Chronic fatigue syndrome. With an emphasis on interleukin-I blockade

Contains fulltext : 191610.pdf (publisher's version ) (Open Access)Radboud University, 6 juli 2018Promotores : Meer, J.W.M. van der, Knoop, J.A.212 p

Cytokine Inhibition in Patients With Chronic Fatigue Syndrome

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Metabolome of chronic fatigue syndrome.

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Cytokine signatures in chronic fatigue syndrome patients: a Case Control Study and the effect of anakinra treatment

Contains fulltext : 182456.pdf (publisher's version ) (Open Access)BACKGROUND: Cytokine disturbances have been suggested to be associated with the Chronic Fatigue Syndrome/Myalgic encephalomyelitis (CFS/ME) for decades. METHODS: Fifty female CFS patients were included in a study on the effect of the interleukin-1-receptor antagonist anakinra or placebo during 4 weeks. EDTA plasma was collected from patients before and directly after treatment. At baseline, plasma samples were collected at the same time from 48 healthy, age-matched female neighborhood controls. A panel of 92 inflammatory markers was determined in parallel in 1 muL samples using a 'proximity extension assay' (PEA) based immunoassay. Since Transforming growth factor beta (TGF-beta) and interleukin-1 receptor antagonist (IL-1Ra) were not included in this platform, these cytokines were measured with ELISA. RESULTS: In CFS/ME patients, the 'normalized protein expression' value of IL-12p40 and CSF-1 was significantly higher (p value 0.0042 and 0.049, respectively). Furthermore, using LASSO regression, a combination of 47 markers yielded a prediction model with a corrected AUC of 0.73. After correction for multiple testing, anakinra had no effect on circulating cytokines. TGF-beta did not differ between patients and controls. CONCLUSIONS: In conclusion, this study demonstrated increased IL-12p40 and CSF-1 concentrations in CFS/ME patients in addition to a set of predictive biomarkers. There was no effect of anakinra on circulating cytokines other than IL-1Ra. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02108210 , Registered April 2014

Cytokine signature in chronic fatigue syndrome

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[Report of the Dutch National Health Council on chronic fatigue syndrome]

In our opinion, the recent report of the Dutch National Health Council on myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) lacks balance: it is very critical on the quality of evidence regarding behavioural interventions, but lacks a critical attitude regarding the presumed somatic components of the disorder. Without solid evidence, the report coins ME/CFS as a severe multisystem disease, and it embraces the diagnostic criteria of the American Institute of Medicine. We underscore the remarks in the report that physicians should not be reluctant to make diagnosis in patients with the disorder, and that these patients should be approached with empathy and respect. Regarding a future research programme, there is need for a well-designed research agenda

[Report of the Dutch National Health Council on chronic fatigue syndrome]

Item does not contain fulltextIn our opinion, the recent report of the Dutch National Health Council on myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) lacks balance: it is very critical on the quality of evidence regarding behavioural interventions, but lacks a critical attitude regarding the presumed somatic components of the disorder. Without solid evidence, the report coins ME/CFS as a severe multisystem disease, and it embraces the diagnostic criteria of the American Institute of Medicine. We underscore the remarks in the report that physicians should not be reluctant to make diagnosis in patients with the disorder, and that these patients should be approached with empathy and respect. Regarding a future research programme, there is need for a well-designed research agenda

Diabetes in patients with HIV: patient characteristics, management and screening

Item does not contain fulltextBACKGROUND: As HIV management has become more successful during the past years, non-communicable diseases have become more prevalent among HIV-infected individuals. As a result, more HIV-infected patients die of cardiovascular diseases, with diabetes being one of the main risk factors. This study evaluates screening and management of diabetes among HIV-infected patients in a university hospital in the Netherlands. METHODS: We examined clinical characteristics, glycaemic control and cardiovascular risk management of HIV-infected patients with coexisting diabetes, and determined the frequency of diabetes screening in those without. RESULTS: Of 518 HIV-infected patients, 28 had been diagnosed with diabetes (5.4%), mostly (20/28) after being diagnosed with HIV. Patients with coexisting diabetes were older, had a longer duration of HIV, lower CD4 cell counts and higher body mass index (BMI), and were more likely to use aspirin, statins and antihypertensive medication than those without diabetes (all p < 0.05). HbA1c values were below 7% (53 mmol/mol) in 54% of patients. Targets for systolic blood pressure (< 140 mmHg), LDL cholesterol (< 2.5 mmol/l) and BMI (< 25 kg/m2) were achieved by 82%, 50% and 29% of patients, respectively. Annual ophthalmology examination, screening for microalbuminuria and foot control were rarely performed. Among the patients without known diabetes, diabetes screening during the past year had been performed using (non-fasting) plasma glucose in 56% and HbA1c in 10%, but 42% of patients had not been screened. CONCLUSION: For HIV-infected individuals with diabetes, glycaemic control and cardiovascular risk management were reasonable, but screening for microvascular complications was rarely performed. Annual diabetes screening of HIV-infected patients was not routine

Pitfalls in cytokine measurements - Plasma TGF-beta 1 in chronic fatigue syndrome

Contains fulltext : 195865.pdf (publisher's version ) (Open Access)4 p