Lane R J M, Soteriou B A, Zhang H, Archard L C
Division of Clinical Neurosciences and Psychological Medicine, Imperial College, London SW7, UK.
J Neurol Neurosurg Psychiatry. 2003 Oct;74(10):1382-6. doi: 10.1136/jnnp.74.10.1382.
To detect and characterise enterovirus RNA in skeletal muscle from patients with chronic fatigue syndrome (CFS) and to compare efficiency of muscle energy metabolism in enterovirus positive and negative CFS patients.
Quadriceps muscle biopsy samples from 48 patients with CFS were processed to detect enterovirus RNA by two stage, reverse transcription, nested polymerase chain reaction (RT-NPCR), using enterovirus group specific primer sets. Direct nucleotide sequencing of PCR products was used to characterise the enterovirus. Controls were 29 subjects with normal muscles. On the day of biopsy, each CFS patient undertook a subanaerobic threshold exercise test (SATET). Venous plasma lactate was measured immediately before and after exercise, and 30 minutes after testing. An abnormal lactate response to exercise (SATET+) was defined as an exercise test in which plasma lactate exceeded the upper 99% confidence limits for normal sedentary controls at two or more time points.
Muscle biopsy samples from 20.8% of the CFS patients were positive for enterovirus sequences by RT-NPCR, while all the 29 control samples were negative; 58.3% of the CFS patients had a SATET+ response. Nine of the 10 enterovirus positive cases were among the 28 SATET+ patients (32.1%), compared with only one (5%) of the 20 SATET- patients. PCR products were most closely related to coxsackie B virus.
There is an association between abnormal lactate response to exercise, reflecting impaired muscle energy metabolism, and the presence of enterovirus sequences in muscle in a proportion of CFS patients.
检测慢性疲劳综合征（CFS）患者骨骼肌中的肠道病毒RNA并进行特征分析，比较肠道病毒阳性和阴性的CFS患者肌肉能量代谢效率。
采用肠道病毒组特异性引物对，通过两步逆转录巢式聚合酶链反应（RT-NPCR）对48例CFS患者的股四头肌活检样本进行处理，以检测肠道病毒RNA。利用PCR产物的直接核苷酸测序对肠道病毒进行特征分析。对照组为29名肌肉正常的受试者。在活检当天，每位CFS患者进行一次次厌氧阈值运动试验（SATET）。在运动前、运动后及测试后30分钟立即测量静脉血浆乳酸水平。运动时乳酸反应异常（SATET+）定义为在两个或更多时间点血浆乳酸超过正常久坐对照组99%置信上限的运动试验。
RT-NPCR检测显示，20.8%的CFS患者肌肉活检样本肠道病毒序列呈阳性，而29份对照样本均为阴性；58.3%的CFS患者有SATET+反应。10例肠道病毒阳性病例中有9例在28例SATET+患者中（32.1%），而20例SATET-患者中只有1例（5%）。PCR产物与柯萨奇B病毒关系最为密切。
在一部分CFS患者中，反映肌肉能量代谢受损的运动时乳酸反应异常与肌肉中存在肠道病毒序列之间存在关联。
