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Letter to the Editor re: “A formal analysis of cytokine networks in Chronic Fatigue Syndrome” by Broderick et al.
Brain, Behavior, and Immunity 24 (2010) 1218
Contents lists available at ScienceDirect
Brain, Behavior, and Immunity journal homepage: www.elsevier.com/locate/ybrbi
Letter to the Editor Letter to the Editor re: ‘‘A formal analysis of cytokine networks in Chronic Fatigue Syndrome’’ by Broderick et al.
Dear Sir, I read with great interest the paper by Broderick G. et al. ‘‘A formal analysis of cytokine networks in Chronic Fatigue Syndrome” published in your journal, Brain Behavior and Immunity (2010). I certainly agree with the conclusions reached by the authors as to the importance of the cytokines IL-2, IFN-c and TNF-a in this syndrome and the indication of a probable viral infection in its aetiopathogenesis. However my perplexity lies in the method used, which as I understand was the measurement via ELISA of cytokine serum concentrations in morning blood samples, comparing them with healthy controls. In fact there are numerous reports of a circadian rhythm to cytokine secretion, and for TNF-a in particular an overlap in concentrations in healthy control subjects according to whether they had slept properly or been wakeful. Patients with Chronic Fatigue Syndrome, in my experience have often complained of either insomnia or of hypersomnia – this would make a single evaluation of cytokine concentrations misleading with respect to healthy control subjects. In other words recent reports,
including those on Rheumatoid Arthritis, also characterized by strong fatigue, are taking multiple measurements of cytokine concentrations throughout the 24 h at standard times in order to compensate for this anomaly. This being said, I very much appreciated the paper and its conclusions. 1. Broderick, G., Fuite, J., Kreitz, A., et al., 2010. Brain. Behav. Immun. 24, 1209–1217. 2. Carlo-Stella, N., Badulli, C., De Silvestri, A., et al., 2006. Clin. Exp. Rheumatol. 24, 179–182. 3. Lange, T., Dimitrov, S., Born, J., 2010. Ann. NY Acad. Sci. 1193, 48–59. 4. Cutolo, M., Straub, R.H., Buttgereit, F., 2008. Ann. Rheum. Dis. 67, 905–908.
Nicoletta Carlo-Stella Via Menocchio 10, Pavia, Italy Fax: +39 0382 304129. E-mail address: [email protected] Available online 16 June 2010
0889-1591/$ - see front matter Ó 2010 Elsevier Inc. All rights reserved. doi:10.1016/j.bbi.2010.06.004
Contents lists available at ScienceDirect
Brain, Behavior, and Immunity journal homepage: www.elsevier.com/locate/ybrbi
Letter to the Editor Letter to the Editor re: ‘‘A formal analysis of cytokine networks in Chronic Fatigue Syndrome’’ by Broderick et al.
Dear Sir, I read with great interest the paper by Broderick G. et al. ‘‘A formal analysis of cytokine networks in Chronic Fatigue Syndrome” published in your journal, Brain Behavior and Immunity (2010). I certainly agree with the conclusions reached by the authors as to the importance of the cytokines IL-2, IFN-c and TNF-a in this syndrome and the indication of a probable viral infection in its aetiopathogenesis. However my perplexity lies in the method used, which as I understand was the measurement via ELISA of cytokine serum concentrations in morning blood samples, comparing them with healthy controls. In fact there are numerous reports of a circadian rhythm to cytokine secretion, and for TNF-a in particular an overlap in concentrations in healthy control subjects according to whether they had slept properly or been wakeful. Patients with Chronic Fatigue Syndrome, in my experience have often complained of either insomnia or of hypersomnia – this would make a single evaluation of cytokine concentrations misleading with respect to healthy control subjects. In other words recent reports,
including those on Rheumatoid Arthritis, also characterized by strong fatigue, are taking multiple measurements of cytokine concentrations throughout the 24 h at standard times in order to compensate for this anomaly. This being said, I very much appreciated the paper and its conclusions. 1. Broderick, G., Fuite, J., Kreitz, A., et al., 2010. Brain. Behav. Immun. 24, 1209–1217. 2. Carlo-Stella, N., Badulli, C., De Silvestri, A., et al., 2006. Clin. Exp. Rheumatol. 24, 179–182. 3. Lange, T., Dimitrov, S., Born, J., 2010. Ann. NY Acad. Sci. 1193, 48–59. 4. Cutolo, M., Straub, R.H., Buttgereit, F., 2008. Ann. Rheum. Dis. 67, 905–908.
Nicoletta Carlo-Stella Via Menocchio 10, Pavia, Italy Fax: +39 0382 304129. E-mail address: [email protected] Available online 16 June 2010
0889-1591/$ - see front matter Ó 2010 Elsevier Inc. All rights reserved. doi:10.1016/j.bbi.2010.06.004