title: Cytokine expression profiles of immune imbalance in post-mononucleosis chronic fatigue.
abstract: BACKGROUND
  As Chronic Fatigue Syndrome (CFS) has been known to follow Epstein-Bar virus (EBV) and other systemic infections; our objective was to describe differences in immune activation in post-infective CFS (PI-CFS) patients and recovered controls. We studied 301 adolescents prospectively over 24 months following the diagnosis of monospot-positive infectious mononucleosis (IM). We found an incidence of CFS at 6, 12 and 24 months of 13%, 7% and 4% respectively.
  
  
  METHODS
  Using chemiluminescent imaging we measured the concentrations of IL-1a, 1b, 2, 4, 5, 6, 8, 10, 12 (p70), 13, 15, 17 and 23, IFN-γ, TNF-α and TNF-β in duplicate plasma samples available in bio-bank from 9 PI-CFS subjects and 12 recovered controls at 24 months post-infection.
  
  
  RESULTS
  Standard comparative analysis indicated significant differences in IL-8 and 23 across subject groups. In constructing a linear classification model IL-6, 8 and 23 were selected by two different statistical approaches as discriminating features, with IL-1a, IL-2 and IFN-γ also selected in one model or the other. This supported an assignment accuracy of better than 80% at a confidence level of 0.95 into PI-CFS versus recovered controls.
  
  
  CONCLUSIONS
  These results suggest that co-expression patterns in as few as 5 cytokines associated with Th17 function may hold promise as a tool for the diagnosis of post-infectious CFS.
authors.affiliation: Division of Pulmonary Medicine, Department of Medicine, University of Alberta, WMC 2E4.41 WC Mackenzie Health Sciences Centre, 8440 112 Street, Edmonton, AB T6G 2R7, Canada. gordon.broderick@ualberta.ca
authors.forename: Gordon
authors.initials: G
authors.lastname: Broderick
authors.forename: Ben Z
authors.initials: BZ
authors.lastname: Katz
authors.forename: Henrique
authors.initials: H
authors.lastname: Fernandes
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Fletcher
authors.forename: Nancy
authors.initials: N
authors.lastname: Klimas
authors.forename: Frederick A
authors.initials: FA
authors.lastname: Smith
authors.forename: Maurice R G
authors.initials: MR
authors.lastname: O'Gorman
authors.forename: Suzanne D
authors.initials: SD
authors.lastname: Vernon
authors.forename: Renee
authors.initials: R
authors.lastname: Taylor
mesh_terms: D000293:Adolescent; D015331:Cohort Studies; D016207:Cytokines / Q000235:genetics*; D005221:Fatigue / Q000235:genetics / Q000276:immunology*; D020869:Gene Expression Profiling; D006801:Humans; D007244:Infectious Mononucleosis / Q000235:genetics / Q000276:immunology*
chemical_list: D016207:Cytokines