Clinical Features of Chronic Fatigue Syndrome Cases with Pathogens Infection: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

 XUCong ¹ , WANGTai-wu ¹ , MOMing-lu ¹ , DUANMing-xiang ¹ , FANGZhi-wei ² ,  XIONGHong-yan ^1,3

1. Department of Military Epidemiology, College of Military Preventive Medicine, Third Military Medical University, Chongqing 400038, China;
2. Students Seventeen Barrack, College of Military Preventive Medicine, Third Military Medical University, Chongqing 400038, China;
3. Clinical Research Center, Southwest Hospital, Third Military Medical University, Chongqing 400038, China;

Corresponding author：

XIONGHong-yan, Email: hongyanxiong@sohu.com

Keywords：

Chronic fatigue syndrome; Pathogens infection; Pathogenesis; Systematic review

DOI：

10.7507/1672-2531.20150201

Video：

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Objective To systematically review the clinical features of chronic fatigue syndrome (CFS) cases with pathogens infection. Methods We electronically searched databases including VIP, WanFang Data, CNKI, CBM, PubMed, MEDLINE, EMbase, The Cochrane Library, Web of Science, Elsevier and Google Scholar from 1994 to 2014 for CFS-related studies. Two reviewers independently screened literature and extracted data. Then we systematically reviewed and analyzed the information on demographic characteristics, clinical manifestations, types of infected pathogens, and results of some biochemical examinations. Results A total of 84 studies (case reports and case series) involving 2 565 CFS cases from 18 countries were included. The major infected pathogens of included CFS cases were mycoplasma, EB virus, intestinal virus, Bernat rickettsia, human-herpes virus, and Gram-negative intestinal bacteria. Fifty-seven studies reported that there might be associations between the pathogenic infection and CFS pathogenesis. Although there were different types of CFS-related pathogens, almost all the studies inferred that pathogens infection linked with immune dysfunction, which might cause CFS symptoms. Conclusion There may be associations between the pathogenic infection and CFS pathogenesis.

Citation： XUCong, WANGTai-wu, MOMing-lu, DUANMing-xiang, FANGZhi-wei, XIONGHong-yan. Clinical Features of Chronic Fatigue Syndrome Cases with Pathogens Infection: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2015, 15(10): 1214-1223. doi: 10.7507/1672-2531.20150201 Copy

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1. 施璐霞, 毛广平. 慢性疲劳综合征研究进展. 云南中医学院学报, 2006, 29(6):49-52.
2. 王斌, 洪永峰, 吴建贤, 等. 慢性疲劳综合征的临床特征与研究进展. 中国临床康复, 2005, 8(35):8078-8081.
3. Fukuda K, Stephen E, Hickie I, et al. The chronic fatigue syndrome:a comprehensive approach to its definition and study. Ann Intern Med, 1994, 121(12):953-959.
4. Jason LA, Richman JA, Rademaker AW, et al. A community-based study of chronic fatigue syndrome. Arch Intern Med, 1999, 159(18):2129-2137.
5. Steele L, Dobbins JG, Fukuda K, et al. The epidemiology of chronic fatigue in San Francisco. Am J Med, 1998, 105(3):83-90.
6. Jordan KM, Landis DA, Downey MC, et al. Chronic fatigue syndrome in children and adolescents:a review. J Adolesc Health, 1998, 22(1):4-18.
7. Komaroff AL, Buchwald DS. Chronic fatigue syndrome:an update. Annu Rev Med, 1998, 49(1):1-13.
8. Tate RL, Mcdonald S, Perdices M, et al. Rating the methodological quality of single-subject designs and n-of-1 trials:Introducing the Single-Case Experimental Design (SCED) Scale. Neuropsychol Rehabil, 2008, 18(4):385-401.
9. Maes M, Ringel K, Kubera M, et al. In myalgic encephalomyelitis/chronic fatigue syndrome, increased autoimmune activity against 5-HT is associated with immuno-inflammatory pathways and bacterial translocation. J Affect Disord, 2013, 150(2):223-230.
10. Frémont M, Coomans D, Massart S, et al. High-throughput 16S rRNA gene sequencing reveals alterations of intestinal microbiota in myalgic encephalomyelitis/chronic fatigue syndrome patients. Anaerobe, 2013, 22:50-56.
11. Strauss B, Löschau M, Seidel T, et al. Are fatigue symptoms and chronic fatigue syndrome following Q fever infection related to psychosocial variables? J Psychosom Res, 2012, 72(4):300-304.
12. Maes M, Twisk FNM, Kubera M, et al. Increased IgA responses to the LPS of commensal bacteria is associated with inflammation and activation of cell-mediated immunity in chronic fatigue syndrome. J Affect Disord, 2012, 136(3):909-917.
13. Chia J, Chia A, Voeller M, et al. Acute enterovirus infection followed by myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and viral persistence. J Clin Pathol, 2010, 63(2):165-168.
14. Lerner AM, Ariza ME, Williams M, et al. Antibody to Epstein-Barr virus deoxyuridine triphosphate nucleotidohydrolase and deoxyribonucleotide polymerase in a chronic fatigue syndrome subset. PloS One, 2012, 7(11):e47891.
15. Loebel M, Strohschein K, Giannini C, et al. Deficient EBV-Specific B-and T-Cell Response in Patients with Chronic Fatigue Syndrome. PloS One, 2014, 9(1):e85387.
16. Swanink CMA, Melchers WJG. Enteroviruses and the chronic fatigue syndrome. Clin Infect Dis, 1994, 19(5):860-864.
17. Lerner AM, Beqaj SH, Deeter RG, et al. IgM serum antibodies to Epstein-Barr virus are uniquely present in a subset of patients with the chronic fatigue syndrome. In Vivo, 2004, 18(2):101-106.
18. Zhang L, Goudh J, Christmas D, et al. Microbial infections in eight genomic subtypes of chronic fatigue syndrome/myalgic encephalomyelitis. J Clin Pathol, 2010, 63(2):156-164.
19. Hickie I, Davenport T, Wakefield D, et al. Post-infective and chronic fatigue syndromes precipitated by viral and non-viral pathogens:prospective cohort study. BMJ, 2006, 333(7568):575.
20. Watt T, Oberfoell S, Balise R, et al. Response to valganciclovir in chronic fatigue syndrome patients with human herpesvirus 6 and Epstein——Barr virus IgG antibody titers. J Med Virol, 2012, 84(12):1967-1974.
21. Vallings R. A case of chronic fatigue syndrome triggered by influenza H1N1 (swine influenza). J Clin Pathol, 2010, 63(2):184-185.
22. Chia JKS, Chia AY. Chronic fatigue syndrome is associated with chronic enterovirus infection of the stomach. J Clin Pathol, 2008, 61(1):43-48.
23. Douche-Aourik F, Berlier W, Féasson L, et al. Detection of enterovirus in human skeletal muscle from patients with chronic inflammatory muscle disease or fibromyalgia and healthy subjects. J Med Virol, 2003, 71(4):540-547.
24. Galbraith DN, Nairn C, Clements GB. Phylogenetic analysis of short enteroviral sequences from patients with chronic fatigue syndrome. J Gen Virol, 1995, 76(7):1701-1707.
25. Lane RJM, Soteriou BA, Zhang H, et al. Enterovirus related metabolic myopathy:a postviral fatigue syndrome. J Neurol Neurosurg Psychiatry, 2003, 74(10):1382-1386.
26. Dowsett EG, Ramsay AM, McCartney RA, et al. Myalgic encephalomyelitis——a persistent enteroviral infection? Postgrad Med J, 1990, 66(777):526-530.
27. McArdle A, McArdle F, MJ Jackson, et al. Investigation by polymerase chain reaction of enteroviral infection in patients with chronic fatigue syndrome. Clin Sci (Lond), 1996, 90(4):295-300.
28. Maes M, Leunis JC. Normalization of leaky gut in chronic fatigue syndrome (CFS) is accompanied by a clinical improvement:effects of age, duration of illness and the translocation of LPS from gram-negative bacteria. Neuro Endocrinol Lett, 2008, 29(6):902-910.
29. Swanink CMA, Stolk-Engelaar VMM. Yersinia enterocolitica and the chronic fatigue syndrome. J Infect, 1998, 36(3):269-272.
30. Sheedy JR, Wettenhall REH, Scanlon D, et al. Increased d-lactic acid intestinal bacteria in patients with chronic fatigue syndrome. In Vivo, 2009, 23(4):621-628.
31. Maes M, Mihaylova I, Leunis J. Increased serum IgA and IgM against LPS of enterobacteria in chronic fatigue syndrome (CFS):indication for the involvement of gram-negative enterobacteria in the etiology of CFS and for the presence of an increased gut——intestinal permeability. J Affect Disord, 2007, 99(1):237-240.
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Chinese Journal of Evidence-Based Medicine

Clinical Features of Chronic Fatigue Syndrome Cases with Pathogens Infection: A Systematic Review

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