Dr. Coleman will NOT be speaking this Saturday, April 28. I’m hoping to reschedule him perhaps in May.
I will not be there either as I’ve contracted the chest-cold from hell. Trust me, you do not want this….
The room is still being held so feel free to come, meet people, encourage others, and share ideas.
Hope to be rid of this thing and back in the saddle by May’s meeting.
Onward!
Monday, April 16, 2018
EBV may trigger some cases of lupus, say NIH-supported researchers.
Infection with Epstein-Barr virus (EBV), the cause of infectious mononucleosis, has been associated with subsequent development of systemic lupus erythematosus and other chronic autoimmune illnesses, but the mechanisms behind this association have been unclear. Now, a novel computational method shows that a viral protein found in EBV-infected human cells may activate genes associated with increased risk for autoimmunity. Scientists supported by the National Institute of Allergy and Infectious Diseases report their findings today in Nature Genetics.
“Many cases of autoimmune illness are difficult to treat and can result in debilitating symptoms. Studies like this are allowing us to untangle environmental and genetic factors that may cause the body’s immune system to attack its own tissues,” said NIAID Director Anthony S. Fauci, M.D. “A better understanding of the complex causes of autoimmunity promises to lead to better treatment and prevention options.”
EBV infection is nearly ubiquitous in the human population worldwide. Most people acquire EBV in early childhood, experience no symptoms or only a brief, mild cold-like illness, and remain infected throughout their lives while remaining asymptomatic. When infection first occurs in adolescence or young adulthood, EBV can lead to a syndrome of infectious mononucleosis characterized by prolonged fever, sore throat, swollen lymph nodes and fatigue. This syndrome, also known as “mono” or the “kissing disease,” generally resolves with rest and only rarely causes serious complications.
When EBV infects human immune cells, a protein produced by the virus — EBNA2 — recruits human proteins called transcription factors to bind to regions of both the EBV genome and the cell’s own genome. Together, EBNA2 and the human transcription factors change the expression of neighboring viral genes.
In the current study, the researchers found that EBNA2 and its related transcription factors activate some of the human genes associated with the risk for lupus and several other autoimmune diseases, including multiple sclerosis, rheumatoid arthritis, inflammatory bowel disease, type 1 diabetes, juvenile idiopathic arthritis and celiac disease.
Previous studies suggested that EBV infection may result in autoimmune diseases, particularly lupus. In the current work, researchers led by John B. Harley, M.D., Ph.D., director of the Center for Autoimmune Genomics and Etiology (CAGE) at Cincinnati Children’s Hospital Medical Center, with his colleagues Matthew T. Weirauch, Ph.D., and Leah C. Kottyan, Ph.D., also of CAGE, wondered whether genetic analysis could further explain the relationship between EBV infection and lupus. Their team developed a new computational and biochemical technique known as the Regulatory Element Locus Intersection algorithm, or RELI. Sifting through and comparing a large collection of genetic and protein data from healthy individuals and those with autoimmune diseases, the team used RELI to identify regulatory regions in genes associated with the risk of developing lupus that also bound EBNA2 and its related transcription factors.
“We were surprised to see that nearly half of the locations on the human genome known to contribute to lupus risk were also binding sites for EBNA2,” said Dr. Harley. “These findings suggest that EBV infection in cells can actually drive the activation of these genes and contribute to an individual’s risk of developing the disease.”
In follow-up analyses, the investigators used RELI to probe regulatory genes associated with other autoimmune diseases and found that EBNA2 bound to genes associated with the risk for multiple sclerosis, rheumatoid arthritis, inflammatory bowel disease, type 1 diabetes, juvenile idiopathic arthritis and celiac disease.
“Because EBV is most often encountered in early childhood, avoiding infection is practically impossible,” said Daniel Rotrosen, M.D., director of the Division of Allergy, Immunology and Transplantation at NIAID. “However, now that we understand how EBV infection may contribute to autoimmune diseases in some people, researchers may be able to develop therapies that interrupt or reverse this process.”
Researchers note that EBV infection is not the only factor that contributes to the development of the seven autoimmune conditions discussed in the paper. Many of the regulatory genes that contribute to lupus and other autoimmune disorders did not interact with EBNA2, and some individuals with activated regulatory genes associated with disease risk do not develop disease.
NIAID conducts and supports research — at NIH, throughout the United States, and worldwide — to study the causes of infectious and immune-mediated diseases, and to develop better means of preventing, diagnosing and treating these illnesses. News releases, fact sheets and other NIAID-related materials are available on the NIAID website.
About the National Institutes of Health (NIH): NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.
NIH…Turning Discovery Into Health®
J Harley, et al. Transcription factors operate across disease loci, with EBNA2 implicated in immunity. Nature Genetics DOI: 10.1038/s41588-018-0102-3 (2018).
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**Comment**
Folks with Lyme/MSIDS have been misdiagnosed with EBV: https://madisonarealymesupportgroup.com/2017/04/11/diagnosed-with-ebv-had-lyme/ and others have it as well as tick-borne infections. The involvement with numerous viruses is quite common in patients as well. https://madisonarealymesupportgroup.com/2016/03/28/combating-viruses/
https://madisonarealymesupportgroup.com/2017/07/14/another-dies-from-powassan/
https://madisonarealymesupportgroup.com/2018/04/21/neurological-lyme-disease-what-you-need-to-know/ “Once microbes start becoming active, inflammation increases and immune functions are further compromised, establishing what I call Chronic Immune Dysfunction (CID). In its weakened state, the immune system allows reactivation of viruses such as Epstein Barr virus (EBV), Cytomegalovirus (CMV), and other similar viruses — all of which most people harbor in their tissues. These viruses are commonly associated with neuroinflammation, and they tend to complicate the picture of LNB.”
https://madisonarealymesupportgroup.com/2017/11/04/24514/ EBV a Key Player in Chronic Illness & Tips to Treat Reactivated EBV.
The Companion Animal Parasite Council, or CAPC, has released its annual 2018 parasite forecasts, and the news isn’t good. The agency reported there will be an increase in prevalence of heartworm and Lyme disease, and heartworm is predicted to continue its aggressive spread across the U.S., with the growth of Lyme disease focused east of the Rockies.
The spread of heartworm is attributed to the hot and wet weather over a two-year span and shifting weather patterns that allow for ideal mosquito breeding conditions, and the relocation of unknown heartworm-positive dogs across the country are to blame, according to CAPC. have created ideal breeding conditions for mosquitoes across the country.
CAPC also predicts the spread of Lyme disease into nonendemic areas, including the Dakotas, Iowa, Missouri, southern Illinois, Ohio, Kentucky, Tennessee, and North Carolina.
“Our annual forecasts provide critical and important information to help veterinarians and pet owners understand parasites are a true risk to both pets and people,” said Dwight Bowman, MS, Ph.D., CAPC board member and professor of parasitology at Cornell University College of Veterinary Medicine. “This year, there are significant shifts in prevalence, making our maps a critical educational tool for veterinary hospitals, and allowing veterinarians and pet owners to see that parasites are ever changing and widespread, sometimes surprisingly so.”
The forecasts support CAPC’s recommendation for annual testing and keeping pets on preventative treatment year-round.
For 2018, CAPC predicts the following risk areas for parasite-related diseases:
CAPC offers prevalence data that localizes reported parasitic disease activity at the county level for veterinarians to use in their discussions about annual testing and year-round protection. This information is available for free at the CAPC website petsandparasites.org.
The forecasts represent the collective expert opinion of academic parasitologists who engage in ongoing research and data interpretation to better and monitor vector-borne disease agent transmission and changing life cycles of parasites, and are based such factors as temperature, precipitation, and population density.
HOST: Dr. Daniel Cameron
DATE: Tuesday, April 24, 2018
TIME: 8 PM EST
FEATURED TOPIC: Teen Lyme
Share your thoughts, ask questions or just listen in and hangout! There will be discussion with a 16-year old boy with Lyme Disease.
Register here: http://danielcameronmd.com/lyme-hangout-teen-adolescent-lyme-disease/. You can can also post questions at the link.
http://danielcameronmd.com/lyme-hangout-teen-adolescent-lyme-disease/?mgi_107=8376/teens-and-lyme-disease
Lyme disease was first identified in 1975 in a group of children and adolescents living in Lyme, Connecticut who suffered from recurrent attacks of asymmetric swelling and pain in the knee. The patients were initially diagnosed with juvenile rheumatoid arthritis.
“The typical patient has had three recurrences, but 16 patients have had none,” noted lead investigator Steere, then a postdoctoral fellow in rheumatology at Yale University.1 “During remission, some patients remembered short periods of joint pain, sometimes lasting only hours, without swelling (and therefore, not included as attacks).”
Pain also occurred in the ankle, wrist, temporomandibular joint, shoulder, hip, and elbow. Other symptoms included malaise, fatigue, headaches, myalgia, periorbital edema, and swelling of the hands or feet. Of the 12 subjects, seven suffered from “profound fatigue and hyperesthesia, sometimes persisting for months after the arthritis had gone,” say Steere and colleagues. 1
A team of researchers including Steere would, 14 years later, report in the New England Journal of Medicine that chronic neurologic Lyme disease was one of the complications of Lyme disease. 2
Steere and colleagues describe an epidemic of oligoarticular arthritis in children and adults in three Connecticut communities. “Attacks were usually short (median 1 week) with much longer intervening periods of complete remission (median 2.5 months), but some attacks lasted for months. To date, the typical patient has had three recurrences, but 16 [of 51] patients had none,” say the authors, adding, “Over half had concomitant fever (100° – 103°F), malaise and fatigue, headache, and myalgia.” 1
Only a handful of studies on children and adolescents with tick-borne diseases have been done, despite the prevalence of the diseases in this age group and the potential for long-term health consequences.
Bloom and colleagues from Tufts University School of Medicine in 1998 describe the complications of Lyme disease in children. “Five children [of 86] developed behavioral changes, forgetfulness, declining school performance, headache or fatigue and, in two cases, a partial complex seizure disorder.”3
Vázquez and colleagues from the Department of Pediatrics and the Yale Children’s Clinical Research Center report children ages 2 to 18 with prior cranial nerve palsy have significantly more behavioral changes (16 percent vs. 2 percent), arthralgias and myalgias (21 percent vs. 5 percent), and memory problems (8 percent vs. 1 percent) an average of four years after treatment for Lyme disease.4
In a second case reported in 1998 by Fallon and colleagues, a 16-year-old boy, named David, was initially presumed to suffer from long-standing depression. He presented with anger, frustration, insomnia, poor appetite, mild weight loss, and passive suicidal ideation. His longstanding depression was “exacerbated recently when he stopped dating a girl after only two weeks because he felt too tired and not smart enough,” according to the researchers. 5 “He reported feeling spaced out all the time, as if in a fog.” David also lived in a Lyme endemic area.
David’s steep decline in cognitive behavior and IQ were initially presumed to be caused by “either laziness or mild depression.”
His symptoms were extensive:
While the young man had “had embedded tick bites,” wrote the researchers, “he could not recall ever having had an erythema migrans rash.”
David’s “Lyme ELISA was negative twice in the prior 3 months, his IgG Western blot revealed 4 of the 5 requisite CDC specific bands.” The neuropsychologic evaluation, said the researchers, showed “significant deficits in processing speed and visual spatial memory.” Researchers added, testing by a brain SPECT “revealed moderate to severe diffusely and heterogeneously decreased perfusion in the cortex and the central white matter, consistent with encephalitis, vasculitis, and Lyme disease.”
David was diagnosed and treated with excellent results for probable Lyme encephalopathy with 12 weeks of intravenous ceftriaxone. He improved on sleep, appetite, headaches, joint pains, numbness, distractibility, short-term memory, and emotional behavior. His depression cleared without the need for antidepressant medications. His IQ improved by 22 points, and his school performance markedly improved.
Like the case of 7-year-old Susan, David’s case also illustrates the need for careful diagnosis and treatment of tick-borne infections in young people. So often these infections look like the common problems see in school-aged children: depression, ADHD, joint pains from growth spurts. These cases show the need to not only look at symptoms, but to be mindful of where students live and play.
Text from Dr. Daniel Cameron’s Book: Lyme Disease takes on Medicine.
https://www.lymedisease.org/membership-change-tbd-working-group-subcommittee/
April, 2018
Sherill Franklin, a small business owner and patient advocate from Pennsylvania, will join the Access to Care Services and Support to Patients Subcommittee of the Tick-Borne Disease Working Group. She will replace Dr. Enid Haller, who is departing.
The announcement was made on the website of the US Department of Health and Human Services, which stated, “Franklin has written extensively about her own 30-year experience with Lyme disease and has advocated for better diagnostic tools and definitive treatments for tick-borne disease.”
In 2015, Franklin wrote a guest blog for LymeDisease.org about why she joined the MyLymeData project. Read it here: https://www.lymedisease.org/mylymedata-franklin/ Taking power over a disease that has brought us to our knees
In 2017, she wrote another guest blog for us as well: https://www.lymedisease.org/sherrill-franklin/ Here are my top priorities for Lyme disease research
The next meeting of the Tick-Borne Disease Working Group will be May 10, from 8:30 a.m. to 6:30 p.m., Eastern Time.
The Working Group will focus on the findings and basis for the draft reports from the work of the six Subcommittee Working Groups that were established on December 12, 2017. These subcommittees were established to assist the Working Group with the development of the report to Congress and the HHS Secretary as required by the 21st Century Cures Act.
This will be an online meeting. Members of the public may attend the meeting via webcast. Instructions for attending this virtual meeting will be posted one week prior to the meeting at: https://www.hhs.gov/ash/advisory-committees/tickbornedisease/index.html.
Click here for more information about the Working Group: https://www.hhs.gov/ash/advisory-committees/tickbornedisease/index.html
