Fatigue in MS, link with cytokines

Discussion in 'Fibromyalgia Main Forum' started by tansy, Dec 21, 2005.

  1. tansy

    tansy New Member

    Fatigue in multiple sclerosis: an example of cytokine mediated sickness
    behaviour?

    Journal: J Neurol Neurosurg Psychiatry. 2006 Jan;77(1):34-9.

    Authors: Heesen C, Nawrath L, Reich C, Bauer N, Schulz KH, Gold SM.

    Affiliation: Department of Neurology, University Hospital Eppendorf,
    Martinistrasse 52, D-20246 Hamburg, Germany.

    NLM Citation: PMID: 16361589


    BACKGROUND: Fatigue is a major complaint of multiple sclerosis (MS)
    patients. However, little is known about its pathophysiological mechanisms.
    Evidence from chronic fatigue syndrome and studies on sickness behaviour
    suggest that immune and neuroendocrine factors may play a causative role in
    the development of fatigue.

    METHODS: We compared whole blood stimulatory capacity for pro- (TNFalpha,
    IFNgamma) and anti-inflammatory cytokines (IL-10) as well as
    hypothalamo-pituitary-adrenal (HPA) axis function in 15 MS patients with
    marked fatigue and 15 patients without fatigue as determined by the Fatigue
    Severity Scale (FSS).

    RESULTS: Proinflammatory cytokines were significantly higher (TNFalpha:
    478.9 v 228.2 pg/ml, p = 0.01; IFNgamma: 57.6 v 27.8 pg/ml; p = 0.01) in MS
    patients with fatigue. Furthermore, TNFalpha values significantly
    correlated with daytime sleepiness as measured by the Epworth Sleepiness
    Scale (r = 0.64, p = 0.001). Controlling for disease activity (as measured
    by the Cambridge Multiple Sclerosis Basic Score), disease duration,
    Expanded Disability Status Scale, and depression further increased the
    correlation of cytokine production and fatigue. HPA axis activity was not
    related to fatigue but was modestly correlated with cognitive impairment.

    CONCLUSION: Our data suggest that fatigue in MS is at least partially
    mediated through activation of proinflammatory cytokines. In line with
    earlier findings, HPA axis dysfunction seems not to be relevant in MS
    fatigue pathogenesis but appears to be linked to cognitive impairment. Our
    findings suggest that increased levels of inflammatory cytokines may be
    involved in MS fatigue. Investigation of cytokine profiles may increase the
    understanding of fatigue pathogenesis in MS.
    [This Message was Edited on 12/21/2005]
  2. tansy

    tansy New Member

    Hi Sharon

    I'm sure others will appreciate the link to this site as well.

    I was suspected of having MS, and over time became aware of the overlaps with ME/CFS, FM, and lyme disease. What I find interesting here is the fatigue is linked to cytokines, just as it has been in ME/CFS.

    It was through researching the overlaps in various chronic illnesses, and what was specific to each of them, that helped me make my own Tx choices.

    love, Tansy[This Message was Edited on 12/21/2005]