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The Effects of Influenza Vaccination on Immune Function in Patients with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis - Source: International Journal of Clinical Medicine, Nov 2012

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By EW Benu, SM Marshall-Gradisnik, et al. • • November 23, 2012

[Note: to view the full text PDF of this article, click here. The findings of this small trial suggest that flu shots may provide immunity, but the tradeoff is that later they may create dysfunctional, potentially toxic immune reactions not seen in controls.]

Immune dysfunction is a hallmark of Chronic Fatigue Syndrome/ Myalgic Encephalomyelitis (CFS/ME). The purpose of this pilot study was to identify the effects of influenza vaccination on immune function in patients with CFS/ME.

We included 7 patients meeting the Centre for Disease Control and Prevention criteria (CDC 1994) for ME/CFS and 8 control subjects. Bloods were collected from all participants prior to vaccination with Influvac, a trivalent inactivated influenza vaccine (TIV), 14 and 28 days following vaccination. The immune parameters examined include Natural Killer (NK) phenotypes, NK cytotoxic activity, FOXP3 and Th1/Th2/Th17 related cytokines. Flow cytometric protocols were employed.

• There was no significant difference in NK phenotypes and Tregs numbers between CFS/ME patients and healthy controls.

• However, NK activity was significantly decreased at baseline and at 28 days while at 14 days it was significantly increased in the CFS/ME patients compared to the healthy controls.

• Th1 pro-inflammatory cytokines were much more increased in the CFS/ME patients at 28 days compared to the non-fatigued controls.

• Only one Th2 cytokine, IL-4, was increased in the CFS/ME participants. FOXP3 expressing Tregs were significantly increased only at day 28 post vaccination in the CFS/ME patients compared to the healthy controls.

• Self-rated well being was lower for patients at day 28 while at baseline and day 14 no differences were observed.

In this pilot study immunization with influenza vaccine is accompanied by a degree of immune dysregulation in CFS/ME patients compared with controls.

While vaccination may protect CFS/ME patients against influenza, it has the ability to increase cytotoxic activity and pro-inflammatory reactions post vaccination.

The role of Tregs [regulatory T cells] in promoting a toxic effect at 28 days post-vaccination in our patient group cannot be ruled out. The benefits of influenza vaccine still likely outweigh the risks CFS/ME patients experience following vaccination.

Source: International Journal of Clinical Medicine, Nov 2012 by Brenu EW, van Driel M, Staines DR, Kreijkamp-Kasper S, Hardcastle SL, Marshall-Gradisnik SM. Faculty of Health Science and Medicine, Population Health and Neuroimmunology Unit, Bond University, Robina, QLD, Australia; School of Medical Science, Griffith Health Institute, Griffith University, Gold Coast Campus, Gold Coast; Discipline of General Practice, School of Medicine, University of Queensland, Brisbane, Australia; Queensland Health, Gold Coast Public Health Unit, Robina, Gold Coast, QLD, Australia. [Email:]

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