+1a Inflamation

From: <a href="https://www.healthrising.org/blog/2015/11/27/fatigue-multiple-sclerosis-chronic-fatigue-syndrome-and-fibromyalgia-is-it-the-same/">The Fatigue in Multiple Sclerosis, Chronic Fatigue Syndrome (ME/CFS) and Fibromyalgia - Is it the Same? - Health Rising</a>

The cytokine situation in ME/CFS is, as always, complicated. A recent review found consistent evidence of one cytokine abnormality in ME/CFS (TGF-b). While natural killer cytotoxicity is consistently reduced in ME/CFS the cytokine results one might expect to result from that have not consistently shown up.

<div id="attachment_20158" class="wp-caption alignleft">The immune situation in ME/CFS and MS is complicated</div>

<a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4615236/?report=reader">A recent study</a> comparing healthy controls and moderately and severely ill ME/CFS patients demonstrates how complicated the cytokine issue is. Of the approximately 25 immune factors measured (IL-1ra, Il-1b, IL-2, IL-4, IL-5, IL-6, IL-6, IL-1, Il-8, IL-9, IL-10, IL-12p70, IL-13, IL-17, FGF, eotaxin, G-CSF, GM-CSF, IP-10, PDGF-BB, IFN-y, TNF-α and VEGF) only six were different between one or more of the groups

When they did differ they often didn’t differ in the direction one might have expected. One would expect that pro-inflammatory cytokines would be lowest in the healthy controls, higher in the moderate patients and highest in the severely ill patients. That pattern, however, rarely occurred.

In fact, the most common pattern to emerge (4/6) in the few cytokines that were different, was that the severely ill patients looked more like the healthy controls than the moderately ill patients.

<ul>

<li>A pro-inflammatory chemokine (RANTES) was significantly higher in the moderate ME/CFS patients than both the healthy controls and the severely ill patients.</li>

<li>An important regulatory pro-inflammatory cytokine IL-1b is strongly associated with fatigue in RA patients. In fact, the authors of a recent animal study proposed that <a href="http://www.ncbi.nlm.nih.gov/pubmed/25040499">IL-1B is a required factor in immunologically produced fatigue</a> in the brain. IL-1b, though, was not increased in the severely ill patients but was in the moderately ill patients. With regards to IL-1B, the severely ill ME/CFS patients looked more like the healthy controls than the moderate ill patients.</li>

<li>Il-6 was decreased in the moderate patients relative to both the healthy controls and the severely ill patients. Again – the severely ill patients looked more like the healthy controls than the moderately ill patients.</li>

<li>IFN-y was significantly increased in the severely ill patients relative to the moderately ill ME/CFS patient but again – not relative to the healthy controls (!).</li>

<li>Only with IL-7 and 8 did the pattern expected show up; these cytokines were highest in the most severely ill.</li>

</ul>

Since duration of illness was not correlated with illness severity, the findings – immune upregulation in the moderately ill and immune downregulation in the severely ill – did not necessarily track with those from the CFI immune study.

It should be noted that similar difficulties with cytokine studies have shown up in MS.

Conclusion – The immune system is complicated and capturing its effects in the blood has not been easy either in ME/CFS or MS.