Longitudinal associations of lymphocyte subsets with clinical outcomes in chronic fatigue syndrome

Fatigue. 2018;6(2):80-91. doi: 10.1080/21641846.2018.1426371. Epub 2018 Jan 12.

Abstract

Background: Chronic fatigue syndrome (CFS) is characterized by prolonged fatigue and other physical and neurocognitive symptoms. Some studies suggest that CFS is accompanied by disruptions in the number and function of various lymphocytes. However, it is not clear which lymphocytes might influence CFS symptoms.

Purpose: To determine if patient reported fatigue symptoms and physical functioning scores significantly changed across time with lymphocyte counts as evidence of a relation among chronic fatigue symptoms and the immune response.

Methods: The current longitudinal, naturalistic study assessed the cellular expression of three lymphocyte subtypes -- natural killer (NK) cells (CD3-CD16+ and CD3-CD56+) and naïve T cells (CD4+CD45RA+) -- to determine whether changes in lymphocytes at 4 time points across 18 months were associated with clinical outcomes, including CFS symptoms, physical functioning, and vitality, among patients with chronic fatigue.. Latent growth curve models were used to examine the longitudinal relationship between lymphocytes and clinical outcomes.

Results: Ninety-three patients with Fukuda-based CFS and seven with non-CFS fatigue provided study data. Results indicated that higher proportions of naïve T cells and lower proportions of NK cells were associated with worse physical functioning, whereas higher proportions of NK cells (CD3-CD16+) and lower proportions of naïve T cells were associated with fewer CFS symptoms.

Conclusion: These findings suggest that lymphocytes are modestly related to clinical outcomes over time.

Keywords: chronic fatigue syndrome; functional status; longitudinal; lymphocyte subsets.