Immune Abnormalities in Patients Meeting New Diagnostic Criteria for Chronic Fatigue Syndrome/Myalgic Encephalomyelitis

Abstract

Background: Immunological abnormalities have been identified in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis patients fulfilling the 1994 Centers for Disease Control diagnostic criteria. Significant developments have been made to diagnostic criteria, but potential immunological markers have not been assessed in patients fulfilling these latest clinical requirements. Therefore, this study evaluated immunological parameters in patients that also fulfill the latest diagnostic criteria available known as the International Consensus Criteria. Methods:The Immunological investigations including Natural Killer cell activity and phenotyping studies for dendritic cells, neutrophils, B cells and regulatory T cells were performed on whole blood samples collected from all participants using flow cytometric protocols. The physical functioning of all participants was also evaluated using scores from the Short Form Health Survey, and the World Health Organization Disability Adjustment Schedule. Results were compared according 1994 Centers of Disease Control and Prevention defined patients, and International Consensus Criteria defined patients, and healthy controls.Results: Natural killer cell activity was consistently and significantly decreased, and regulatory T cells were significantly increased in both patient groups compared to healthy controls. Differences were found in human neutraphil antigens and expression of natural killer cell receptors between patient groups. Highly significant correlations were also found between physical status and some immune parameters in International Consensus Criteria defined patients. Conclusion:This preliminary investigation on different diagnostic criteria suggests that the International Consensus Criteria may be more effective at detecting salient differences in the immune system.

The status of and future research into Myalgic Encephalomyelitis and Chronic Fatigue Syndrome: the need of accurate diagnosis, objective assessment, and acknowledging biological and clinical subgroups

“…“Fatigue” is not obligatory to meet the diagnosis ME. The distinction between patients with ME/CFS with post-exertional malaise and patients without post-exertional malaise is reflected by particular clinical and immunological differences (Maes et al, 2012a; Brenu et al, 2013). …”

“…Prevalence rates of ME (Carruthers et al, 2011) remain to be investigated, but based upon (Nacul et al, 2011; Jason et al, 2012b; Maes et al, 2012a; Brenu et al, 2013) it is estimated that 30–50% of the subjects meeting the CFS (Fukuda et al, 1994) criteria fulfill the more stringent criteria for ME (Carruthers et al, 2011). Patients experience significantly more impairment than patients with hypertension, congestive heart failure, type II diabetes mellitus, acute myocardial infarction, multiple sclerosis and depression (Komaroff et al, 1996).…”

“…However, immunological abnormalities, antigens, increased oxidative and nitrosative stress, and gastro-intestinal dysfunction seem to be at the core of the etiology of ME/CFS (Maes and Twisk, 2010). The distinction between patients meeting the proposed criteria for ME (Carruthers et al, 2011) and patients with CFS (Fukuda et al, 1994) not fulfilling these criteria is reflected by specific immunological abnormalities (Brenu et al, 2013). …”