title: Enhanced glucocorticoid sensitivity in patients with chronic fatigue syndrome.
abstract: OBJECTIVE
  Alterations of the immune-neuroendocrine interplay have been described in chronic fatigue syndrome (CFS). Employing a recently developed method, the study set out to investigate whether patients with CFS have an altered sensitivity to glucocorticoids (GCs) when under stress.
  
  
  METHODS
  A total of 21 CFS patients and 20 healthy age- and gender-matched controls underwent a standardized psychosocial stress test (Trier Social Stress Test, TSST). Salivary and plasma cortisol levels were measured repeatedly following exposure to the stressor. GC sensitivity was assessed in vitro by dexamethasone inhibition of lipopolysaccharide-stimulated production of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNC-α).
  
  
  RESULTS
  Cortisol responses following the TSST did not differ significantly between CFS patients and healthy controls. GC sensitivity differed significantly between CFS patients and healthy controls, with CFS patients showing a greater sensitivity towards GCs (TNF-α: F 1/39 = 7.32, P = 0.01; IL-6: F 1/39 = 9.73, P = 0.004).
  
  
  CONCLUSIONS
  Consistent with recent evidence, CFS patients are characterized by an enhanced sensitivity to glucocorticoids. The implications for secondary processes, such as the regulatory influence of glucocorticoids on immune processes, are discussed.
authors.affiliation: 1Center for Psychobiological and Psychosomatic Research, University of Trier, Germany.
authors.forename: Jens
authors.initials: J
authors.lastname: Gaab
authors.affiliation: 1Center for Psychobiological and Psychosomatic Research, University of Trier, Germany.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Rohleder
authors.affiliation: 1Center for Psychobiological and Psychosomatic Research, University of Trier, Germany.
authors.forename: Vera
authors.initials: V
authors.lastname: Heitz
authors.affiliation: 1Center for Psychobiological and Psychosomatic Research, University of Trier, Germany.
authors.forename: Tanja
authors.initials: T
authors.lastname: Schad
authors.affiliation: 1Center for Psychobiological and Psychosomatic Research, University of Trier, Germany.
authors.forename: Veronika
authors.initials: V
authors.lastname: Engert
authors.affiliation: 1Center for Psychobiological and Psychosomatic Research, University of Trier, Germany.
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Schürmeyer
authors.affiliation: 1Center for Psychobiological and Psychosomatic Research, University of Trier, Germany.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Ehlert