CHRONIC EPSTEIN BARR VIRUS INFECTION AND CHRONIC FATIGUE SYNDROME

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，并表征多个方面的 慢性疲劳综合症 迄今为止，该研究项目涉及 近170名患者 包括7名被诊断为 严重的慢性EBV感染的基础上，临床，历史， 分子和血清学特征。 我们继续检查免疫学 严重慢性EBV相关淋巴细胞增生症患者的特征- 并探索治疗方法。 干扰素被证明没有什么价值，但 免疫抑制疗法的使用具有良好的效果。 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。 迄今 我们没有一致的实验室异常， 慢性疲劳综合征的诊断，然而，我们一直在 探讨群体性异常的依据和意义， 神经精神免疫和内分泌系统 在过去的一年里，我们 完成了第二组垂体-肾上腺的研究， 对促肾上腺皮质激素释放激素和ACTH的反应性， 神经肽和儿茶酚水平。 研究结果表明 一种新的神经内分泌缺陷，可能表明中枢CRH缺乏 release. 由于CRH诱导中枢神经系统觉醒，这些神经内分泌结果 提出了一种新的机制， 病人可以解释。 在过去的一年里，我们完成了初步的 对照免疫研究显示淋巴细胞的离散异常 表型和体外对有丝分裂原的反应性， 轻度免疫激活 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.