Risks for Developing Myalgic Encephalomyelitis/Chronic Fatigue Syndrome in College Students Following Infectious Mononucleosis: A Prospective Cohort Study
Risks for Developing Myalgic Encephalomyelitis/Chronic Fatigue Syndrome in College Students Following Infectious Mononucleosis: A Prospective Cohort Study
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DOI：
10.1093/cid/ciaa1886
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发表时间：
2021-12-01
影响因子：
11.8
通讯作者：
Katz, Ben Z.
中科院分区：
文献类型：
--
作者：
Jason, Leonard A.;Cotler, Joseph;Katz, Ben Z.
背景肌痛性脑脊髓炎/慢性疲劳综合征（ME/CFS）涉及严重的疲劳，不清醒的睡眠和认知障碍，导致功能障碍;以前的研究没有评估危险因素与行为和免疫数据收集前发展ME/CFS。每年高达5%的大学生发生传染性单核细胞增多症（IM），9-12%的学生在6个月后符合ME/CFS的标准。我们试图确定ME/CFS的预测因子。我们在学年开始时招募大学生（时间1），确定那些发生IM的人（时间2），并跟踪他们6个月（时间3），确定3组：发生ME/CFS的人，严重ME/CFS（满足>1组标准）和无症状的人。我们进行了8次行为和心理调查，并在3个时间点分析了细胞因子。4501名学生中有238名（5.3%）发生IM; 6个月后，238名学生中有55名（23%）符合ME/CFS标准，157名（66%）无症状。157名无症状学生中的67名作为对照。严重ME/CFS的学生在3个时间点与无症状的学生进行比较。前一组与后一组在时间1（在发展IM之前）在压力、应对、焦虑或抑郁方面没有差异，但在几个行为指标方面不同，并且IL-6和IL-13水平显著较低。在时间2（当他们发展为IM时），两个ME/CFS组倾向于有更多的自主神经抱怨和行为症状，而重度ME/CFS组的IL-12水平高于恢复组，而IL-13水平低于恢复组。在基线时，那些发展ME/CFS的人比那些康复的人有更多的身体症状和免疫异常，但没有更多的心理症状。
Background. Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) involves severe fatigue, unrefreshing sleep, and cognitive impairment, leading to functional difficulties; prior studies have not evaluated risk factors with behavioral and immune data collected before developing ME/CFS. Up to 5% of university students develop infectious mononucleosis (IM) annually, and 9-12% meet criteria for ME/CFS 6 months later. We sought to determine predictors of ME/CFS.Methods. We enrolled college students at the start of the school year (time 1), identified those who developed IM (time 2), and followed them for 6 months (time 3), identifying 3 groups: those who developed ME/CFS, severe ME/CFS (meeting >1 set of criteria), and who were asymptomatic. We conducted 8 behavioral and psychological surveys and analyzed cytokines at 3 time points.Results. 238 of the 4501 students (5.3%) developed IM; 6 months later, 55 of the 238 (23%) met criteria for ME/CFS and 157 (66%) were asymptomatic. 67 of the 157 asymptomatic students served as controls. Students with severe ME/CFS were compared with students who were asymptomatic at 3 time points. The former group was not different from the latter group at time 1 (prior to developing IM) in stress, coping, anxiety, or depression but were different in several behavioral measures and had significantly lower levels of IL-6 and IL-13. At time 2 (when they developed IM), the 2 ME/CFS groups tended to have more autonomic complaints and behavioral symptoms while the severe-ME/CFS group had higher levels of IL-12 and lower levels of IL-13 than the recovered group.Conclusions. At baseline, those who developed ME/CFS had more physical symptoms and immune irregularities, but not more psychological symptoms, than those who recovered.