Journal of Chronic Fatigue Syndrome: Volume 12, Issue 2, 2004

Volume 12, Issue 2, 2004

 * Editorial by Kenny De Meirleir & Neil McGregor
 * Evidence for Brucella spp. and Mycoplasma spp. Co-Infections in Blood of Chronic Fatigue Syndrome Patients"'Abstract - We examined the blood of 94 North American Chronic Fatigue Syndrome (CFS) patients using forensic polymerase chain reaction and found that a subset (10.6%) of CFS patients show evidence of Brucella spp. infections compared to one of 70 control subjects (Odds Ratio = 8.2; 95% Confidence Limits (CL) 1–66; P < .01). Rural patients showed a higher incidence of Brucella spp. infections over urban patients (OR = 5.5, 95% CL 1.3–23.5, P < .02). Since CFS patients also have a high prevalence of one of four Mycoplasma species and sometimes show evidence of infections with Chlamydia pneumoniae, we examined Brucella-positive patients for other bacterial infections. Previously we found that 8% of the CFS patients showed evidence of C. pneumoniae and about 50% show evidence of Mycoplasma spp. infections. Since the presence of one or more chronic systemic infections may predispose patients to other infections, we examined the prevalence of C. pneumoniae and Mycoplasma spp. infections in Brucella-positive patients. We found only one Brucella-positive patient with C. pneumoniae and four other patients with evidence of Mycoplasma spp., suggesting that such bacterial infections occur independently in CFS patients. Control subjects (N = 70) had low rates of Brucella spp. (1.4%), Mycoplasma spp. (7.2%) or C. pneumoniae (1.4%) infections, and there were no co-infections in control subjects. The results indicate that a subset of CFS patients show evidence of infection with Brucella spp., and some of these patients also have other bacterial infections.'"
 * Association Between Fennell Phase Inventory Scores and Immune and RNase-L Parameters in Chronic Fatigue Syndrome"'Abstract - All patients suffering from a chronic condition, are challenged to manage the reality of their disease, the accompanying anxiety, the problems of daily living, and the effect on relationships. Therefore, when confronted with debilitating complaints, patients suffering from chronic fatigue syndrome (CFS) need to adapt to a new way of living during the course of their illness. Fennell developed an integrated model to manage CFS. This article is a follow-up of a study by Jason et al. (9, 10) to verify the existence of the different phases. Although not all differences are statistically significant, a clear distinction is made according to the conclusions drawn by Jason et al. (9, 10). Relationships between these distinctions and measures of symptoms, disability, psychological distress, coping, and immune parameters were revealed using non-parametric statistical tests.'"
 * Employment Status and Financial Repercussions in 60 Patients with Chronic Fatigue Syndrome in Spain: Utility of the Fatigue Impact Scale"'Abstract - Chronic fatigue syndrome (CFS) is a disabling disorder with implications in employment status. We enrolled 60 patients who fulfilled the CDC diagnostic criteria of Holmes and those of Fukuda. All patients underwent a protocol involving a structured questionnaire to record diagnostic criteria items, clinical features of fatigue, social features and associated symptoms; application of the Fatigue Impact Scale (FIS); an employment repercussion questionnaire; and information on evolution of the symptoms. Statistical comparisons were performed with the Mann-Whitney U test and correlations with the Spearman test. A close correlation was found between work inactivity and higher scores in the FIS cognitive dimension. Patient age and duration of symptoms also correlated with high cognitive scores. Chronic fatigue syndrome patients report a considerable decrease in quality of life, and most of them have work limitations, particularly those with poor overall FIS scores and cognitive function scores.'"
 * Risk Factors for the Development of Severe ME/CFS — A Pilot Study"'Abstract - The pilot phase is reported of a case-control study to determine risk factors for severe CFS/ME. One hundred fifty-seven members of the ME Association, selected at random, were sent postal questionnaires, with a 56% response. The Barthel index was used as a validated proxy measure to distinguish severe disease (cases) and those less severe. Thirteen of 88 respondents had severe disease, and 44 mild disease. Two matched controls from the ‘mild’ group were selected per case. Of possible risk factors, odds ratios greater than 2 were found for comorbidities, damaging initial treatment and occupational chemical exposure, although in this study they were not statistically significant. These data suggest that additional studies are warranted.'"
 * Immunological Changes After Both Exercise and Activity in Chronic Fatigue Syndrome: A Pilot Study"'Abstract - Background: The chronic fatigue syndrome (CFS) is characterized by post-exertional malaise and fatigue. We designed this pilot study to explore whether the illness was associated with alterations in immunological markers following exercise. Methods: We measured immunological markers before and up to three days after either a sub-maximal or maximal bicycle exercise test. We studied nine patients with CFS and nine age-and sex-matched healthy but sedentary controls. We also studied the same patients with CFS at home after a night's sleep and then after traveling to the study center. Results: There were no significant differences in any of the cell markers after a sub-maximal exercise test compared to a maximal test. However, we found elevated concentrations of plasma transforming growth factor beta (TGF-ß), even before exercise, in subjects with CFS (median (IQR) of 904 (182-1072) pg/ml) versus controls (median (IQR) of 50 (45-68) pg/ml) (P < .001). Traveling from home to the hospital significantly elevated TGF-ß concentrations from a resting median (IQR) concentration of 1161 (130-1246) pg/ml to a median (IQR) concentration of 1364 (1155-1768) pg/ml (P < .02). There was also a sustained increase in plasma tumor necrosis factor alpha (TNF-cc) after exercise in CFS patients, but not in controls (P = .004 for the area under the curve), although traveling had no such effect. CD3, CD4 and HLA DR-expressing lymphocyte counts were lower in CFS patients, but exercise had the same effect in both groups, causing an immediate increase in circulating cell numbers that lasted less than three hours. Conclusions: These results suggest that the relationship between physical activity and both pro-inflammatory and anti-inflammatory cytokines merits further investigation in patients with CFS. The results also emphasize the importance of defining a truly resting baseline condition in such studies.'"
 * Enterovirus Related Myopathy in a Subset of Chronic Fatigue Syndrome? - Critical Reviews and Comments on Current Research.
 * Book Review"'Abstract - HANDBOOK OF CHRONIC FATIGUE SYNDROME. LA Jason, PA Fennell and RR Taylor. John Wiley & Sons, Inc., Hoboken, New Jersey, 2003, 794 pp., ISBN 0-471-41512-X, Reviewed by Elke Van Hoof."