Review Lorusso:


een verzwakt en overaktief afweersysteem

en (chronische) infekties

als pathofysiologische verklaring voor ME/CVS








Take-home messages

  • Patients with CFS appear to have a variety of abnormalities in their immune cells
  • that support the presence of an underlying immunological problem.

  • These immunological findings show
  • that patients with CFS may have an infection and

    that the immune system is chronically activated in response.

  • Several of the differentially expressed genes are related to immunological functions
  • and implicate immune dysfunction in the pathophysiology of disease.

    Once identified, these genes could serve as CFS biomarkers.

  • A clear understanding of the mechanism of CFS is needed to
  • develop treatments that will cure most cases of the disease.




Immunological aspects of chronic fatigue syndrome.

Autoimmun Rev. 2008 Sep 15. [Epub ahead of print]

Lorusso L, Mikhaylova SV, Capelli E, Ferrari D, Ngonga GK, Ricevuti G.


Chronic fatigue syndrome (CFS) is a specific clinical condition that characterises unexplained disabling fatigue and a combination of non-specific accompanying symptoms for at least 6 months, in the absence of a medical diagnosis that would otherwise explain the clinical presentation.


Other common symptoms include headaches, myalgia, arthralgia, and post-exertional malaise; cognitive difficulties, with impaired memory and concentration; unrefreshing sleep; and mood changes.


Similar disorders have been described for at least two centuries and have been differently named neurasthenia, post-viral fatigue, myalgic encephalomyelitis and chronic mononucleosis.


Recent longitudinal studies suggest that some people affected by chronic fatigue syndrome improve with time but that most remain functionally impaired for several years.


The estimated worldwide prevalence of CFS is 0.4-1% and it affects over 800,000 people in the United States and approximately 240,000 patients in the UK.


No physical examination signs are specific to CFS and

no diagnostic tests identify this syndrome.


The pathophysiological mechanism of CFS is unclear.


The main hypotheses include

  • altered central nervous system functioning
  • resulting from an abnormal immune response against a common antigen;

  • a neuroendocrine disturbance;
  • cognitive impairment caused by response to infection or other stimuli
  • in sentient people.


The current concept is that CFS pathogenesis is a multifactorial condition.


Various studies have sought evidence for a disturbance in immunity in people with CFS.

  • An alteration in cytokine profile,
  • a decreased function of natural killer (NK) cells,
  • a presence of autoantibodies and
  • a reduced responses of T cells to mitogens and other specific antigens

have been reported.


The observed high level of pro-inflammatory cytokines

may explain some of the manifestations such as fatigue and flu-like symptoms and

influence NK activity.


Abnormal activation of the T lymphocyte subsets and

a decrease in antibody-dependent cell-mediated cytotoxicity

have been described.


An increased number of

  • CD8+ cytotoxic T lymphocytes and
  • CD38 and
  • HLA-DR activation markers

have been reported, and

  • a decrease in CD11b expression associated with
  • an increased expression of CD28+ T subsets

has been observed.



This review discusses the immunological aspects of CFS and

offers an immunological hypothesis for the disease processes.




PMID: 18801465 [PubMed - as supplied by publisher]









Met dank aan Rob die me op deze studie attent maakte.