Cytokine production & fatigue in patients with Chronic Fatigue Syndrome (CFS) & healthy control subjects in response to exercise

We have studied the relationship between the cytokine

production induced in vivo by prolonged isometric exercise and

the symptom complex marked by fatigue in patients with chronic

fatigue syndrome (CFS). Twelve male patients and 13 matched

male control subjects undertook an isometric hand-grip

exercise protocol utilizing dynamometers. Subjects undertook

30 minutes of exercise, for which the target force was set at

40% of the maximal voluntary contraction and the duty cycle

was 50%. Prior to, during, and for 24 hours following the

exercise, blood samples were collected and assayed for the

presence of cytokines, including interferon-gamma and

interferon-alpha, interleukin-1 beta, and tumor necrosis

factor-alpha. At those times subjects also completed the

Profile of Mood States (POMS) questionnaire, which served as a

measure of changes in subjective fatigue. No significant

alteration in the level of any of the cytokines in the plasma

of patients or control subjects was detected before, during,

or after exercise. Surprisingly, the patients’ levels of

fatigue, depression, and confusion, as measured by the POMS,

decreased in response to the exercise. These data do not

confirm the presence of an immunologic process correlating

with the exacerbation of fatigue after exercise experienced by

patients with CFS. Limitations in the study design and in the

sensitivity of the cytokine assays may have affected our


MCM: AR Lloyd also provides the Intro to Immunologic studies

p. S134 and (with Nancy Klimas) the Summary p. S160

Lloyd A,Gandevia S,Brockman A,Hales J,Wakefield D

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