Journal
PSYCHOSOMATIC MEDICINE
Volume 74, Issue 1, Pages 46-54Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/PSY.0b013e31824152ed
Keywords
fatigue; real-time PCR; Fatigue Impact Scale
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Funding
- National Multiple Sclerosis Society
- CFIDS Association
- National Institutes of Health from National Institute of Neurological Disorders and Stroke [R21 NS057821]
- National Institute of Arthritis and Musculoskeletal and Skin Diseases
- NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE [R21NS057821] Funding Source: NIH RePORTER
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Objective: Chronic fatigue syndrome (CFS) and multiple sclerosis (MS) are characterized by debilitating fatigue, yet evaluation of this symptom is subjective. We examined metabolite-detecting, adrenergic, and immune gene expression (messenger ribonucleic acid [mRNA]) in patients with CFS (n = 22) versus patients with MS (n = 20) versus healthy controls (n = 23) and determined their relationship to fatigue and pain before and after exercise. Methods: Blood samples and fatigue and pain ratings were obtained at baseline and 0.5, 8, 24, and 48 hours after sustained moderate exercise. Leukocyte mRNA of four metabolite-detecting receptors (acid-sensing ion channel 3, purinergic type 2X4 and 2X5 receptors, and transient receptor potential vanilloid type 1) and four adrenergic (alpha-2a, beta-1, and beta-2 receptors and catechol-O-methyltransferase) and five immune markers (CD14, toll-like receptor 4 [TLR4], interleukin [IL] 6, IL-10, and lymphotoxin alpha) was examined using quantitative polymerase chain reaction. Results: Patients with CFS had greater postexercise increases in fatigue and pain (10Y29 points above baseline, p < .001) and greater mRNA increases in purinergic type 2X4 receptor, transient receptor potential vanilloid type 1, CD14, and all adrenergic receptors than controls (mean T standard error = 1.3 +/- 0.14-to 3.4 +/- 0.90-fold increase above baseline, p = .04-.005). Patients with CFS with comorbid fibromyalgia (n = 18) also showed greater increases in acid-sensing ion channel 3 and purinergic type 2X5 receptors (p < .05). Patients with MS had greater postexercise increases than controls in beta-1 and beta-2 adrenergic receptor expressions (1.4 +/- 0.27- and 1.3 +/- 0.06-fold increases, respectively, p = .02 and p < .001) and greater decreases in TLR4 (p = .02). In MS, IL-10 and TLR4 decreases correlated with higher fatigue scores. Conclusions: Postexercise mRNA increases in metabolite-detecting receptors were unique to patients with CFS, whereas both patients with MS and patients with CFS showed abnormal increases in adrenergic receptors. Among patients with MS, greater fatigue was correlated with blunted immune marker expression.
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