A cluster of patients with a chronic mononucleosis-like syndrome. Is Epstein-Barr virus the cause?

Holmes, Gary P.

doi:10.1001/jama.257.17.2297

Cited by 90 publications

(68 citation statements)

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“…The elevation of antibodies to various viruses is thought to be caused by a nonspecific polyclonal B-lymphocytic response (16). However, the elevated levels of antibodies to BDV identified in our previous studies (25,31) and this study ( Fig.…”

Section: Discussioncontrasting

confidence: 46%

Borna Disease Virus Infection in Two Family Clusters of Patients with Chronic Fatigue Syndrome

Nakaya

Takahashi

Nakamura

et al. 1999

Microbiology and Immunology

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A high rate of Borna disease virus (BDV) infection has been demonstrated in patients with chronic fatigue syndrome (CFS). Herein, we focused on BDV infection in two family clusters of patients with CFS: a father, mother, two sons and one daughter (family #1); and a father, mother, two daughters and one son (family #2), All members, except for the elder son in family #1 and the father and son in family #2, were diagnosed with CFS. The results supported that all the family members with CFS were infected with BDV, as evidenced by the presence of antibodies to viral p40, p24 and/or gp18 and BDV p24 RNA in peripheral blood mononuclear cells. The healthy members, except for the father of family #2 who was positive for antibody to p24, were all negative by both assays. Follow-up studies in family #1 continued to reveal BDV antibodies and BDV RNA, except in the mother, who lost the RNA upon slight recovery from the disease.

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Section: Discussioncontrasting

confidence: 46%

Borna Disease Virus Infection in Two Family Clusters of Patients with Chronic Fatigue Syndrome

Nakaya

Takahashi

Nakamura

et al. 1999

Microbiology and Immunology

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“…Previous CFS studies have been limited or based upon symptoms only. [40][41][42][43][44][45][46][47][48][49][50][51][52] In our CFS systematic review, 1 we found 36 additional so-called CFS patients who had serologic evidence of herpesviruses infection (EBV, CMV, HHV6) and one or more co-infections. we named the 36 additional CFS patients with co-infections group-B CFS.…”

Section: Recent Findings Diagnostic Panel and Group-a And -B Subsetsmentioning

confidence: 99%

Abortive lytic Epstein–Barr virus replication in tonsil-B lymphocytes in infectious mononucleosis and a subset of the chronic fatigue syndrome

Lerner¹,

Beqaj²

2012

VAAT

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A systematic 2001-2007 review of 142 chronic fatigue syndrome (CFS) patients identified 106 CFS patients with elevated serum IgG antibodies to the herpesviruses EpsteinBarr virus (EBV), cytomegalovirus, or human herpesvirus (HHV) 6 in single or multiple infections, with no other co-infections detected. We named these 106 patients group-A CFS. Eighty-six of these 106 group-A CFS patients (81%) had elevated EBV early antibody, early antigen (diffuse), serum titers. A small group of six patients in the group-A EBV subset of CFS, additionally, had repetitive elevated-serum titers of antibody to the early lytic replicationencoded proteins, EBV dUTPase, and EBV DNA polymerase. The presence of these serum antibodies to EBV dUTPase and EBV DNA polymerase indicated EBV abortive lytic replication in these 6 CFS patients. None of 20 random control people (age-and sex-matched, with blood drawn at a commercial laboratory) had elevated serum titers of antibody to EBV dUTPase or EBV DNA polymerase (P , 0.01). This finding needs verification in a larger group of EBV CFS subset patients, but if corroborated, it may represent a molecular marker for diagnosing the EBV subset of CFS. We review evidence that EBV abortive lytic replication with unassembled viral proteins in the blood may be the same in infectious mononucleosis (IM) and a subset of CFS. EBV-abortive lytic replication in tonsil plasma cells is dominant in IM. No complete lytic virion is in the blood of IM or CFS patients. Complications of CFS and IM include cardiomyopathy and encephalopathy. Circulating abortive lytic-encoded EBV proteins (eg, EBV dUTPase, EBV DNA polymerase, and others) may be common to IM and CFS. The intensity and duration of the circulating EBV-encoded proteins might differentiate the IM and EBV subsets of CFS. Abortive lytic replication may be a pathogenic mechanism for EBV disease. EBV (HHV4) is a gamma herpesvirus composed of dsDNA about 170 Kb in length. For this discussion, there are early genes (including expressions of encoded proteins EBV dUTPase, DNA polymerase, and nuclear proteins) and late genes (including expressions of capsid and membrane proteins). Abortive infection infers incomplete virion expressions of either early or late proteins, but the virion is incomplete. The lytic virus infers a complete virion. The pathologic consequences of EBV abortive replication are currently being investigated by authors.

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“…Currently, considerable attention is being devoted to 'chronic mononucleosis', also known as 'chronic active Epstein-Barr virus (EBV) infection'. The syndrome is characterized by chronic fatigue, fever, myalgia, pharyngitis, headache, depression and cognitive change (Buchwald et al 1987;Holmes et al 1987). Antibody titres against EB virus are somewhat higher in patients with these symptoms than they are in the general population, but exposure to EBV is so ubiquitous that there are no cut-off levels which reliably distinguish patients from controls.…”

Section: Prediction In Social Sciencementioning

confidence: 99%

The social construction of mental illness

Eisenberg

1988

Psychol. Med.

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A cluster of patients with a chronic mononucleosis-like syndrome. Is Epstein-Barr virus the cause?

Cited by 90 publications

References 0 publications

Borna Disease Virus Infection in Two Family Clusters of Patients with Chronic Fatigue Syndrome

Borna Disease Virus Infection in Two Family Clusters of Patients with Chronic Fatigue Syndrome

Abortive lytic Epstein–Barr virus replication in tonsil-B lymphocytes in infectious mononucleosis and a subset of the chronic fatigue syndrome

The social construction of mental illness

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A cluster of patients with a chronic mononucleosis-like syndrome. Is Epstein-Barr virus the cause?

Cited by 90 publications

References 0 publications

Borna Disease Virus Infection in Two Family Clusters of Patients with Chronic Fatigue Syndrome

Borna Disease Virus Infection in Two Family Clusters of Patients with Chronic Fatigue Syndrome

Abortive lytic Epstein&ndash;Barr virus replication in tonsil-B lymphocytes in infectious mononucleosis and a subset of the chronic fatigue syndrome

The social construction of mental illness

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Product

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Abortive lytic Epstein–Barr virus replication in tonsil-B lymphocytes in infectious mononucleosis and a subset of the chronic fatigue syndrome