CHRONIC FATIGUE IN LYME DISEASE

其目的是确定涉及慢性炎症的致病机制， 疲劳综合症 研究将集中在慢性 疲劳+螺旋体感染后的认知障碍 B.burgdorferi（B B）（莱姆病的病因）。 对照品将匹配 b感染的受试者没有这样的问题。 受试者将在 单个时间点和连续的临床参数（使用疲劳和 认知评定量表）和免疫参数。 以下具体 将讨论以下问题： 1. 是否有诱发因素？ 记录HLA-DR类型，过敏 患者的病史、抑郁/心理特征和皮试反应 vs.对照 2. 是否涉及免疫激活？ 检查血液和脑脊液 对于免疫复合物（IC），使用聚乙二醇，色谱法，和 Raji细胞试验;自发、有丝分裂原和抗原诱导的淋巴细胞 增殖;和细胞因子/可溶性标志物，使用ELISA在患者与 对照 3. 免疫激活是否针对Bb？ 将IC隔离至探头， 抗Bb抗体。 比较体外淋巴细胞反应性和细胞因子 在患者与对照中产生Bb。 4. 比较单纯疲劳患者与认知疲劳患者的免疫特征 损伤 相关的体液、细胞和可溶性免疫参数 通过测量疲劳和认知的临床参数。 5. 疲劳或认知受损的患者是否有持续的Bb 感染？ 使用单克隆/多克隆探针分离IC检测Bb抗原 抗体、ELISA和免疫印迹。 本研究针对感染后疲劳患者的特定亚组 研究免疫激活和持续感染在其 疲劳，以及认知障碍与疲劳的关系。 这 这项工作应该为异质性患者群体提供见解， 慢性疲劳综合症

The objective is to define pathogenic mechanisms involved in chronic fatigue syndrome. Studies will concentrate on patients with chronic fatigue + cognitive impairment following infection by the spirochete B.burgdorferi (Bb) (the cause of Lyme disease). Controls will be matched Bb-infected subjects without such problems. Subjects will be evaluated at single time points and serially for clinical parameters (using fatigue and cognition rating scales) and immune parameters. The following specific points will be addressed: 1. Are predisposing factors involved? Document HLA-DR type, allergy history, depression/psychologic profile, and skin test response of patients vs. controls. 2. Is immune activation involved? Examine blood and cerebrospinal fluid for immune complexes (IC) using polyethylene glycol, chromatography, and Raji cell assay; spontaneous, mitogen, and antigen-induced lymphocyte proliferation; and cytokines/soluble markers using ELISA in patients vs. controls. 3. Is immune activation directed against Bb? Isolate IC to probe for anti-Bb antibodies. Compare in vitro lymphocyte reactivity and cytokine production to Bb in patients vs. controls. 4. Compare the immune profile of patient with fatigue alone vs cognitive impairment. Correlate humoral, cellular, and soluble immune parameters with measured clinical parameters of fatigue and cognition. 5. Do fatigue or cognitively impaired patients have persistent Bb infection? Probe isolated IC for Bb antigens using monoclonal/polyclonal antibodies, ELISA, and immunoblot. This study targets a specific subgroup of postinfectious fatigue patients to examine the role of immune activation and persistent infection in their fatigue, and the relationship of cognitive impairment to fatigue. This work should provide insights for the heterogeneous group of patients with chronic fatigue syndromes.