Our primary aim is to study the roles that infection and the immune response play in the symptoms of patients suffering from chronic, unexplained diseases.
Why we believe our initiative is important:
The study of infection-associated chronic diseases is a relatively new field, and more research is needed. Examples of infection-associated chronic diseases include Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Chronic Lyme Disease (CLD). ME/CFS and CLD overlap in many aspects; they are multi-system and complex diseases with potentially devastating physical and cognitive symptoms. These diseases can significantly impair the lives of patients and result in substantial reductions in previous levels of occupational, educational, social, or personal activities. A broad spectrum, innovative approach to discovery surrounding these debilitating diseases is paramount and a priority at Stanford.
It is common for physicians in the United States to take a skeptical position towards these patients’ symptoms, and this skepticism is unfortunately enhanced because most (if not all) results of conventional laboratory and radiological tests are normal.
At Stanford the group of Jose G. Montoya, MD, Professor of Medicine in the Division of Infectious Diseases and Geographic Medicine, has taken the approach of exploring whether infection can be a trigger for these patients’ ailments. We postulated that infection, or the body’s immune response to it, can play an etiologic role in ME/CFS, CLD, and other chronic illnesses. We also hypothesized that prolonged and specific antimicrobial interventions could result in partial or complete reversal of patients’ symptoms. Since then, we have been able to successfully identify several subgroups of patients whose lives have been dramatically changed with our approach.1 It is important to emphasize, however, that our approach does not work in all patients.
1 Kogelnik et al. “Use of valganciclovir in patients with elevated antibody titers against Human Herpesvirus-6 (HHV-6) and Epstein-Barr Virus (EBV) who were experiencing central nervous system dysfunction including long-standing fatigue.” J Clin Virol. 2006 Dec; 37 Suppl 1: S33-8.
Our Short-Term Goals
- Establish and support a clinic that evaluates patients with chronic diseases in which infection or its immune response may play an etiologic role.
- Initiate clinical trials that assess the role of specific antimicrobial interventions in patients with chronic diseases that are likely to have an infectious etiology.
- Collaborate with faculty from departments that will contribute to designing and implementing these studies.
- Create a database using clinical and research data from all Stanford patients with infection-associated chronic diseases.
- Determine the etiologic role of specific infectious agents in the illness of patients with chronic diseases.
- Discover, define, and establish objective parameters that quantify the degree of physical, cognitive and immunological dysfunction observed in patients with chronic diseases.
- Collaborate with the Stanford Human Immune Monitoring Center (HIMC) and other groups to explore the dynamics of the immune system and gene expression in patients with chronic diseases that may unveil the etiology and pathogenesis of these diseases.
- Determine the role of genetics in predisposing patients to developing chronic diseases.
- Collaborate with the Stanford Blood Center Human Leukocyte Antigen (HLA) laboratory and the HIMC to determine whether patients with specific HLA groups are predisposed to chronic illnesses.
- Collaborate with the Stanford Institute for Immunity Transplantation and Infection (ITI) bioinformatics team and other bioinformatics teams at Stanford to synthesize and analyze patient and research data.
- Engage basic scientists and clinicians in the center’s work by distributing seed grants that can evolve into projects funded by the National Institutes of Health (NIH).
- Create a Stanford-based web site for the “Stanford Initiative for the Study of Infection-Associated Chronic Diseases.”
- Establish a one-day biennial international symposium at Stanford covering the newest discoveries in infection-associated chronic and inflammatory diseases. Our goal is to host the first symposium within the next three years.
- Establish a biennial conference to educate practicing physicians, fellows, residents, and medical students on the clinical care of these patients.
Our mission is to become a center of excellence that improves the health of patients with chronic diseases in which infection or its immune response plays a major etiologic role.
Additonally, our mission is to provide leadership, facilitate multidisciplinary collaboration, make new discoveries, and educate in the field of infection-associated chronic diseases.
Our Long-Term Goal
- Establish an inpatient center separate from a hospital environment where patients with chronic diseases can benefit from a holistic approach to their treatment.
- Patients will receive treatment over the course of weeks to months for the specific infectious agents likely to be playing a role in their disease.
- In addition, they will receive complementary treatments to promote recovery and healing.