Evaluation of Immune Dysregulation in an Austrian Patient Cohort Suffering from Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Lena Lutz,Sonja Zehetmayer,Johanna Rohrhofer,Michael Stingl,Eva Untersmayr

doi:10.3390/biom11091359

Lena Lutz, Sonja Zehetmayer + Show 3 more

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https://doi.org/10.3390/biom11091359

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Journal: Biomolecules	Publication Date: Sep 14, 2021
Citations: 8	License type: CC BY 4.0

Affiliation: Medical University of Vienna, Statistics Austria

Abstract

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a severe multi-systemic disease characterized by debilitating fatigue that is not relieved by rest. The causes of the disease are still largely unexplained, and no causative treatment is currently available. Changes in the immune response are considered as fundamental in the development of ME/CFS. Thus, we aimed to evaluate the immunological profile of ME/CFS patients in a retrospective data analysis. As part of the routine workup for ME/CFS patients, a differential blood count, leukocyte subtyping, and quantification of immunoglobulins and IgG subclasses, as well as a complement analysis, was performed. Out of 262 ME/CFS patients, 64.9% had a reduction or deficiency in at least one of the listed immune parameters. In contrast, 26.3% showed signs of immune activation or inflammation. A total of 17.6% of the ME/CFS patients had an unclassified antibody deficiency, with IgG3 and IgG4 subclass deficiencies as the most common phenotypes. Reduced MBL (mannose-binding lectin) levels were found in 32% of ME/CFS patients, and MBL deficiency in 7%. In summary, the present results confirmed the relevance of immune dysfunction in ME/CFS patients underlining the involvement of a dysfunctional immune response in the disease. Thus, immune parameters are relevant disease biomarkers, which might lead to targeted therapeutic approaches in the future.

Highlights

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a multi-systemic disease with an estimated prevalence of 0.3 to 0.8% in the general population [1] Approximately 25,000 patients of all age and socioeconomic groups are calculated to be affected in Austria, but precise data is missing
The disease is defined by chronic debilitating fatigue lasting more than six months and various other symptoms such as sleep disturbances, mental and physical pain, neurological and cognitive impairment, as well as autoimmunity or immunodeficiencies [4]
As changes in the immune response are considered to play a key role in the development of ME/CFS, we aimed to evaluate the immunological profile of ME/CFS patients in a retrospective manner

Summary

Introduction

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a multi-systemic disease with an estimated prevalence of 0.3 to 0.8% in the general population [1] Approximately 25,000 patients of all age and socioeconomic groups are calculated to be affected in Austria (as of January 2019 [2]), but precise data is missing. The onset is usually acute with flu-like symptoms but can manifest in a subacute or insidious manner. The disease is defined by chronic debilitating fatigue lasting more than six months and various other symptoms such as sleep disturbances, mental and physical pain, neurological and cognitive impairment, as well as autoimmunity or immunodeficiencies [4]. Rest does not relieve the fatigue, which is typically worsened after physical and mental exertion (post-exertional malaise, PEM)

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