1

http://www.aafp.org/afp/20000701/149.html
Management of Aphthous Ulcers.
Author: DAVID R. MCBRIDE, M.D.
Lynn Community Health Center, 269 Union St., Lynn, MA 01901.
American Academy of Family Physicians.
July 01, 2000.

Aphthous ulcers are a common and painful problem.
[ A canker sore. Aphthous ulcers are one of the most common problems that occur in the mouth. About 20% of the population (1 in 5 people) have aphthous ulcers at any given time. Aphthous ulcers typically last for 10-14 days and they heal without leaving a scar.]

Benign aphthae tend to be small (less than 1 cm in diameter) and shallow. Aphthous ulcers that occur in conjunction with symptoms of uveitis, genital ulcerations, conjunctivitis, arthritis, fever or adenopathy should prompt a search for a serious etiology. The lack of clarity regarding the etiology of aphthous ulcers has resulted in treatments that are largely empiric. These treatments include antibiotics, anti-inflammatories, immune modulators, anesthetics and alternative (herbal) remedies. ...

Infection-causing ulceration in the mouth should be considered when evaluating patients with oral symptoms. A common infection, ... is herpes5. When Tzank staining is available, a sample from a herpetic lesion will reveal inclusion-bearing giant cells. Other viral, bacterial, treponemal and fungal agents have the potential to cause mouth ulcers. Biopsy alone or in conjunction with a culture of lesions or blood testing may aid in distinguishing the causative agent. ...

[Potential causative agents include:]
Herpesvirus (HP-1 & HP-2), Cytomegalovirus (HP-5), Varicella (chickenpox), Coxsackievirus, Cryptosporidium, Pemphigus vulgaris, Cyclic neutropenia, Squamous cell carcinoma, HLA B27-positive arthritis following nongonococcal urethritis or bacillary dysentery, Lupus erythematosus, and others ...

Topical and systemic antibiotic treatments are empiric and are used because of a belief that some as-yet-undiscovered infectious agent is causing the aphthous ulcer. ...

Local anti-inflammatory agents may be the most helpful way to speed healing and relieve symptoms in the management of recurrent minor aphthous ulcers. Triamcinolone 0.1 percent (Kenalog in Orabase) can be applied to ulcers two to four times a day. This preparation also provides a protective local coating for the ulcer. Early initiation of this treatment may result in a more rapid response. The paste can be applied until the ulcer is healed.

For more extensive oral ulceration, dexamethasone elixir, 0.5 mg per 5 mL, may be used as a rinse and expectorated. Patients should be warned of the potential for secondary fungal infection when using a steroid rinse. Systemic steroids are generally not recommended in the management of aphthous ulcers, although they may be helpful in the management of conditions that mimic aphthous ulcers.

Alternative Agents
Sucking on zinc gluconate lozenges is anecdotally reported to provide local relief and speeding of healing time for aphthous ulcers. Vitamin C, vitamin B complex and lysine may speed healing when taken orally at the onset of lesions. Sage and chamomile mouthwash, created by infusing equal amounts of the two herbs in water, may be helpful when used four to six times a day. Echinacea is reported to speed healing, perhaps through its immune modulatory effect. Carrot, celery and cantaloupe juices also have been reported as helpful complementary agents. ...

2

http://www.ncbi.nlm.nih.gov/entrez/query....
Modulatory effects of Epstein-Barr, herpes simplex, and human
herpes-6 viral infections and coinfections on cytokine synthesis. .
by Gosselin J, Flamand L, D'Addario M, Hiscott J, Stefanescu I, Ablashi DV, Gallo RC, Menezes J.
Laboratory of Immunovirology, Faculty of Medicine,
University of Montreal, Quebec, Canada.
J Immunol. 1992 Jul 1;149(1):181-7.

Herpes viruses such as EBV, HSV, and human herpes virus-6 (HHV-6) have a marked tropism for cells of the immune system and therefore infection by these viruses may result in alterations of immune functions, leading at times to a state of immunosuppression. .. we found that EBV, HSV-1, and HHV-6 act differentially on the immune system with regard to their effect on the synthesis of IL-1 beta, IL-6, and TNF-alpha, i.e., three immunoregulatory cytokines mainly secreted by activated monocytes/macrophages.

... Different amounts of IL-1 beta protein were detected in infected PBMC cultures, HHV-6 being the strongest IL-1 beta up-regulatory among these three herpes viruses. Spontaneous releases of IL-6 and TNF-alpha were found reduced after infection by HHV-6 and EBV, respectively.

In comparison to EBV and HHV-6, HSV-1 proved to be a weak monokine enhancer. Results of coinfection studies indicated that virus-induced suppressive effects on cytokine synthesis are dominant. In fact, EBV inhibited TNF-alpha synthesis even in the presence of HHV-6, a strong up-regulator of TNF-alpha synthesis. Similarly, EBV was unable to stimulate IL-6 production in the presence of HHV-6.

Viral structural component(s) appeared to be responsible for the up-regulation of IL-6 by both EBV and HSV-1, and of TNF-alpha by HSV-1. Taken together, our observations illustrate that herpes viruses can selectively regulate cytokine synthesis thereby disturbing immune homeostasis; this effect may favor pathogenic events, including the reactivation and/or spread of other infectious agents within the host.

3

http://www.healingpeople.com/ht/...
Principal & Proposed Treatments.
By Anonymous,
Healing People Network,
2000

... the herpes virus has the devious habit of hiding out deep in the DNA of nerve ganglia, where it remains inactive for months or years. From time to time the virus reactivates, travels down the nerve, and starts an eruption. Common triggers include stress, dental procedures, infections, and trauma. ...

Melissa officinalis (Lemon Balm)
... is widely sold in Europe as a topical cream for the treatment of genital and oral herpes. ...

... applied at the first sign of blisters or on a regular basis for the prevention of flare-ups.

... Treated subjects showed a significantly better rate of recovery than those on placebo ....

Topical melissa is not associated with any significant side effects ....

L-Lysine
... L-lysine probably works best when it is combined with dietary changes that restrict levels of another amino acid, arginine. (To do this, cut down on gelatin, chocolate, peanuts, almonds and other nuts, seeds, and to a lesser extent wheat.)

Those treated with L-lysine experienced, on average, fewer herpes flare-ups than the placebo group, a significant result. The L-lysine group also experienced significantly less severe flare-ups and shorter healing time.

Foods high in L-lysine include vegetables, beans, fish, turkey, and chicken. When taken as a supplement, a typical daily dose is 1,000 mg.

... In animal studies, high dosages have caused gallstones and elevated cholesterol levels,13,14 so you may want to use caution when using L-lysine if you have either of these problems. ...

4

http://www.emmessar.com/chemical/patents/...
Homeopathic dilutions of growth factors to treat such disorders.
By Barbara Brewitt;
(6812 Woodlawn Ave. NE., Seattle, WA 98115-5420),
United States Patent, 5,626,617 May 6, 1997

Disorders which may be effectively treated with the compositions of the present invention include chronic viral disorders, such as HIV, AIDS, chronic fatigue syndrome and Epstein-Barr viral infections, cancer and diabetes. ...

... the treatment of chronic viral infections by administration of homeopathic dilutions of growth factors. Chronic viral infections, such as herpes simplex virus, Epstein-Barr virus (EBV), human immunodeficiency virus (HIV), papilloma virus, AIDS, chronic fatigue syndrome, Coxsackie B, hauta virus and hepatitis B virus, affect signal transduction mechanisms with deleterious effects within and between the host's immune and nervous systems. During chronic viral infection, host cell signal transduction and cell cycle regulation are altered, often causing cell injury and cell death. ...

Chronic, or long-term, viral infections occur when the virus is able to overcome or effectively disrupt the normal neuronal and immunological defense mechanisms of the host. Several viruses, such as herpes simplex virus, EBV, human herpes 6 virus (HH6V), hepatitis B and HIV are able to cause latent (asymptomatic) infections in specific cell populations. Viral replication subsequently occurs in response to extracellular stimuli (Garcia-Blanco, M. A. and Cullen, B. R. 1991 Science 254:815-820). Infections become persistent when continuous viral replication occurs without substantial disruption of host cell function. Viral infections are terminated only when viral replication is disrupted.

Viral infection erodes feedback communication between the host's immune and nervous systems. For example, synthesis of adrenocorticotrophic hormone (ACTH) by lymphocytes after viral infection disrupts the normal feedback loop between pituitary/hypothalamus secretion of ACTH and the adrenal gland's synthesis of glucocorticoids in response to ACTH signals. Over-expression of ACTH causes increased expression of glucocorticoids which consequentially down-regulates the pituitary and suppresses the activities of T lymphocytes. This constant stress response often leads to extreme fatigue and exhaustion in patients with chronic viral infections. In an immune compromised patient, chronic infection leads to entry of virions into the bloodstream, the lymphatic vessels and/or the nerve pathways resulting in infection of new and distant cell populations.

DNA viral infections are often correlated with chronic or cancerous illnesses.
For example, hepatitis B viral infection may be correlated with liver cirrhosis of the time and primary hepatocellular carcinoma 58% of the time compared to 17% in a control group. EBV infection correlates with Hodgkin's disease of the mixed cellularity type 60% of the time. Herpes type viral nucleic acid sequences from herpes simplex 1 and 2, cytomegalovirus and EBV have been found in the cerebrospinal fluid of patients with acute encephalitiso In addition, EBV has been found to induce receptors for human herpes 6 virus (HH6V). HH6V has, in turn, been found to be a cofactor in causing chronic fatigue syndrome and AIDS. The ability of viruses to cause cancer is contained within specific sequences of the viral genome. These sequences, known as oncogenes, have the ability to modulate gene transcription and regulation.

Gene transcription and regulation is modulated under normal conditions by growth factors. Growth factors are cell signalling polypeptides that bind to specific cell membrane receptors and initiate a cascade of intracellular events that affect cell proliferation and differentiation. As stated above, many growth factors bind to the same cell surface receptors as viruses and therefore activate the same metabolic pathways used by viral infected or transformed cells.

Growth factors and viruses use the same transcription sites to regulate cell proliferation. ...

Chronic viral infections can lead to up-regulation of growth factor expression.
For example, HIV infection up-regulates expression of tumor necrosis factor alpha (TNF.alpha.) and transforming growth factor beta (TGF.beta.). Over-expression of either of these growth factors disrupts normal transcriptional control of gene expression, leading to suppression of hematopoietic progenitor cells and increased HIV replication. TGF.beta., secreted by HIV-infected lymphocytes, also promotes growth of Kaposi's sarcoma cells, fibroblasts and endothelial cells. ...

Homeopathic practitioners believe that the potency of a compound increases with increasing dilutions. The standard homeopathic dosage is 10-15 drops of a 10.sup.-12 molar, or 6C, solution administered three times per day. A 6C dilution approximates 1 ng/ml, which is used in cell culture but would be considered a lower than physiological dose when used orally.

Highly dilute homeopathic medicines have been effective in treating some viruses in vivo. Homeopathic dilutions of 1.times.10.sup.-200 to 1.times.10.sup.-1000 of typhoidinum, hydrophobinum, tuberculinum, nux vomica and malandrinum ...

Electromagnetic signals are believed to exert an effect at the cell membrane.
Cell membranes maintain a carefully controlled surface potential that is measurable and reproducible. These potentials are transiently altered by electromagnetic fields or viral attachment, as well as by binding of neurotransmitters, hormones and growth factors. Electrical stimulation of cells temporally changes the cell's membrane potential and evokes consequential changes of RNA, DNA and protein synthesis (Bourguignon, G. J. and Bourguignon, L. Y. 1987 FASEB J. 1:398-402; Rodan, G. A. et al. 1978 Science 190:690-692). ...

Growth factors which may be utilized in the present invention include granulocyte macrophage-colony stimulating factor (GM-CSF), granulocyte-colony stimulating factor (G-CSF), macrophage-colony stimulating factor (M-CSF), tumor necrosis factor (TNF.alpha.), transforming growth factors (TGF), epidermal growth factors (EGF), stem cell factor (SCF) platelet-derived growth factors (PDGF), nerve growth factor (NGF), fibroblast growth factors (FGF), insulin-like growth factor (IGF), growth hormone, interleukin-1, interleukin-2, keratinocyte growth factor, ciliary neurotrophic growth factor, Schwann cell-derived growth factor, vaccinia virus growth factor, insulin, bombyxin, neu differentiation factor, v-Sis and glial growth factor/acetylcholine receptor-inducing activity. ...

The Life Information System TEN (LISTEN) (BioSource, Inc., Orem, Utah) which determines skin resistance or electrical conductance ... is a modified computer-based system which, in addition to determining electrical resistance at specific conductance points, can be used to administer radio frequency signals corresponding to specific compounds, such as homeopathic dilutions of growth factors. These signals are generated by digital codes pre-programmed into the system by the manufacturer. The patient to be evaluated holds a source electrode, or brass bar, covered with wet sterile gauze in one hand. The practitioner holds a second brass electrode, or probe, like a pen and touches a specific conductance point in the other hand or in a foot with the probe while firmly supporting the finger or toe. ...

Electrical conductances of fifteen Epstein-Barr virus (EBV) patients were measured at acupuncture points for the immune system using the LISTEN system. ... Higher than normal conductances were found at points corresponding to: lymph drainage of tonsils/throat (LY1aR) lymph tissue of lungs (LY4R); connective tissue (FICR); spleen lymphocytes homing to the lower body and gastrointestinal tract (SP2L); and spleen B lymphocytes and blood purification duties of spleen (SP3L). These results coincide with the clinical symptoms of patients with chronic EBV infection.

Eleven of the fifteen patients were subsequently treated for 3-9 months with a combination of homeopathic growth factor signals and botanicals corresponding to the LISTEN digital codes. Each patient was treated once per month using the previously outlined protocol. ... significant improvement in electrical conductances occurred. Fewer clinical symptoms were also observed and reported by the patients. For example, the patients had less upper respiratory distress, less sore throats, more energy, fewer complaints regarding tendonitis, and somewhat improved digestion. These are all typical complaints of EBV patients. ...

MSM ( Methyl Sulfonyl Methane - Anti Rheumatic & Anti Arthritic & Anti Allergic),
DMG (Dimethyl Glycine - Athletic performance enhancer),
TMG (Tri-Methyl-Glycine).

5

http://www.cdc.gov/ncidod/diseases/ebv.htm
Epstein-Barr Virus and Infectious Mononucleosis.
By D. Scott Schmid, Ph.D., Leader,
Herpesvirus Group and National VZV Laboratory
National Center for Infectious Diseases,
13 Sep 2005

... Epstein-Barr virus, frequently referred to as EBV, is a member of the herpesvirus family and one of the most common human viruses. The virus occurs worldwide, and most people become infected with EBV sometime during their lives. In the United States, as many as 95% of adults between 35 and 40 years of age have been infected. Infants become susceptible to EBV as soon as maternal antibody protection (present at birth) disappears. Many children become infected with EBV, and these infections usually cause no symptoms or are indistinguishable from the other mild, brief illnesses of childhood. In the United States and in other developed countries, many persons are not infected with EBV in their childhood years. When infection with EBV occurs during adolescence or young adulthood, it causes infectious mononucleosis 35% to 50% of the time.

Symptoms of infectious mononucleosis are fever, sore throat, and swollen lymph glands. Sometimes, a swollen spleen or liver involvement may develop. Heart problems or involvement of the central nervous system occurs only rarely, and infectious mononucleosis is almost never fatal. There are no known associations between active EBV infection and problems during pregnancy, such as miscarriages or birth defects. Although the symptoms of infectious mononucleosis usually resolve in 1 or 2 months, EBV remains dormant or latent in a few cells in the throat and blood for the rest of the person's life. Periodically, the virus can reactivate and is commonly found in the saliva of infected persons. This reactivation usually occurs without symptoms of illness.

EBV also establishes a lifelong dormant infection in some cells of the body's immune system. A late event in a very few carriers of this virus is the emergence of Burkitt's lymphoma and nasopharyngeal carcinoma, two rare cancers that are not normally found in the United States. EBV appears to play an important role in these malignancies, but is probably not the sole cause of disease.

... transmission of EBV requires intimate contact with the saliva (found in the mouth) of an infected person. Transmission of this virus through the air or blood does not normally occur. The incubation period, or the time from infection to appearance of symptoms, ranges from 4 to 6 weeks. Persons with infectious mononucleosis may be able to spread the infection to others for a period of weeks. However, no special precautions or isolation procedures are recommended, since the virus is also found frequently in the saliva of healthy people. In fact, many healthy people can carry and spread the virus intermittently for life. These people are usually the primary reservoir for person-to-person transmission. For this reason, transmission of the virus is almost impossible to prevent.

The clinical diagnosis of infectious mononucleosis is suggested on the basis of the symptoms of fever, sore throat, swollen lymph glands, and the age of the patient. Usually, laboratory tests are needed for confirmation. Serologic results for persons with infectious mononucleosis include an elevated white blood cell count, an increased percentage of certain atypical white blood cells, and a positive reaction to a "mono spot" test.

There is no specific treatment for infectious mononucleosis, other than treating the symptoms. No antiviral drugs or vaccines are available. Some physicians have prescribed a 5-day course of steroids to control the swelling of the throat and tonsils. The use of steroids has also been reported to decrease the overall length and severity of illness, but these reports have not been published. ...

When "mono spot" or heterophile test results are negative, additional laboratory testing may be needed to differentiate EBV infections from a mononucleosis-like illness induced by cytomegalovirus, adenovirus, or Toxoplasma gondii. Direct detection of EBV in blood or lymphoid tissues is a research tool and is not available for routine diagnosis. Instead, serologic testing is the method of choice for diagnosing primary infection. ...

Our general recommendation is for patients to consult with an infectious disease specialist or their local or state public health department. ...

6

http://www.umm.edu/patiented/articles/what_causes..., and
http://www.umm.edu/patiented/articles/what_chronic...
What is/causes Chronic Fatigue Syndrome (CFS)?
By Anonymous,
University of Maryland Medical Center.
2004

... the majority of patients report some preceding moderate to serious physical illness (e.g., a chronic viral infection) or emotional event (e.g., episode of depression). ...

Abnormalities in the Hypothalamus-Pituitary-Adrenal Axis.
Of particular interest to researchers are higher incidences of abnormalities in the hormone system known as the hypothalamus-pituitary-adrenal (HPA) axis. This system produces or regulates hormones and brain chemicals that control important functions, including sleep, response to stress, and depression. CFS patients tend to have an underactive HPA-axis ....

Stress Hormone Deficiencies.
A number of studies on CFS patients have observed deficiencies in cortisol levels, a stress hormone produced in the hypothalamus. [Also present with systemic viral, bacterial, fungal, or worm parasitic infestations.]

Abnormalities in Neurotransmitters.
Other research has reported that some patients with CFS have abnormally high levels of serotonin, a neurotransmitter (chemical messenger in the brain). Such elevated levels in the brain are associated with fatigue. Yet another study reported that deficiencies in dopamine, another important neurotransmitter, may play a role in CFS. ...

Viral infection.
Because most of the features of CFS resemble those of a lingering viral illness, many researchers have focused on the possibility that a virus or some other infectious agent causes the syndrome in some cases. ...

1. In up to 80% of cases, chronic fatigue syndrome starts suddenly with a flu-like condition.

2. Although no specific virus has been identified as a single cause, CFS patients typically have elevated levels of antibodies to many organisms that cause fatigue and other CFS symptoms. Such organisms include those that cause Lyme disease, candida ("yeast infection"), herpesvirus type 6 (HHV-6), human T cell lymphotropic virus (HTLV), Epstein-Barr, measles, coxsackie B, cytomegalovirus, or parvovirus. ...

Adenosine triphosphate (ATP)
... allergies, stress, and infections may deplete a chemical in the body called adenosine triphosphate (ATP). This chemical stores energy in cells, and studies have reported a deficiency in many CFS patients. Supporting this theory was a study in which patients reported reduced CFS symptoms after they took a vitamin-like supplement called NADH, which increases ATP levels. ...

imbalances in ... white blood cells called T-cells, which serve as infection fighters in the immune system. The result of T-cell abnormalities is that the immune system becomes persistently overactive and produces an excess of inflammatory substances called cytokines. Excess amounts of cytokines cause inflammation and damage in the cells of the body and play an important role in many chronic diseases. This activity also produces fatigue, muscle aches, and other symptoms of CFS. ... The cytokines called interleukin-6 and interleukin-1 are both elevated in CFS patients ....

.. neurally mediated hypotension (NMH).
NMH causes a dramatic drop in blood pressure when standing up, even for as short a time as ten minutes. It is the result of a disturbance in the central nervous system that signals the heart to slow down and lower blood pressure when a person stands up. Blood pools in the feet and legs before circulating back up to the heart. Its immediate effect can be lightheadedness, nausea, and fainting. Some experts posit that it may be caused by a virus or other infection.

Physical Deconditioning and Disturbed Circadian Rhythms.
Some experts believe that CFS is a disorder of the sleep-wake cycle. (They argue that some mentally or physically stressful event, such as a viral infection, may disrupt natural circadian rhythms, and that an inability to reset these rhythms results in a perpetual cycle of sleep disturbances. ... CFS patients are no more physically unfit than their sedentary peers without the disease, and that the limited level of activity among people with CFS is due to the fatigue and other symptoms of the disease itself. ...

Mutations in Mitochondria.
... the mitochondria, the tiny structures that supply energy to the cell. ... they had a specific genetic mitochondrial mutation called cytochrome b. This that might have been due to a viral infection or other environmental assault. ...

... heavily implicated multiple vaccinations given to military personnel during the Gulf War (but not those given before). In addition some specific vaccines, such as anthrax or botulinum, may have adverse long-term effects. Some researchers suspect that the symptoms were caused by a substance called squalene that was added to some vaccines to boost effectiveness. ...