Department of Neurology & Neurosciences, UMDNJ-New Jersey Medical School, Newark, New Jersey, USA.
J Womens Health (Larchmt). 2010 May;19(5):951-8. doi: 10.1089/jwh.2009.1697.
Some think chronic fatigue syndrome (CFS) and fibromyalgia (FM) are variants of the same illness process. This would imply that CFS patients with and without comorbid FM have similar biological underpinnings. To test this, we compared serotonergic-based responses, plasma prolactin (PRL), and self-reported measures of fatigue to intravenous infusion of tryptophan among patients with CFS alone, CFS + FM, and healthy controls.
Men and women with CFS alone or CFS + FM and healthy subjects, none with current major depressive disorder (MDD), were given 120 mg of L-tryptophan per kg lean body mass intravenously (i.v.). Before and after tryptophan infusion, blood samples were collected, and plasma PRL, tryptophan, and kynurenine concentrations were determined.
Women with CFS alone, but not CFS + FM, showed upregulated plasma PRL responses compared with controls. There were no differences among groups of men. Plasma tryptophan and kynurenine concentrations did not differ among groups.
These results indicate that women with CFS alone have upregulated serotonergic tone that is not seen in those with comorbid FM. The lack of effect in men suggests a mechanism that might explain, in part, the increased prevalence of CFS in women. The data support the interpretation that CFS in women is a different illness from FM.
一些人认为慢性疲劳综合征（CFS）和纤维肌痛（FM）是同一疾病过程的变体。这意味着患有和不伴有共病 FM 的 CFS 患者具有相似的生物学基础。为了验证这一点，我们比较了色氨酸静脉输注后 CFS 患者、CFS+FM 患者和健康对照组的基于 5-羟色胺能的反应、血浆泌乳素（PRL）和自我报告的疲劳程度。
患有单纯 CFS 或 CFS+FM 的男性和女性以及没有当前重度抑郁症（MDD）的健康受试者，均按每公斤瘦体重 120mg 的剂量静脉注射 L-色氨酸。在色氨酸输注前后采集血样，测定血浆 PRL、色氨酸和犬尿氨酸浓度。
与对照组相比，单纯 CFS 女性患者的血浆 PRL 反应上调，但 CFS+FM 女性患者则无此表现。男性患者之间无差异。各组之间的血浆色氨酸和犬尿氨酸浓度没有差异。
这些结果表明，单纯 CFS 女性患者的 5-羟色胺能张力上调，而共病 FM 患者则无此表现。男性患者无影响提示可能存在一种机制，部分解释了女性 CFS 患病率增加的原因。数据支持这样的解释，即女性 CFS 是一种不同于 FM 的疾病。
