Klimas en kollega's hebben 15 cytokines (boodschappers van het immuunsysteem)
in het plasma van 40 ME/CVS-patiënten 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 Th1►Th2-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 patiënten 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
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