Follow FrankTwisk on Twitter  
   

 

 

 

 

Klimas/Fletcher:

 

Afwijkend cytokine-profiel

ME/CVS-patiŽnten

wijst op Th1Th2-shift

 

 

 

 


 

Klimas en kollega's hebben 15 cytokines (boodschappers van het immuunsysteem)

in het plasma van 40 ME/CVS-patiŽnten en 59 gezonde proefpersonen onderzocht.

 

Sterk verhoogd waren de concentraties van de pro-inflammatoire cytokine LTalpha,

de Th1-cytokine IL-12 en de twee voornaamste Th2-cytokines Il-4 en IL-5.

 

Verhoogd waren de hoeveelheden pro-inflammatoire cytokine IL-1a, IL-1b en IL-6.

 

Verlaagd was de hoeveelheid Th1-cytokine IL-15, de hoeveelheid ontstekingsonderdrukkende cytokine IL-13 en de NK-cel mobiliserende cytokine IL-8.

 

Dit beeld bevestigt dat er bij ME/CVS vaak sprake is van een Th1Th2-shift (klik hier).

 

Opvallend is voorts dat de Th17-cytokines (IL-17 en IL-23) niet verhoogd zijn.

Wellicht is dit mede het gevolg van het feit dat het hier om gemiddelden gaat en

er slechts bij een deel van de patiŽnten ook sprake van een aktieve Th17-response is.

 

Overigens merken de auteurs terecht op dat het beeld (immuunaktivatie/inflammatie)

niet typisch iets is voor ME/CVS, maar ook voor MS, reuma, golfoorlogsyndroom etc.

 

 

 

 

 

 


 

Citaten uit het uitgebreide studierapport:

 

 

The cytokine changes

observed

between CFS patients and

healthy, matched controls

are likely to be

indicative of

immune activation and

inflammation.

 

Along with

the TH1 abnormalities,

we found

upregulation of

TH2 associated cytokines,

IL-4 and IL-5,

in the CFS subjects.

 

Fibromyalgia,

GWI,

rheumatologic disorders and

multiple sclerosis

may have similar cytokine patterns.

 

The results imply

a disorganized regulatory pattern of TH1 function,

critical to antiviral defense.

 

The data from this study

support a TH2 shift,

pro-inflammatory cytokine up regulation and

down regulation of

important mediators of

cytotoxic cell function.

 

 


 

Plasma cytokines in women with chronic fatigue syndrome

Journal of Translational Medicine 2009, 7:96. doi:10.1186/1479-5876-7-96

Fletcher MA, Zeng XR, Barnes Z, Levis S, Klimas NG.

 

Published: 12 November 2009

 

 

Background

 

Chronic Fatigue Syndrome (CFS) studies

from our laboratory and others

have described cytokine abnormalities.

 

Other studies reported

no difference

between CFS and

controls.

 

However,

methodologies varied widely

and few studies measured more than 4 or 5 cytokines.

 

Multiplex technology permits

the determination of cytokines

for a large panel of cytokines simultaneously

with high sensitivity and

with only 30ul of plasma per sample.

 

No widely accepted laboratory test or marker

is available for

the diagnosis or

prognosis

of CFS.

 

This study screened

plasma factors

to identify circulating

biomarkers

associated with CFS.

 

 

Methods

 

Cytokines

were measured

in plasma

from female CFS cases and

healthy controls.

Multiplex technology provided

profiles of

16 plasma factors

 

including

 

the pro-inflammatory cytokines:

tumor necrosis factor alpha (TNFalpha),

lymphotoxin alpha (LTalpha),

IL-Ialpha,

IL-1beta,

IL-6;

 

TH1 cytokines:

interferon gamma (IFNgamma),

IL-12p70,

IL-2,

IL-15;

 

TH2:

IL-4,

IL-5;

 

TH17 cytokines,

IL-17 and

IL-23;

 

anti-inflammatory cytokines

IL-10,

IL-13;

 

the inflammatory mediator and

neutrophil attracting chemokine IL-8 (CXCL8).

 

Analysis by

receiver operating characteristic (ROC) curve

assessed

the biomarker potential

of each cytokine.

 

 

Results

 

The following cytokines were

elevated

in CFS compared to controls:

 

LTalpha,

IL-1alpha,

IL-1beta,

IL-4,

IL-5,

IL-6 and

IL-12.

 

The following cytokines were

decreased

in CFS:

IL-8,

IL-13 and

IL-15.

 

The following cytokines were

not different:

TNFalpha,

IFNgamma,

IL-2,

IL-10,

IL-23 and

IL-17.

 

Applying (ROC) curve analyses,

areas under the curves (AUC)

for

IL-5 (0. 84),

LTalpha (0.77),

IL-4 (0.77),

IL-12 (0.76)

indicated good biomarker potential.

 

The AUC of

IL-6 (0.73),

IL-15 (0.73),

IL-8 (0.69),

IL-13 (0.68)

IL-1alpha (0.62),

IL-1beta (0.62)

showed

fair potential as

biomarkers.

 

 

Conclusions

 

Cytokine abnormalities are common in CFS.

 

In this study,

10 o 16 cytokines examined

showed good to fair promise as

biomarkers.

 

However,

the cytokine changes

observed are likely to more

indicative of immune activation and inflammation,

rather than specific for CFS.

 

As such,

they are targets

for 3 therapeutic strategies.

 

Newer techniques allow

evaluation of large panels of cytokines

in a cost effective fashion.

 

 

 

full-text:

http://www.translational-medicine.com/content/pdf/1479-5876-7-96.pdf

 

 


 

Met dank aan Rob