CHRONIC FATIGUE IN LYME DISEASE

目的是确定慢性病的致病机制 疲劳综合症。 研究将集中于慢性病患者 螺旋体感染后疲劳认知障碍 伯氏疏螺旋体 (Bb)（莱姆病的病因）。 控件将被匹配 Bb感染者没有这样的问题。 受试者将在 单个时间点和连续临床参数（使用疲劳和 认知评分量表）和免疫参数。 具体如下 将解决以下问题： 1.是否有诱发因素？ 文件 HLA-DR 类型、过敏 患者的病史、抑郁/心理状况和皮试反应 与控制。 2. 是否涉及免疫激活？ 检查血液和脑脊液 使用聚乙二醇、色谱法和免疫复合物 (IC) Raji细胞测定；自发淋巴细胞、有丝分裂原淋巴细胞和抗原诱导淋巴细胞 扩散；使用 ELISA 检测患者与对照组的细胞因子/可溶性标记物 控制。 3. 免疫激活是针对Bb的吗？ 隔离 IC 以探测 抗 Bb 抗体。 比较体外淋巴细胞反应性和细胞因子 患者与对照中 Bb 的产生。 4. 比较单纯疲劳患者与认知疲劳患者的免疫状况 损害。 关联体液、细胞和可溶性免疫参数 测量疲劳和认知的临床参数。 5.疲劳或认知障碍患者是否有持续性Bb 感染？ 使用单克隆/多克隆探针分离 Bb 抗原的 IC 抗体、ELISA 和免疫印迹。 这项研究针对感染后疲劳患者的特定亚组 检查免疫激活和持续感染在其疾病中的作用 疲劳以及认知障碍与疲劳的关系。 这个 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.