Markers of inflamm. & immune activation in chronic fatigue & Chronic Fatigue Syndrome (CFS)

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OBJECTIVE: Chronic fatigue syndrome (CFS) has been hypothesized to

result from immune activation. We examined the role of serum

markers of inflammation and immune activation among patients

with CFS and in those with chronic fatigue (CF) not meeting

the case definition.

METHODS: Assays for soluble interleukin

2 (IL-2) receptor, IL-6, C-reactive protein, beta

2-microglobulin, and neopterin were performed in 153 fatigued

patients in a referral clinic. Patients were classified

according to whether they met criteria for CFS, reported onset

of illness with a viral syndrome or had a temperature > 37.5

degrees C on examination.

RESULTS: Compared to control

subjects, mean concentrations of C-reactive protein, beta

2-microglobulin, and neopterin were higher in patients with

CFS (p < or = 0.01) and CF (p < or = 0.01). Results did not

distinguish CFS from CF. IL-6 was elevated among febrile

patients compared to those without this finding (p < or =

0.001), but other consistent differences between patient

subgroups were not observed. The presence of several markers

was highly correlated (p < 0.01).

CONCLUSION: Our findings

that levels of several markers were significantly correlated

points to a subset of patients with immune system activation.

Whether this phenomenon reflects an intercurrent, transient,

common condition, such as an upper respiratory infection, or

is the result of an ongoing illness associated process is

unknown. Overall, serum markers of inflammation and immune

activation are of limited diagnostic usefulness in the

evaluation of patients with CSF and CF.

MCM: Studied soluble IL-2 receptor, IL-6, C-reactive protein,

beta-2-microglobulin, and neopterin in 98 pts w CFS and 55 w

CF as well as controls. Found soluble IL-2 receptor and IL-6

levels were not significantly different. C-reactive protein,

beta-2-microglobulin, and neopterin levels were significantly

higher in both pt groups compared to controls.

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