Cytokine expression profiles of immune imbalance in post-mononucleosis chronic fatigue
- Source: Translational Medicine, Sep 13, 2012
By Gordon Broderick, MD, et al.
[Note: A provisional full text PDF of this article is available at http://www.translational-medicine.com/content/pdf/1479-5876-10-191.pdf. This study by ME/CFS researchers at clinics in Canada and several US states measured a broad range of cytokines, using uniform laboratory protocols, in patients diagnosed according to uniform criteria, all after infection with the same pathogen (Epstein-Barr) and all still ill at 24 months post infection. Cytokines, produced by the immune system, are involved in the inflammatory response.]
Background: As Chronic Fatigue Syndrome (CFS) has been known to follow Epstein-Bar virus (EBV) and other systemic infections, our objective was to describe differences in immune activation in:
• Post-infective CFS (PI-CFS) patients
• And recovered controls.
We studied 301 adolescents prospectively over 24 months following the diagnosis of monospot-positive infectious mononucleosis (IM).
We found an incidence of CFS at 6, 12 and 24 months of 13%, 7% and 4% respectively.
Methods: Using chemiluminescent imaging we measured the concentrations of IL-1a, 1b, 2, 4, 5, 6, 8, 10, 12 (p70), 13, 15, 17 and 23, IFN-gamma, TNF-alpha and TNF-beta in duplicate plasma samples available in bio-bank from 9 PI-CFS subjects and 12 recovered controls at 24 months post-infection.
Standard comparative analysis indicated significant differences in IL-8 and 23 across subject groups.
In constructing a linear classification model IL-6, 8 and 23 were selected by two different statistical approaches as discriminating features, with IL-1a, IL-2 and IFN-gamma also selected in one model or the other.
This supported an assignment accuracy of better than 80% at a confidence level of 0.95 into PI-CFS versus recovered controls.
Conclusion: These results suggest that co-expression patterns in as few as 5 cytokines associated with Th17 function may hold promise as a tool for the diagnosis of post-infectious CFS.
Source: Translational Medicine, Sep 13, 2012. PMID: 22973830, by Groderick G, Katz BZ, Fernandes H, Fletcher MA, Klimas NG, Smith FA, O’Gorman MRG, Vernon SD, Taylor R. University of Alberta, Edmonton, Alberta, Canada; Children’s Memorial Hospital, Chicago, Illinois; University of Miami, Florida; Miami Veterans Affairs Medical Center, Miami, Florida; Feinberg School of Medicine, Northwestern, Chicago, Illinois; CFIDS Assoc. of America, Charlotte, North Carolina, USA. [Email: Gordon.email@example.com]