Epstein-Barr virus induced gene-2 upregulation identifies a particular subtype of Chronic Fatigue Syndrome/Myalgic Encephalomyelitis, by Jonathan R Kerr in Frontiers in Pediatrics, 13 March 2019


Research abstract:

Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) is a chronic
multisystem disease characterised by a variety of symptoms, and exhibits various features of an autoimmune-like disease. Subtypes are well recognised but to date are difficult to identify objectively.

The disease may be triggered by infection with a variety of micro-organisms, including Epstein-Barr virus (EBV). A subset of CFS/ME patients exhibit up regulation of EBV virus induced gene 2 (EBI2) mRNA in peripheral blood mononuclear cells (PBMC), and these patients appear to have a more severe disease phenotype and lower levels of EBNA1 IgG. EBI2 is induced by EBV infection and has been found to be upregulated in a variety of
autoimmune diseases.

EBI2 is a critical gene in immunity and central nervous system function; it is a negative regulator of the innate immune response in monocytes. Its heterogeneous expression in CFS/ME could explain the variable occurrence of a variety of immune and neurological abnormalities which are encountered in patients with CFS/ME.

The EBI2 subtype occurred in 38-55% CFS/ME patients in our studies. Further work is required to confirm the role of EBV and of EBI2 and its oxysterol ligands in CFS/ME, and to identify the most practical means to identify patients of the EBI subtype. There are two EBI2 antagonists currently in development, and these may hold promise for the treatment of CFS/ME patients of the EBI subtype.

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3 Responses to Epstein-Barr virus induced gene-2 upregulation identifies a particular subtype of CFS/ME

  1. Dee says:

    I tend to agree. I had glandular fever in 1999 and have been up and down with bad health since then. Was after some 20 odd years later finally diagnosed with CFS and also fibromyalgia. No one would listen to me, my symptoms were ignored and I was told there was nothing wrong. Was not until I changed doctors to see a lady dr after my hysterectomy that I found out this was not normal, that there were a lot of things happening in my body all of this time. Here in NZ we don’t have much in the way of technology to aid us, just chronic pain management which is not helpful at all. We have no further support other than take physio, occupational therapy and behaviour therapy, all have long wait times between appointments and all are very pushy and not very understanding of my illness.

    I do hope in the future people become more aware, drs are given more skills to find and help treat both cfs and fibro.

  2. Tina Roberts says:

    I was diagnosed with EBV 1995. ME I. 2005 then Fibromyalgia in 2015. I have never been well since the EBV. I’m 58 now.

  3. This would confirm my experience too. I had Glandular Fever in 1973, which triggered the ME symptoms and have never got better. After being virtually told I was a liar and fobbed off for decades, I finally got a diagnosis in 2008.