Chronic fatigue syndrome: biochemical examination of blood

Abstract:

Though patients with chronic fatigue syndrome (CFS) have lots of complaints, abnormal findings cannot be detected by biochemical screening tests. However, some specialized blood tests have revealed neuroendocrine immune axis abnormalities, which is closely associated with each other. Recent studies indicate that CFS can be understood as a special condition based on abnormality of the psycho-neuro-endocrino-immunological system, with the distinguishing feature of CFS seeming to be the secondary brain dysfunction caused by several cytokines and/or autoantibodies. In this paper, we summarize these abnormalities found in CFS and show the neuro-molecular mechanism leading to chronic fatigue.

 

Source: Hakariya Y, Kuratsune H. Chronic fatigue syndrome: biochemical examination of blood. Nihon Rinsho. 2007 Jun;65(6):1071-6. [Article in Japanese] https://www.ncbi.nlm.nih.gov/pubmed/17561699

 

Antinuclear antibodies in patients with chronic fatigue syndrome

Abstract:

Significance of antinuclear antibodies (ANA) in the patients with chronic fatigue syndrome (CFS) was reviewed. When indirect immunofluorescence with the HEp-2 cells as the substrates was used, prevalence of the positive ANA was reportedly 15-25%. The ANA titers were low and the immunofluorescent staining patterns were heterogeneous.

One group in the USA reported that ‘nuclear envelope staining pattern’ was found in more than 50% of the patients with CFS. This results, however, have not been confirmed by any other research groups. Clinical significance of the positive ANA in the CFS patients resides in differential diagnoses of systemic lupus erythematosus and other diffuse connective tissue diseases. Recently, several ANAs specific to CFS have been described.

We reported anti-68/48kD protein antibodies utilizing SDS-PAGE/ immunoblot method. These autoantibodies were found in 13% of 114 CFS patients and 0% in healthy subjects (p < 0.05). Hypersomnia and difficulty in concentration were found more frequently in the CFS patients with this specific autoantibody.

 

Source: Nishikai M. Antinuclear antibodies in patients with chronic fatigue syndrome. Nihon Rinsho. 2007 Jun;65(6):1067-70. [Article in Japanese] https://www.ncbi.nlm.nih.gov/pubmed/17561698

 

Spectroscopic diagnosis of chronic fatigue syndrome by multivariate analysis of visible and near-infrared spectra

Abstract:

We have recently evaluated the possibility of visible and near-infrared (Vis-NIR) spectroscopy for diagnosis of chronic fatigue syndrome(CFS). Vis-NIR spectra in the 600-1,100 nm region for sera from CFS patients and healthy donors were subjected to principal component analysis (PCA) and soft independent modeling of class analogy (SIMCA) to develop multivariate models to discriminate between CFS patients and healthy donors. The PCA and SIMCA model predicted successful prediction of the masked samples. Furthermore, taking advantage of Vis-NIR spectroscopy to enable noninvasive analysis, our preliminary results have shown that SIMCA model from Vis-NIR spectra of thumb has achieved 70-80% correct determinations. In this review, we will introduce the potential of the Vis-NIR spectroscopy for CFS diagnosis.

 

Source: Sakudo A, Kuratsune H, Hakariya Y, Kobayashi T, Ikuta K. Spectroscopic diagnosis of chronic fatigue syndrome by multivariate analysis of visible and near-infrared spectra. Nihon Rinsho. 2007 Jun;65(6):1051-6. [Article in Japanese] https://www.ncbi.nlm.nih.gov/pubmed/17561696

 

Chronic fatigue syndrome and herpesvirus reactivation

Abstract:

Human herpesvirus 6(HHV-6) and human herpesvirus 7(HHV-7) establish life-long latency, reactivate frequently, and are shed in saliva. To identify the factor(s) of their reactivation, we have studied the association with the reactivation and fatigue. Reactivation was examined for viral DNA by real-time PCR method. As a result, healthy adults shed the reactivated HHV-6 in the saliva during work -induced fatigue, and the copy number of HHV-6 DNA was reduced after holidays. However, no significant HHV-6 DNA increase was observed in chronic fatigue syndrome (CFS) patients. In contrast, increase of HHV-7 reactivation was observed both in the case of work-induced fatigue and CFS. These findings suggest that the amount of HHV-6 and HHV-7 reactivation can be an objective biomarker for fatigue.

 

Source: Kondo K. Chronic fatigue syndrome and herpesvirus reactivation. Nihon Rinsho. 2007 Jun;65(6):1043-8. [Article in Japanese] https://www.ncbi.nlm.nih.gov/pubmed/17561695

 

Identification and application of marker genes for differential diagnosis of chronic fatigue syndrome

Abstract:

Chronic fatigue syndrome (CFS) is a complex disease and has no laboratory biomarkers, which makes diagnosis of CFS difficult. Several research groups challenged to identify genes specific for CFS; however, there are no overlaps between studies. The U.S. Centers for Disease Control and Prevention reported remarkable gene expression profiles of a large scale cohort study recruited 227 people. Reported genes were mostly different from the previously reported genes, again featuring the complexity of CFS. Separately, we identified 9 genes that were significantly and differentially expressed between CFS patients and healthy subjects using an original microarray. The changes in expression of 9 genes were confirmed by quantitative PCR. We also demonstrated the usefulness of 9 genes for differential diagnosis of CFS.

 

Source: Kawai T, Rokutan K. Identification and application of marker genes for differential diagnosis of chronic fatigue syndrome. Nihon Rinsho. 2007 Jun;65(6):1029-33. [Article in Japanese] https://www.ncbi.nlm.nih.gov/pubmed/17561693

 

Psychological symptoms in chronic fatigue syndrome

Abstract:

Patients with chronic fatigue syndrome (CFS) frequently complain of psychological symptoms including depression, anxiety, and neuropsychological impairment. In addition, patients with CFS have been reported to be more likely to have psychiatric diseases such as major depressive disorder, panic disorder, generalized anxiety disorder, and personality disorder.

In the present review article, psychological symptoms and psychiatric comorbidity in CFS patients were introduced. In addition, differentiation between CFS and psychiatric disorders were discussed, because there have been few studies on comorbidity and differentiation between CFS and undifferentiated somatoform disorder although there has been heated debate about the existence of CFS itself.

 

Source: Yoshiuchi K. Psychological symptoms in chronic fatigue syndrome. Nihon Rinsho. 2007 Jun;65(6):1023-7. [Article in Japanese] https://www.ncbi.nlm.nih.gov/pubmed/17561692

 

Sleep disturbance in chronic fatigue syndrome

Abstract:

Attempts to elucidate the complex pathophysiology of chronic fatigue syndrome (CFS) must consider subjective and objective sleep. Several reports of CFS showed the high rate of sleep disturbance such as insomnia, hypersomnia, circadian rhythm sleep disorder, sleep apnea/hypopnea syndrome and so on. To analyze pulse wave continuously in sleep of CFS patients by laser blood flowmeter, we set base line component (0.01-0.08 Hz) and pulse wave component(0.70-1.50 Hz). Results of FFT analysis indicate that the CFS can have at least three subtypes of pulse dynamics in sleep. There probably are different types of illnesses now contained within the CFS construct, in which identifying subtypes of sleep disturbance can be one important key.

 

Source: Kumano-go T, Adachi H, Sugita Y. Sleep disturbance in chronic fatigue syndrome. Nihon Rinsho. 2007 Jun;65(6):1017-22. [Article in Japanese] https://www.ncbi.nlm.nih.gov/pubmed/17561691

 

Clinical features of chronic fatigue syndrome–symptoms

Abstract:

Chronic fatigue syndrome (CFS) is a clinically defined condition characterized by long-lasting disabling fatigue, resulting in severe impairment in daily functioning and associated symptoms such as memory and concentration difficulties, muscle aches, sleep disturbances, and headache. Common symptoms encountered in CFS patients were reviewed and top 10 common symptoms were described in detail with special reference to the particular features of each symptom helpful to diagnose CFS.

 

Source: Ban N, Saiki T, Ko G, Kuwahata A. Clinical features of chronic fatigue syndrome—symptoms. Nihon Rinsho. 2007 Jun;65(6):1011-5. [Article in Japanese] https://www.ncbi.nlm.nih.gov/pubmed/17561690

 

Chronic fatigue syndrome and neurotransmitters

Abstract:

Chronic fatigue syndrome (CFS) is an idiopathic illness characterized by persistent fatigue, which could be caused by a variety of etiologic factors including viral infection, abnormal production of cytokines and abnormal acylcarnitine metabolism. Recent studies suggest that CFS is closely associated with attenuation of central synaptic transmission mediated by neurotransmitters such as serotonin and glutamate. Attenuation of serotonin neurotransmission can be caused by increased expression of serotonin transporter, which results either from viral infection and subsequent production of interferon–alpha or from abnormal promoter for serotonin transporter gene. Other neurotransmitter systems may be also involved in CFS mediated by abnormal acylcarnitine metabolism and autoantibodies for neurotransmitter receptors. In this review, we focus recent data on CFS in terms of neurotransmitters.

 

Source: Miwa S, Takikawa O. Chronic fatigue syndrome and neurotransmitters. Nihon Rinsho. 2007 Jun;65(6):1005-10. [Article in Japanese] https://www.ncbi.nlm.nih.gov/pubmed/17561689

 

Genetic background of chronic fatigue syndrome

Abstract:

Although previous twin and family studies have suggested the involvement of genetic factor(s) in the pathogenesis of chronic fatigue syndrome (CFS), responsible gene for CFS was not known. We have recently reported the association of serotonin transporter gene polymorphism in CFS. A significant increase of longer (L and XL) alleic variants was found in the CFS patients compared to the controls. Compared to S allele, the L allele is believed to retain higher transcriptional activity, which causes decreased concentration of serotonin in the extracellular space, namely, active serotonin in CFS. These results thus support the serotonin hypothesis in the pathogenesis of CFS.

 

Source: Narita M, Narita N. Genetic background of chronic fatigue syndrome. Nihon Rinsho. 2007 Jun;65(6):997-1002. [Article in Japanese] https://www.ncbi.nlm.nih.gov/pubmed/17561688