Biomarkers for chronic fatigue.
Biomarkers for chronic fatigue.
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DOI：
10.1016/j.bbi.2012.06.006
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发表时间：
2012-11
期刊：
影响因子：
--
通讯作者：
Fletcher MA
中科院分区：
文献类型：
--
作者：
Klimas NG;Broderick G;Fletcher MA
持续6个月或更长时间的疲劳称为慢性疲劳。慢性疲劳(CF)加上至少8种症状中的4种，以及没有可以解释这些症状的疾病，构成了慢性疲劳综合征/肌痛性脑脊髓炎(CFS/ME)的病例定义。炎症、免疫系统激活、自主神经功能障碍、下丘脑-垂体-肾上腺轴功能受损和神经内分泌失调都被认为是疲劳的根本原因。识别与CFS/ME一致相关的客观标志物是诊断和治疗的一个重要目标，因为目前的病例定义完全基于体征和症状。这篇综述主要集中在与CFS/ME相关的疲劳生物标志物的最新文献，以及与其他疾病相关的文献。这些标志物分布在人体的几个核心调控系统中。神经、内分泌和免疫系统的改变和/或功能障碍会产生复杂的症状结构。我们认为，新的洞察力将取决于我们在分子水平上开发和部署CFS/ME发病机制的综合描述的能力。在获得这样的分子签名之前，开发有效治疗方法的努力将继续受到严重限制。
Fatigue that persists for 6 months or more is termed chronic fatigue. Chronic fatigue (CF) in combination with a minimum of 4 of 8 symptoms and the absence of diseases that could explain these symptoms, constitute the case definition for chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). Inflammation, immune system activation, autonomic dysfunction, impaired functioning in the hypothalamic-pituitary-adrenal axis, and neuroendocrine dysregulation have all been suggested as root causes of fatigue. The identification of objective markers consistently associated with CFS/ME is an important goal in relation to diagnosis and treatment, as the current case definitions are based entirely on physical signs and symptoms. This review is focused on the recent literature related to biomarkers for fatigue associated with CFS/ME and, for comparison, those associated with other diseases. These markers are distributed across several of the body’s core regulatory systems. A complex construct of symptoms emerges from alterations and/or dysfunctions in the nervous, endocrine and immune systems. We propose that new insight will depend on our ability to develop and deploy an integrative profiling of CFS/ME pathogenesis at the molecular level. Until such a molecular signature is obtained efforts to develop effective treatments will continue to be severely limited.