Hanevik Kurt, Kristoffersen Einar, Mørch Kristine, Rye Kristin Paulsen, Sørnes Steinar, Svärd Staffan, Bruserud Øystein, Langeland Nina
Department of Clinical Science, Lab-building 8.floor, University of Bergen, N-5021, Bergen, Norway.
Center for Tropical Infectious Diseases, Haukeland University Hospital, Bergen, Norway.
BMC Immunol. 2017 Jan 28;18(1):5. doi: 10.1186/s12865-017-0190-3.
The role of pathogen specific cellular immune responses against the eliciting pathogen in development of post-infectious chronic fatigue syndrome (PI-CFS) is not known and such studies are difficult to perform. The aim of this study was to evaluate specific anti-Giardia cellular immunity in cases that developed CFS after Giardia infection compared to cases that recovered well. Patients reporting chronic fatigue in a questionnaire study three years after a Giardia outbreak were clinically evaluated five years after the outbreak and grouped according to Fukuda criteria for CFS and idiopathic chronic fatigue. Giardia specific immune responses were evaluated in 39 of these patients by proliferation assay, T cell activation and cytokine release analysis. 20 Giardia exposed non-fatigued individuals and 10 healthy unexposed individuals were recruited as controls.
Patients were clinically classified into CFS (n = 15), idiopathic chronic fatigue (n = 5), fatigue from other causes (n = 9) and recovered from fatigue (n = 10). There were statistically significant antigen specific differences between these Giardia exposed groups and unexposed controls. However, we did not find differences between the Giardia exposed fatigue classification groups with regard to CD4 T cell activation, proliferation or cytokine levels in 6 days cultured PBMCs. Interestingly, sCD40L was increased in patients with PI-CFS and other persons with fatigue after Giardia infection compared to the non-fatigued group, and correlated well with fatigue levels at the time of sampling.
Our data show antigen specific cellular immune responses in the groups previously exposed to Giardia and increased sCD40L in fatigued patients.
针对引发病原体的病原体特异性细胞免疫反应在感染后慢性疲劳综合征（PI-CFS）发展中的作用尚不清楚，且此类研究难以开展。本研究的目的是评估与恢复良好的病例相比，贾第虫感染后发生慢性疲劳综合征（CFS）的病例中的特异性抗贾第虫细胞免疫。在一次贾第虫暴发三年后通过问卷调查报告慢性疲劳的患者，在暴发五年后进行临床评估，并根据CFS和特发性慢性疲劳的福冈标准进行分组。通过增殖试验、T细胞活化和细胞因子释放分析对其中39例患者的贾第虫特异性免疫反应进行评估。招募20名暴露于贾第虫的无疲劳个体和10名未暴露的健康个体作为对照。
患者临床分类为CFS（n = 15）、特发性慢性疲劳（n = 5）、其他原因导致的疲劳（n = 9）和已从疲劳中恢复（n = 10）。这些暴露于贾第虫的组与未暴露的对照组之间存在统计学上显著的抗原特异性差异。然而，我们未发现暴露于贾第虫的疲劳分类组在培养6天的外周血单核细胞（PBMC）中的CD4 T细胞活化、增殖或细胞因子水平方面存在差异。有趣的是，与无疲劳组相比，PI-CFS患者和其他贾第虫感染后出现疲劳的人血清CD40配体（sCD40L）升高，且与采样时的疲劳水平密切相关。
我们的数据显示，先前暴露于贾第虫的组中存在抗原特异性细胞免疫反应，且疲劳患者的sCD40L升高。
