Maes Clinics @ TRIA, Bangkok, Thailand.
J Affect Disord. 2013 Sep 5;150(2):223-30. doi: 10.1016/j.jad.2013.03.029. Epub 2013 May 10.
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is accompanied by activation of immuno-inflammatory pathways, increased bacterial translocation and autoimmune responses to serotonin (5-HT). Inflammation is known to damage 5-HT neurons while bacterial translocation may drive autoimmune responses. This study has been carried out to examine the autoimmune responses to 5-HT in ME/CFS in relation to inflammation and bacterial translocation.
We examined 5-HT antibodies in 117 patients with ME/CFS (diagnosed according to the centers for disease control and prevention criteria, CDC) as compared with 43 patients suffering from chronic fatigue (CF) but not fulfilling the CDC criteria and 35 normal controls. Plasma interleukin-1 (IL-1), tumor necrosis factor (TNF)α, neopterin and the IgA responses to Gram-negative bacteria were measured. Severity of physio-somatic symptoms was measured using the fibromyalgia and chronic fatigue syndrome rating scale (FF scale).
The incidence of positive autoimmune activity against 5-HT was significantly higher (p<0.001) in ME/CFS (61.5%) than in patients with CF (13.9%) and controls (5.7%). ME/CFS patients with 5-HT autoimmune activity displayed higher TNFα, IL-1 and neopterin and increased IgA responses against LPS of commensal bacteria than those without 5-HT autoimmune activity. Anti-5-HT antibody positivity was significantly associated with increased scores on hyperalgesia, fatigue, neurocognitive and autonomic symptoms, sadness and a flu-like malaise.
The results show that, in ME/CFS, increased 5-HT autoimmune activity is associated with activation of immuno-inflammatory pathways and increased bacterial translocation, factors which are known to play a role in the onset of autoimmune reactions. 5-HT autoimmune activity could play a role in the pathophysiology of ME/CFS and the onset of physio-somatic symptoms. These results provide mechanistic support for the notion that ME/CFS is a neuro-immune disorder.
肌痛性脑脊髓炎/慢性疲劳综合征 (ME/CFS) 伴随着免疫炎症途径的激活、细菌易位增加和对 5-羟色胺 (5-HT) 的自身免疫反应。已知炎症会损害 5-HT 神经元，而细菌易位可能会引发自身免疫反应。本研究旨在检查 ME/CFS 中与炎症和细菌易位相关的 5-HT 自身免疫反应。
我们检查了 117 例 ME/CFS 患者（根据疾病控制和预防中心 (CDC) 的标准诊断）的 5-HT 抗体，与 43 例未满足 CDC 标准但患有慢性疲劳 (CF) 的患者和 35 名正常对照进行比较。测量了血浆白细胞介素-1 (IL-1)、肿瘤坏死因子 (TNF)α、新蝶呤和革兰氏阴性菌的 IgA 反应。使用纤维肌痛和慢性疲劳综合征评定量表 (FF 量表) 测量生理-躯体症状的严重程度。
ME/CFS 患者（61.5%）中对 5-HT 的自身免疫活性阳性的发生率明显高于 CF 患者（13.9%）和对照组（5.7%）（p<0.001）。ME/CFS 患者中具有 5-HT 自身免疫活性的患者表现出更高的 TNFα、IL-1 和新蝶呤，并且对共生菌 LPS 的 IgA 反应增加，而不具有 5-HT 自身免疫活性的患者则没有。抗 5-HT 抗体阳性与痛觉过敏、疲劳、神经认知和自主症状、悲伤和流感样不适的评分增加显著相关。
结果表明，在 ME/CFS 中，增加的 5-HT 自身免疫活性与免疫炎症途径的激活和细菌易位增加有关，这些因素已知在自身免疫反应的发生中起作用。5-HT 自身免疫活性可能在 ME/CFS 的病理生理学和生理-躯体症状的发生中起作用。这些结果为 ME/CFS 是一种神经免疫障碍的观点提供了机制支持。
