Environmental, Neuro-immune, and Neuro-oxidative Stress Interactions in Chronic Fatigue Syndrome
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Environmental, Neuro-immune, and Neuro-oxidative Stress Interactions in Chronic Fatigue Syndrome Geir Bjørklund 1 Michael Maes 6,7
&
Maryam Dadar 2 & Lyudmila Pivina 3,4 & Monica Daniela Doşa 5 & Yuliya Semenova 3,4 &
Received: 29 December 2019 / Accepted: 13 May 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Chronic fatigue syndrome/myalgic encephalomyelitis (CFS) is a complex, multisystem disease that is characterized by long-term fatigue, exhaustion, disabilities, pain, neurocognitive impairments, gastrointestinal symptoms, and post-exertional malaise, as well as lowered occupational, educational, and social functions. The clinical and biomarker diagnosis of this disorder is hampered by the lack of validated diagnostic criteria and laboratory tests with adequate figures of merit, although there are now many disease biomarkers indicating the pathophysiology of CFS. Here, we review multiple factors, such as immunological and environmental factors, which are associated with CFS and evaluate current concepts on the involvement of immune and environmental factors in the pathophysiology of CFS. The most frequently reported immune dysregulations in CFS are modifications in immunoglobulin contents, changes in B and T cell phenotypes and cytokine profiles, and decreased cytotoxicity of natural killer cells. Some of these immune aberrations display a moderate diagnostic performance to externally validate the clinical diagnosis of CFS, including the expression of activation markers and protein kinase R (PKR) activity. Associated with the immune aberrations are activated nitro-oxidative pathways, which may explain the key symptoms of CFS. This review shows that viral and bacterial infections, as well as nutritional deficiencies, may further aggravate the immune-oxidative pathophysiology of CFS. Targeted treatments with antioxidants and lipid replacement treatments may have some clinical efficacy in CFS. We conclude that complex interactions between immune and nitro-oxidative pathways, infectious agents, environmental factors, and nutritional deficiencies play a role in the pathophysiology of CFS. Keywords Chronic fatigue syndrome . Myalgic encephalomyelitis . Environmental factors . Neuro-immune . Inflammation . Infection . Ionizing radiation . Nutritional deficiencies
Introduction * Geir Bjørklund [email protected] * Monica Daniela Doşa [email protected] 1
Council for Nutritional and Environmental Medicine, Toften 24, 8610 Mo i Rana, Norway
2
Agricultural Research, Education and Extension Organization (AREEO), Razi Vaccine and Serum Research Institute, Karaj, Iran
3
Semey Medical University, Semey, Kazakhstan
4
CONEM Kazakhstan Environmental Health and Safety Research Group, Semey Medical University, Semey, Kazakhstan
5
Department of Pharmacology, Faculty of Medicine, Ovidius University of Constanta, Campus, 900470 Constanta, Romania
6
Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
7
Impact Research Center, Deakin Uni
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