CHRONIC EPSTEIN BARR VIRUS INFECTION AND CHRONIC FATIGUE SYNDROME

这个项目的目标是描述严重的慢性感染的特征。 与爱泼斯坦-巴尔病毒的关系，并从多个方面描述了 慢性疲劳综合征。到目前为止，这项研究项目涉及到 近170名患者。包括7名患者，他们被诊断为 严重的慢性EB病毒感染基于临床，病史， 分子和血清学特征。我们继续检查免疫学 重度慢性EB病毒相关性淋巴增殖症患者的特征 治疗和探索治疗方法。干扰素被证明价值不大，但 目前正在使用免疫抑制疗法，效果良好。 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症患者进行研究。到目前为止 我们没有发现一致的实验室异常情况 慢性疲劳综合症的诊断，然而，我们已经被 追寻群体性异常的依据和意义 神经精神、免疫和内分泌系统。在过去一年里，我们 完成了对垂体-肾上腺的第二组研究 促肾上腺皮质激素释放激素和促肾上腺皮质激素的反应性 脊髓液中神经肽和儿茶酚水平。研究结果表明， 一种可能提示中枢性促肾上腺皮质激素释放激素缺乏的新型神经内分泌缺陷 放手。由于CRH诱导中枢神经系统唤醒，这些神经内分泌发现 提示慢性疲劳综合征嗜睡的新机制 病人可能会被解释。在过去的一年里我们完成了初步的 受控免疫研究显示淋巴细胞呈离散异常 表型和体外对有丝分裂原的反应性 轻微的免疫激活。在未来的一年里，我们将重点关注 这些发现。

The goals of this project are to characterize severe chronic infections with Epstein Barr Virus and to characterize multiple aspects of the chronic fatigue syndrome. To date this research project has involved nearly 170 patients. Included are 7 patients who were diagnosed with severe chronic EBV infections on the basis of clinical, historical, molecular and serologic features. We continue to examine immunologic features of patients with severe chronic EBV-associated lymphoprolifer- ation and explore treatments. Interferon proved of little value, but immunosuppressive therapies are being used with good results. Detailed immunologic, neurologic, endocrinologic and psychologic studies are being conducted on selected patients with chronic fatigue. To date we have no consistent laboratory abnormality that permits a clear diagnosis of the chronic fatigue syndrome, however, we have been pursuing the basis and meaning of the group abnormalities in neuropsychiatric, immune and endocrine systems. During the past year we completed a second set of studies of the pituitary-adrenal responsiveness to corticotropin releasing hormone and ACTH and of neuropeptide and catechol levels in spinal fluid. The findings suggest a novel neuroendocrine defect that may indicate 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. During the past year we completed initial controlled immune studies revealing discrete abnormalities in lymphocyte phenotype and in vitro responsiveness to mitogens in patterns suggesting mild immune activation. In the coming year we will focus heavily of these findings.