Evaluation of four clinical laboratory parameters for the diagnosis of myalgic encephalomyelitis

Meirleir, Kenny L. De; Mijatovic, Tatjana; Subramanian, Krishnamurthy; Schlauch, Karen; Lombardi, Vincent

doi:10.1186/s12967-018-1696-z

Cited by 2 publications

(1 citation statement)

References 64 publications

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“…Our data are in keeping with studies identifying two distinct clusters of long COVID patients in a large UK cohort of 500,000, with fatigue predominating in one and respiratory symptoms in the other [36]. Importantly, changes in prostaglandin E2 levels (generated by COX-2 from conversion of arachidonic acid) have been associated with chronic fatigue syndrome [38] and targeting this eicosanoid pathway may be therapeutic benefit. Our data demonstrating low levels of CXCR2 associated with severe disease during acute COVID-19 and ongoing fatigue during convalescence support a protective role for CXCR2 in inflammation, in keeping with CXCR2 deficiency inducing an exaggerated inflammatory response associated with increased macrophage accumulation at inflamed sites [39].…”

Section: Discussionsupporting

confidence: 87%

Monocyte migration profiles define disease severity in acute COVID-19 and unique features of long COVID

Scott

Pearmain²,

Knight³

et al. 2023

Eur Respir J

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BackgroundCOVID-19 is associated with a dysregulated immune response but it is unclear how immune dysfunction contributes to the chronic morbidity persisting in many COVID-19 patients during convalescence (long COVID).MethodsWe assessed phenotypical and functional changes of monocytes in COVID-19 patients during hospitalization and up to 9 months of convalescence following COVID-19, respiratory syncytial virus (RSV) or influenza A (flu). Progressive fibrosing interstitial lung disease (PFILD) patients were included a positive control for severe, ongoing lung injury.ResultsMonocyte alterations in acute COVID-19 patients included aberrant expression of leucocyte migration molecules, continuing into convalescence (n=142) and corresponding to specific symptoms of long COVID. Long COVID patients with unresolved lung injury, indicated by sustained shortness of breath and abnormal chest radiology, were defined by high monocyte expression of chemokine receptor CXCR6 (p<0.0001) and adhesion molecule PSGL-1 (p<0.01), alongside preferential migration of monocytes towards CXCR6 ligand CXCL16 (p<0.05) which is abundantly expressed in the lung. Monocyte CXCR6 and lung CXCL16 were heightened in PFILD patients (p<0.001) confirming a role for the CXCR6-CXCL16 axis in ongoing lung injury. Conversely, monocytes from long COVID patients with ongoing fatigue exhibited sustained reduction of the prostaglandin-generating enzyme COX-2 (p<0.01) and CXCR2 expression (p<0.05). These monocyte changes were not present in RSV or flu convalescence.ConclusionsOur data define unique monocyte signatures that define subgroups of long COVID patients, indicating a key role for monocyte migration in COVID-19 pathophysiology. Targeting these pathways may provide novel therapeutic opportunities in COVID-19 patients with persistent morbidity.

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Section: Discussionsupporting

confidence: 87%

Monocyte migration profiles define disease severity in acute COVID-19 and unique features of long COVID

Scott

Pearmain²,

Knight³

et al. 2023

Eur Respir J

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Increased gut permeability and bacterial translocation are associated with fibromyalgia and myalgic encephalomyelitis/chronic fatigue syndrome: implications for disease-related biomarker discovery

Martín,

Blanco-Suárez,

Zambrano

et al. 2023

Front. Immunol.

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BackgroundThere is growing evidence of the significance of gastrointestinal complaints in the impairment of the intestinal mucosal barrier function and inflammation in fibromyalgia (FM) and in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). However, data on intestinal permeability and gut barrier dysfunction in FM and ME/CFS are still limited with conflicting results. This study aimed to assess circulating biomarkers potentially related to intestinal barrier dysfunction and bacterial translocation and their association with self-reported symptoms in these conditions.MethodsA pilot multicenter, cross-sectional cohort study with consecutive enrolment of 22 patients with FM, 30 with ME/CFS and 26 matched healthy controls. Plasma levels of anti-beta-lactoglobulin antibodies (IgG anti-β-LGB), zonulin-1 (ZO-1), lipopolysaccharides (LPS), soluble CD14 (sCD14) and interleukin-1-beta (IL-1β) were assayed using ELISA. Demographic and clinical characteristics of the participants were recorded using validated self-reported outcome measures. The diagnostic accuracy of each biomarker was assessed using the receiver operating characteristic (ROC) curve analysis.ResultsFM patients had significantly higher levels of anti-β-LGB, ZO-1, LPS, and sCD14 than healthy controls (all P < 0.0001). In ME/CFS patients, levels of anti-β-LGB, ZO-1, LPS, and sCD14 were significantly higher than controls, but lower than in FM (all P < 0.01), while there was no significant difference in IL-1β level. In the FM and ME/CFS cohorts, both anti-β-LGB and ZO-1 correlated significantly with LPS and sCD14 (P < 0.001 for both). In the FM group, both anti-β-LGB and ZO-1 were correlated significantly with physical and mental health components on the SF-36 scale (P < 0.05); whereas IL-1β negatively correlated with the COMPASS-31 score (P < 0.05). In the ME/CFS cohort, ZO-1 was positively correlated with the COMPASS-31 score (P < 0.05). The ROC curve analysis indicated a strong ability of anti-β-LGB, ZO-1, LPS and sCD14 to predictively distinguish between FM and ME/CFS from healthy controls (P < 0.0001).ConclusionBiomarkers of intestinal barrier function and inflammation were associated with autonomic dysfunction assessed by COMPASS-31 scores in FM and ME/CFS respectively. Anti-β-LGB antibodies, ZO-1, LPS, and sCD14 may be putative predictors of intestinal barrier dysfunction in these cohorts. Further studies are needed to assess whether these findings are causal and can therefore be applied in clinical practice.

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Evaluation of four clinical laboratory parameters for the diagnosis of myalgic encephalomyelitis

Cited by 2 publications

References 64 publications

Monocyte migration profiles define disease severity in acute COVID-19 and unique features of long COVID

Monocyte migration profiles define disease severity in acute COVID-19 and unique features of long COVID

Increased gut permeability and bacterial translocation are associated with fibromyalgia and myalgic encephalomyelitis/chronic fatigue syndrome: implications for disease-related biomarker discovery

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