Evidence for the existence of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) with and without abdominal discomfort (irritable bowel) syndrome.
Evidence for the existence of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) with and without abdominal discomfort (irritable bowel) syndrome.
复制标题
存在肌痛性脑脊髓炎/慢性疲劳综合征 (ME/CFS) 伴或不伴腹部不适（肠易激）综合征的证据。
DOI：
--
复制
发表时间：
2014
期刊：
影响因子：
--
通讯作者：
M. Berk
中科院分区：
文献类型：
--
作者：
M. Maes;J. Leunis;M. Geffard;M. Berk
背景
有证据表明，肌痛性脑脊髓炎/慢性疲劳综合征（ME/CFS）伴随着胃肠道症状;和伊加和IgM反应针对脂多糖（LPS）的肠道细菌，表明细菌易位。
方法
本研究旨在检查ME/CFS受试者与慢性疲劳（CF）受试者的胃肠道症状。这两组人被分为两类，一类满足福田的标准，另一类不满足福田的标准。在这些组中，我们研究了胃肠道症状与针对肠道细菌的伊加和IgM反应之间的关联。
结果
通过对胃肠道症状进行聚类分析，我们发现ME/CFS受试者腹部不适综合征（ADS）的聚类分析诊断率（59.6%）显著高于CF受试者（17.7%）。ADS的诊断与肠易激综合征（IBS）的诊断密切相关。有证据表明ME/CFS由两个亚组组成，即ME/CFS伴和不伴ADS。因子分析显示4个因子，即1）炎症-痛觉过敏; 2）疲劳-不适; 3）胃肠道症状/ADS;和4）神经认知症状。ME/CFS伴ADS组对肠道细菌LPS的伊加、IgM反应明显高于无ADS组。
结论
研究结果表明，ADS是ME/CFS患者的一个特征，细菌移位（肠漏）增加与ADS症状相关。这项研究已经确定了一种途径表型，即细菌易位，与ME/CFS和ADS/IBS相关，并可能驱动全身炎症过程。
BACKGROUND
There is evidence that Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is accompanied by gastro-intestinal symptoms; and IgA and IgM responses directed against lipopolysaccharides (LPS) of commensal bacteria, indicating bacterial translocation.
METHODS
This study was carried out to examine gastro-intestinal symptoms in subjects with ME/CFS versus those with chronic fatigue (CF). The two groups were dissected by dichotomizing those fulfilling and not fulfilling Fukuda's critera. In these groups, we examined the association between gastro-intestinal symptoms and the IgA and IgM responses directed against commensal bacteria.
RESULTS
Using cluster analysis performed on gastro-intestinal symptoms we delineated that the cluster analysis-generated diagnosis of abdominal discomfort syndrome (ADS) was significantly higher in subjects with ME/CFS (59.6%) than in those with CF (17.7%). The diagnosis of ADS was strongly associated with the diagnosis of irritable bowel syndrome (IBS). There is evidence that ME/CFS consists of two subgroups, i.e. ME/CFS with and without ADS. Factor analysis showed four factors, i.e. 1) inflammation-hyperalgesia; 2) fatigue-malaise; 3) gastro-intestinal symptoms/ADS; and 4) neurocognitive symptoms. The IgA and IgM responses to LPS of commensal bacteria were significantly higher in ME/CFS patients with ADS than in those without ADS.
CONCLUSIONS
The findings show that ADS is a characteristic of a subset of patients with ME/CFS and that increased bacterial translocation (leaky gut) is associated with ADS symptoms. This study has defined a pathway phenotype, i.e bacterial translocation, that is related to ME/CFS and ADS/IBS and that may drive systemic inflammatory processes.