Chronic fatigue syndrome: Inflammation, immune function, and neuroendocrine interactions
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Investigations into the underlying cause of chronic fatigue syndrome have advanced the field considerably in the past year. Gene microarray data have led to a better understanding of pathogenesis. Recent research has evaluated genetic signatures, described biologic subgroups, and suggested potential targeted treatments. Acute viral infection studies found that initial infection severity was the single best predictor of persistent fatigue. Genomic studies showed that persistent cases express Epstein Barr virus-specific genes and demonstrate abnormalities of mitochondrial function. Studies of immune dysfunction extended observations of natural killer cytotoxic cell dysfunction of the cytotoxic T cell through quantitative evaluation of intracellular perforins and granzymes. Other research has focused on a subgroup of patients with reactivated viral infection. These advances should result in targeted therapies that impact immune function, hypothalamic-pituitary-adrenal axis regulation, and persistent viral reactivation.
- Fukada K, Straus S, Hickie I: The chronic fatigue syndrome: A comprehensive approach to its definition and study. Ann Intern Med 1994, 121:953–959.
- Landay A, Jessop C, Lennette E, Levy J: Chronic fatigue syndrome: Clinical condition associated with immune activation. Lancet 1991, 338:707–712. CrossRef
- Plioplys A: Differential diagnosis in medical assessment. In Handbook of Chronic Fatigue Syndrome. Edited by Jason L, Fennel P, Taylor R. Hoboken: John Wiley and Sons; 2003:26–41.
- Maher KJ, Klimas NG, Fletcher MA: Chronic fatigue syndrome is associated with diminished intracellular perforin. Clin Exp Immunol 2005, 142:505–511.
- Hickie I, Davenport T, Wakefield D, et al.: Post-infective and chronic fatigue syndromes precipitated by viral pathogens: Prospective cohort study. BMJ 2006, 333:575. CrossRef
- Appel S, Chapman J, Shoenfeld Y: Infections and vaccination in chronic fatigue syndrome: Myth or reality. Autoimmunity 2007, 40:48–53. CrossRef
- Maes M, Mihaylova I, De Ruyter M: Lower serum zinc in chronic fatigue syndrome (CFS): Relationships to immune dysfunctions and relevance for the oxidative stress status in CFS. J Affect Disord 2006, 90:141–147. CrossRef
- Maes M, Mihaylova I, Leunis JC: In chronic fatigue syndrome, the decreased levels of omega-3 poly unsaturated fatty acids are related to lower serum zinc and defects in T cell activation. Neuro Endocrinol Lett 2005, 26:745–751.
- Maes M, Mihaylova I, Leunis JC: Chronic fatigue syndrome is accompanied by an IgM-related immune response directed against neopitopes formed by oxidative or nitrosative damage to lipids and proteins. Neuro Endocrinol Lett 2006, 27:615–621.
- Puri BK: Long-chain polyunsaturated fatty acids and the pathophysiology of myalgic encephalomyelitis (chronic fatigue syndrome). J Clin Pathol 2007, 60:122–124. CrossRef
- Grans H, Nilsson M, Dahlman-Wright K, Evengard B: Reduced levels of oestrogen receptor B (beta) mRNA in Swedish patients with chronic fatigue syndrome. J. Clin Pathol 2007, 60:195–198. CrossRef
- Cleare AJ, Bearn J, Allain T, et al.: Contrasting neuroendocrine responses in depression and chronic fatigue syndrome. J Affect Disord 1995, 34:283–289. CrossRef
- Demitrack MA, Dale JK, Straus SE, et al.: Evidence for impaired activation of the hypothalamic-pituitary-adrenal axis in patients with chronic fatigue syndrome. J Clin Endocrinol Metab 1991, 73:1224–1234. CrossRef
- Ter Wolbeek M, van Doornen LJ, Kavelaars A, et al.: Longitudinal analysis of pro-and anti-inflammatory cytokine production in severely fatigued adolescents. Brain Behav Immun 2007, Epub ahead of print.
- Berneman ZN, Ablashi DV, Li G, et al.: Human herpesvirus 7 is a T-lymphotropic virus and is related to, but significantly different from, human herpesvirus 6 and human cytomegalovirus. Proc Natl Acad Sci 1992, 89:10552–10556. CrossRef
- White PD, Thomas JM, Kangro HO, et al.: Predictions and associations of fatigue syndrome and mood disorders that occur after infectious mononucleosis. Lancet 2001, 358:1946–1954. CrossRef
- Chapenko S, Krumina A, Kozireva S, et al.: Activation of human herpesvirus 6 and 7 in patients with chronic fatigue syndrome. J Clin Virol 2006, 37(Suppl 1):S47–S51. CrossRef
- Petersen I, Thomas JM, Hamilton WT, White PD: Risk and predictors of fatigue after infectious mononucleosis in a large primary care cohort. QJM 2006; 99:49–55. CrossRef
- Gow JW, Behan WM, Simpson K, et al.: Studies on enterovirus in patients with chronic fatigue syndrome. Clin Infect Dis 1994, 18(Suppl 1):S126–S129.
- Maes M, Mihaylova I, Leunis JC: Increased serum IgA and IgM against LPS of enterobacteria higher in chronic fatigue syndrome (CFS): Indication for the involvement of gramnegative bacteria in the etiology of CFS and for the presence of an increased gut-intestinal permeability. J Affect Disord 2007, 99:237–240. CrossRef
- Chia JK, Chia AY: Chronic fatigue syndrome is associated with chronic enterovirus infection of the stomach. J Clin Pathol 2007, Epub ahead of print.
- Jerjes WK, Taylor NF, Wood PJ, Cleare AJ: Enhanced feedback sensitivity to prednisolone in chronic fatigue syndrome. Psychoneuroendocrinology 2007 32:192–198. CrossRef
- Rajeevan MS, Smith AK, Dimulescu I, et al.: Glucocorticoid receptor polymorphisms and haplotypes associated with chronic fatigue syndrome. Genes Brain Behav 2007, 6:167–176. CrossRef
- Vernon SD, Whistler T, Cameron B, et al.: Preliminary evidence of mitochondrial dysfunction associated with post-infective fatigue after acute infection with Epstein Barr Virus. BMC Infect Dis 2006, 6:15. CrossRef
- Klimas NG, Salvato FR, Morgan R, Fletcher MA: Immunologic abnormalities in chronic fatigue syndrome. J Clin Microbiol 1990, 28:1403–1410.
- Landay AL, Jessop C, Lennette ET, Levy JA: Chronic fatigue syndrome: clinical condition associated with immune activation. Lancet 1991, 338:707–712. CrossRef
- Maher K, Klimas N, Fletcher MA: Immunology. In Handbook of Chronic Fatigue Syndrome. Edited by Jason L, Fennel P, Taylor R. Hoboken: John Wiley and Sons; 2003:124–151.
- Caligiuri M, Murray C, Buchwald D, et al.: Phenotypic and functional deficiency in natural killer cells in patients with chronic fatigue syndrome. J Immunol 1987, 139:3306–3313.
- Siegel SD, Antoni MH, Fletcher MA, et al.: Impaired natural immunity, cognitive dysfunction, and physical symptoms in patients with chronic fatigue syndrome: Preliminary evidence for a subgroup? J Psychosom Res 2006, 60:559–566. CrossRef
- Kerr JR, Hodgetts A, Langford PR, et al.: Current research priorities in chronic fatigue syndrome/myalgic encephalitis: Disease mechanisms, a diagnostic test and specific treatments. J Clin Pathol 2007, 60:113–116. CrossRef
- Kogelnik AM, Loomis K, Hoegh-Petersen M, et al.: Use of valganciclovir in patients with elevated antibody titers against Human Herpesvirus-6 (HHV-6) and Epstein-Barr Virus (EBV) who were experiencing central nervous system dysfunction including long-standing fatigue. J Clin Virol 2006, 37Suppl 1:S33–S38. CrossRef
- Lerner AM, Beqaj SH, Deeter RG, et al.: A six-month trial of valganciclovir in the Epstein-Barr virus subset of chronic fatigue syndrome: improvement in left ventricular function. Drugs Today (Barc). 2002, 38:549–561. CrossRef
- Lundell K, Qazi S, Eddy L, Uckun FM: Clinical activity of folinic acid in patients with chronic fatigue syndrome. Arzneimittelforschung 2006, 56:399–404.
- Vermeulen RC, Scholte HR: Azithromycin in chronic fatigue syndrome (CFS), an analysis of clinical data. J Transl Med 2006, 4:34. CrossRef
- Chronic fatigue syndrome: Inflammation, immune function, and neuroendocrine interactions
Current Rheumatology Reports
Volume 9, Issue 6 , pp 482-487
- Cover Date
- Print ISSN
- Online ISSN
- Current Science Inc.
- Additional Links