From the Journal of Medical Virology, 25 July 2013.
Persistent human herpesvirus-6 infection in patients with an inherited form of the virus
Shara N. Pantry(1), Maria M. Medveczky(1), Jesse H. Arbuckle(1), Janos Luka(2), Jose G. Montoya(3), Jianhong Hu(4), Rolf Renne(4), Daniel Peterson(5), Joshua C. Pritchett(6), Dharam V. Ablashi(6), Peter G. Medveczky(1,*)
1) Department of Molecular Medicine, University of South Florida, Morsani College of Medicine, Tampa, Florida
2) Bioworld Consulting Laboratories, Mt. Airy, Maryland
3) Department of Infectious Disease, Stanford University, Stanford, California
4) Department of Molecular Genetics and Microbiology, University of Florida, Gainesville, Florida
5) Sierra Internal Medicine, Incline Village, Nevada
6) The HHV-6 Foundation, Santa Barbara, California
* Correspondence to: Peter G. Medveczky, University of South Florida College of Medicine, 12901 Bruce B. Blvd., MDC Box 7, Tampa, FL 33612.
Human herpesvirus-6 (HHV-6)A and 6B are ubiquitous betaherpesviruses viruses with lymphotropic and neurotropic potential. As reported earlier, these viruses establish latency by integration into the telomeres of host chromosomes.
Chromosomally integrated HHV-6 (CIHHV-6) can be transmitted vertically from parent to child. Some CIHHV-6 patients are suffering from neurological symptoms, while others remain asymptomatic. Four patients with CIHHV-6 and CNS dysfunction were treated with valganciclovir or foscarnet.
HHV-6 replication was detected by reverse transcriptase polymerase chain reaction amplification of a late envelope glycoprotein.
In this study we also compared the inherited and persistent HHV-6 viruses by DNA sequencing. The prevalence of CIHHV-6 in this cohort of adult patients from the USA suffering from a wide range of neurological symptoms including long-term fatigue were found significantly greater than the reported 0.8% in the general population.
Long-term antiviral therapy inhibited HHV-6 replication as documented by loss of viral mRNA production. Sequence comparison of the mRNA and the inherited viral genome revealed that the transcript is produced by an exogenous virus.
In conclusion, the data presented here document that some individuals with CIHHV-6 are infected persistently with exogenous HHV-6 strains that lead to a wide range of neurological symptoms; the proposed name for this condition is inherited herpesvirus 6 syndrome or IHS. J. Med. Virol. © 2013 Wiley Periodicals, Inc.
From Evidence Based Complementary and Alternative Medicine, 4 June 2013.
Efficacy and safety of medicinal plants or related natural products for fibromyalgia: a systematic review.
de Souza Nascimento S, Desantana JM, Nampo FK, Ribeiro EA, da Silva DL, Araújo-Júnior JX, da Silva Almeida JR, Bonjardim LR, de Souza Araújo AA, Quintans-Júnior LJ.
Department of Physiology, Federal University of Sergipe, Marechal Rondom Avenue, 49000-100 São Cristovão, SE, Brazil.
To assess the effects of medicinal plants (MPs) or related natural products (RNPs) on fibromyalgia (FM) patients, we evaluate the possible benefits and advantages of MP or RNP for the treatment of FM based on eight randomized placebo-controlled trials (RCTs) involving 475 patients.
The methodological quality of all studies included was determined according to JADAD and “Risk of Bias” with the criteria in the Cochrane Handbook for Systematic Reviews of Interventions 5.1.0.
Evidence suggests significant benefits of MP or RNP in sleep disruption, pain, depression, joint stiffness, anxiety, physical function, and quality of life.
Our results demonstrated that MP or RNP had significant effects on improving the symptoms of FM compared to conventional drug or placebo; longer tests are required to determine the duration of the treatment and characterize the long-term safety of using MP, thus suggesting effective alternative therapies in the treatment of pain with minimized side effects.
From the Journal of Psychosomatic Research<, 22 July 2013 (E-published first).
The process of cognitive behaviour therapy for chronic fatigue syndrome: Which changes in perpetuating cognitions and behaviour are related to a reduction in fatigue?
Marianne J. Heins*, Hans Knoop, William J. Burk, Gijs Bleijenberg
* Corresponding author at: Radboud University Nijmegen Medical Centre, Expert Centre for Chronic Fatigue, 4628, PO Box 9101, 6500 HB Nijmegen, The Netherlands.
Cognitive behaviour therapy (CBT) can significantly reduce fatigue in chronic fatigue syndrome (CFS), but little is known about the process of change taking place during CBT. Based on a recent treatment model (Wiborg et al. J Psych Res 2012), we examined how (changes in) cognitions and behaviour are related to the decrease in fatigue.
We included 183 patients meeting the US Centers for Disease Control criteria for CFS, aged 18 to 65years, starting CBT. We measured fatigue and possible process variables before treatment; after 6, 12 and 18weeks; and after treatment. Possible process variables were sense of control over fatigue, focusing on symptoms, self-reported physical functioning, perceived physical activity and objective (actigraphic) physical activity. We built multiple regression models, explaining levels of fatigue during therapy by (changes in) proposed process variables.
We observed large individual variation in the patterns of change in fatigue and process variables during CBT for CFS. Increases in the sense of control over fatigue, perceived activity and self-reported physical functioning, and decreases in focusing on symptoms explained 20 to 46% of the variance in fatigue. An increase in objective activity was not a process variable.
A change in cognitive factors seems to be related to the decrease in fatigue during CBT for CFS. The pattern of change varies considerably between patients, but changes in process variables and fatigue occur mostly in the same period.
From Frontiers in Physiology, 24 July 2013.
Migraine in gulf war illness and chronic fatigue syndrome: prevalence, potential mechanisms, and evaluation.
Rayhan RU, Ravindran MK, Baraniuk JN.
Division of Rheumatology, Immunology and Allergy, Department of Medicine, Georgetown University Washington, DC, USA.
To assess the prevalence of headache subtypes in Gulf War Illness (GWI) and Chronic Fatigue Syndrome (CFS) compared to controls.
Approximately, 25% of the military personnel who served in the 1990-1991 Persian Gulf War have developed GWI. Symptoms of GWI and CFS have considerable overlap, including headache complaints. Migraines are reported in CFS. The type and prevalence of headaches in GWI have not been adequately assessed.
50 GWI, 39 CFS and 45 controls had structured headache evaluations based on the 2004 International Headache Society criteria.
All subjects had history and physical examinations, fatigue and symptom related questionnaires, measurements of systemic hyperalgesia (dolorimetry), and assessments for exclusionary conditions.
Migraines were detected in 64% of GWI (odds ratio = 11.6 [4.1-32.5]) (mean [±95% CI]) and 82% of CFS subjects (odds ratio =
22.5 [7.8-64.8]) compared to only 13% of controls. There was a predominance of females in the CFS compared to GWI and controls.
However, migraine status was independent of gender in GWI and CFS groups (x (2) = 2.7; P = 0.101). Measures of fatigue, pain, and other ancillary criteria were comparable between GWI and CFS subjects with and without headache.
The high prevalence of migraine in CFS was confirmed and extended to GWI subjects. GWI and CFS may share dysfunctional central
pathophysiological pathways that contribute to migraine and subjective symptoms. The high migraine prevalence warrants the inclusion of a structured headache evaluation in GWI and CFS subjects, and treatment when present.