Uit een studie van dr. Michael Maes, Karl Ringel en ondergetekende blijkt dat
interleukin-1 (IL-1α en
-β) en tumor necrosis factor-α (TNF-α),
markers voor inflammatie,
in ME/CVS in veel sterkere mate aanwezig zijn dan dan in depressie met fysieke klachten en
ME/CVS én "depressie" beide gepaard gaan met (cellulaire) immuunactivatie
(neopterine).
In depressie die vergezeld gaat met lichamelijke klachten is er
een nauw verband tussen inflammatie aan de ene kant en
immuunactivatie aan de andere kant, in ME/CVS niet.
Het feit dat ME/CVS en depressie met fysieke klachten immunologisch deels overlappen,
verklaart wellicht waarom ME/CVS soms gepaard gaat met "inflammatoire depressie".
Ook bij de diagnose depressie zou immunologisch onderzoek moeten plaatsvinden,
omdat depressie een vergaarbakdiagnose is en lichamelijke oorzaken kan hebben.
Inflammatory and cell-mediated immune biomarkers
in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and depression:
inflammatory markers are higher in
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome than in depression
Psychother Psychosom 2012;81(5):286-295. doi: 10.1159/000336803.
Michael Maes a, Frank N.M. Twisk b, Karl Ringel c
- Maes Clinics, TRIA, Bangkok, Thailand;
- ME-de-patiënten Foundation, Limmen, The Netherlands;
- Immunologische Laboratorien, Aachen, Germany
Abstract
Background:
Depression is an inflammatory disorder
while many authors declare
myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)
to be a functional disorder.
The aim of the present study
is to compare inflammatory and cell-mediated immune (CMI) responses
between depression and ME/CFS.
Methods:
We measured
two proinflammatory cytokines (PICs) in plasma,
interleukin-1 (IL-1) and tumor necrosis factor-α (TNF-α),
with enzyme-linked immunosorbent assays, and
serum neopterin with a radioimmunoassay
in controls, ME/CFS and depressive patients.
Results:
Plasma PICs were significantly higher in ME/CFS than in depression and
higher in both patient groups than in controls.
Increased PIC levels in depression were attributable to
the presence of fatigue and physio-somatic symptoms.
Serum neopterin did not differ significantly between depression and ME/CFS
but was higher in both patient groups than in controls.
The significant positive correlations between neopterin and either IL-1 or TNF-α
were significantly greater in depression than in ME/CFS.
Conclusions:
Since PICs cause depression-like behaviors and fatigue/malaise,
we suggest that
inflammation may play a role in the pathophysiology of ME/CFS and depression.
Increased neopterin also seems to contribute to the pathophysiology of both disorders.
This study has detected a shared 'pathway phenotype',
i.e. disorders in inflammatory and CMI pathways,
which underpins both ME/CFS and depression and,
therefore, may explain the co-occurrence of both disorders.
ME/CFS and depression are discriminated from each other
by increased PICs in ME/CFS and
differences in the immune cell communication networks.
http://content.karger.com/produktedb/produkte.asp?doi=336803
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