University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center for Psychopathology and Emotion Regulation (ICPE), Groningen, The Netherlands.
Department of Internal Medicine, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.
PLoS One. 2017 Oct 18;12(10):e0185608. doi: 10.1371/journal.pone.0185608. eCollection 2017.
FSS have been suggested to follow activation of the immune system, triggered by herpes virus infections. The aim of this study was to find out whether herpes virus infections were associated with the experience of FSS in adolescents, and whether this association was mediated by hsCRP, as a general marker of immune activation.
This study was performed in TRAILS, a large prospective population cohort of 2230 adolescents (mean age: 16.1 years, SD = .66, 53.4% girls). FSS were assessed using the somatic complaints subscale of the Youth Self-Report. FSS were analyzed as total scores and divided in two group clusters based on previous studies in this cohort. Levels of hsCRP and antibody levels to the herpes viruses HSV1, HSV2, CMV, EBV and HHV6 were assessed in blood samples at age 16. Also a value for pathogen burden was created adding the number of viruses the adolescents were seropositive for. Multiple regression analysis with bootstrapping was used to analyze the association between viral antibodies and pathogen burden, hsCRP and FSS scores.
Antibody levels and pathogen burden were not associated with FSS total scores or FSS scores in both symptom groups. hsCRP was associated with the total FSS score (B = .02, 95% CI: .004 to .028, p = .01) and FSS score in the symptom group of headache and gastrointestinal complaints (B = .02, 95% CI: .001 to .039, p = .04).
Our study showed no association between herpes virus infections and FSS in general or specific FSS symptom clusters. A role for inflammatory processes in FSS development was supported by the significant association we found between hsCRP levels and FSS, especially in the symptom group of headache and gastrointestinal complaints.
功能性身体症状（FSS）被认为是由疱疹病毒感染引发的免疫系统激活的结果。本研究旨在探究疱疹病毒感染是否与青少年经历 FSS 有关，以及这种关联是否由 hsCRP 介导，hsCRP 是免疫激活的一般标志物。
该研究在 TRAILS 中进行，这是一个由 2230 名青少年（平均年龄：16.1 岁，标准差=0.66，53.4%为女孩）组成的大型前瞻性队列研究。使用青少年自我报告的躯体抱怨子量表评估 FSS。FSS 分析为总得分，并根据该队列中的先前研究分为两个症状聚类组。在 16 岁时采集血液样本，评估 hsCRP 水平和疱疹病毒 HSV1、HSV2、CMV、EBV 和 HHV6 的抗体水平。还创建了一个病原体负担值，方法是将青少年血清阳性的病毒数量相加。使用带有自举法的多元回归分析来分析病毒抗体和病原体负担、hsCRP 与 FSS 评分之间的关系。
抗体水平和病原体负担与 FSS 总分或两个症状聚类组的 FSS 评分均无关。hsCRP 与 FSS 总分（B=0.02，95%CI：0.004-0.028，p=0.01）和头痛和胃肠道抱怨症状聚类组的 FSS 评分（B=0.02，95%CI：0.001-0.039，p=0.04）显著相关。
我们的研究表明，疱疹病毒感染与一般 FSS 或特定 FSS 症状聚类之间无关联。hsCRP 水平与 FSS 之间的显著相关性支持炎症过程在 FSS 发展中的作用，尤其是在头痛和胃肠道抱怨症状聚类组中。
