The immune system in chronic fatigue syndrome

: a pilot study

Abstract

Chronic Fatigue Syndrome (CFS) is a heterogenous disorder of unknown aetiology characterised by debilitating fatigue, headaches sleep disturbances and a delayed post exertional malaise. It often has an acute onset, possibly after a viral infection or a period of stress, and is a diagnosis of exclusion with no diagnostic test available. The immune system was compared in 33 rigorously defined CFS/ME patients and 24 healthy controls. CFS/ME patients had significantly greater numbers of transitional B cells and naïve B cells and reduced plasmablasts when compared to healthy controls. CFS/ME patients had significantly increased levels of T helper memory effector cells, T helper effector cells and cytotoxic effector T cells with reduced levels of CD8+ lymph node homing naïve and memory T cells when compared to healthy controls. CFS/ME patients had significantly raised levels of IL 12 p70, IL 21, IL22, IL 27 and TNF alpha when compared to healthy controls. No differences were seen in levels of NK cell subpopulations, absolute numbers or cytotoxicity function but NK cell CD69 expression was significantly increased in CFS/ME patients. No differences were seen between CFS/ME patients and healthy controls in levels of T regulatory cells, Th1 cells, Th2 cells, or in Th17 cells. No significant differences were seen between CFS/ME patients and healthy controls in antibody levels to rubella, toxoplasmosis, CMV or EBV. While the cause of these multiple changes is unclear, it is tempting to postulate whether they may suggest a subtle tendency to autoimmunity.

Date of Award	Mar 2019
Original language	English
Awarding Institution	University of Portsmouth
Supervisor	Roslyn Victoria Gibbs (Supervisor)