Autoimmunity Reviews. September 15, 2008
Immunological aspects of chronic fatigue syndrome
http://www.ncbi.nlm.nih.gov/pubmed/18801465?dopt=Abstract
Lorenzo Lorusso(a), Svetlana V. Mikhaylova(b), Enrica Capelli(c), Daniela
Ferrari(d), Gaelle K. Ngonga(d), Giovanni Ricevuti(e,f,*)
Abstract
Chronic fatigue syndrome (CFS) is a specific clinical condition that characterises unexplained disabling fatigue and a combination of non-specific accompanying symptoms for at least 6 months, in the absence of a medical diagnosis that would otherwise explain the clinical presentation. Other common symptoms include headaches, myalgia, arthralgia, and post-exertional malaise; cognitive difficulties, with impaired memory and concentration; unrefreshing sleep; and mood changes. Similar disorders have been described
for at least two centuries and have been differently named neurasthenia, post-viral fatigue, myalgic encephalomyelitis and chronic mononucleosis. Recent longitudinal studies suggest that some people affected by chronic fatigue syndrome improve with time but that most remain functionally impaired for several years. The estimated worldwide prevalence of CFS is 0.4-1% and it affects over 800,000 people in theUnited States and approximately 240,000 patients in the UK
concept is that CFS pathogenesis is a multifactorial condition. Various studies have sought evidence for a disturbance in immunity in people with CFS. An alteration in cytokine profile, a decreased function of natural killer (NK) cells, a presence of autoantibodies and a reduced responses of T cells to mitogens and other specific antigens have been reported. The observed high level of pro-inflammatory cytokines may explain some of the manifestations such as fatigue and flu-like symptoms and influence NK\ activity. Abnormal activation of the T lymphocyte subsets and a decrease in antibody-dependent cell-mediated cytotoxicity have been described. An
increased number of CD8+ cytotoxic T lymphocytes and CD38 and HLA-DR activation markers have been reported, and a decrease in CD11b expression associated with an increased expression of CD28+ T subsets has been observed. This review discusses the immunological aspects of CFS and offers an immunological hypothesis for the disease processes.
Ferrari(d), Gaelle K. Ngonga(d), Giovanni Ricevuti(e,f,*)
Abstract
Chronic fatigue syndrome (CFS) is a specific clinical condition that characterises unexplained disabling fatigue and a combination of non-specific accompanying symptoms for at least 6 months, in the absence of a medical diagnosis that would otherwise explain the clinical presentation. Other common symptoms include headaches, myalgia, arthralgia, and post-exertional malaise; cognitive difficulties, with impaired memory and concentration; unrefreshing sleep; and mood changes. Similar disorders have been described
for at least two centuries and have been differently named neurasthenia, post-viral fatigue, myalgic encephalomyelitis and chronic mononucleosis. Recent longitudinal studies suggest that some people affected by chronic fatigue syndrome improve with time but that most remain functionally impaired for several years. The estimated worldwide prevalence of CFS is 0.4-1% and it affects over 800,000 people in the
concept is that CFS pathogenesis is a multifactorial condition. Various studies have sought evidence for a disturbance in immunity in people with CFS. An alteration in cytokine profile, a decreased function of natural killer (NK) cells, a presence of autoantibodies and a reduced responses of T cells to mitogens and other specific antigens have been reported. The observed high level of pro-inflammatory cytokines may explain some of the manifestations such as fatigue and flu-like symptoms and influence NK\ activity. Abnormal activation of the T lymphocyte subsets and a decrease in antibody-dependent cell-mediated cytotoxicity have been described. An
increased number of CD8+ cytotoxic T lymphocytes and CD38 and HLA-DR activation markers have been reported, and a decrease in CD11b expression associated with an increased expression of CD28+ T subsets has been observed. This review discusses the immunological aspects of CFS and offers an immunological hypothesis for the disease processes.
Take-home messages
- Patients with CFS appear to have a variety of abnormalities in their
immune cells that support the presence of an underlying immunological
problem.
- These immunological findings show that patients with CFS may have an
infection and that the immune system is chronically activated in response.
- Several of the differentially expressed genes are related to immunological
functions and implicate immune dysfunction in the pathophysiology of
disease. Once identified, these genes could serve as CFS biomarkers.
- A clear understanding of the mechanism of CFS is needed to develop
treatments that will cure most cases of the disease.
- Patients with CFS appear to have a variety of abnormalities in their
immune cells that support the presence of an underlying immunological
problem.
- These immunological findings show that patients with CFS may have an
infection and that the immune system is chronically activated in response.
- Several of the differentially expressed genes are related to immunological
functions and implicate immune dysfunction in the pathophysiology of
disease. Once identified, these genes could serve as CFS biomarkers.
- A clear understanding of the mechanism of CFS is needed to develop
treatments that will cure most cases of the disease.
