Abstract
Acute fatigue after exertion, like acute inflammation after injury, is useful for our body. On the contrary, both chronic fatigue and chronic inflammation are deleterious, and they are associated in many diseases. In this first part, we will analyze different immune phenomena (bystander activation, memory of the innate immune system, link with the intestinal microbiota) involved in triggering chronic inflammation. This review aims at looking for links between different signs and symptoms associated with chronic fatigue, as well as between different diseases in which severe chronic fatigue can manifest. Possible underlying mechanisms for these phenomena are discussed. This is a proposal made by a researcher, with no clinical experience, to doctors confronted with an entity that is still largely mysterious. The link between chronic inflammation, neuroinflammation and fatigue will be examined in a second part.
Highlights
Like acute inflammation after injury, is useful for our body. Both chronic fatigue and chronic inflammation are deleterious, and they are associated in many diseases
This review aims at looking for links between different signs and symptoms associated with chronic fatigue, as well as between different diseases in which severe chronic fatigue can manifest
Possible underlying mechanisms for these phenomena are discussed. This is a proposal made by a researcher, with no clinical experience, to doctors confronted with an entity that is still largely mysterious
Summary
La fatigue chronique est un syndrome associé à de nombreuses maladies comme le cancer, les maladies neurodégénératives, les syndromes post-infectieux ou les rhumatismes inflammatoires chroniques. On ne peut donc pas exclure que la fatigue intellectuelle soit, comme la fatigue musculaire, liée à une production localement insuffisante d’ATP, mais il est probable que la fatigue intellectuelle corresponde à des mécanismes plus complexes. Les principaux éléments considérés aujourd’hui comme caractéristiques du SFC sont 1) une fatigue chronique débilitante, source de souffrance mentale majeure pour le patient, durant au moins six mois ; 2) un malaise post-effort avec aggravation des autres symptômes après un effort ou un stress, et une récupération anormalement lente ; ce trait, appelé SEID, (systemic exercice intolerance disease) est parfois utilisé comme dénomination alternative au ME/CFS ; 3) un sommeil non réparateur ; 4) des troubles cognitifs (mémoire, capacité de concentration) ; et, parfois, 5) une intolérance orthostatique survenant lors d’une position verticale prolongée (pour des revues récentes sur le SFC, voir [3,4,5]). Le rôle absolument décisif des m/s n° 10, vol 37, octobre 2021
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