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The Banbury Center Workshop

Cold Spring Harbor Laboratory
February 23-26, 2003

During February 23-26, 2003, the Centers for Disease Control and Prevention (CDC) and the CFIDS Association of America cosponsored a meeting, Towards Understanding of Cellular and Molecular Mechanisms of Medically Unexplained Fatigue, at the Banbury Center, Cold Spring Harbor Laboratory, New York.

The objective of the meeting was to identify gaps in current approaches to the study of medically unexplained fatigue. In particular, will further progress require paradigm shifts, new technologies, or simply more work in currently established directions?

The first morning focused on chronic fatigue and the state of the science. Presentations and discussion reviewed the spectrum of ailments in medically unexplained fatiguing illnesses, the magnitude of medically unexplained fatigue as a public health problem, cognitive behavioral and emotional factors in chronic fatigue, neuroendocrine perturbations in chronic fatigue, and acute infection-immunologic perturbations and chronic fatigue. The afternoon session was concerned with influences on the structure and function of the brain. Presentations covered the relevance of cerebral perfusion and neurometabolic-synaptic activity to CFS, regulation of the neurohypophyseal system, communication between the brain and the immune system, and immunologic stress, the brain, and CFS.

The second day began with a session on infection, immunity, sex, and the brain. There were presentations and discussion concerning neuroendocrine regulation of immunity, maternal infection, fetal brain development and health, chronic consequences of persistent infection, and immunity. This was followed by a series of talks and discussion on analytical approaches searching for markers applicable to medically unexplained fatigue. This encompassed what psychopharmacology tells us about the pathophysiology of medically unexplained fatigue, biomarker discovery in illness with no lesion, sex (male vs. female) as a determinant of disease, and microchimerism.

The third day involved discussion of presentations and preparation of a report on future research directions to better understand the cellular and molecular mechanisms of medically unexplained fatigue.

Meeting Participants

Invited participants included:

  • Jack C. de la Torre
    University of California, San Diego, CA
  • Birgitta Evengard
    Karolinska Institute, Stockholm, Sweden
  • Carol M. Artlett
    Thomas Jefferson University, Philadelphia, PA
  • Anthony J Cleare
    Guy's King's and St Thomas' School of Medicine, London, UK
  • Mary Ann Fletcher
    University of Miami School of Medicine, Miami, FL
  • Eleanor Hanna
    National Institutes of Health, Bethesda, MD
  • Leonard A. Jason
    DePaul University, Chicago, IL
  • Kevin D. Karem
    CDC, Atlanta, GA
  • Andrew Lloyd
    University of New south Wales, Sydney, Australia
  • Ian Hickie
    St George Hospital, Sydney, Australia
  • James F. Jones
    National Jewish Medical and Research Center, Denver, CO
  • Kimberly Kenney
    CFIDS Association of America, Charlotte, NV
  • Steven F. Maier
    University of Colorado, Boulder, CO
  • Andrew H. Miller
    Emory University, Atlanta, GA
  • Rosane Nisenbaum
    CDC, Atlanta, GA
  • Paul H. Patterson
    California Institute of Technology, Pasadena, CA
  • Mangalathu Rajeevan
    CDC, Atlanta, GA
  • Sharon Shriver
    Penn State University, University Park, PA
  • Esther M. Sternberg
    National Institutes of Health, Bethesda, MD
  • Dimitris Papanicolaou
    Emory University, Atlanta, GA
  • Charles L. Raison
    Emory University, Atlanta, GA
  • William C. Reeves
    CDC, Atlanta, GA
  • Celia D. Sladek
    University of Colorado Health Sciences Center, Denver, CO
  • Elizabeth R. Unger
    CDC, Atlanta, GA
  • Suzanne Vernon
    CDC, Atlanta, GA
  • Simon Wessely
    Institute of Psychiatry, London, UK
  • Peter D. White
    St. Bartholomew's Hospital, London, UK
  • Ute Vollmer-Conna
    University of New South Wales, Sydney, Australia
  • Toni Whistler
    CDC, Atlanta, GA

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