Markers of inflammation and immune activation in chronic fatigue and chronic fatigue syndrome.
Markers of inflammation and immune activation in chronic fatigue and chronic fatigue syndrome.
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发表时间：
1997-02
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通讯作者：
D. Buchwald;M. Wener;T. Pearlman;P. Kith
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作者：
D. Buchwald;M. Wener;T. Pearlman;P. Kith
目的慢性疲劳综合征（CFS）被认为是免疫激活的结果。我们研究了CFS患者和不符合病例定义的慢性疲劳（CF）患者中炎症和免疫激活血清标志物的作用。方法对转诊门诊的153例疲劳患者进行可溶性白细胞介素2（IL-2）受体、IL-6、C-反应蛋白、β 2-微球蛋白和新喋呤测定。根据患者是否符合CFS的标准，报告病毒综合征的发病或检查时体温> 37.5摄氏度对患者进行分类。结果与对照组相比，CFS（p <或= 0.01）和CF（p <或= 0.01）患者的C反应蛋白、β 2微球蛋白和新蝶呤的平均浓度较高。结果不能区分CFS和CF。与无此发现的患者相比，发热患者中IL-6升高（p <或= 0.001），但未观察到患者亚组之间的其他一致性差异。几种标记物的存在高度相关（p < 0.01）。结论我们的研究结果表明，几种标志物的水平显着相关点的一个子集的患者免疫系统激活。这种现象是否反映了一种并发的、短暂的、常见的疾病，如上呼吸道感染，或者是一种正在进行的疾病相关过程的结果尚不清楚。总体而言，炎症和免疫活化的血清标志物在评价CSF和CF患者中的诊断有用性有限。
OBJECTIVE Chronic fatigue syndrome (CFS) has been hypothesized to result from immune activation. We examined the role of serum markers of inflammation and immune activation among patients with CFS and in those with chronic fatigue (CF) not meeting the case definition. METHODS Assays for soluble interleukin 2 (IL-2) receptor, IL-6, C-reactive protein, beta 2-microglobulin, and neopterin were performed in 153 fatigued patients in a referral clinic. Patients were classified according to whether they met criteria for CFS, reported onset of illness with a viral syndrome or had a temperature > 37.5 degrees C on examination. RESULTS Compared to control subjects, mean concentrations of C-reactive protein, beta 2-microglobulin, and neopterin were higher in patients with CFS (p < or = 0.01) and CF (p < or = 0.01). Results did not distinguish CFS from CF. IL-6 was elevated among febrile patients compared to those without this finding (p < or = 0.001), but other consistent differences between patient subgroups were not observed. The presence of several markers was highly correlated (p < 0.01). CONCLUSION Our findings that levels of several markers were significantly correlated points to a subset of patients with immune system activation. Whether this phenomenon reflects an intercurrent, transient, common condition, such as an upper respiratory infection, or is the result of an ongoing illness associated process is unknown. Overall, serum markers of inflammation and immune activation are of limited diagnostic usefulness in the evaluation of patients with CSF and CF.