chronic fatigue syndrome （cfs） amp fibromyalgia （fm） 治疗慢性疲劳综合征（cfs）amp纤维肌痛（fm）课件

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1、TreatingChronicFatigueSyndrome(CFS)&Fibromyalgia(FM)byTargetingtheMethylationCycleDerekEnlander,MD860FifthAvenueNewYork,NY10065USA1-212-794-2000denlander@aol.comBasiccellprocessPathogenisisVirusasCausativeAgentCFSoftenstartswithaflu-likeepisodeCFSsymptomswaxandwane

2、AntiviralpathwaysareactivatedCFSsymptomsaresimilartomanyviralconditionsincluding:EBVmononucleosisRossRivervirusGeographicoutbreakshavebeenreportedGeneexpressionprofilingfoundgeneticvariantsthatimpactantiviraldefensesAntiviraltreatmentshavebeeneffectiveininsmallstudie

3、sAmpligenisoprinosinebetainterferonvalganiclovirVirusesImplicatedInCFSHumanherpesvirusesEBV(HHV-4)CMV(HHV-5)HHV-6HHV-7StealthVirus(Simian)EnterovirusesPolioCoxsackieA&BEchovirusFoamyvirus[spumavirus]ParvovirusB-19Hepatitis-CvirusJHKVRubellavirusRossRivervirus(RRV)Ino

4、ue-MelnickvirusBornavirusHERVHumanEndogenousRetrovirusHHV6virusDiscoveredin1986byAblashiandSalahuddinatNCIinpatientswithlymphoproliferativedisease(slidebykindpermissionofDharamAblashi)HHV-6isanenveloped,double-strandedDNAviruswithanicosahedralcapsidandvirionsizeof160

5、-200nm.Thegenomecontains70proteins.Someoftheseproteins(earlyantigenandimmediateearlyantigen)canbeusedtodetectactiveinfections.Twoverydistinctvariantswith90%nucleotidesequencehomology.ThegenomeofvariantAorBrangesfrom159–170kb.BetaherpesvirusandgenusroseolavirusOver90%

6、ofadultsseropositivePredominantlyCD4lymphotropicHHV-6hastwovariants,AandB. Eachvariantisassociatedwithasubsetofillnesses.HHV-6AinfectioncomeslaterinlifeandhasbeenlinkedtothepathogenesisofCFS,rhomboencephalitis,andMS.ItalsoplaysaroleinHIV,causingmoreimmunosuppressioni

7、nAIDSpatients.HHV-6BisthecausativeagentofExanthemsubitum,isstronglylinkedtoinfectionsintransplantpatientsandisalsoassociatedwithepilepsyandpost-transplantacutelimbicencephalitis.HHV-6Aismorelytic,andreadilyinfectsavarietyofneuralandothercellssuchasastrocytes,andisals

8、omoreneurotropic,leadingtocognitivedisordersinCFSandMSpatients.BothA&Bstrainscauseencephalitis,amnesia,facialparalysis,chronicmyeli