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Immune responses associated with chronic fatigue syndrome: a case-control study.

Mawle AC, Nisenbaum R, Dobbins JG, Gary HE, Stewart JA, Reyes M, Steele L, Schmid DS, Reeves WC.
Immune responses associated with chronic fatigue syndrome: a case-control study.
Journal of Infectious Diseases, vol. 175, pages 136-141, 1997.

Summary

An extensive panel of immunologic tests was performed on specimens from the Atlanta case-control study to search for specific immunologic abnormalities and markers associated with CFS. Blood or blood cells from the study participants was analyzed for multiple aspects of cellular and antibody-mediated immunity. Lymphocyte populations were examined by flow cytometry for the expression of various immune cell surface markers. T lymphocyte responsiveness was measured against a variety of antigens and global T cell activators. Cell culture supernatant fluids from resting and stimulated T cells were assayed for the presence of IL-1a, IL-1b, IL-2, IL-4, IL-6, TNF-a, TNF-b, and TGF-b. Serum was examined for the presence of soluble membrane markers (sCD4, sCD8, and sIL-2 receptor). NK cell function and numbers were analyzed. Delayed-type hypersensitivity was measured by skin patch test. Allergin sensitivity was measured, as were levels of circulating antibodies of all classes, complement components C3 and C4, and red blood cell magnesium. None of the reported immunologic associations with CFS, such as low NK cell number, decreased NK cell function, and increased T cell activation markers were observed in this study. No immunologic markers or specific cell surface markers were associated with CFS among the cases taken as a whole. When patients were subclassified on the basis of onset type, sudden versus gradual, several subtle differences in cytokine secretion and/or T cell surface molecule expression were observed when compared with matched controls. The significance of these differences is not clear at this time.

Abstract

An exploratory case-control study was conducted to assess whether the many reported differences in the immune function of chronic fatigue syndrome patients (CFS) are detectable in rigorously defined cases of CFS. Although many studies have reported differences between cases and controls in various measures of immune function, none of these differences were found in all studies. In this study, no differences were found in white blood cell numbers; immune complex, complement or serum immunoglobulin levels; in delayed type hypersensitivity and allergic responses; NK cell function; and proliferative responses to mitogens and antigens. Marginal differences were detected in cytokine responses and in cell surface markers in the total CFS population. However, when the patients were subgrouped either by the type of disease onset (gradual or sudden) or by how well they were feeling on the day of testing, more pronounced differences were seen.

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