Radboud Expertise Center for Q Fever, Department of Internal Medicine, Division of Infectious Diseases, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, the Netherlands; Department of Internal Medicine, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, the Netherlands.
Department of Internal Medicine, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, the Netherlands.
J Infect. 2019 May;78(5):349-357. doi: 10.1016/j.jinf.2019.01.006. Epub 2019 Jan 23.
Q fever fatigue syndrome (QFS) is a state of prolonged fatigue following around 20% of acute Q fever cases. It is thought that chronic inflammation plays a role in its etiology. To test this hypothesis we measured circulating cytokines and the ex-vivo cytokine production in patients with QFS and compared with various control groups.
MATERIALS/METHODS: Peripheral blood mononuclear cells (PBMCs), whole blood, and serum were collected from 20 QFS patients, 19 chronic fatigue syndrome (CFS) patients, 19 Q fever seropositive controls, and 25 age- and sex-matched healthy controls. Coxiella-specific ex-vivo production of tumor necrosis factor (TNF)α, interleukin (IL)-1β, IL-6, and interferon (IFN) was measured, together with a total of 92 circulating inflammatory proteins.
PBMCs of QFS patients produced more IL-6 (P = 0.0001), TNFα (P = 0.0002), and IL-1β (P = 0.0005) than the various control groups when stimulated with Coxiella antigen. QFS patients had distinct differences in circulating inflammatory markers compared to the other groups, including higher concentrations of circulating IL-6 and IFNγ.
QFS patients showed signs of chronic inflammation compared to asymptomatic Q fever seropositive controls, CFS patients, and healthy controls, of which the monocyte-derived cytokines TNFα, IL-1β, and especially IL-6, are likely crucial components.
Q 热疲劳综合征（QFS）是急性 Q 热病例约 20%后出现的持续性疲劳状态。据认为，慢性炎症在其发病机制中起作用。为了验证这一假说，我们测量了 QFS 患者的循环细胞因子和体外细胞因子产生情况，并与各种对照组进行了比较。
材料/方法：从 20 例 QFS 患者、19 例慢性疲劳综合征（CFS）患者、19 例 Q 热血清阳性对照者和 25 名年龄和性别匹配的健康对照者中采集外周血单核细胞（PBMC）、全血和血清。共测量了 Coxiella 特异性体外产生的肿瘤坏死因子（TNF）α、白细胞介素（IL）-1β、IL-6 和干扰素（IFN），以及 92 种循环炎症蛋白。
当用 Coxiella 抗原刺激时，QFS 患者的 PBMC 产生更多的 IL-6（P=0.0001）、TNFα（P=0.0002）和 IL-1β（P=0.0005）比各种对照组。与其他组相比，QFS 患者的循环炎症标志物存在明显差异，包括循环 IL-6 和 IFNγ浓度较高。
与无症状 Q 热血清阳性对照者、CFS 患者和健康对照者相比，QFS 患者表现出慢性炎症迹象，其中单核细胞衍生的细胞因子 TNFα、IL-1β 尤其是 IL-6 可能是关键成分。
