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Association of peripheral inflammatory markers with chronic fatigue in a population-based sample.
Brain Behav Immun. 2009 Mar; 23(3):327-37.BB

Abstract

Alterations in the innate immune response may contribute to the pathogenesis of chronic fatigue syndrome (CFS). However, studies have been limited by small sample sizes, use of patients from tertiary care settings, inappropriate selection of controls, and failure to control for confounding demographic, medical and behavioral factors independently associated with immune activity. It is also not known whether specific symptoms account for observed associations between CFS and the innate immune response. To address these limitations, the current study examined plasma concentrations of high-sensitivity c-reactive protein (hs-CRP), white blood cell count (WBC) and a combined inflammation factor in a large population-based sample. Log-transformed mean plasma concentrations of hs-CRP were increased in subjects with CFS (n=102) and in subjects with unwellness symptoms that did not meet diagnostic criteria for CFS (defined as "insufficient fatigue" [ISF]) (n=240) when compared to subjects who were well (n=115). Log transformed WBC was increased in ISF and was increased at a trend level in CFS. The combined inflammation factor was increased in both CFS and ISF. Subjects with CFS and ISF did not differ on any of the inflammation measures. In the entire subject population, the physical component summary score (PCS), but not the mental component summary score (MCS), from the Medical Outcomes Study Short Form-36 (SF-36) was negatively associated with each of the inflammation measures. Depressive symptoms were also associated with increased log hs-CRP. After adjustment for age, sex, race, location of residence, BMI, depressive status and immune-modulating medications, subjects classified as ISF continued to demonstrate increased log hs-CRP, WBC and elevations on the inflammation factor when compared to well controls; however, associations between CFS and log hs-CRP and the inflammation factor were no longer statistically significant. After adjustment, PCS score also remained independently associated with each of the inflammation measures. These findings support a role for innate immune activation in unexplained fatigue and unwellness, but do not suggest that immune activation is specific to CFS.

Authors+Show Affiliations

Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 1365C Clifton Road, Room 5004, Atlanta, GA 30322, USA. craison@emory.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19111923

Citation

Raison, Charles L., et al. "Association of Peripheral Inflammatory Markers With Chronic Fatigue in a Population-based Sample." Brain, Behavior, and Immunity, vol. 23, no. 3, 2009, pp. 327-37.
Raison CL, Lin JM, Reeves WC. Association of peripheral inflammatory markers with chronic fatigue in a population-based sample. Brain Behav Immun. 2009;23(3):327-37.
Raison, C. L., Lin, J. M., & Reeves, W. C. (2009). Association of peripheral inflammatory markers with chronic fatigue in a population-based sample. Brain, Behavior, and Immunity, 23(3), 327-37. https://doi.org/10.1016/j.bbi.2008.11.005
Raison CL, Lin JM, Reeves WC. Association of Peripheral Inflammatory Markers With Chronic Fatigue in a Population-based Sample. Brain Behav Immun. 2009;23(3):327-37. PubMed PMID: 19111923.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association of peripheral inflammatory markers with chronic fatigue in a population-based sample. AU - Raison,Charles L, AU - Lin,Jin-Mann S, AU - Reeves,William C, Y1 - 2008/12/11/ PY - 2008/06/26/received PY - 2008/11/25/revised PY - 2008/11/26/accepted PY - 2008/12/30/entrez PY - 2008/12/30/pubmed PY - 2009/6/18/medline SP - 327 EP - 37 JF - Brain, behavior, and immunity JO - Brain Behav. Immun. VL - 23 IS - 3 N2 - Alterations in the innate immune response may contribute to the pathogenesis of chronic fatigue syndrome (CFS). However, studies have been limited by small sample sizes, use of patients from tertiary care settings, inappropriate selection of controls, and failure to control for confounding demographic, medical and behavioral factors independently associated with immune activity. It is also not known whether specific symptoms account for observed associations between CFS and the innate immune response. To address these limitations, the current study examined plasma concentrations of high-sensitivity c-reactive protein (hs-CRP), white blood cell count (WBC) and a combined inflammation factor in a large population-based sample. Log-transformed mean plasma concentrations of hs-CRP were increased in subjects with CFS (n=102) and in subjects with unwellness symptoms that did not meet diagnostic criteria for CFS (defined as "insufficient fatigue" [ISF]) (n=240) when compared to subjects who were well (n=115). Log transformed WBC was increased in ISF and was increased at a trend level in CFS. The combined inflammation factor was increased in both CFS and ISF. Subjects with CFS and ISF did not differ on any of the inflammation measures. In the entire subject population, the physical component summary score (PCS), but not the mental component summary score (MCS), from the Medical Outcomes Study Short Form-36 (SF-36) was negatively associated with each of the inflammation measures. Depressive symptoms were also associated with increased log hs-CRP. After adjustment for age, sex, race, location of residence, BMI, depressive status and immune-modulating medications, subjects classified as ISF continued to demonstrate increased log hs-CRP, WBC and elevations on the inflammation factor when compared to well controls; however, associations between CFS and log hs-CRP and the inflammation factor were no longer statistically significant. After adjustment, PCS score also remained independently associated with each of the inflammation measures. These findings support a role for innate immune activation in unexplained fatigue and unwellness, but do not suggest that immune activation is specific to CFS. SN - 1090-2139 UR - https://www.unboundmedicine.com/medline/citation/19111923/Association_of_peripheral_inflammatory_markers_with_chronic_fatigue_in_a_population_based_sample_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0889-1591(08)00426-1 DB - PRIME DP - Unbound Medicine ER -