title: Antibody to Epstein-Barr virus deoxyuridine triphosphate nucleotidohydrolase and deoxyribonucleotide polymerase in a chronic fatigue syndrome subset.
abstract: BACKGROUND
  A defined diagnostic panel differentiated patients who had been diagnosed with chronic fatigue syndrome (CFS), based upon Fukuda/Carruthers criteria. This diagnostic panel identified an Epstein-Barr virus (EBV) subset of patients (6), excluding for the first time other similar "clinical" conditions such as cytomegalovirus (CMV), human herpesvirus 6 (HHV6), babesiosis, ehrlichiosis, borreliosis, Mycoplasma pneumoniae, Chlamydia pneumoniae, and adult rheumatic fever, which may be mistakenly called CFS. CFS patients were treated with valacyclovir (14.3 mg/kg q6h) for ≥ 12 months. Each patient improved, based upon the Functional Activity Appraisal: Energy Index Score Healthcare Worker Assessment (EIPS), which is a validated (FSS-9), item scale with high degree of internal consistency measured by Cronbach's alpha.
  
  
  METHODS
  Antibody to EBV viral capsid antigen (VCA) IgM, EBV Diffuse Early Antigen EA(D), and neutralizing antibodies against EBV-encoded DNA polymerase and EBV-encoded dUTPase were assayed serially approximately every three months for 13-16 months from sera obtained from patients with CFS (6) and from sera obtained from twenty patients who had no history of CFS.
  
  
  RESULTS
  Antibodies to EBV EA(D) and neutralizing antibodies against the encoded-proteins EBV DNA polymerase and deoxyuridine triphosphate nucleotidohydrolase (dUTPase) were present in the EBV subset CFS patients. Of the sera samples obtained from patients with CFS 93.9% were positive for EA(D), while 31.6% of the control patients were positive for EBV EA(D). Serum samples were positive for neutralizing antibodies against the EBV-encoded dUTPase (23/52; 44.2%) and DNA polymerase (41/52; 78.8%) in EBV subset CFS patients, but negative in sera of controls.
  
  
  CONCLUSIONS
  There is prolonged elevated antibody level against the encoded proteins EBV dUTPase and EBV DNA polymerase in a subset of CFS patients, suggesting that this antibody panel could be used to identify these patients, if these preliminary findings are corroborated by studies with a larger number of EBV subset CFS patients.
authors.affiliation: Department of Medicine, Oakland University William Beaumont School of Medicine, Rochester, Michigan, United States of America. amartinlerner@yahoo.com
authors.forename: A Martin
authors.initials: AM
authors.lastname: Lerner
authors.forename: Maria E
authors.initials: ME
authors.lastname: Ariza
authors.forename: Marshall
authors.initials: M
authors.lastname: Williams
authors.forename: Leonard
authors.initials: L
authors.lastname: Jason
authors.forename: Safedin
authors.initials: S
authors.lastname: Beqaj
authors.forename: James T
authors.initials: JT
authors.lastname: Fitzgerald
authors.forename: Stanley
authors.initials: S
authors.lastname: Lemeshow
authors.forename: Ronald
authors.initials: R
authors.lastname: Glaser
mesh_terms: D000328:Adult; D057134:Antibodies, Neutralizing / Q000276:immunology*; D000956:Antigens, Viral; D004259:DNA-Directed DNA Polymerase / Q000276:immunology; D015673:Fatigue Syndrome, Chronic / Q000276:immunology* / Q000821:virology; D005260:Female; D004854:Herpesvirus 4, Human / Q000235:genetics* / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011755:Pyrophosphatases / Q000276:immunology
chemical_list: D057134:Antibodies, Neutralizing; D000956:Antigens, Viral; C033305:Epstein-Barr virus early antigen; D004259:DNA-Directed DNA Polymerase; D011755:Pyrophosphatases; C020020:dUTP pyrophosphatase