Mood Symptoms and Chronic Fatigue Syndrome Due to Relapsing-Remitting Multiple Sclerosis Are Associated with Immune Activation and Aberrations in the Erythron. — CFSMEATLAS
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Mood Symptoms and Chronic Fatigue Syndrome Due to Relapsing-Remitting Multiple Sclerosis Are Associated with Immune Activation and Aberrations in the Erythron.
Almulla, Abbas F, Abdul Jaleel, Al-Karrar Kais, Abo Algon, Ali Abbas et al. · Brain sciences · 2023 · DOI
Quick Summary
This study looked at 63 people with multiple sclerosis (MS) and 30 healthy controls to understand why MS patients experience chronic fatigue, depression, and anxiety. Researchers found that about half of the MS patients had signs of immune system overactivation and problems with red blood cell levels. These immune and blood abnormalities were linked to their fatigue and mood symptoms.
Why It Matters
This research identifies immune activation and red blood cell abnormalities as potential biological mechanisms underlying fatigue and mood symptoms in MS, findings that may be relevant to ME/CFS patients who experience similar symptom profiles. Understanding these immune and hematological pathways could inform development of targeted treatments for chronic fatigue and mood disturbances in both conditions.
Observed Findings
46% of MS patients displayed activation of immune-inflammatory response and compensatory immune response systems with Th1 and Th17 cytokine profiles
Remitted RRMS patients showed significantly increased scores on chronic fatigue, depression, anxiety, autonomic dysfunction, and insomnia scales compared to controls
Lowered hematocrit and hemoglobin levels were associated with chronic fatigue and mood symptoms in remitted RRMS patients
M1 macrophage activation, Th1/Th17 cytokines, and growth factors partially explained the variance in fatigue and affective symptoms
About 50% of remitted RRMS patients exhibited symptom profiles resembling chronic fatigue despite being in clinical remission
Inferred Conclusions
Immune-inflammatory pathway activation persists during remitted phases of RRMS and is associated with clinically significant fatigue and mood symptoms
Erythron abnormalities (reduced hemoglobin and hematocrit) represent additional biological pathways contributing to fatigue in MS
Both immune activation and hematological markers represent potential therapeutic targets for managing chronic fatigue and mood disturbances in MS
Remaining Questions
Do immune activation and erythron abnormalities precede the development of fatigue symptoms, or do they result from them?
What This Study Does Not Prove
This study does not establish causation—immune activation and erythron abnormalities are correlated with fatigue and mood symptoms but may not cause them. The findings are from MS patients and may not directly apply to ME/CFS. The cross-sectional design cannot determine whether immune changes precede symptoms or result from them.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →