Global ETD Search

91	An investigation of the association between toxin producing staphylococcus, biochemical changes and jaw muscle pain. McGregor, Neil Roland January 2000 (has links) Objectives: To assess the expression of the symptoms of jaw muscle pain and its association with alterations in biochemistry, other symptoms and the carriage of staphylococci. Methods: Three different study populations were assessed. The first was selected and examined by the author and consisted of 43 pain and 41 age and sex matched controls. The second was a study of CFS patients who were blinded to the author and the author subsequently examined the associations between jaw muscle symptom reporting and the standardised biochemistry measures. The third study was also blinded to the author but included an investigation of staphylococci and certain cytokine and biochemistry measures. Results: The three studies clearly establish an association between the carriage of toxicogenic coagulase negative staphylococci and the expression of jaw muscle pain in both males and females. These associations were homogeneous and were found whether the patients were selected on the basis of having jaw muscle pain or selected from within a population of patients selected on the basis of having Chronic Fatigue Syndrome. The studies associated the changes with variations in biochemistry and these were in turn associated with symptom expression within the jaw muscle pain patients. These biochemical alterations included the dysregulation of immune cell counts, cytokines, electrolyte and protein metabolism. These symptoms and biochemical changes were associated with pain severity and illness duration and staphylococcal toxin production. From the data a model was developed which shows the mechanisms involved in the development of chronic pain in the jaw muscles. Conclusions: The carriage of toxicogenic coagulase-negative staphylococci were found to be associated with the expression of jaw muscle pain and the alterations in biochemistry associated with these symptoms.
92	RUOLO POTENZIALE DEL MICROBIOMA NELLA SINDROME DA AFFATICAMENTO CRONICO/ ENCEFALOMIELITE MIALGICA (CFS/ME) / POTENTIAL ROLE OF MICROBIOME IN CHRONIC FATIGUE SYNDROME/MYALGIC ENCEPHALOMYELITIS (CFS/ME) LUPO, GIUSEPPE FRANCESCO DAMIANO 08 April 2020 (has links) La Sindrome da Affaticamento Cronico/Encefalomielite Mialgica (CFS/ME), è una grave malattia multisistemica caratterizzata da anomalie immunologiche e disfunzioni del metabolismo energetico. Recenti evidenze suggeriscono l’esistenza di una forte correlazione tra disbiosi e condizione patologica. La presente ricerca ha analizzato la composizione del microbiota intestinale ed orale in pazienti con CFS/ME rispetto a controlli sani e ha determinato se eventuali differenze osservate potrebbero essere utili in futuro per l'identificazione di biomarcatori diagnostici. La composizione batterica fecale e salivare dei pazienti con CFS/ME è stata studiata mediante sequenziamento Illumina degli ampliconi del gene 16S rRNA. Il microbiota fecale dei pazienti con CFS/ME ha mostrato una significativa riduzione di Lachnospiraceae, in particolare di Anaerostipes, rispetto ai gruppi di soggetti senza CFS/ME e un incremento di Phascolarctobacterium faecium e unclassified Ruminococcus. Bacteroides vulgatus, unclassified Bacteroides, Bacteroides uniformis e unclassified Barnesiella sono risultati significativamente più abbondanti nei pazienti con CFS/ME. Il microbiota orale dei pazienti con CFS/ME ha mostrato un aumento significativo di Rothia dentocariosa. Il profilo metabolico fecale di un sottogruppo di pazienti con CFS/ME ha mostrato un aumento complessivo di SCFA e di derivati dell'indolo rispetto ai gruppi non CFS/ME, suggerendo un aumento dei processi di fermentazione. I nostri risultati supportano l'ipotesi autoimmune per la CFS/ME e se saranno confermati da studi più ampi, le differenze rilevate nei profili microbici dei pazienti CFS/ME potrebbero essere utilizzate come markers per una diagnosi più accurata e per lo sviluppo di strategie terapeutiche specifiche. / The Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME), is a severe multisystemic disease characterized by immunological abnormalities and dysfunction of energy metabolism. Recent evidence suggest that there is a strong correlation between dysbiosis and pathological condition. The present research investigated the composition of the intestinal and oral microbiota in CFS/ME patients in comparison to healthy controls and determined whether any observed differences could be useful for the identification of diagnostic biomarkers. The fecal and salivary bacterial composition in CFS/ME patients was investigated by Illumina sequencing of 16S rRNA gene amplicons. The fecal microbiota of CFS/ME patients showed a significant reduction of Lachnospiraceae, particularly Anaerostipes, compared to the non-CFS/ME groups, and an increase of Phascolarctobacterium faecium and unclassified Ruminococcus. Bacteroides vulgatus, unclassified Bacteroides, Bacteroides uniformis and unclassified Barnesiella resulted significantly more abundant in CFS/ME patients. The oral microbiota of CFS/ME patients showed a significant increase of Rothia dentocariosa. The fecal metabolic profile of a subgroup of CFS/ME patients revealed an overall increase of SCFAs and indole derivatives compared to the non-CFS/ME groups, suggesting an increase in the fermentation processes. Our results support the autoimmune hypothesis for CFS/ME condition and if confirmed by larger studies, the differences detected in the microbial profiles of CFS/ME patients may be used as markers for a more accurate diagnosis and for the development of specific therapeutic strategies. AGR/16: MICROBIOLOGIA AGRARIA
93	Circulating miRNAs in myalgic encephalomyelitis : chronic fatigue syndrome Nepotchatykh, Evguenia 08 1900 (has links) L'encéphalomyélite myalgique (EM) est une maladie chronique complexe et hétérogène dont l'étiologie et la physiopathologie restent mal comprises. Cette maladie comporte une multitude de symptômes et se caractérise par une fatigue constante inexpliquée, non soulagée par le repos et un malaise post-effort (MPE), qui se traduit par une aggravation des symptômes à la suite d’une activité physique ou cognitive minimale. Bien que le MPE soit le symptôme caractéristique de l'EM, plusieurs symptômes peuvent varier au fil du temps selon les personnes affectées en termes de fréquence et d'intensité. Environ 60 % des personnes atteintes d'EM souffrent d’une dysautonomie, plus fréquemment d’une intolérance orthostatique (IO) et, souvent, d’un syndrome de tachycardie orthostatique posturale (STOP). L’IO et le STOP sont déclenchés par un changement de position de couché à debout et sont aggravés par le MPE. Les patients gravement atteints par l’EM sont confinés à la maison et souvent cloués au lit. L'EM est une maladie qui affecte globalement des millions de personnes, incluant plus de 500,000 Canadiens. Cependant, le nombre de personnes souffrant de cette maladie pourrait en fait être une sous-représentation de la réalité car environ 84 à 91 % d’entre elles ne sont toujours pas diagnostiquées. Le diagnostic de l’EM est difficile en raison du manque de biomarqueurs validés et du chevauchement dans les symptômes avec d'autres maladies telles que la fibromyalgie (FM). La FM est une autre maladie chronique dont l'étiologie demeure inconnue avec une prévalence d'environ 2 à 3 % de la population et présente plusieurs symptômes en commun avec l'EM, tels que la fatigue, les problèmes de sommeil et les troubles cognitifs. Alors que l'EM est davantage caractérisée par la MPE, la FM est associée aux douleurs chroniques, à un faible seuil de douleur et à une sensibilité musculaire. Avec des preuves à l’appui et compte tenu de la nature hétérogène de l’EM, il est reconnu que la pathogénèse de cette maladie est le résultat d’une combinaison de facteurs. D’abord, il y a les prédispositions génétiques, car souvent plusieurs membres de la famille sont atteints. Ensuite, il y a les expositions environnementales telles que les toxines, les moisissures, l’exposition aux métaux lourds (mercure, arsenic, etc.). De plus, les infections par des agents pathogènes viraux (H1N1, EBV, etc.) ou bactériens (Borrelia burgdorferi), ainsi que des stress majeurs peuvent jouer un rôle comme agent déclencheur dans la maladie. Les microARN (miARN) sont une classe de petits ARN non codants qui possèdent la capacité de réguler l'expression de plusieurs gènes et ont donc un impact considérable sur les fonctions physiologiques. Il est important de noter que l’expression de nombreux miARN est modulée par les facteurs génétiques, épigénétiques et environnementaux. Nous proposons que les miARN jouent un rôle dans la pathogenèse de l'EM en modulant plusieurs voies physiologiques dont la réponse au stress. L'objectif général de cette thèse était d'examiner le rôle des miARN dans la physiopathologie de l'EM et leur contribution dans la variabilité et à la gravité des symptômes. Dans le premier article, nous avions pour objectif d’identifier les miARN impliqués dans l’EM. Ceci nous a conduit à découvrir 11 miARN circulants qui sont dérégulés et associés au MPE déclenché par l'application d'une provocation standardisée. Basé sur les changements d’expression de ces miARN après un stress appliqué provoquant un MPE chez les participants EM, nous avons pu créer un algorithme capable de différentier avec succès les individus EM des témoins sains. De plus, en utilisant le regroupement k-means, nous avons identifié quatre sous-groupes distincts de patients atteints d'EM présentant des profils de miARN et une gravité de la maladie différents. Parmi les 11 miARN identifiés, l'expression dérégulé de hsa-miR-29a-3p, hsa-miR-150-5p et hsa-miR-374b-5p avait été précédemment associée à la FM dans la population norvégienne. L'objectif du deuxième article était d'évaluer les niveaux d'expression des 11 miARN associés à l'EM chez les patients atteints de FM ainsi que chez ceux présentant un diagnostic comorbide d'EM et de FM (EM+FM). Nous avons observé des signatures d'expression différentielles des 11 miARN entre les individus EM, FM et EM+FM. Ces résultats nous ont permis de développer un modèle de prédiction basé sur une approche d’apprentissage automatique, capable de différentier les maladies EM et FM. L'un des miARN identifiés dans notre panel diagnostic d’EM, hsa-miR-150-5p, est prédit de réguler l'expression du gène SLC6A2 codant pour le transporteur de norépinephrine (NET). L’inactivation du transporteur NET a été mise en évidence par la découverte de mutations inactivatrices associées à une forme familiale rare de STOP ce qui n’est pas le cas pour la majorité des personnes atteintes de STOP. Néanmoins, chez ces personnes le niveau de la protéine NET et son expression sont souvent réduites. L'objectif du troisième manuscrit était d'étudier l'implication de miR-150-5p dans le STOP et IO survenant chez les personnes souffrant d'EM, EM+FM et STOP sans EM ni FM. Dans cette étude, nous avons confirmé une élévation du taux plasmatique de norépinephrine chez les participants atteints de STOP (avec et sans EM), suggérant une réduction de la protéine NET. Parmi les patients atteints d'EM avec STOP/IO et les patients STOP uniquement (sans EM), nous avons déterminé un mécanisme double par lequel le STOP est déclenché, centré sur deux profils distincts impliquant des taux plasmatiques faibles et élevés de miR-150-5p. Nous avons réalisé des expériences in vitro permettant de moduler les niveaux d’expression du miR-150-5p dans la lignée cellulaire SH-SY5Y, et mis en évidence une augmentation de l'expression du gène SLC6A2 suggérant un mécanisme indirect impliquant une réduction significative dans les niveaux de protéine EZH2, un puissant répresseur transcriptionnel de SLC6A2 et une autre cible confirmée de miR-150-5p. Dans cette thèse, nous avons identifié un panel diagnostic constitué de 11 miARN circulants qui, grâce à une combinaison d'un test d'effort, peuvent aider au diagnostic des individus atteints d'EM et révéler de nouvelles informations sur la physiopathologie de l'EM. De plus, ce panel de miARN peut être utilisé pour différentier les conditions de EM, FM et EM+FM, ce qui est vital pour la compréhension de la physiopathologie de chaque maladie. Finalement, nous proposons un nouveau mécanisme par lequel l'altération de miR-150-5p peut déclencher le STOP/IO chez les individus atteints d'EM, EM+FM ainsi que chez ceux souffrant de STOP sans EM. Le diagnostic précis des individus à l'aide des miARNs en tant que biomarqueurs aidera à déterminer des mesures préventives, à établir des traitements efficaces et à identifier des cibles thérapeutiques pour la maladie EM par une manipulation directe ou indirecte de l'expression des miARN. / Myalgic encephalomyelitis (ME) is a complex chronic heterogeneous illness whose etiology and pathophysiology remain poorly understood. This disease has a multitude of symptoms, and it is characterised by unexplained constant fatigue unrelieved by rest and post-exertional malaise (PEM), which is reported as a worsening of symptoms following a minimal physical or cognitive activity. While PEM is the hallmark symptom of ME, some symptoms can vary overtime among affected individuals in frequency and intensity. About 60% of people with ME experience autonomic dysfunctions often refereed as dysautonomia and can result in orthostatic intolerance (OI) and in some cases in Postural Orthostatic Tachycardia Syndrome (POTS). Both OI and POTS are triggered by a change of position from supine to standing and are worsened by PEM. Severely affected patients are housebound and often bedridden. ME is common in all populations and it is known to affect over 500,000 Canadians. However, the number of people suffering from this disease may be in fact an underrepresentation of the reality because about 84-91% remain undiagnosed. Diagnosis is challenging due to a lack of validated biomarkers and overlap in symptoms with other diseases such as Fibromyalgia (FM). FM is another chronic illness with unknown etiology with a prevalence of about 2-3% of the population and has several common symptoms with ME such as fatigue, sleep problems and cognitive impairment. While ME is more characterised by PEM, FM is associated with more chronic pain, low pain threshold and muscle tenderness. With supporting evidence and the heterogeneous nature of ME, it is evident that the pathophysiology of this disease includes a combination of factors. First of all, there are predisposing genetic factors since it is common to observe several affected family members. Then, there are environmental exposures such as toxins, mold, exposure to heavy metals (mercury, arsenic, etc.). In addition, viral pathogen infections (H1N1, EBV, etc.) or bacterial infections (Borrelia burgdorferi) as well as major stress can play a role as a triggering agent in the disease. MicroRNAs (miRNAs) are a class small non-coding RNAs that possess the ability to regulate the expression of several genes and therefore greatly impact physiological functions. Of note, the expression of many miRNAs is modulated by genetic, epigenetic, and environmental factors. We propose that miRNAs play a role in the pathogenesis of ME by modulating several physiological pathways particularly in response to stress. The general objective of this thesis was to examine the role of miRNAs in the pathophysiology of ME and their contribution to symptom variability, and severity. In firstly paper, we aimed to determine the miRNAs involved in ME disease. We have identified using microarray technology and confirmed by qPCR a panel of 11 circulating miRNAs that are deregulated and associated with PEM in response triggered by the application of a standardized provocation maneuver. Based on the changes of those miRNAs due to the applied stress test that provokes PEM in ME participants, we were able to create an algorithm capable of successfully differentiate ME individuals from healthy controls (HC). In addition, using k-means clustering, we have identified four distinct subgroups of ME patients with different miRNA profiles and severity of the disease. Among the selected 11 miRNAs, hsa-miR-29a-3p, hsa-miR-150-5p and hsa-miR-374b-5p downregulated expression was previously associated with FM in the Norwegian population. The objective of the second paper was to investigate the expression levels of the 11 associated miRNAs with ME in FM patients as well as those with a comorbid diagnosis of ME and FM (ME+FM). We observed differential expression signatures of the 11 miRNAs between ME, FM and ME+FM individuals. These results prompted us to develop a prediction model based on machine learning approach, which can differentiate ME and FM illnesses. One of the miRNAs identified in our ME diagnostic panel, hsa-miR-150-5p is predicted to regulate the expression of SLC6A2 gene encoding norepinephrine transporter (NET). Inactivation of NET transporter by mutations was discovered in rare familial form of POTS which is not the case for most people with POTS. Nevertheless, in these people the level of the NET protein and its expression are often reduced. The objective of the third manuscript was to investigate the implication of miR-150-5p in POTS and OI occurring in people suffering of ME, ME+FM and POTS without ME or FM. In this study, we confirmed an elevation of plasma norepinephrine in participants with POTS (with and without ME), suggesting a reduction in NET protein. Among ME patients with POTS/OI, and POTS-only patients (without ME), we determined a dual mechanism by which POTS is triggered centered on two distinct profiles involving low and high plasma miR-150-5p levels. We performed in vitro experiments and with modulation of miR-150-5p expression levels in SH-SY5Y cells line, we observe an increase in SLC6A2 expression, suggesting an indirect mechanism involving a significant reduction in levels of EZH2 protein, a powerful transcriptional repressor of SLC6A2 and another confirmed target of miR-150-5p. In this thesis, we have identified a panel of circulating miRNAs, which in combination to a stress test, can aid in the accurate diagnosis of ME individuals and reveal new insights into the ME pathophysiology. In addition, this panel of miRNAs at baseline can be used to differentiate ME from FM or when it co-exists with the ME (ME+FM), which is crucial for understanding the pathophysiology of each illness. And finally, we propose a first mechanism by which alteration of miR-150-5p can trigger POTS/OI in individuals with ME, ME+FM as well as in those suffering of POTS without ME. The accurate diagnosis of individuals with the help of miRNAs as biomarkers will help to establish preventive measures, effective treatments, and therapeutic targets for ME disease by a direct or indirect manipulation of miRNA expression. microARN circulants Fibromyalgie Apprentissage automatique Biomarqueurs diagnostiques Test d'effort circulating microRNAs Fibromyalgia Machine Learning Diagnostic Biomarkers Post-Exertional Stress-Test
94	Action in Chronic Fatigue Syndrome: an Enactive Psycho-phenomenological and Semiotic Analysis of Thirty New Zealand Women's Experiences of Suffering and Recovery Hart, M J Alexandra January 2010 (has links) This research into Chronic Fatigue Syndrome (CFS) presents the results of 60 first-person psycho-phenomenological interviews with 30 New Zealand women. The participants were recruited from the Canterbury and Wellington regions, 10 had recovered. Taking a non-dual, non-reductive embodied approach, the phenomenological data was analysed semiotically, using a graph-theoretical cluster analysis to elucidate the large number of resulting categories, and interpreted through the enactive approach to cognitive science. The initial result of the analysis is a comprehensive exploration of the experience of CFS which develops subject-specific categories of experience and explores the relation of the illness to universal categories of experience, including self, ‘energy’, action, and being-able-to-do. Transformations of the self surrounding being-able-to-do and not-being-able-to-do were shown to elucidate the illness process. It is proposed that the concept ‘energy’ in the participants’ discourse is equivalent to the Mahayana Buddhist concept of ‘contact’. This characterises CFS as a breakdown of contact. Narrative content from the recovered interviewees reflects a reestablishment of contact. The hypothesis that CFS is a disorder of action is investigated in detail. A general model for the phenomenology and functional architecture of action is proposed. This model is a recursive loop involving felt meaning, contact, action, and perception and appears to be phenomenologically supported. It is proposed that the CFS illness process is a dynamical decompensation of the subject’s action loop caused by a breakdown in the process of contact. On this basis, a new interpretation of neurological findings in relation to CFS becomes possible. A neurological phenomenon that correlates with the illness and involves a brain region that has a similar structure to the action model’s recursive loop is identified in previous research results and compared with the action model and the results of this research. This correspondence may identify the brain regions involved in the illness process, which may provide an objective diagnostic test for the condition and approaches to treatment. The implications of this model for cognitive science and CFS should be investigated through neurophenomenological research since the model stands to shed considerable light on the nature of consciousness, contact and agency. Phenomenologically based treatments are proposed, along with suggestions for future research on CFS. The research may clarify the diagnostic criteria for CFS and guide management and treatment programmes, particularly multidimensional and interdisciplinary approaches. Category theory is proposed as a foundation for a mathematisation of phenomenology. action Chronic Fatigue Syndrome Myalgic Encephalomyelitis Chronic Immune Deficiency Syndrome enaction social enaction social enactivism enactive psycho-phenomenological psychophenomenological vipassana groundlessness mind-body korper leib co-generative Focusing co-creative environment Antonio Damasio reciprocal constraints Pierre Vermersch Claire Petitmengin Antione Lutz narrative discourse phenomenal invariants Evan Thompson Merleau-Ponty Algirdis Julien Greimas Husserl first-person Fransisco Varela modelling invariants Natalie Depraz isotope John Boyd OODA loop Jonathan Shear Shaun Gallagher Arthur Kleinman Humberto Maturana second-person Alva Noe Dan Zahavi stages Embodied Mind Canterbury Wellington New Zealand non-dual non-reductive embodied phenomenological third-person graph-theoretical cluster analysis cognitive science experience solution subject-specific categories universal categories universal categories self energy illness process intersubjectivity Mahayana Buddhism contact narrative recovered making sense recursive loop perception dynamical decompensation neurology diagnosis empathy treatment management neurophenomenological neurophenomenology consciousness veracity agency multidimensional interdisciplinary category theory enculturation mathematisation of phenomenology interview nomenclature diagnostic criteria incidence prevalence coping strategy etiology epidemiology psychosomatic medicine meaning women girl female anthropology sociology cognitive behavioral therapy exercise therapy recovery mindful awareness suffering symbolisation Prasangika no-self aggregates wheel of karma cognition basic element analysis mental factors operational closure stereotypes enactive ontologically fragile self grief process-knowledge epoche phenomenal invariants textual invariants compound meaning saturation formalisation cluster analysis inter-session review inter-individual validation explicitation interview intricacy confidence psychophenomenology self-esteem sanction self dis-integration permanence continuity ego-self emotion surrender semiotic square meditation empathy semiotic compassion existential feelings goal obstruction movement transformation change somatic Giovanna Colombetti agoraphobia panic anxiety psychotherapy sleep rest pain weakness strength stamina Diego Cosmelli heaviness food chemicals allergy recovering despair frustration helplessness fear efference valence afference as-if-body-loop consciousness representation attention recovery intention sustainable sustainability neurasthenia existential feelings asthenia hysteria mononucleosis samatha-vispasnya prajna vijnana Eugene Gendlin Abhidharma dukkha shamatha interdependence vipashyana

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