ter Wolbeek Maike, van Doornen Lorenz J P, Kavelaars Annemieke, van de Putte Elise M, Schedlowski Manfred, Heijnen Cobi J
Laboratory of Psychoneuroimmunology, University Medical Center Utrecht, 3508 AB Utrecht, The Netherlands.
Brain Behav Immun. 2007 Nov;21(8):1063-74. doi: 10.1016/j.bbi.2007.04.007. Epub 2007 Jun 1.
In the adolescent population, fatigue is associated with somatic complaints, unrefreshing sleep, cognitive disturbances and symptoms of depression and anxiety. This pattern of symptoms resembles the one described in chronic fatigue syndrome (CFS). Since immunological alterations have been reported in CFS patients, we wondered whether also severely fatigued girls from a healthy population would show comparable alterations in psychological and immunological parameters. We tested this hypothesis in a longitudinal design, allowing a reliable assessment of the participants' characteristic immune status. Groups of severely fatigued (N=67) and non-fatigued (N=61) participants were selected. Severely fatigued girls reported more depressive symptoms, anxiety, reduced sleep quality, and somatic and CFS-related symptoms than non-fatigued participants across three measurements during one year (T1: spring, T2: autumn, T3: spring). In contrast, no group differences in mitogen-induced cytokine production or T-cell proliferation in vitro or in leukocyte subset counts were observed. Although absolute cytokine production and cell counts were affected by seasonal variation, the within-subject values, relatively to the rest of the participants, were fairly stable. Data from a small group of CFS patients (N=11) showed similarities in self-reported complaints between CFS patients and fatigued participants. Interestingly, CFS patients showed a distinct immune profile when compared to the severely fatigued or non-fatigued participants, i.e. increased levels of anti-inflammatory cytokines (IL-10, decreased IFN-gamma/IL-10 ratio) and reduced levels of pro-inflammatory cytokines (IL-6, TNF-alpha) over all three time points analyzed. These results show that, although overlap in symptomatology between the general population and patients with CFS was observed, only CFS patients show a skewing of the cytokine balance towards an anti-inflammatory profile.
在青少年人群中，疲劳与躯体不适、睡眠不解乏、认知障碍以及抑郁和焦虑症状相关。这种症状模式类似于慢性疲劳综合征（CFS）中所描述的情况。由于已有报道称CFS患者存在免疫改变，我们想知道来自健康人群的严重疲劳女孩在心理和免疫参数方面是否也会出现类似改变。我们采用纵向设计对这一假设进行了测试，以便可靠地评估参与者的特征性免疫状态。选取了严重疲劳组（N = 67）和非疲劳组（N = 61）的参与者。在一年中的三次测量（T1：春季，T2：秋季，T3：春季）期间，严重疲劳的女孩比非疲劳参与者报告了更多的抑郁症状、焦虑、睡眠质量下降以及躯体和与CFS相关的症状。相比之下，在体外丝裂原诱导的细胞因子产生、T细胞增殖或白细胞亚群计数方面未观察到组间差异。尽管绝对细胞因子产生和细胞计数受季节变化影响，但相对于其他参与者，个体内部的值相当稳定。一小群CFS患者（N = 11）的数据显示，CFS患者和疲劳参与者在自我报告的症状方面存在相似之处。有趣的是，与严重疲劳或非疲劳参与者相比，CFS患者呈现出独特的免疫特征，即在所有三个分析时间点上，抗炎细胞因子（IL - 10，IFN - γ/IL - 10比值降低）水平升高，促炎细胞因子（IL - 6，TNF - α）水平降低。这些结果表明，尽管在普通人群和CFS患者之间观察到症状学上的重叠，但只有CFS患者的细胞因子平衡偏向抗炎特征。
