http://www.hhv-6conference.com/pdfs/HHV6SatBroch08.pdf
http://www.hhv-6conference.com/satellite/index.php
International Symposium on Viruses in Chronic Fatigue Syndrome & Post-Viral Fatigue
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A satellite meeting of the 6th International Conference on HHV-6 & 7
June 22 & 23, 2008
Baltimore, Maryland, USA
There is increasing evidence of an infectious etiology in a subset of CFS
patients, most often with viral agents. The sudden onset of CFS in some
patients with an "infectious-like" illness, the nature of some of the
symptoms, the state of chronic immune activation, and prospective
epidemiologic studies demonstrating incident cases of CFS developing
following several well-characterized and documented infectious illnesses
have made plausible the possibility that the illness can be triggered and
perpetuated by an infectious agent, at least in some patients with CFS.
Sincerely,
Anthony Komaroff
Symposium Co-Chair
Satellite Conference Topics:
* Clinician forum on antiviral therapies
* HHV-6 in CFS
* Other Viruses in CFS
* Borna virus in CFS
* EBV in CFS
* Parvovirus B-19 in CFS
* Retrovirus K-18 activation
* Enterovirus
* Post viral fatigue
Conference Co-Chairs:
* Anthony Komaroff (USA)
* Andrew Lloyd (Australia)
Program Committees:
* Dharam Ablashi (USA)
* John Chia (USA)
* Jonthan Kerr (UK)
* Anthony Komaroff (USA)
* Andrew Lloyd (Australia)
* Jose G. Montoya (USA)
Primary Sponsors:
* The HHV-6 Foundation
* IACFS/ME
Co-Sponsors:
* The CFIDS Association
* Whittemore Peterson Institute
* Epiphany Biosciences
* Angel Donors
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Speaker Topics
HHV-6 & CFS
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Anthony Komaroff MD Overview on HHV-6 & CFS
Kazuhiro Kondo MD, PhD Identification of novel HHV-6 neurovirulent latent
protein that causes mood disorders in CFS, psychosis
and HHV-6 encephalopathy
Jose G. Montoya MD Antiviral treatment of CFS patients with elevated
antibodies to HHV-6 & EBV
Chronic EBV and CFS
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Barbara Savoldo MD Chronic EBV, fatigue and immunotherpy by cytotoxic
T-cell lymphocyte infusion
Marshall Williams PhD EBV DUTPase in CFS and sickness behavior
Brigitte Huber PhD EBV and interferon activation of retrovirus K-18 in
CFS
Enterovirus and CFS
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Nora Chapman PhD Overview of enterovirus infections and diagnostic
testing
John Chia MD Enterovirus infections in CFS
Parvovirus and CFS
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Mariko Seishima MD Elevated Parvovirus antibodies and complement in CFS
Borna virus and CFS
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Liv Bode PhD Human Borna virus infections: a possible role in
chronic fatigue syndrome?
Keizo Tomonaga DVM, PhD Borna Virus antibodies in CFS patients vs. controls
Immunological Markers and Infectin in CFS
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Nancy Klimas MD Immune markers in viral illness and CFS
Post-viral Fatigue: Prospective Studies
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Peter White MD Overview on Post-Viral Fatigue
Andrew Lloyd MD Post-viral fatigue after acute infections
Ute Vollmer-Conna BSc Cytokines in Post-viral fatigue
PhD UNSW
Microarray Studies
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Jonthan Kerr MD, PhD Gene expression subtypes in patients with CFS and ME
Suzanne Vernon PhD Host genetics and viral infection
Twin Studies on Viruses in CFS
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Birgitta Evengard MD, Viral markers in Swedish twins discordant for CFS
PhD
Clinician Forum: Treating CFS Patients with Antivirals
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Dan Peterson MD Antiviral treatment of patients with HHV-6, EBV &
enterovirus: Case reports
Kenny De Meirleir MD, RNaseL activity: correlation to viral infection in
Ph.D CFS and viral infections
Marin Lerner, MD EBV & CMV in CFS and cardiomyopath
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Symposium Speakers
HHV-6 & CFS
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Jose G. Montoya, MD, Stanford University, USA
Dr. Montoya is Associate Professor of Medicine and Associate Chief for
Clinical Affairs for the Division of Infectious Diseases at Stanford
university School of Medicine, Director of the Toxoplasmosis Serology
Laboratory and Director of the Immunocompromised Host Service at Stanford
Medical Center. He is new to the CFS field, but made news recently with his
roche sponsored placebo controlled trial of valganciclovir in a subset of
CFS patients with elevated titers to HHV-6 and EBV. Montoya initiated the
trial after he found that several CFS patients with exceptionally high
antibody titers to HHV-6 & EBV responded very well to antiviral treatment,
with full remissions. He hopes to announce the preliminary results of this
trial at the conference.
Anthony Komaroff, MD, Harvard Medical School, Boston, USA
Dr. Komaroff is the Simcox-Clifford-Higby professor of medicine at Harvard
Medical School (HMS), and editor-in-chief of Harvard Health Publications at
HMS. Komaroff was director of the Division of General Medicine at Brigham
and Women's Hospital for 15 years. One of the earliest physician
investigators to study Chronic Fatigue Syndrome, Komaroff has been a member
of the CFS Coordinating Committee of the u.S. Department of Health and
Human Services. One of the first to report HHV-6 reactivation in chronic
fatigue syndrome, Dr. Komaroff's research has found immunological,
neuroimaging and neurocognitive deficits in CFS patients that cannot be
explained by concurrent depression. His epidemiological research also has
helped to establish the point prevalence of CFS in adults living in the u.S.
Kazuhiro Kondo, MD, PhD, Jikei University School of Medicine, Tokyo
Kazuhiro Kondo is Professor and Chairman of the Department of Virology at
the Jikei university School of Medicine in Tokyo. He is internationally
recognized as one of the top experts on HHV-6 molecular biology. His
research focuses on the role of HHV-6 in latency associated genes and the
role of HHV-6 & 7 in CFS and other states of fatigue. In a recent study he
found that HHV-6 and HHV-7 reactivation in the saliva can be used as
objective biomarkers for fatigue. His latest work involves the
identification of a novel HHV-6 neurovirulent latent protein that he can
cause mood disorders in CFS, psychosis and HHV-6 encephalopathy.
Chronic EBV and CFS
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Marshall Williams, PhD, Ohio State University, USA
A specialist in microbiology and immunology, Dr. Williams and his associate
ron Glaser have published ground-breaking research on how stress modulates
now the immune system and herpesvirus reactivation, and certain viral
enzymes affect normal cellular metabolism and herpesvirus replication.
They discovered that the EBV-encoded dUTPase induces the increased
expression of pro-inflammatory cytokines and IL-10 from human macrophages
and that mice injected with duTPase develop sickness behavior in the absence
of viral replication. They hope to develop drugs based upon the action of
the duTPase which may be useful in cancer and viral chemotherapy.
Brigitte Huber, PhD, Tufts University, Boston, USA
Brigitte Huber studied immunogenetics at university of London and is
currently a Professor of Pathology at Tufts university. She is currently
studying the presence of retrovirus HERV K-18 as marker for those who might
develop CFS after an acute infection such as mononucleosis. Her research
shows that EBV induces the HERV K-18 envelope gene to trigger the expression
of a specific superantigen and that there are more HERV K-18 alleles in
post-mono CFS patients than in controls. She hopes to identify other subsets
among CFS patients.
Barbara Savoldo MD, Baylor College of Medicine, Houston, USA
Dr. Savoldo has authored or co-authored over 20 papers on EBV immunotherapy
in EBV associated lymphoproliferative disorders and the use of cytotoxic T
cell lymphocyte infusion to restore the EBV-specific EBV related T cell
responses. She and her associates at Baylor College of Medicine have
recently completed a trial of autologous EBV specific CTLs for patients with
severe chronic EBV and will report on those findings. Severe chronic EBV
was defined in their trial as patients with elevated EBV DNA (over 4,000
copies per ml in the peripheral blood) and free EBV DNA in the serum or
spinal fluid. An earlier trial completed in 2002 was successful.
Enterovirus and CFS
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Nora Chapman, PhD, University of Nebraska, Omaha, USA
Dr. Chapman studies persistent coxsackievirus infections in murine models of
chronic myocarditis and dilated cardiomyopathy. She has demonstrated that
the expression of viral proteins in the heart generate significant
impairment of cardiomyocyte function and promote the generation of dilated
cardiomyopathy. She and her associates at university of nebraska became
interested in the role of enterovirus in CFS after working with Dr. John
Chia who found enterovirus infections in the gut biopsies of CFS patients,
by staining slides of gut tissues using antigen specific monoclonal
antibodies.
John Chia, MD, UCLA School of Medicine & EV Med Research, California, USA
Dr. Chia is President of eV Med research and Assistant Clinical Professor at
UCLA School of Medicine. An infectious disease specialist by training, Chia
became interested in the role of enterovirus in Chronic Fatigue Syndrome and
recently published original research from a study that found 135 out of 165
(82%) of CFS patients had stomach biopsy samples that stained positive for
enterovirus antigens compared with 7/34 or 20% of the controls. He also
found that 9/24 or 37% of CFS patients had enterovirus rnA in their gut
tissue compared to 1 of 21 controls. Dr. Chia is actively investigating
treatment strategies for persistent enterovirus infections.
Parvovirus and CFS
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Mariko Seishima, MD, Ogaki Municipal Hospital
Mariko Seishima is a dermatologist who has investigated the underlying cause
of various dermatological disorders. Seishima recently studied patients who
developed chronic fatigue after a Parvovirus B-19 infection and found that 3
out of 210 developed persistent symptoms. Although Parvovirus DNA and IgM
antibodies disappeared from the sera, his group found that complement levels
were lower in those who developed CFS than those who did not.
Borna Virus and CFS
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Liv Bode, PhD, Robert Koch Institute, Berlin, Germany
Dr. Bode, PhD, permanent scientist at the robert Koch Institute and lecturer
in virology and infectious diseases at the Free University of Berlin, has
authored or co-authored over 45 papers on Borna virus (BDV) infection in
both animals and in human psychiatric disease including chronic fatigue. She
contributed to high-ranking priority publications on BDV target cells in
blood, isolation of human virus, and antiviral therapy (amantadine), the
latter shown to be effective both in vitro against human and equine
isolates, and in vivo in depressed patients in open trials. Borna virus does
not circulate in the blood. Therefore, she and her associates developed
sensitive methods to detect the virus activity through circulating immune
complexes, antigenemia and free antibodies. Since the diagnosis of Borna
virus in humans is controversial, the findings in human disease have been a
matter of scientific and even political debate, recently leading to Dr.
Bode's Whistleblower award from the Association of German Scientists (VDW)l.
Studies in Japan and more recently, in China have demonstrated higher levels
of antibodies in patients with CFS than in controls, supporting the
suggestion by Bode and her associates that Borna virus plays a role in human
neurological disease.
Keizo Tomanga, DVM, PhD, Osaka University, Japan
Dr. Tomonaga has published over 30 papers on Borna virus (BDV). Once thought
to be exclusively an animal virus important to horses, this neurotropic
virus has now been implicated in human psychiatric disease and chronic
fatigue syndrome. Dr. Tomonaga has studied the mechanisms by which Borna
virus persists in the brain. He and his associate Kazuyoshi Ikuta have found
Borna virus antibodies and Borna virus rnA in the families of CFS patients
at higher levels than in controls. Tomanga has also demonstrated that BDV
infection impairs astrocyte function which results in reduced inflammatory
response and persistent infection.
Immunological Markers and InfectiOn in CFS
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Nancy Klimas, MD, University of Miami, USA
Dr. Klimas is the President of the International Association for Chronic
Fatigue Syndrome/ME, the organization of researchers and clinicians
dedicated to furthering our knowledge of this disabling illness. She is a
Professor of Medicine, Psychology, Microbiology and Immunology at the
university of Miami School of Medicine. Dr Klimas directs the UM/VAMC Gulf
War and Chronic Fatigue Syndrome Research Center. Her interests include
studying the interaction between inflammation, immune function and the
neuroendocrine system in CFS and GWI and has found a number of immune
function abnormalities including a defect in nK cell activity. She has also
identified a subgroup of CFS patients characterized by impaired natural
immunity and cognitive dysfunction. She also studies gene expression before,
during and after an exercise challenge in GWI and CFS.
Post-Viral Fatigue: Prospective Studies
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Peter White, MD, Queen Mary School of Medicine, London, UK
Peter White is a Professor of Psychological Medicine at the Wolfson Institute
of Preventive Medicine. He was an early leader in efforts to learn more about
post-viral fatigue and the reason why some patients with acute mononucleosis
develop chronic fatigue syndrome, while others are unaffected.
Andrew Lloyd, MD, UNSW School of Medical Sciences
Dr. Lloyd is Associate Professor of the Inflammation research Unit at the
University of New South Wales in Australia. An infectious disease
specialist and immunologist, he put together an important CDC-funded
prospective study of several hundred patients who developed acute illnesses
such as mononucleosis and then followed them over time to determine the
percentage that went on to develop Chronic Fatigue Syndrome. He found that
roughly 11% of patients who suffer from acute infections of mononucleosis, Q
Fever and ross river fever ultimately go on to develop CFS or post viral
fatigue. He has since used these samples to determine that eight key
cytokines were not significantly different in the CFS patients compared to
those who recovered. He has also gleaned valuable information from this
study on the genes that are differentially expressed in post viral fatigue.
Ute Vollmer-Conna, PhD, UNSW School of Psychiatry
Dr. Vollmer-Conna is a psychoneuroimmunologist who has authored or
co-authored over a dozen studies on the pathophysiology of post-infective
and chronic fatigue. She works with Andrew Lloyd and a multidisciplinary
team of scientists and clinicians on the Dubbo Infective Outcomes Study. Her
most recent paper reported a comprehensive analysis of the longitudinal
production profiles of eight cytokines, which failed to reveal substantive
differences between controls and patients with post-viral fatigue.
Microarray Studies
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Jonathan Kerr, MD, PhD, St. George's University of London, UK
A microbiologist by training, Dr. Kerr's interest in CFS began during a
study of the parvovirus B-19 infection when he realized that a percentage of
cases ultimately developed CFS. Dr. Kerr has recently defined seven genomic
subtypes of CFS based on 88 genes that are expressed differently in CFS
patients than they are in normal controls. Another recent study by Dr.
Kerr is on the role of stress in Parvovirus B-19 infections; he demonstrated
that those with high levels of stress are more likely to develop CFS and
arthritis after an acute parvovirus infection. He is developing diagnostic
tests based on mass spectrometry and analysis of vial gene expression.
Suzanne Vernon, PhD, CFIDS Association of America, USA
Suzanne D. Vernon, Ph.D. joined the staff of the CFIDS Association as
Scientific Director in november 2007. Dr. Vernon began her scientific
career in 1990 at the Centers for Disease Control and Prevention (CDC) in
Atlanta, Georgia where since 1997 she led the CDCs CFS laboratory team. More
than half of her 75 peer-reviewed scientific publications deal with CFS
genomics and pathophysiology. In her new capacity as Scientific Director,
Dr. Vernon leads the Association's expanded research program which includes
developing priorities to achieve expedited progress for therapeutic
interventions and cure, building collaborative networks worldwide, and
serving as the Association's scientific expert in numerous settings.
New Twin Study on Viruses in CFS
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Birgitta Evengard, MD, PhD, Umea University, Umea, Sweden
Dr. Evengard is head of the Department of Infectious Disease at Umea
university in Sweden. She previous position was adjunct professor at the
Dept Clinical Microbiology at the Karolinska Institute in Stockholm, Sweden.
She has published several important studies on fatigue in the context of
pathogens. A specialist in infectious diseases and clinical immunology, Dr.
Evengard has studied the epidemiology of fatigue in a large study of over
12,000 Swedish twin pairs and found an incidence which was higher than
expected and that both environmental and genetic factors were important in
chronic fatigue syndrome. In a recent study she found increased levels of
Candida albicans in the fecal microflora of chronic fatigue syndrome
patients during the acute phase of their illness. Dr. Evengard will include
new data on a study of viral markers and cytokines in Swedish twin pairs
discordant for CFS in her talk.
Clinician Forum: Treating CFS Patients with Antivirals Panel Discussion
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Dan Peterson, MD, Sierra Nevada Internal Medicine, Incline Village, USA
Dr. Peterson is a clinician and CFS expert who documented a CFS outbreak in
Nevada in 1985 and who was, along with his partner Paul Cheney, among the
first to suggest that viruses such as HHV-6 and EBV might be involved in the
Chronic Fatigue Syndrome and co-authored several important papers describing
the neurological dysfunction and NK cell deficits found in cases that broke
out in Nevada in the late 1980's. Peterson was one of the first to conduct a
trial of an antiviral/immunomodulator drug, (Ampligen) for CFS patients. He
is also the Medical Director of the Whittemore Peterson Institute for
Neuroimmune Disease in Reno, Nevada.
Kenny de Meirleir, MD, PhD, Himmunitas Foundation, Belgium
A prominent clinician/researcher in CFS/ME, Kenny runs a large clinic for
CFS/ME patients in Brussels, Belgium. He is also professor of Physiology,
Pathophysiology and Medicine at the Vrije Universiteit Brussel and clinical
professor at the University of Nevada Medical School in Reno. Kenny has
published award winning studies on exercise physiology in CFS.
Kenny has published many research papers on chronic fatigue syndrome issues
on topics such as intracellular immune dysfunction, mitochondrial disorders,
joint hypermobility, and impairment of the 2-5A synthetase/RNase L pathway
in chronic fatigue syndrome patients. He has also been a leader in the use
of antiviral and immunomodulating treatments such as Ampligen, Kutapressin
(nexavir) and herb/vitamin combinations known to have antiviral/immune
boosting qualities.
Martin Lerner, MD, William Beaumont Hospital, Michigan, USA
The former Director of Infectious Diseases at Wayne State university School
of Medicine, Dr. Lerner has published over 10 papers since 1993 on the role
of subclinical myocarditis in a subset of CFS patients. He has also reported
success with long courses of antiviral therapy in patients with chronic EBV
and CMV infections. Dr. Lerner uses antibody tests for early antigen to CMV
and EBV that are not available in most commercial laboratories; he believes
that they are better for differentiating active from latent infections.
Although these papers received very little attention in the past, there has
been interest in the tie between viral myocarditis and CFS recently since a
series of three papers from Germany have found HHV-6 and parvovirus B-19 to
be the most common viruses found in biopsies of patients with viral
myocarditis. Both viruses are also implicated in CFS.
Tags: CFS, virus, EBV, HHV
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