Review: Epstein-Barr virus (EBV) reactivation and therapeutic inhibitors, 2019, Kerr

Paywalled, https://jcp.bmj.com/content/early/2019/07/16/jclinpath-2019-205822.full
Sci hub, not available from Sci hub at time of posting.

 

The abstract seems to pivot around this statement:

Chronic EBV reactivation is an important mechanism in the pathogenesis of many such diseases,

which, as far as I know, is entirely groundless. I wish people would not write hyped reviews of this sort. The medical literature will soon be a morass of disinformation.

 

If only there was some way to completely eliminate a herpesvirus infection that was invented in the 1990s, like autologous directed T-cell therapy. Small molecule therapies not even in clinical trials...

CFS researchers are Sims characters at this point, bumping into walls and cashing checks.

 

There is certainly no proof. I am not sure that there is any meaningful evidence. Psychological stress can raise cortisol levels but not to a level that would 'weaken' immunity. Cortisol has both enhancing and inhibiting effects on all sorts of processes. If anything it seems likely that an immune response works better with the sort of rise in cortisol that occurs under stress - presumably that it what the rise is adapted to - dealing with threats like infection.

 

It already is.

 

Probably, but I like to cling to the thought that as yet it is more like a cappuccino or a Dutch glass of lager - you have to struggle through a mass of froth to get to the drink but there is still a drink lower down.

 

I think a true Irish Guinness might just touch on the depth and density of the froth......

 

Anecdotal
The chemistry lecturer at uni has commented that he sees glandular fever symptoms reactivate every year at exam time.

 

Not sure. The head on a well-poured glass of Guinness should not be more than a centimetre once settled. A Dutch lager can have four centimetres. The other thing about Guinness is that the weightiness of the good stuff is such that in contrast to other beers, the bubbles do not rise, the beer flows downwards around them. A joy to watch - quite magical in fact.

 

indeed. Not a Guinness drinker but OH used to have business trips to Eire and enthused on " the real stuff".

Perhaps a qualification to a badly poured pint, but that would be a waste (and a different metaphor)

 

I think we can be pretty sure that is not viral reactivation, just feeling lousy because of the stress of an exam. For many years my mother was the person at Colindale Central Public Health Laboratory in charge of EBV epidemiology. If there had been evidence of reactivation in that sort of situation it would have been known about. All the evidence is that there is a single series of events involving B cell activation followed by cytotoxic T cell expansion at infection and only rarely a reactivation, mostly in seriously immunodeficient individuals. The person who probably knows most about this is Dorothy Crawford in Edinburgh who worked with my mother years ago and dealt with genuine reactivation cases in the context of lymphomas.

 

Ah, now, if you are talking about a badly poured Guiness, then morass doesn't even touch it. All that creamy stuff going to waste down the tap drain - not a pretty sight.

 

Why would not the majority of CFS patients have encephalitis lethargica due to a herpesvirus? It is late temporal exposure with a primed immune system.

No peripheral test would really be indicative of a CNS infection, you would have to do histology of the brainstem. No blood biomarker for ALS, Parkinsons et al. exist. Regardless, patients do possess improper peripheral native control to EBV/CMV, at least according to Loebel.

I personally think it is an environmental stressor causing BBB damage, but it is ridiculous no one has tried the treatment I proposed.