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fever blisters

Ian A. York iayork at panix.com
Fri Mar 8 11:26:07 EST 1996

[posted and mailed]

In article <4hn13e$cdl at thorn.cc.usm.edu>,
Jennifer Rebecca Criswell <criswell at ocean.st.usm.edu> wrote:
>I have a question about the Herpes Virus and fever blisters.  Is it true 
>that an arginine low diet can help to prevent these infections?  I 
>recently read an article that pointed to high arginine levels in some 
>foods, such as peanuts, as a major factor in the appearance of fever 
>blisters.  The article also says that if a persons diet includes enough 
>lysine to "offset" the high argigine, fever blisters will not appear.  Is 
>all of this true?  I would appreciate any information on this subject.  

The low-arginine diet doesn't seem to have been looked at very much in 
the literature.

As far as the lysine, it's hard to be sure, but there might be some
effect.  Several trials have seen a moderate effect ([3],[5],[6],[10]),
some have seen none ([4],[7],[11]).  It's worth emphasizing that even the
positive trials didn't see a large improvement - we're talking about a
modest reduction in symptoms and/or frequency of recurrence. 

Some of the non-clinical trials also have suggested there might be an
effect (e.g. [1],[2],[9]) but these are very artifical situations that
are of questionable relevance to a natural infection in man. 


[1]   Ishihara C Iida J Mizukoshi N Yamamoto N Yamamoto K Kato K Azuma I
Effect of N alpha-acetylmuramyl-L-alanyl-D-isoglutaminyl-N
      epsilon-stearoyl- L-lysine on resistance to herpes simplex virus
      type-1 infection in cyclophosphamide-treated mice.
Vaccine 1989 Aug;7(4):309-13
The restoration of resistance by N
      epsilon-stearoyl-L-lysine [MDP-Lys(L18)] on herpes simplex virus
      (HSV) type-1 infection was examined in cyclophosphamide (CY)-treated
      mice. MDP-Lys(L18) was shown to restore the resistance to HSV
      infection in CY-treated mice when it was injected either
      subcutaneously, intravenously, or intraperitoneally before
      infection. Treatment with MDP-Lys(L18) in CY-treated mice restored
      impaired activity for inhibiting HSV growth in the liver.

[2]   Ayala E Krikorian D
Effect of L-lysine monohydrochloride on cutaneous herpes simplex
      virus in the guinea pig.
Journal of Medical Virology 1989 May;28(1):16-20
The effect of topical applications of crystalline lysine therapy on
      cutaneous herpes simplex virus (HSV) inoculations and subsequent
      dorsal root ganglia (DRG) infection was studied in male Hartley
      guinea pigs. Although HSV-I was recovered from the inoculated sites
      from all animals, the L-lysine-treated skin remained clinically
      normal, whereas untreated controls manifested clinical symptoms up
      to 3 days postinoculation (p.i.). However, cocultivation of DRG
      (C1-S1) indicated a selective tropism of infective particles to
      specific DRG in the groups treated with amino acids. In
      lysine-treated animals, HSV was recovered from a few DRG (T-12,
      T-13, and L-1) at 3 days p.i. and from DRG T-10 in leucine-treated
      controls; yet no HSV was recovered from DRG of untreated controls.
      These results suggest an immunomodulatory effect of L-lysine on
      inoculation site infections and the possible potentiation of
      subsequent DRG manifestation in amino-acid-treated animals.

[3]   Griffith RS Walsh DE Myrmel KH Thompson RW Behforooz A
Success of L-lysine therapy in frequently recurrent herpes simplex
      infection. Treatment and prophylaxis.
Dermatologica.  175(4):183-90, 1987
A double-blind, placebo-controlled, multicenter trial of oral
      L-lysine monohydrochloride for the prevention and treatment of
      recurrent herpes simplex (HSV) infection was conducted. The
      treatment group was given L-Lysine monohydrochloride tablets (1,000
      mg L-lysine per dose) 3 times a day for 6 months. A total of 27 (6
      male and 21 female) subjects on L-lysine and 25 (6 male and 19
      female) subjects on placebo completed the trial. The L-lysine
      treatment group had an average of 2.4 (p less than 0.05) less HSV
      infections, symptoms were significantly (p less than 0.05)
      diminished in severity and healing time was significantly reduced (p
      less than 0.05). L-Lysine appears to be an effective agent for
      reduction of occurrence, severity and healing time for recurrent HSV

[4]   Kagan C
Failure of lysine?
Archives of Dermatology 1985 Jan;121(1):21

[5]   McCune MA Perry HO Muller SA O'Fallon WM
Treatment of recurrent herpes simplex infections with L-lysine
In a prospective, randomized, double-blind, placebo-controlled,
      cross-over study of forty-one patients we found that oral ingestion
      of 1,248 mg a day of L-Lysine monohydrochloride shows evidence of
      decreasing the recurrence rate of herpes simplex attacks in
      nonimmunocompromised hosts. A dose of 624 mg a day was not
      effective. L-Lysine may also be capable of decreasing the severity
      of symptoms associated with recurrences. Neither dosage showed any
      evidence of shortening the healing time compared to placebo.

[6]   Walsh DE Griffith RS Behforooz A
Subjective response to lysine in the therapy of herpes simplex.
To test the effect of lysine supplementation on herpes infection,
      1543 subjects were surveyed by questionnaire after a six-month trial
      period. The study included subjects with cold sores, canker sores,
      and genital herpes. Of these, 54% had been diagnosed and treated by
      a physician. The results showed that the average dosage used was 936
      mg of lysine daily. Eighty-four per cent of those surveyed said that
      lysine supplementation prevented recurrence or decreased the
      frequency of herpes infection. Whereas 79% described their symptoms
      as severe or intolerable without lysine, only 8% used these terms
      when taking lysine. Without lysine, 90% indicated that healing took
      six to 15 days, but with lysine 83% stated that lesions healed in
      five days or less. Overall, 88% considered supplemental lysine an
      effective form of treatment for herpes infection.

[7]   DiGiovanna JJ  Blank H
Failure of lysine in frequently recurrent herpes simplex infection.
      Treatment and prophylaxis.
Archives of Dermatology 1984 Jan;120(1):48-51
Lysine has been claimed to be effective in the treatment and
      prevention of episodes of recurrent herpes simplex (HS) infection.
      We carried out a double-blind, placebo-controlled trial of oral
      lysine hydrochloride therapy (400 mg, three times a day) in a group
      of 21 patients in good general health with a history of frequently
      recurring infection. Using our measures of episode frequency,
      duration, and severity, we were unable to detect any substantial
      benefit of lysine therapy either as a treatment for episodes in
      progress or as a prophylactic drug for the prevention of
      recurrences. We conclude that it is unlikely that lysine improves
      frequently recurrent HS infections in the majority of patients.

[8]   Kagan C
Effect of acyclovir, bromovinyldeoxyuridine, vidarabine, and
      L-lysine on latent ganglionic herpes simplex virus in vitro
American Journal of Medicine 1983 Oct;75(4):A59

[9]   Bonina L Nash AA Arena A Leung KN Wildy P
T cell-macrophage interaction in arginase-mediated resistance to
      herpes simplex virus.
Virus Research 1984 Sep;1(6):501-5
Peritoneal macrophages activated by-products derived from a herpes
      simplex virus-specific helper T cell clone were used to investigate
      intrinsic and extrinsic resistance mechanisms to herpes simplex
      virus type 1 infection in vitro. T cell-activated macrophages
      produced fewer infective centres, indicating enhanced intrinsic
      resistance, and markedly reduced the growth of virus in a permissive
      cell line. The reduction in virus growth correlated with the
      depletion of arginine in the support medium, presumably resulting
      from increased arginase production by activated macrophages. The
      significance of these findings for antiviral immunity in vivo is

[10]  Griffith RS Norins AL Kagan C
A multicentered study of lysine therapy in Herpes simplex infection.
Dermatologica 1978;156(5):257-67
Lysine appears to suppress the clinical manifestations of
      herpesvirus infection. 45 patients with frequently recurring herpes
      infection were given 312-1,200 mg of lysine daily in single or
      multiple doses. The clinical results demonstrated a beneficial
      effect from supplementary lysine in accelerating recovery from
      herpes simplex infection and suppressing recurrence. Tissue culture
      studies have demonstrated an enhancing effect on viral replication
      when the amino acid ratio of arginine to lysine favors arginine. The
      opposite, preponderance of lysine to arginine, suppresses viral
      replication and inhibits cytopathogenicity of herpes simplex virus.
      The codons characterizing herpes simplex DNA apparently specify
      production of viral capsids at the expense of host cell histones.

[11]  Kagan C
Letter: Lysine therapy for herpes simplex.
Lancet 1974 Jan 26;1(848):137

[12] Inglis VB
Requirement of arginine for the replication of herpes virus.
Journal of General Virology 1968 Jul;3(1):9-17

      Ian York   (iayork at panix.com)  <http://www.panix.com/~iayork/>
      "-but as he was a York, I am rather inclined to suppose him a
       very respectable Man." -Jane Austen, The History of England

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