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Enhanced glucocorticoid sensitivity in patients with chronic fatigue syndrome

Published online by Cambridge University Press:  24 June 2014

Jens Gaab ,
Nicolas Rohleder ,
Vera Heitz ,
Tanja Schad ,
Veronika Engert ,
Thomas H Schürmeyer  and
Ulrike Ehlert
Jens Gaab*
Affiliation:
Center for Psychobiological and Psychosomatic Research, University of Trier, Germany
Nicolas Rohleder
Affiliation:
Center for Psychobiological and Psychosomatic Research, University of Trier, Germany
Vera Heitz
Affiliation:
Center for Psychobiological and Psychosomatic Research, University of Trier, Germany
Tanja Schad
Affiliation:
Center for Psychobiological and Psychosomatic Research, University of Trier, Germany
Veronika Engert
Affiliation:
Center for Psychobiological and Psychosomatic Research, University of Trier, Germany
Thomas H Schürmeyer
Affiliation:
Center for Psychobiological and Psychosomatic Research, University of Trier, Germany
Ulrike Ehlert
Affiliation:
Center for Psychobiological and Psychosomatic Research, University of Trier, Germany
*
Dr phil. Jens Gaab, Institute for Psychology, Clinical Psychology II, University of Zürich, Zürichbergstr. 43, CH-8044 Zürich, Switzerland. Tel. + 41 16343096; Fax: + 41 16343696. E-mail: jgaab@klipsy.unizh.ch
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Abstract

Objective:

Alterations of the immune–neuroendocrine interplay have been described in chronic fatigue syndrome (CFS). Employing a recently developed method, the study set out to investigate whether patients with CFS have an altered sensitivity to glucocorticoids (GCs) when under stress.

Methods:

A total of 21 CFS patients and 20 healthy age- and gender-matched controls underwent a standardized psychosocial stress test (Trier Social Stress Test, TSST). Salivary and plasma cortisol levels were measured repeatedly following exposure to the stressor. GC sensitivity was assessed in vitro by dexamethasone inhibition of lipopolysaccharide-stimulated production of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNC-α).

Results:

Cortisol responses following the TSST did not differ significantly between CFS patients and healthy controls. GC sensitivity differed significantly between CFS patients and healthy controls, with CFS patients showing a greater sensitivity towards GCs (TNF-α: F1/39 = 7.32, P = 0.01; IL-6: F1/39 = 9.73, P = 0.004).

Conclusion:

Consistent with recent evidence, CFS patients are characterized by an enhanced sensitivity to glucocorticoids. The implications for secondary processes, such as the regulatory influence of glucocorticoids on immune processes, are discussed.

Keywords

ACTHchronic fatigue syndromecortisoldexamethasoneglucocorticoid sensitivityHPA axisinterleukin-6psychosocial stresstumor necrosis factor-alpha
Type
Research Article
Information
Acta Neuropsychiatrica , Volume 15 , Issue 4 , August 2003 , pp. 184 - 191
Copyright
Copyright © 2003 Blackwell Munksgaard

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