Post-Acute Infection Syndromes Will Be the Focus of New YSM Center https://medicine.yale.edu/news-arti...yndromes-will-be-the-focus-of-new-ysm-center/ Researchers will investigate Long COVID, myalgic encephalomyelitis/chronic fatigue syndrome, and post-treatment Lyme disease at the Center for infection & Immunity Yale School of Medicine (YSM) officially launched its new Center for Infection & Immunity (CII), established within the Department of Immunobiology, on August 18. Akiko Iwasaki, PhD The COVID-19 pandemic and the prevalence of Long COVID have shed light on the urgent need to study post-acute infection syndromes. The mission of the new center will be to provide a greater understanding of the basic science behind infectious diseases, with an emphasis on Long COVID, post-treatment Lyme disease, and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). It is the first center of its kind, says its creator Akiko Iwasaki, PhD, YSM’s Sterling Professor of Immunobiology. “Post-acute infection syndromes have historically been ignored. They’ve been going on for decades—or maybe hundreds of years—but we haven’t been paying attention,” says Iwasaki. “Our center is uniquely positioned to tackle these diseases because of our building expertise from Long COVID and our many collaborations across different disciplines.” Post-acute infection syndrome refers to chronic diseases that occur after an acute viral, bacterial or parasitic infection. They occur most frequently in middle-aged women. While not new, the syndrome’s prevalence is significantly growing as a result of the COVID-19 pandemic, in which as many as 10% of infections have led to Long COVID, leaving individuals with lingering, often debilitating symptoms. Researchers estimate that 75 million people globally are suffering with the disease, and as new infections continue to arise daily, there’s “no end in sight,” says Iwasaki. “The pandemic gives us perspective to understand how viruses have affected our risk to other diseases and our health as a human population over history,” says Nancy J. Brown, MD, Jean and David W. Wallace Dean of Yale School of Medicine. Long COVID highlights need for post-acute infection syndrome research Following the pandemic’s onset, researchers across disciplines at Yale and beyond came together to unravel the mysteries of this new infectious disease. The need for a new center to support this extensive collaboration soon became clear, says Iwasaki. “So we created CII to mediate greater cooperation and promote the sharing of ideas, samples, and data.” “The center grew within the Iwasaki lab,” says Nicole Darricarrère, PhD, the scientific program director of CII. “So we’re training and incubating within her amazing environment. We’re fortunate to have people from her lab with such expertise.” New center will study infectious disease pathobiology and prevention The research through CII will focus on the pathobiology of Long COVID, ME/CFS, and post-treatment Lyme syndrome. Although these post-acute infection syndromes are triggered by different pathogens, because they often share similar symptoms—including fatigue, unrefreshing sleep, dysautonomia, and pain—Iwasaki believes they share similar pathologies. “If we can identify even with one of these diseases what an underlying cause of disease is, then we can apply that knowledge to prevent and treat other kinds of post-acute infection syndromes.” The other arm of the center will focus on disease prevention. This includes research on different vaccination strategies and universal vaccines for different agents. “Vaccines are really important in preventing these diseases,” says Iwasaki. “So I’m also hopeful that we can develop better preventative mechanisms to go along with our more disease treatment-focused research.” The center’s members will include the following world-leading experts: Anne Wyllie, PhD, Nathan Grubaugh, PhD, Craig Wilen, MD, PhD, Maudry Laurent-Rolle, MD, PhD, Ellen Foxman, MD, PhD, Ruslan Medzhitov, PhD, Anna Pyle, PhD, Benjamin Goldman-Israelow, MD, PhD, Erol Fikrig, MD, David Martinez, PhD, Albert Ko, MD, Carolina Lucas, PhD, Inci Yildirim, MD, PhD, Albert Shaw, MD, PhD, John Tsang, PhD, Lisa Sanders, MD, Carlos Oliveira, MD, PhD, Charles Dela Cruz, MD, PhD, Justin Belsky, MD, Harlan Krumholz, MD, David van Dijk, PhD, Wade Shulz, MD, PhD, Leying Guan, PhD, and Smita Krishnaswamy, PhD.
It buggers this bogged brain as to when and why medicine stopped assuming that when symptoms persist after acute stage, the pathogen was still mucking about somewhere in the patient. Isn't the way of infections typically acute and treat (if treatable)? Then either the patient's infection resolves, or the infection persists - unless proven otherwise. Until they can account for privileged sites, it startles me how willing some can be to not seriously pursue tissue testing and the like, including autopsies that exhaustively check for brain infections.
Post-Acute Infection. Not a good name. Very specific and ME/CFS is not just Post-acute "Infection". But then again, it is a great term for immunologists. No immunologist might question why Post-treatment Lyme disease syndrome includes the word "treatment" in its title. It may be the treatment that makes things go wrong, not lyme infection itself.
I did have the same thought. I suspect that chronic Ciguatera and Gulf War Illness are ME/CFS-like responses to toxins, no trigger infection needed. But if an answer was found for post-infection ME/CFS, then there would be good clues to explore for the rest. It's a name that works for the current time.
Part of me is appreciative of the implication in "post-acute", although it's effectively muted by "syndrome". I'm curious, too, what sort of internal political dynamics might appear considering Yale's history in at least one area they'd be looking at. I hope they give Iwasaki free rein.
This is pretty good news. Unfortunately no details like staffing or funding that would allow us to estimate how much research they'll be undertaking. Regardless, it's part of a trend of increasing awareness of ME/CFS, long Covid, and similar.
This is fantastic news. Agreed on the need to include non-infectious causes but this is a good start.
Unfortunately, I couldn't find any information on funding. When I googled them I at least found out that they are currently recruiting for one position, probably not the worst of signs https://www.ziprecruiter.com/c/Yale...cialist/-in-New-Haven,CT?jid=94f422852473ad1d. Staff is listed on their official website https://medicine.yale.edu/cii/staff/. They also have a list of "members". A large focus of the center is also the development of vaccines, which is Iwasaki's speciality. Whilst an interesting, extremely important and of course life saving field of study, this probably won't have any effect on people already suffering from post-viral conditions. Perhaps it can be beneficial to attract funding though.
And profitable. Wouldn't want to ignore the Bayh-Doyle Act. Remember when academic research had the feel of being above smear, above the mercenary? Some people feel that may have changed a little back in 1980 with Bayh-Doyle.
Trial By Error: An Interview with Yale’s Akiko Iwasaki "In this comment in The Lancet Infectious Diseases, published earlier this year, she and Mt Sinai’s David Putrino outlined four hypotheses about the possible root causes of long Covid. We spoke earlier today about these possible root causes, her concerns about claims that long Covid is psychosomatic, and the importance of learning from patients." https://virology.ws/2023/09/21/trial-by-error-an-interview-with-yales-akiko-iwasaki/
Merged thread ME/CFS, Long COVID, and Chronic Lyme Disease Research Aided by $3 Million in Donor Gifts to Yale School of Medicine https://medicine.yale.edu/news-arti...on-in-donor-gifts-to-yale-school-of-medicine/
I am so glad this project has funding. Bring on the treatments. But still there will always be sick people, as long as there are people. I find it so unacceptably tragic that any sick person should be made to take on the view that they individually are the “burden” while there exists a whole huge society that could quite easily with no great effort at all, choose to value, care for and treat them. This woman wasn’t a burden to her family because she got sick. Her family were burdened by a society that wasn’t going to support them or to support her. They were burdened by watching her made to suffer. By having to learn how to support someone without being shown by society how to do this. They were burdened by a punishing economic system of extraction.
