Cytokine expression provides clues to the pathophysiology of Gulf War illness and myalgic encephalomyelitis
Cytokine expression provides clues to the pathophysiology of Gulf War illness and myalgic encephalomyelitis
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DOI：
10.1016/j.cyto.2014.11.019
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发表时间：
2015-03-01
期刊：
影响因子：
3.8
通讯作者：
Lombardi, Vincent C.
中科院分区：
文献类型：
--
作者：
Khaiboullina, Svetlana F.;DeMeirleir, Kenny L.;Lombardi, Vincent C.
海湾战争病(GWI)是一种病因不明的慢性疾病，其特征是持续的症状，如认知障碍、不明原因的疲劳、弥漫性疼痛、头痛和胃肠道异常。目前的报告表明，多达20万名曾在1990-1991年波斯湾战争中服役的退伍军人遭受了痛苦。已经提出了几个潜在的GWI触发因素，包括化学暴露、毒素、疫苗和未知的感染源。然而，GWI的确切原因还没有确定，可以持续描述这种疾病的特定生物标记物也没有定义。肌痛性脑脊髓炎(ME)是一种症状相似且重叠的疾病，被诊断为GWI的患者通常符合ME的诊断标准。出于这些原因，GWI通常被认为是ME的一个子组。为了探索这种可能性，并确定可能有助于理解GWI病理生理学的免疫参数，我们检测了GWI患者的77种血清细胞因子，并将这些数据与ME患者和健康对照组进行了比较。我们的分析确定了一组细胞因子，它们对ME和GWI的敏感性分别为92.5%和64.9%。5种最重要的细胞因子按重要性从大到小依次为IL-7、IL-4、肿瘤坏死因子-α、IL-13和IL-17F。当从健康对照组中区分GWI和ME病例时，观察到的特异性仅为33.3%，这表明在细胞因子表达方面，GWI病例在许多参数上都比ME病例在更大程度上类似于对照组。这些结果表明，血清细胞因子在更大程度上代表了ME的病理，并进一步表明，尽管这两种疾病的症状重叠，但它们具有不同的免疫学特征。(C)2014爱思唯尔有限公司。保留所有权利。
Gulf War illness (GWI) is a chronic disease of unknown etiology characterized by persistent symptoms such as cognitive impairment, unexplained fatigue, pervasive pain, headaches, and gastrointestinal abnormalities. Current reports suggest that as many as 200,000 veterans who served in the 1990-1991 Persian Gulf War were afflicted. Several potential triggers of GWI have been proposed including chemical exposure, toxins, vaccines, and unknown infectious agents. However, a definitive cause of GWI has not been identified and a specific biological marker that can consistently delineate the disease has not been defined. Myalgic encephalomyelitis (ME) is a disease with similar and overlapping symptomology, and subjects diagnosed with GWI typically fit the diagnostic criteria for ME. For these reasons, GWI is often considered a subgroup of ME. To explore this possibility and identify immune parameters that may help to understand GWI pathophysiology, we measured 77 serum cytokines in subjects with GWI and compared these data to that of subjects with ME as well as healthy controls. Our analysis identified a group of cytokines that identified ME and GWI cases with sensitivities of 92.5% and 64.9%, respectively. The five most significant cytokines in decreasing order of importance were IL-7, IL-4, TNF-alpha, IL-13, and IL-17F. When delineating GWI and ME cases from healthy controls, the observed specificity was only 33.3%, suggesting that with respect to cytokine expression, GWI cases resemble control subjects to a greater extent than ME cases across a number of parameters. These results imply that serum cytokines are representative of ME pathology to a greater extent than GWI and further suggest that the two diseases have distinct immune profiles despite their overlapping symptomology. (C) 2014 Elsevier Ltd. All rights reserved.