Abstract
BackgroundResearch has identified immunological abnormalities in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME), a heterogeneous illness with an unknown cause and absence of diagnostic test. There have been no CFS/ME studies examining innate and adaptive immune cells longitudinally in patients with varying severities. This is the first study to investigate immune cells over 6 months while also examining CFS/ME patients of varying symptom severity.MethodsParticipants were grouped into 18 healthy controls, 12 moderate and 12 severe CFS/ME patients and flow cytometry was used to examine cell parameters at 0 and 6 months.ResultsOver time, iNKT CD62L expression significantly increased in moderate CFS/ME patients and CD56bright NK receptors differed in severe CFS/ME. Naïve CD8+T cells, CD8−CD4− and CD56−CD16− iNKT phenotypes, γδ2T cells and effector memory subsets were significantly increased in severe CFS/ME patients at 6 months. Severe CFS/ME patients were significantly reduced in CD56brightCD16dim NKG2D, CD56dimCD16− KIR2DL2/DL3, CD94−CD11a− γδ1T cells and CD62L+CD11a− γδ1T cells at 6 months.ConclusionsSevere CFS/ME patients differed from controls and moderate CFS/ME patients over time and expressed significant alterations in iNKT cell phenotypes, CD8+T cell markers, NK cell receptors and γδT cells at 6 months. This highlights the importance of further assessing these potential immune biomarkers longitudinally in both moderate and severe CFS/ME patients.Electronic supplementary materialThe online version of this article (doi:10.1186/s12967-015-0653-3) contains supplementary material, which is available to authorized users.
Highlights
Research has identified immunological abnormalities in Chronic Fatigue Syndrome/Myalgic Encepha‐ lomyelitis (CFS/ME), a heterogeneous illness with an unknown cause and absence of diagnostic test
Age data is represented as mean ± SD and gender is represented as percentage of group which that is female in control (n = 18), moderate CFS/ME (n = 12) and severe CFS/ME (n = 12) groups
Dr Bells Disability scale (DRS) and the Karnofsky Performance Scale (KPS) were significantly different between all groups, with severe CFS/ME patients scores being further worsened significantly compared to moderate CFS/ME (Fig. 1)
Summary
Research has identified immunological abnormalities in Chronic Fatigue Syndrome/Myalgic Encepha‐ lomyelitis (CFS/ME), a heterogeneous illness with an unknown cause and absence of diagnostic test. A number of parameters have been shown to alter in patients, including T regulatory cells (Tregs), iNKT cells, CD8+ T cells and cytokines [6, 8, 10] Alterations in both innate and adaptive immune cells reflect the extent of immune. Longitudinal studies of CFS/ME have demonstrated consistently reduced NK cell activity while there was variation in cytokine levels over time. It appears that longitudinal examination of immune cells in CFS/ME may allow an assessment of consistent immune parameters as potential biomarkers for the illness [2, 11]. This research further investigates immunological markers of the innate and adaptive immune system at 0 and 6 months in moderate and severe CFS/ME patients
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