Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Immunological Patient Stratification in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

Johanna Rohrhofer
ORCID logo ,
Lisa Hauser
,
Lisa Lettenmaier
,
Lena Lutz
,
Larissa Koidl
,
Salvatore Alessio Gentile
,
Davide Ret
ORCID logo ,
Michael Stingl
,
Eva Untersmayr
* ORCID logo
Version 1 : Received: 30 November 2023 / Approved: 30 November 2023 / Online: 30 November 2023 (16:56:26 CET)

A peer-reviewed article of this Preprint also exists.

Rohrhofer, J.; Hauser, L.; Lettenmaier, L.; Lutz, L.; Koidl, L.; Gentile, S.A.; Ret, D.; Stingl, M.; Untersmayr, E. Immunological Patient Stratification in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. J. Clin. Med. 2024, 13, 275. Rohrhofer, J.; Hauser, L.; Lettenmaier, L.; Lutz, L.; Koidl, L.; Gentile, S.A.; Ret, D.; Stingl, M.; Untersmayr, E. Immunological Patient Stratification in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. J. Clin. Med. 2024, 13, 275.

Abstract

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a complex disease characterized by profound fatigue, post-exertional malaise (PEM), and neurocognitive dysfunction. Immune dysregulation and gastrointestinal symptoms are commonly observed in ME/CFS patients. Despite affecting approximately 0.89% of the general population, the underlying pathophysiological mechanisms remain poorly understood. This study aimed to elucidate the relationship between immunological characteristics and intestinal barrier function in ME/CFS patients. ME/CFS patients were stratified into two groups based on their immune competence. After documentation of detailed medical records, serum and plasma samples were collected for assessment of inflammatory immune mediators and biomarkers for intestinal barrier integrity by ELISA. We found reduced complement protein C4a levels in immunodeficient ME/CFS patients suggesting a sub-group specific innate immune dysregulation. ME/CFS patients without immunodeficiencies exhibit a mucosal barrier leakage, as indicated by elevated levels of Lipopolysaccharide-binding protein (LBP). Stratifying ME/CFS patients based on immune competence enabled the distinction of two subgroups with different pathophysiological patterns. The study highlights the importance of emphasizing precise patient stratification in ME/CFS, particularly in the context of defining suitable treatment strategies. Given the substantial health and socioeconomic burden associated with ME/CFS, urgent attention and research efforts are needed to define causative treatment approaches.

Keywords

myalgic encephalomyelitis, chronic fatigue syndrome, immunology, immunodeficiencies, mucosal barrier function, patient stratification, post-viral fatigue, intestinal barrier leakage, debilitating disease

Subject

Medicine and Pharmacology, Immunology and Allergy

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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