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Normalization of leaky gut in chronic fatigue syndrome (CFS) is accompanied by a clinical improvement: Effects of age, duration of illness and the translocation of LPS from gram-negative bacteria – Source: Neuro Endocrinology Letters, Dec 29, 2008

  [ 10 votes ]   [ Discuss This Article ]
By M Maes, JC Leunis • • January 6, 2009

[Note: LPS (lipopolysaccharide) is a component of the outer membrane of gram-negative bacteria (a class of bacteria that are generally infectious). Enterobacteria are associated with many illnesses including UTI and pneumonia, but “entero” means gut, which is where most reside. They include serious pathogens and “opportunistic pests.” For more information, see the related article "Inflammatory and oxidative and nitrosative stress pathways underpinning chronic fatigue, somatization and psychosomatic symptoms."]

Background: There is now evidence that an increased translocation of LPS from gram negative bacteria with subsequent gut-derived inflammation, i.e. induction of systemic inflammation and oxidative & nitrosative stress (IO&NS), is a new pathway in chronic fatigue syndrome (CFS).

Methods: The present study examines the serum concentrations of IgA and IgM to LPS of gram-negative enterobacteria, i.e., Hafnia Alvei; Pseudomonas Aeruginosa, Morganella Morganii, Pseudomonas Putida, Citrobacter Koseri, and Klebsielle Pneumoniae in CFS patients both before and after intake of natural anti-inflammatory and anti-oxidative substances (NAIOSs), such as glutamine, N-acetyl cysteine and zinc, in conjunction with a leaky gut diet during 10-14 months.

We measured the above immune variables as well as the Fibromyalgia and Chronic Fatigue Syndrome Rating Scale in 41 patients with CFS before and 10-14 months after intake of NAIOSs.

Results: Subchronic intake of those NAIOSs significantly attenuates the initially increased IgA and IgM responses to LPS of gram negative bacteria. Up to 24 patients showed a significant clinical improvement or remission 10-14 months after intake of NAIOSs. A good clinical response is significantly predicted by attenuated IgA and IgM responses to LPS, the younger age of the patients, and a shorter duration of illness (< 5 years).


• The results show that normalization of the IgA and IgM responses to translocated LPS may predict clinical outcome in CFS.

• The results support the view that a weakened tight junction barrier with subsequent gut-derived inflammation is a novel pathway in CFS and that it is a new target for drug development in CFS.

• Meanwhile, CFS patients with leaky gut can be treated with specific NAIOSs and a leaky gut diet.

Source: Neuro Endocrinology Letters, Dec 29, 2008. [E-pub ahead of print] PMID: 19112401, by Maes M, Leunis JC. M-Care4U Outpatient Clinics; Clinical Research Center for Mental Health, Belgium.

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