National Centre for Epidemiology and Public Health, Research School of Population Health, ANU, Acton, ACT, 2601, Australia.
CFS Discovery, Donvale Medical Specialist Centre, Donvale, VIC, 3111, Australia.
J Transl Med. 2018 Apr 12;16(1):97. doi: 10.1186/s12967-018-1473-z.
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is clinically defined and characterised by persistent disabling tiredness and exertional malaise, leading to functional impairment.
This study introduces the weighted standing time (WST) as a proxy for ME/CFS severity, and investigates its behaviour in an Australian cohort. WST was calculated from standing time and subjective standing difficulty data, collected via orthostatic intolerance assessments. The distribution of WST for healthy controls and ME/CFS patients was correlated with the clinical criteria, as well as pathology and cytokine markers. Included in the WST cytokine analyses were activins A and B, cytokines causally linked to inflammation, and previously demonstrated to separate ME/CFS from healthy controls. Forty-five ME/CFS patients were recruited from the CFS Discovery Clinic (Victoria) between 2011 and 2013. Seventeen healthy controls were recruited concurrently and identically assessed.
WST distribution was significantly different between ME/CFS participants and controls, with six diagnostic criteria, five analytes and one cytokine also significantly different when comparing severity via WST. On direct comparison of ME/CFS to study controls, only serum activin B was significantly elevated, with no significant variation observed for a broad range of serum and urine markers, or other serum cytokines.
The enhanced understanding of standing test behaviour to reflect orthostatic intolerance as a ME/CFS symptom, and the subsequent calculation of WST, will encourage the greater implementation of this simple test as a measure of ME/CFS diagnosis, and symptom severity, to the benefit of improved diagnosis and guidance for potential treatments.
肌痛性脑脊髓炎/慢性疲劳综合征（ME/CFS）是一种临床定义和特征为持续性、致残性疲劳和劳累后不适，导致功能障碍的疾病。
本研究引入加权站立时间（WST）作为 ME/CFS 严重程度的替代指标，并对澳大利亚队列中的行为进行了研究。WST 是通过直立不耐受评估中收集的站立时间和主观站立困难数据计算得出的。健康对照组和 ME/CFS 患者的 WST 分布与临床标准以及病理学和细胞因子标志物相关。纳入 WST 细胞因子分析的有激活素 A 和 B，这些细胞因子与炎症有关，之前已被证明可将 ME/CFS 与健康对照组区分开来。2011 年至 2013 年间，从 CFS 发现诊所（维多利亚）招募了 45 名 ME/CFS 患者。同期招募了 17 名健康对照者并进行了相同的评估。
ME/CFS 参与者和对照组之间的 WST 分布存在显著差异，通过 WST 比较严重程度时，有六个诊断标准、五个分析物和一个细胞因子也存在显著差异。ME/CFS 与研究对照组的直接比较中，只有血清激活素 B 显著升高，而广泛的血清和尿液标志物或其他血清细胞因子没有观察到显著变化。
对直立试验行为的深入了解，以反映直立不耐受作为 ME/CFS 的一种症状，以及随后的 WST 计算，将鼓励更广泛地实施这种简单的测试，作为 ME/CFS 诊断和症状严重程度的衡量标准，从而改善诊断并为潜在治疗提供指导。
