Chronic fatigue syndrome: Inflammation, immune function, and neuroendocrine interactions
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.
KeywordsChronic Fatigue Syndrome Serum Zinc Infectious Mononucleosis Valganciclovir Chronic Fatigue Syndrome Patient
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References and Recommended Reading
- 1.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.Google Scholar
- 3.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.Google Scholar
- 14.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.Google Scholar
- 20.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.PubMedCrossRefGoogle Scholar
- 21.Chia JK, Chia AY: Chronic fatigue syndrome is associated with chronic enterovirus infection of the stomach. J Clin Pathol 2007, Epub ahead of print.Google Scholar
- 27.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.Google Scholar
- 31.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.PubMedCrossRefGoogle Scholar