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Immunological abnormalities in patients with Chronic Fatigue Syndrome (CFS)

  [ 12 votes ]   [ Discuss This Article ] • December 3, 1994

Between January 1991 and January 1993, 265 patients who
fulfilled the CDC criteria of the working case definition of
Chronic Fatigue Syndrome (CFS) have been observed at our
Institution and submitted for clinical and laboratory
evaluation. One hundred and sixty-three patients were females
and 102 males, the median age was 35 years (range 4-55 years);
all patients reported profound and prolonged fatigue, lasting
for a median of 3 years (range 6 months-10 years), preceded or
accompanied at appearance by fever in 185 cases, and
neuropsychologic problems including inability to concentrate,
difficulty in thinking, confusion, irritability,
forgetfulness, and depression. The fatigue was so severe that
it required 102 patients to stop their working activities for
a period of time ranging from 3 months to 2 years (range 7
months). In 40 consecutive patients a comprehensive
immunologic testing by single and two-colour flow cytometry
was performed and results compared with a group of 35 healthy,
age- and sex-matched controls.
Whilst no significant differences were found in the
absolute numbers of circulating total T cells (CD3+) and of
total helper/inducer (CD4+) or suppressor/cytotoxic (CD8+) T
cells, an evident reduction in CD3-/CD16+ and CD57+/CD56+ NK
lymphocytes along with an expansion of the CD8+/CD56+ and
CD16-/CD56+ NK subsets, were found in the CFS group. In
addition, CD56+ NK cells from CFS subjects were found to
express an increased amount of cell adhesion molecules (CD11b,
CD11c, CD54) and activation antigens (CD38). Both the
percentage and absolute numbers of CD4+ T cells bearing the
CD45RA antigen appeared significantly reduced in CFS patients,
and CD4+ T lymphocytes from CFS subjects displayed an
increased expression of the intercellular adhesion molecule-1
(ICAM-1/CD54). Finally, the total numbers of circulating
(CD19+) B lymphocytes, were significantly higher in CFS cases
than in controls, and in 11 out of 30 CFS patients the
increase in circulating B cells was sustained by the expansion
of the CD5+/CD19+ subset of B lymphocytes. We conclude that
CFS is a syndrome not previously described in Italy, with
already known clinical characteristics and appears to be
associated with several immunologic abnormalities, including
those reported previously in cohort of patients from different
countries. We also show for the first time that CD56- NK cell
subsets from CFS patients display an abnormally increased
expression of cell adhesion molecules and activation markers.

Tirelli U, Marotta G, Improta S, Pinto A

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