Jose Montoya, MD, professor of medicine at Stanford University, Palo Alto, California, presented findings from the largest such study to date, involving 192 patients with ME/CFS diagnosed by published criteria and 392 healthy but sedentary control patients. He found significant elevations in serum of patients compared with serum of control patients for 17 specific cytokines, 13 of them pro-inflammatory, that correlated with symptom severity among the patients (P values for linear trend ranged from 0.0062 to 0.0366).
The findings, Dr Montoya said, "likely substantiate many of the symptoms experienced by patients and the immune nature of the disease." And, he added, they also suggest that immune-modulating agents might be useful to treat some of the condition's inflammation-related symptoms.
Dr Komaroff commented, "Many of us for 20 to 30 years have held the hypothesis that symptoms of this illness likely are caused by increased cytokine levels in the brain due to chronic immune activation.... This is a very excellent demonstration of it. If those cytokines are the explanation for the symptoms, you would expect there to be a correlation between how high the cytokine was and how severe the symptom was, and that's what they found."
Another study, presented by Kenny L. DeMeirleir, MD, PhD, medical director of the Nevada Center for Biomedical Research in Reno, Nevada, involved 70 male and 70 female patients with ME/CFS and the same numbers of matched sedentary control participants. His team uncovered significant differences for four specific immune/inflammatory markers in venous blood samples (prostaglandin E2, interleukin 8, soluble CD14 [a surrogate marker for bacterial lipopolysaccharide], and CD57+ lymphocytes; P < .001 for each).
As a panel, the four markers correctly classified 89.5% of the males and 97.1% of the females with ME/CFS, as defined by published criteria.