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Increased serum IgA and IgM against LPS of enterobacteria in Chronic Fatigue Syndrome (CFS): Indication for the involvement of gram-negative enterobacteria in the etiology of CFS and for the presence of an increased gut-intestinal permeability

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By Michael Maes, et al. • • October 2, 2006

Journal: Journal of Affective Distorders, 2006 September 27; [E-publication ahead of print] Authors and Affiliations: Michael Maes,*1,2 Ivana Mihaylova,1 and Jean-Claude Leunis3 - 1) MCare4U Outpatient Clinics, Belgium, 2) Department of Psychiatry, Vanderbilt University, Nashville, TN, USA, 3) Laboratory Ategis, Waver, Belgium *Corresponding author. M-Care4U Outpatient Clinics, Olmenlaan 9, 2610 Antwerp, Belgium. Tel.: +32 3 4809282; fax: +32 3 2889185; e-mail: PMID: 17007934

There is now evidence that Chronic Fatigue Syndrome (CFS) is accompanied by immune disorders and by increased oxidative stress. The present study has been designed in order to examine the serum concentrations of IgA and IgM to LPS of gram-negative enterobacteria, i.e. Hafnia alvei; Pseudomonas aeruginosa, Morganella morganii, Proteus mirabilis, Pseudomonas putida, Citrobacter koseri, and Klebsiella pneumoniae in CFS patients, patients with partial CFS and normal controls. We found that the prevalences and median values for serum IgA against the LPS of enterobacteria are significantly greater in patients with CFS than in normal volunteers and patients with partial CFS. Serum IgA levels were significantly correlated to the severity of illness, as measured by the FibroFatigue scale and to symptoms, such as irritable bowel, muscular tension, fatigue, concentration difficulties, and failing memory.

The results show that enterobacteria are involved in the etiology of CFS and that an increased gut intestinal permeability has caused an immune response to the LPS of gram-negative enterobacteria. It is suggested that all patients with CFS should be checked by means of the IgA panel used in the present study and accordingly should be treated for increased gut permeability. Keywords: Chronic fatigue syndrome; Inflammation; Immunity; Autoimmune; IgA; Enterobacteria; Gut permeability; Oxidative stress; Leaky gut

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