Chronic Fatigue Syndrome: Wessely SC

Kanaan RA, Lepine JP, Wessely SC. · King's College London, Department of Psychological Medicine, Institute of Psychiatry, London, UK. · Psychosom Med. · Pubmed #18040094 links to  free full text

Abstract: OBJECTIVE: To review the evidence for overlap in the phenomenology of the Functional Somatic Syndromes (FSS). The FSS show considerable comorbidity, leading some to suggest they may be aspects of the same disorder. METHODS: We conducted a selective review of peer-reviewed articles on the co-occurrence of FSS symptoms and diagnoses. RESULTS: Considerable evidence of overlap was found at the level of symptoms, diagnostic criteria, and clinical diagnoses made. CONCLUSIONS: Phenomenological commonalities support a close relationship between the FSS, although differences remain in other domains. Whether the FSS may best be considered the same or different will depend on the pragmatics of diagnosis.

Skowera A, Cleare A, Blair D, Bevis L, Wessely SC, Peakman M. · Department of Immunology, Guy's, King's & St Thomas's School of Medicine, King's College London, London, UK. · Clin Exp Immunol. · Pubmed #14738459 links to  free full text

Abstract: The aetiology of chronic fatigue syndrome (CFS) is not known. However, it has been suggested that CFS may be associated with underlying immune activation resulting in a Th2-type response. We measured intracellular production of interferon (IFN)-gamma and interleukin (IL)-2; type 1 cytokines), IL-4 (type 2) and IL-10 (regulatory) by both polyclonally stimulated and non-stimulated CD4 and CD8 lymphocytes from patients with CFS and control subjects by flow cytometry. After polyclonal activation we found evidence of a significant bias towards Th2- and Tc2-type immune responses in CFS compared to controls. In contrast, levels of IFN-gamma, IL-2 and IL-10-producing cells were similar in both study groups. Non-stimulated cultures revealed significantly higher levels of T cells producing IFN-gamma or IL-4 in CFS patients. Concluding, we show evidence for an effector memory cell bias towards type 2 responsiveness in patients with CFS, as well as ongoing type 0 immune activation in unstimulated cultures of peripheral blood cells.

Skowera A, Stewart E, Davis ET, Cleare AJ, Unwin C, Hull L, Ismail K, Hossain G, Wessely SC, Peakman M. · Department of Immunology, Guy's, King's & St Thomas' School of Medicine, King's College London, London, UK. · Clin Exp Immunol. · Pubmed #12165094 links to  free full text

Abstract: It is established that veterans of the 1991 Gulf War have an increased frequency of experiencing multiple symptoms. The underlying mechanism of these ailments is unclear, although they do not correspond to any clearly defined syndrome. The most common symptoms overlap with those of chronic fatigue syndrome (CFS). CFS was recently associated with a novel subtype of antinuclear autoantibody (ANA) that reacts with nuclear envelope (NE) antigens. NE autoantibodies are not known to be linked with any distinct clinical condition, but have been observed in patients with unusual mixed chronic autoimmune disorders and connective tissue diseases. In this study we examined whether NE ANAs are a feature of patients with CFS and symptomatic Gulf War veterans (sGWV). We studied the prevalence of ANA in 130 sGWV, 90 well Gulf War veterans (wGWV), 128 symptomatic Bosnia and Era veterans (sBEV), 100 CFS patients, and 111 healthy control subjects matching for age and sex. We found no significant difference in the prevalence of ANAs between any of the groups. None of the patients/or veterans we studied had ANA of the NE type. Our results show that multisymptom illness due to CFS or related to Gulf War service is not associated with antinuclear autoimmunity.