Chronic fatigue syndrome: inflammation, immune function, and neuroendocrine interactions.
Investigations into the underlying cause of chronic fatigue syndrome have advanced the field considerably in the past year. Gene microarray data have led to a better understanding of pathogenesis. Recent research has evaluated genetic signatures, described biologic subgroups, and suggested potential targeted treatments. Acute viral infection studies found that initial infection severity was the single best predictor of persistent fatigue. Genomic studies showed that persistent cases express Epstein Barr virus-specific genes and demonstrate abnormalities of mitochondrial function. Studies of immune dysfunction extended observations of natural killer cytotoxic cell dysfunction of the cytotoxic T cell through quantitative evaluation of intracellular perforins and granzymes. Other research has focused on a subgroup of patients with reactivated viral infection. These advances should result in targeted therapies that impact immune function, hypothalamic-pituitary-adrenal axis regulation, and persistent viral reactivation.
Klimas
Nancy G
NG
University of Miami Miller School of Medicine, 1201 NW 16th Street, VA Medical Center, 200 BMRC, 6th Floor, Miami, FL 33125, USA. nancy.klimas@va.gov
Koneru
Anne O'Brien
AO
D015673:Fatigue Syndrome, Chronic / Q000209:etiology* / Q000503:physiopathology; D023281:Genomics; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000276:immunology* / Q000503:physiopathology; D007154:Immune System Diseases / Q000150:complications* / Q000503:physiopathology; D007109:Immunity; D007249:Inflammation; D010913:Pituitary-Adrenal System / Q000276:immunology* / Q000503:physiopathology; D014780:Viruses / Q000472:pathogenicity