A Martin Lerner
Dr. A. Martin Lerner (also known as Martin Lerner) was a much beloved and respected ME/CFS specialist who died in October 2015, at the age of 86.
He was one of the experts on the "Committee on the Diagnostic Criteria for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome" that was convened for the 2015 Institute of Medicine report, as well as, one of the authors of the 2003 Canadian Consensus Criteria for Myalgic Encephalomyelitis, published as Myalgic Encephalomyelitis/Chronic Fatigue Syndrome:Clinical Working Case Definition,Diagnostic and Treatment Protocols
He was a strong advocate of using antivirals because he hypothesized CFS is caused by 3 herpesviruses: Epstein-Barr virus, cytomegalovirus and/or Human herpesvirus 6. "These three viruses establish “latent” infection in B-lymphocytes, monocyte-macrophage precursors, or T-lymphocytes respectively. Virus reactivation, and both abortive and complete virus multiplication occur. Therefore CFS patients have been described with continuing primary or reactivated infections.
- 2012, Antibody to Epstein-Barr Virus Deoxyuridine Triphosphate Nucleotidohydrolase and Deoxyribonucleotide Polymerase in a Chronic Fatigue Syndrome Subset (FULL TEXT)
Abstract - "Background: A defined diagnostic panel differentiated patients who had been diagnosed with chronic fatigue syndrome (CFS), based upon Fukuda/Carruthers criteria. This diagnostic panel identified an Epstein-Barr virus (EBV) subset of patients (6), excluding for the first time other similar “clinical” conditions such as cytomegalovirus (CMV), human herpesvirus 6 (HHV6), babesiosis, ehrlichiosis, borreliosis, Mycoplasma pneumoniae, Chlamydia pneumoniae, and adult rheumatic fever, which may be mistakenly called CFS. CFS patients were treated with valacyclovir (14.3 mg/kg q6h) for ≥12 months. Each patient improved, based upon the Functional Activity Appraisal: Energy Index Score Healthcare Worker Assessment (EIPS), which is a validated (FSS-9), item scale with high degree of internal consistency measured by Cronbach's alpha. Methods: Antibody to EBV viral capsid antigen (VCA) IgM, EBV Diffuse Early Antigen EA(D), and neutralizing antibodies against EBV-encoded DNA polymerase and EBV-encoded dUTPase were assayed serially approximately every three months for 13–16 months from sera obtained from patients with CFS (6) and from sera obtained from twenty patients who had no history of CFS. Results: Antibodies to EBV EA(D) and neutralizing antibodies against the encoded-proteins EBV DNA polymerase and deoxyuridine triphosphate nucleotidohydrolase (dUTPase) were present in the EBV subset CFS patients. Of the sera samples obtained from patients with CFS 93.9% were positive for EA(D), while 31.6% of the control patients were positive for EBV EA(D). Serum samples were positive for neutralizing antibodies against the EBV-encoded dUTPase (23/52; 44.2%) and DNA polymerase (41/52; 78.8%) in EBV subset CFS patients, but negative in sera of controls. Conclusions: There is prolonged elevated antibody level against the encoded proteins EBV dUTPase and EBV DNA polymerase in a subset of CFS patients, suggesting that this antibody panel could be used to identify these patients, if these preliminary findings are corroborated by studies with a larger number of EBV subset CFS patients."
- 2003, Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols
"Abstract - Recent years have brought growing recognition of the need for clinical criteria for myalgic encephalomyelitis (ME), which is also called chronic fatigue syndrome (CFS). An Expert Subcommittee of Health Canada established the Terms of Reference, and selected an Expert Medical Consensus Panel representing treating physicians, teaching faculty and researchers. A Consensus Workshop was held on March 30 to April 1, 2001 to culminate the review process and establish consensus for a clinical working case definition, diagnostic protocols and treatment protocols. We present a systematic clinical working case definition that encourages a diagnosis based on characteristic patterns of symptom clusters, which reflect specific areas of pathogenesis. Diagnostic and treatment protocols, and a short overview of research are given to facilitate a comprehensive and integrated approach to this illness. Throughout this paper, “myalgic encephalomyelitis” and “chronic fatigue syndrome” are used interchangeably and this illness is referred to as “ME/CFS.”
Talks & interviews
Talks on Lerner's webpage
- August 22, 2007 – Dr. A Martin Lerner presenting Medical Grand Rounds at William Beaumont Hospital in Royal Oak, MI on the Topic of Chronic Fatigue Syndrome.
- May 23, 2008 – Dr. A Martin Lerner’s presentation on The Sub-grouping & Treatment for ME/CFS, at the 3rd annual Invest in ME International ME/CFS Conference in London, England.
- October 12, 2010 – Dr. A Martin Lerner’s presentation on Successful Antiviral Treatment of CFS and Its Science at the CFSAC biannual meeting hosted by the Department of Health and Human Services in Washington, DC.
- August 20, 2011 Part 1 – Dr. A Martin Lerner presenting at William Beaumont Hospital in Royal Oak, MI to infectious disease physicians in Michigan "A Primer on ME/CFS -Background, Virology, Immunology, Pathologic Physiology, Diagnosis and Treatment." PDF Download of presentation slides PDF Download of ME/CFS Treatment Resource Guide for Practitioners
- August 20, 2011 Part 2 – Dr. A Martin Lerner presenting at William Beaumont Hospital in Royal Oak, MI to infectious disease physicians in Michigan "A Primer on ME/CFS -Background, Virology, Immunology, Pathologic Physiology, Diagnosis and Treatment." PDF Download of presentation slides PDF Download of ME/CFS Treatment Resource Guide for Practitioners
Invest in ME International ME Conference
- 2008, Speaker at the 3rd Invest in ME International ME Conference on Diagnosis and Treatment of ME/CFS - Longitudinal Observations of Cardiac and Antiviral studies DVD available
- Lerner, AM; Ariza, ME; Williams, M; Jason, L; Beqaj, S; Fitzgerald, JT; Lemeshow, S; Glaser, R (2012), "Antibody to Epstein-Barr Virus Deoxyuridine Triphosphate Nucleotidohydrolase and Deoxyribonucleotide Polymerase in a Chronic Fatigue Syndrome Subset", PLoS ONE, 7 (11): e47891, doi:10.1371/journal.pone.0047891
- Carruthers, Bruce M.; Jain, Anil Kumar; De Meirleir, Kenny L.; Peterson, Daniel L.; Klimas, Nancy G.; Lerner, A. Martin; Bested, Alison C.; Flor-Henry, Pierre; Joshi, Pradip; Powles, A C Peter; Sherkey, Jeffrey A.; van de Sande, Marjorie I. (2003), "Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols", Journal of Chronic Fatigue Syndrome, 11 (2): 7-115, doi:10.1300/J092v11n01_02