Increased IgA responses to the LPS of commensal bacteria is associated with inflammation and activation of cell-mediated immunity in chronic fatigue syndrome
– Source: Journal of Affective Disorders, Oct 1, 2011
By Michael Maes, et al.
[Note: commensal bacteria are the normally harmless populations of bacteria living in the gut. Translocation of these bacteria occurs when the gut lining breaks down, becoming more permeable, and bacteria leak out into the bloodstream. Cell-mediated immunity is a complex immune response against infected cells.]
Background: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is accompanied by:
a. Systemic IgA/IgM responses against the lipopolysaccharides (LPS) of commensal bacteria;
b. Inflammation, e.g., increased plasma interleukin-(IL)1 and tumor necrosis factor (TNF)alpha; and
c. Activation of cell-mediated immunity (CMI), as demonstrated by increased neopterin.(1)
Methods: To study the relationships between the IgA/IgM responses to the LPS of microbiota, inflammation, CMI and the symptoms of ME/CFS we measured the IgA/IgM responses to the LPS of 6 different enterobacteria, serum IL-1, TNF alpha, neopterin, and elastase in 128 patients with ME/CFS and chronic fatigue (CF).
Severity of symptoms was assessed by the Fibromyalgia and Chronic Fatigue Syndrome (FF) Rating Scale.
Serum IL-1, TNF alpha, neopterin and elastase are significantly higher in patients with ME/CFS than in CF patients.
There are significant and positive associations between the IgA responses to LPS and serum IL-1, TNF alpha, neopterin and elastase.
Patients with an abnormally high IgA response show increased serum IL-1, TNF alpha and neopterin levels, and higher ratings on irritable bowel syndrome (IBS) than subjects with a normal IgA response.
Serum IL-1, TNF alpha and neopterin are significantly related to fatigue, a flu-like malaise, autonomic symptoms, neurocognitive disorders, sadness and irritability.
Conclusions: The findings show that increased IgA responses to commensal bacteria in ME/CFS are associated with inflammation and cell mediated immunity activation, which are associated with symptom severity.
It is concluded that increased translocation of commensal bacteria may be responsible for the disease activity in some ME/CFS patients.
Source: Journal of Affective Disorders, Oct 1, 2011. PMID: 21967891, by Maes M, Twisk FN, Kubera M, Ringel K, Leunis JC, Geffard M. Maes Clinics @ TRIA, Bangkok, Thailand.
1. See accompanying report, "Evidence for inflammation and activation of cell-mediated immunity in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)..." by Maes M, et al., Journal of Affective Disorders, Oct 3, 2011