Conti F, Magrini L, Priori R, Valesini G, Bonini S
Università di Roma La Sapienza, I Clinica Medica, Italy.
Allergy. 1996 Feb;51(2):124-7.
Chronic fatigue syndrome (CFS) is a syndrome of uncertain etiopathogenesis characterized by disabling fatigue associated with a variable number of somatic and/or neuropsychologic symptoms. In patients with CFS, several immunologic abnormalities can be detected, including a higher prevalance of allergy. The aim of this study was to determine whether CFS patients, well studied for their allergy profile, show signs of eosinophil activation, as detectable by the measurement in serum of eosinophil cationic protein (ECP) levels. In 35 consecutive CFS outpatients (diagnosis based on the Centers for Disease Control case definition), ECP was measured in serum by a competitive enzyme immunoassay (ECP-FEIA kit, Kabi Pharmacia Diagnostics, Uppsala, Sweden). Fourteen disease-free subjects with no history of CFS or allergy were selected as controls. ECP serum levels were significantly higher in CFS patients than in controls (18.0 +/- 11.3 micrograms/l vs 7.3 +/- 2.1 micrograms/l; P < 0.01). In the CFS population, the prevalence of RAST positivity to one or more allergens was 77%, while no control showed positive RAST. Twelve of the 14 CFS patients with increased ECP serum levels were RAST-positive. However, CFS RAST-positive patients had no significantly higher ECP serum levels than CFS RAST-negative patients (19.3 +/- 12.4 micrograms/l vs 13.6 +/- 3.7 micrograms/l; P = 0.4). This is the first report of increased serum levels of ECP in CFS. On the basis of the available data, it is discussed whether eosinophil activation has a pathogenetic role in CFS or is linked to the frequently associated allergic condition, or, finally, whether a common immunologic background may exist for both atopy and CFS.
慢性疲劳综合征（CFS）是一种病因发病机制不明的综合征，其特征为使人衰弱的疲劳，并伴有多种躯体和/或神经心理症状。在CFS患者中，可以检测到几种免疫异常，包括过敏的较高患病率。本研究的目的是确定，经充分研究其过敏特征的CFS患者，是否表现出嗜酸性粒细胞活化的迹象，这可通过测量血清中嗜酸性粒细胞阳离子蛋白（ECP）水平来检测。在35例连续的CFS门诊患者中（根据疾病控制中心的病例定义进行诊断），采用竞争性酶免疫测定法（ECP - FEIA试剂盒，瑞典乌普萨拉的卡比 Pharmacia诊断公司）测量血清中的ECP。选择14名无CFS或过敏病史的无病受试者作为对照。CFS患者的血清ECP水平显著高于对照组（18.0±11.3微克/升对7.3±2.1微克/升；P<0.01）。在CFS人群中，对一种或多种变应原的RAST阳性率为77%，而对照组均未显示RAST阳性。14例血清ECP水平升高的CFS患者中有12例RAST阳性。然而，CFS的RAST阳性患者的血清ECP水平并不显著高于CFS的RAST阴性患者（19.3±12.4微克/升对13.6±3.7微克/升；P = 0.4）。这是关于CFS患者血清ECP水平升高的首次报告。根据现有数据，讨论了嗜酸性粒细胞活化在CFS中是否具有致病作用，或者是否与常见的过敏状况有关，或者最后，特应性和CFS是否可能存在共同的免疫背景。
