Immunological abnormalities in the chronic fatigue syndrome (for editorial comment, see page 117)

The chronic fatigue syndrome is a disorder of unknown aetiology which is characterized by debilitating fatigue. Recent evidence has suggested that viruses may persist in the tissues of patients with chronic fatigue syndrome. A concurrent immunological disturbance is likely to be associated with the persistence of viral antigens. Therefore, the humoral and cellular immunity of 100 patients who were suffering from chronic fatigue syndrome and that of 100 healthy, age‐ and sex‐matched control subjects were compared. This study documents the frequent occurrence of abnormalities within the cellular and humoral immune systems of patients with well‐defined chronic fatigue syndrome. Disordered immunity may be central to the pathogenesis of chronic fatigue syndrome. In patients with chronic fatigue syndrome, a significant (P<0.01) reduction was found in the absolute number of peripheral blood lymphocytes in the total T‐cell (CD2), the helper/inducer T‐cell (CD4) and the suppressor/cytotoxic T‐cell (CD8) subsets. A significant (P<0.001) reduction also was found in T‐cell function, which was measured: in vivo by delayed‐type hypersensitivity skin‐testing (reduced responses were recorded in 50 [88%] of 57 patients); and in vitro by phytohaemagglutinin stimulation. Reduced immunoglobulin (Ig) levels were common (56% of patients), with the levels of serum lgG3‐ and IgG1‐subclasses particularly (P<0.05) affected.