Abstract

BackgroundDespite extensive research, no reliable biological marker for chronic fatigue syndrome (CFS) has yet been identified. However, hyperactivation of melanotrophs in the pituitary gland and increased levels of plasma alpha-melanocyte-stimulating hormone (α-MSH) have recently been detected in an animal model of chronic stress. Because CFS is considered to be caused partly by chronic stress events, increased α-MSH plasma levels may also occur in CFS patients. We therefore examined α-MSH levels in CFS patients.MethodsFifty-five CFS patients, who were previously diagnosed within 10 years of with the disease, were enrolled in this study. Thirty healthy volunteers were studied as controls. Fasting bloods samples were collected in the morning and evaluated for their plasma levels of α-MSH, adrenocorticotropic hormone (ACTH), serum cortisol and dehydroepiandrosterone sulfate (DHEA-S). Mean levels of α-MSH were compared between the CFS and control groups using Welch's t test.ResultsThe mean plasma α-MSH concentration in the CFS group (17.9 ± 1.0 pg/mL) was significantly higher than that in healthy controls (14.5 ± 1.0 pg/mL, p = 0.02). However, there was a wide range of values in the CFS group. The factors correlated with the plasma α-MSH values were analyzed using Spearman's rank correlation. A negative correlation was found between the duration of the CFS and the plasma α-MSH values (p = 0.04, rs = -0.28), but no correlations with ACTH, cortisol or DHEA-S levels were identified (p = 0.55, 0.26, 0.33, respectively). The CFS patients were divided into two groups: patients diagnosed for ≤ 5 years' duration, and those diagnosed for 5-10 years' duration. They were compared with the healthy controls using one-way ANOVA and Tukey-Kramer multiple comparison tests. The mean α-MSH concentration in the ≤ 5 years group was 20.8 ± 1.2 pg/mL, which was significantly higher than that in the healthy controls (p < 0.01). There was no significant difference between the 5-10 year group (15.6 ± 1.4 pg/mL) and the healthy controls.ConclusionsCFS patients with a disease duration of ≤ 5 years had significantly higher levels of α-MSH in their peripheral blood. α-MSH could be a potent biological marker for the diagnosis of CFS, at least during the first 5 years after onset of the disease.

Highlights

  • Despite extensive research, no reliable biological marker for chronic fatigue syndrome (CFS) has yet been identified

  • Significant increases in plasma alpha-melanocyte-stimulating hormone (a-MSH) levels were observed in this animal model, and the removal of the pituitary gland totally suppressed the increase induced by the stimulus

  • We hypothesized that a similar increase in plasma a-MSH levels reflecting the activation of melanotrophs under chronic stress might occur in humans, especially in patients suffering from persistent fatigue

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Summary

Introduction

No reliable biological marker for chronic fatigue syndrome (CFS) has yet been identified. Because CFS is considered to be caused partly by chronic stress events, increased a-MSH plasma levels may occur in CFS patients. These heterogeneity and lack of reliable biomarkers result in lack of clues for exploring CFS etiology and pathology To prevent this vicious circle, identifications of multiple objective biomarkers for CFS have long been sought. Significant increases in plasma a-MSH levels were observed in this animal model, and the removal of the pituitary gland totally suppressed the increase induced by the stimulus. These results suggested that hyper-activation of melanotrophs induced the over-secretion of a-MSH from the pituitary gland in response to continuous stress. We compared plasma a-MSH levels in CFS patients with healthy controls during the first 10 years of the disease

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