Panel Concurs: Immune System
Involved in CFIDS
Research on the immune system could
light on the cause of chronic fatigue and immune dysfunction syndrome (CFIDS) —
including whether a pathogenic agent such as a virus or bacteria is involved.
This was one conclusion reached by a panel of experts that convened last fall
for the third in a series of scientific symposia on CFIDS.
The symposium was sponsored by The
Association of America, the U.S. Centers for Disease Control and Prevention and
the National Institutes of Health Office of Research on Women’s
A number of studies have suggested
immune system may play a role in CFIDS, which is also known as chronic fatigue
syndrome (CFS). New findings include the discovery of autoantibodies in CFS
patients, which has led to increased speculation that the illness may be an
autoimmune disorder. Because many cases of CFS begin with a flu or mono-like
illness, viruses, bacteria and toxins have also been studied as possible
“The immune system may provide important
clues to CFS, but it cannot be studied in isolation,” said Association President
& CEO Kim Kenney. “A new emphasis on multidisciplinary research to explore
links between the immune, neuroendocrine and cardiovascular systems in CFS is
crucial to developing a better understanding of this complex illness.”
Following a day of presentations by
from around the world, an independent panel composed of researchers and
practitioners in many fields — including biostatistics, endocrinology,
immunology, infectious disease, internal medicine, microbiology, psychiatry and
rheumatology, developed a statement on the key issues surrounding the role of
the immune system in CFS.
The panel agreed that:
- The immune system is involved in
CFS. Substantial published evidence shows that many CFS patients have
immunological abnormalities, including increased natural killer cell activity,
increased number of activated T cells, decreased lymphocyte stimulation and
increased production of some pro-inflammatory cytokines, which act as chemical
messengers between cells. The panel noted that the ability to understand the
exact role these changes play in the development of CFS is constrained by
major limitations in the studies conducted to date.
- Infections may also play a
role. The panel concluded that direct and indirect evidence points to
the involvement of active viral or bacterial infections in the development of
some cases of CFS, although no single agent has been found in all
- CFS is a multisystem
disorder. In addition to the immune system, the endocrine and
autonomic nervous systems may be implicated in CFS. The panel acknowledged
that little is known about the influence of any of these systems in
individuals with the illness.
- More research is needed to
define the immunological aspects of CFS. The panel outlined future
research needs, including multiple site, longitudinal studies to: explore the
possible association of infectious agents with the immunological profile seen
in CFS; link immunological findings to symptoms and functional disability; and
explore the use of anti-inflammatory cytokines, antivirals, antibiotics and
immunomodulatory agents in the treatment of CFS.
The CFS assessment symposia series
designed to examine the role of the neurological, endocrine, circulatory and
immune systems in CFS. The symposia gather experts to evaluate research
findings, identify promising next steps for research, define research and
funding priorities and create collaborative research teams.