CHRONIC EPSTEIN BARR VIRUS INFECTION AND CHRONIC FATIGUE SYNDROME

慢性爱泼斯坦巴尔病毒感染和慢性疲劳综合症

• 批准号: 5200475
• 负责人: S E STRAUS
• 金额: --
• 依托单位: NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/5200475
• 关键词: Epstein Barr virus; T lymphocyte; arginine vasopressin; artificial immunosuppression; chronic fatigue syndrome; corticotropin releasing factor; cortisol; diagnosis design /evaluation; human subject; human therapy evaluation; lymphocyte proliferation; neuroendocrine system; neuroimmunomodulation; pathologic process; pituitary adrenal axis; seasonal affective disorder

The goals of this project are to characterize severe chronic infections with Epstein Barr Virus (EBV) and other lymphoproliferative disorders, and to elucidate multiple aspects of the chronic fatigue syndrome which was, earlier, considered to be related to EBV infection. To date this research project has involved over 300 patients. Included are 9 patients who were diagnosed with severe chronic EBV infections on the basis of clinical, histological, molecular and serologic features. We continue to examine immunologic features of patients with severe chronic EBV- associated lymphoproliferation and explore treatments. Acyclovir, alpha and gamma interferons proved of little value, but immunosuppressive therapies are being used with good long-term results. Detailed immunologic, neurologic, endocrinologic and psychologic studies are being conducted on selected patients with chronic fatigue. To date, we still have no consistent laboratory abnormality that permits a clear diagnosis of the chronic fatigue syndrome. A series of earlier studies of the pituitary-adrenal suggested deficient central CRH release. Since CRH induces CNS arousal, these neuroendocrine findings suggest a new mechanism whereby the lethargy of Chronic Fatigue Syndrome patients may be explained. We are pursuing these observations in a new series of studies and a fresh patient cohort. Arginine-Vasopression infusions were given to CFS patients and controls to stimulate and test the HPA axis and the data are under analysis, 62 of 70 desired were enrolled in a placebo- controlled trial of hydrocortisone treatment. It should permit us to test the hypothesis that corticosteroid deficit leads to symptoms. We completed a study showing the absence of seasonality in CFS symptoms, further distinguishing the it from Seasonal Affective Disorder. We recognized discrete abnormalities in CFS patient lymphocyte phenotype and in vitro responsiveness to mitogens in patterns suggesting mild immune activation. We noted a reduction in naive T Cells and an increase in memory T cell bearing adhesion markers. We have begun to pursue these findings and related immune studies in populations a new CFS patint cohort and in patients with acute influenza. A vigorous, multidisciplinary approach to the syndrome continues.

该项目的目标是描述严重慢性感染的特征 与爱泼斯坦巴尔病毒（EBV）和其它淋巴增生性疾病， 并阐明慢性疲劳综合征的多个方面， 早期被认为与EBV感染有关。 更准确地推测这起 该研究项目涉及300多名患者。 包括9名患者 被诊断患有严重的慢性EBV感染， 临床、组织学、分子和血清学特征。 我们继续 检测慢性EB病毒重度感染患者的免疫学特征， 相关的淋巴细胞增生并探索治疗方法。 阿昔洛韦，α 和γ干扰素被证明没有什么价值， 目前正在使用的治疗方法取得了良好的长期效果。 详细的免疫学、神经学、内分泌学和心理学研究 正在对选定的慢性疲劳患者进行研究。 到目前为止， 我们仍然没有一致的实验室异常， 慢性疲劳综合征的诊断。 一系列早期的研究 提示中枢CRH释放不足。 以来 CRH诱导中枢神经系统觉醒，这些神经内分泌研究结果表明， 慢性疲劳综合征患者嗜睡的机制， 得到解释。 我们正在一系列新的 研究和新的患者队列。 精氨酸-血管加压素输注 给予CFS患者和对照组以刺激和测试HPA轴， 数据正在分析中，70名受试者中有62名接受了安慰剂治疗， 氢化可的松治疗的对照试验 它应该允许我们 测试皮质类固醇缺乏导致症状的假设。 我们 完成了一项研究，显示CFS症状没有季节性， 进一步区分它和季节性情感障碍。 我们 在CFS患者淋巴细胞表型中识别出离散异常， 体外对有丝分裂原的反应性表明， activation. 我们注意到幼稚T细胞减少， 记忆T细胞携带粘附标记。 我们已经开始追求这些 一种新的CFS病例的人群中的发现和相关免疫研究 队列和急性流感患者。 一个充满活力， 继续采取多学科方法治疗该综合征。