasaki Disease, and the film, Contagion, where he acted as a creative consultant (and provided inspiration for one of the characters). But these are but tiny portions of the research Dr. Lipkin contributes to at the CII. That is why I was so excited when Prof. Lipkin agreed to speak with me about the CII’s latest findings on Chronic Fatigue Syndrome.

The first thing you learn about W. Ian Lipkin is that he’s extremely and perpetually busy, making it difficult to find a time to actually sit down and talk. After a week of negotiations with his personal assistant, Prof. Lipkin decided to E-mail me himself. At 6 A.M. on a Sunday. “Best for me would be 9am.”

Had an obnoxious ray of sunlight not accidentally woken me up at 8:30 A.M., I probably would have slept through my only shot at an interview. Well, it was what I wanted, wasn’t it? So I set forth, sleep deprived and slightly hungover, to meet Lipkin in his 105th street townhouse home. When I found his house, Prof. Lipkin was waiting in the kitchen, eating a sandwich and fiddling with an espresso maker. Thankfully, some of that coffee found its way into the miniature mug being handed to me. And, eventually, we started talking about the CII.

Chronic Fatigue Syndrome is a strange beast. While its name might suggest that it’s some acute form of senioritis, in reality it’s a debilitating illness which over a million Americans suffer from. Symptoms extend beyond prolonged fatigue; CFS sufferers also experience muscle pain, unsatisfying sleep, headaches, impaired memory, and mental fog as well as a host of other flu-like symptoms. While some symptoms may suggest that a viral infection is the culprit behind CFS, many scientists are not sure. In fact, there is much debate in the medical community over what exactly causes CFS. The biggest lead comes from a 2009 paper published in Science, which linked CFS to two viruses: XMRV and pMLV.

However, the paper’s results were never successfully replicated by other laboratories, which sparked skepticism among researchers. And so, as Lipkin puts it, “We went ahead and set up a study to test this thing once and for all.” Using blood samples from 147 patients with CFS and 146 controls, researchers searched for traces of XMRV and pMLV. In the end none of the participating groups found any presence of genes characteristic of the two viruses in question. The conclusion is that the 2009 discovery may have been the result of some sample contamination. For now the true cause of CFS is again a mystery. Personally, Lipkin believes that CFS may not be one disease but instead a category of symptoms caused by a large set of factors, which will present new challenges to CFS researchers.

But to Lipkin the CFS study is just one of many side projects. For example, he has a team down in Grenada investigating why a tilapia fish farm is experiencing an 80% mortality rate. But while these projects are important, Lipkin considers them his “day job… it’s easy, almost automated.” We talked about his long term interests: epigenetics, cancer prediction, preventative medicine, and creating an international network of infectious disease specialists. It’s that last one that he feels is most important for improving world health. “You don’t need 65 people [referring to the number of researchers at the New York CII], just 600 feet and a sequencing machine.”

Somehow the conversation segued from morality of eugenics (“look, I don’t want to create Aryan supermen”) to diseases caused by gastrointestinal fauna to Bill Clinton’s eating habits. “There’s this picture of Bill Clinton at Katz’s deli eating two whole sandwiches and fries,” Lipkin remembers, that being before, of course, Clinton’s quadruple bypass surgery and later implantation of two coronary stents. Now he’s a vegan, Prof. Lipkin informs me. Absentmindedly I reply that so is Clint Eastwood.

“I hadn’t heard of that, let’s look it up.” He pulls out his laptop and starts Googling “Clint Eastwood + Vegan.” “Now I’m really intrigued.” After only a few clicks, he found an article claiming Eastwood has invited prominent members of the GOP to his place for steak dinners. “I don’t think he’s a vegan if he’s eating steak dinners,” Prof. Lipkin tells me with a grin, “another myth bites the dust.”

Portrait via The Center for Infection and Immunity

 

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8 Comments

  1. Anonymous

    Cool interview. Dr. Lipkin finds time to speak with undergrad from Bwog.
    Bwog is gaining gravitas.

  2. Anonymous

    Isn't it still Saturday?

  3. Anonymous  

    Jon Snow endowed what?! Mark your spoilers next time Bwog.

  4. sheila darbyshire

    Very sad for the millions of people suffering from me/cfs to hear that after decades of being virtually ignored by the medical establishment, lipkin sees us as a "side issue". yep,we've been shafted again!

  5. Michael Crighton II

    Good point: were Lipkin to be locked in a six hundred foot space with a sequencing machine and internet access, would he, in due time, reproduce the works of Shakespeare ? It's just a matter of thermodynamics, eh!

  6. Chris

    If that is all you've got to report, Lipkin wasted precious time with you. Coming out of his university, this is truly pathetic.

    Your information about CFS doesn't sound like it came from Lipkin, but was taken straight from the CDC web site or any number of misleading sources. Line up those symptoms and it really sound so bad, does it?

    The flu doesn't make you lose IQ points, or your whereabouts in the place you live. It doesn't render you unable to walk safely down a flight of stairs or put you in a wheelchair. Sleep inertia? Many patients can't get to sleep in the first place because their pituitary hormones aren't functioning correctly; then their cortisol is ramped up at night in a re-advancing reverse of circadian rhythm, and they never get stage 3/4 deep sleep. On an exercise bike, they are Lance Armstrong's polar opposites - months, years after onset. Regardless of cause, many patients do have several active viruses most people handle: i.e., they are immune-compromised. As Lipkin left no doubt at his XMRV press conference, CFS patients are indeed sick, as he learned studying Borna and Japanese CFS patients years ago. Very sick - unable to work, attend school, and in some cases do anything but lie in bed, protected from all light and sound, hooked up to IVs. The latter are the ones getting Rituximab in Norway, an expensive and risky anti-cancer drug. Our mortality list around the world grows by the month. One of the latest was an undergrad in California; you can watch his YouTubes and literally see him waste away.

    That's why "ME/CFS" is increasingly used outside mainstream media, although many U.S. doctors don't even know that "ME" (a British name) stands for myalgic encephalomyelitis, brain stem inflammation with muscle pain.

    The CDC has not adopted that name, or done any number of other things it should have. They and NIH have 25 years of butt-covering to continue as they channel money away, control the pace of public knowledge and ignorance, and save the insurance industry a ton.

    With so much on his plate like stopping the next Spanish Flu, what's amazing is that Lipkin had time for US - tapped by Anthony Fauci only because a retrovirus in the blood supply would have been an unacceptable public risk. Still, he gets it.

  7. Anonymous

    Sufferin' succotash! No one is dismissive about CFS or CSF patients. The causes of CSF are not understood and the previous work about the possible viral causes were not confirmed in the current study reported by Dr. Lipkin. Clearly new directions have to be developed and that will require support of NIH.

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