Normalization of leaky gut in chronic fatigue syndrome (CFS) is accompanied by a clinical improvement: effects of age, duration of illness and the translocation of LPS from gram-negative bacteria.
BACKGROUND
There is now evidence that an increased translocation of LPS from gram negative bacteria with subsequent gut-derived inflammation, i.e. induction of systemic inflammation and oxidative & nitrosative stress (IO&NS), is a new pathway in chronic fatigue syndrome (CFS).


METHODS
The present study examines the serum concentrations of IgA and IgM to LPS of gram-negative enterobacteria, i.e. Hafnia Alvei; Pseudomonas Aeruginosa, Morganella Morganii, Pseudomonas Putida, Citrobacter Koseri, and Klebsielle Pneumoniae in CFS patients both before and after intake of natural anti-inflammatory and anti-oxidative substances (NAIOSs), such as glutamine, N-acetyl cysteine and zinc, in conjunction with a leaky gut diet during 10-14 months. We measured the above immune variables as well as the Fibromyalgia and Chronic Fatigue Syndrome Rating Scale in 41 patients with CFS before and 10-14 months after intake of NAIOSs.


RESULTS
Subchronic intake of those NAIOSs significantly attenuates the initially increased IgA and IgM responses to LPS of gram negative bacteria. Up to 24 patients showed a significant clinical improvement or remission 10-14 months after intake of NAIOSs. A good clinical response is significantly predicted by attenuated IgA and IgM responses to LPS, the younger age of the patients, and a shorter duration of illness (< 5 years).


CONCLUSIONS
The results show that normalization of the IgA and IgM responses to translocated LPS may predict clinical outcome in CFS. The results support the view that a weakened tight junction barrier with subsequent gut-derived inflammation is a novel pathway in CFS and that it is a new target for drug development in CFS. Meanwhile, CFS patients with leaky gut can be treated with specific NAIOSs and a leaky gut diet.
Maes
Michael
M
MCare4U Outpatient Clinics, Belgium.
Leunis
Jean-Claude
JC
D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000907:Antibodies, Bacterial / Q000097:blood*; D000975:Antioxidants / Q000627:therapeutic use; D018988:Bacterial Translocation / Q000276:immunology; D004035:Diet Therapy; D004755:Enterobacteriaceae / Q000276:immunology* / Q000378:metabolism; D015673:Fatigue Syndrome, Chronic / Q000097:blood / Q000276:immunology* / Q000382:microbiology / Q000628:therapy; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D007422:Intestines / Q000276:immunology* / Q000382:microbiology; D008070:Lipopolysaccharides / Q000276:immunology / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress / Q000276:immunology; D013997:Time Factors; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D000907:Antibodies, Bacterial; D000975:Antioxidants; D007070:Immunoglobulin A; D007075:Immunoglobulin M; D008070:Lipopolysaccharides