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Is chronic fatigue syndrome an autoimmune disease?
Chronic Fatigue Syndrome
There is significant evidence indicating that chronic fatigue syndrome is a biological illness, which may be caused, in part, by an overactive immune system, often triggered by an infection.
Chronic fatigue syndrome (CFS), also known as myalgic encephalomyelitis (ME), is a complex multisystem disease that is characterized by severe fatigue, cognitive dysfunction, chronic pain, flu-like symptoms, and autonomic dysfunction, which severely impairs a patient’s ability to perform daily living activities. 1
Multiple factors are believed to play a role in causing chronic fatigue syndrome, including genetics, bacterial and viral infections, and alterations in the immune system.
Is chronic fatigue syndrome an autoimmune disease?
Investigators have found evidence suggesting that to some degree, chronic fatigue syndrome is an autoimmune disease. They suspect that constant viral infections can induce autoimmunity through molecular mimicry, 2 resulting in CFS symptoms. This theory “proposes that viruses trigger the disease, cause immune abnormalities and leave a dysfunctional immune system and/or autoimmunity.” 2
How does this occur? An infection triggers the immune system to produce antibodies to fight the harmful pathogen (i.e. bacteria, viruses). But in some cases, the immune response goes awry and antibodies mistakenly attack health tissue in the brain. These autoantibodies can bind to or block specific receptors in the brain, disrupting how they function and causing neuroinflammation (brain inflammation). This autoimmune response can lead to the onset of symptoms associated with chronic fatigue syndrome.
Symptoms started after a viral-like illness
An estimated 50% to 70% of patients with CFS report that their symptoms started after they had a viral-like illness 2 or infection. 3 Studies suggest that it’s not limited to viral infections but bacterial infections, as well, can trigger an autoimmune response, resulting in chronic fatigue syndrome.
Furthermore, a significant number of patients with this syndrome have other immune or autoimmune disorders, such as fibromyalgia or Hashimoto’s disease. And, these individuals frequently have a family history of autoimmune disorders. 4
There is growing “scientific evidence which indicates that the body’s immune system is playing an important role in the causation of [chronic fatigue syndrome].” 5
Could chronic fatigue syndrome be due to an immune dysfunction?
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Are you struggling with chronic fatigue syndrome? It may be due to an autoimmune response.
Immune dysfunction linked with chronic fatigue syndrome
For years, researchers have examined whether chronic fatigue syndrome is an autoimmune disease and the role of the immune system. In 2019, investigators reported, “For the first time, we have shown that people who are prone to develop a CFS-like illness have an overactive immune system, both before and during a challenge to the immune system.” 5
These findings add to the “growing weight of scientific evidence which indicates that the body’s immune system is playing an important role in the causation of [chronic fatigue syndrome].” 5 Other researchers have come to similar conclusions. Russell et al. suggest that their study supports “the hypothesis that abnormal immune mechanisms are important in CFS.” 6
CFS symptoms linked to an underlying infection-triggered autoimmune process
In some individuals who have a genetic predisposition, chronic fatigue syndrome may be a variant of an autoimmune disorder, in which an infection(s) has triggered the production of autoantibodies. 7
These autoantibodies attack specific neuronal targets in the brain, disrupting how the cells function and causing brain inflammation. This can lead to symptoms of chronic fatigue syndrome.
Although there is no single laboratory test that can diagnose CFS and determine whether chronic fatigue syndrome is an autoimmune disorder, clinicians have utilized the Autoimmune Brain Panel™ to help identify whether CFS symptoms may be due to an underlying infection-triggered autoimmune process.
References
- Dihub Franziska Sotzny, Julià Blanco, Enrica Capelli, Jesús Castro-Marrero, Sophie Steiner, Modra Murovska, Carmen Scheibenbogen. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome – Evidence for an autoimmune disease, Autoimmunity Reviews. Volume 17, Issue 6, 2018, Pages 601-609. https://www.sciencedirect.com/science/article/pii/S1568997218300880?via%3
- Rasa, S. et al. Chronic viral infections in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Journal of Translational Medicine. volume 16, Article number: 268 (2018). https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-018-1644-y
- Blomberg J, Rizwan M, Böhlin-Wiener A, et al. Antibodies to Human Herpesviruses in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Patients. Front Immunol. 2019;10:1946. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6702656/
- Alice Russell, Nilay Hepgul, Naghmeh Nikkheslat, Alessandra Borsini, Zuzanna Zajkowska, Natalie Moll, Daniel Forton, Kosh Agarwal, Trudie Chalder, Valeria Mondelli, Matthew Hotopf, Anthony Cleare, Gabrielle Murphy, Graham Foster, Terry Wong, Gregor A. Schütze, Markus J. Schwarz, Neil Harrison, Patricia A. Zunszain, Carmine M. Pariante, Persistent fatigue induced by interferon-alpha: a novel, inflammation-based, proxy model of chronic fatigue syndrome. Psychoneuroendocrinology. Volume 100, 2019, Pages 276-285. https://www.sciencedirect.com/science/article/pii/S0306453018301963
- Nicola Davis. The Guardian. Chronic fatigue syndrome ‘could be triggered by overactive immune system.’ Dec. 17, 2018. https://www.theguardian.com/society/2018/dec/17/chronic-fatigue-syndrome-could-be-triggered-by-overactive-immune-system
- Russel A. et al. Persistent fatigue induced by interferon-alpha: a novel, inflammation-based, proxy model of chronic fatigue syndrome. Psychoneuroendocrinology. 2019 Feb;100:276-285. https://www.ncbi.nlm.nih.gov/pubmed/30567628
- Fluge Ø, Risa K, Lunde S, et al. B-Lymphocyte Depletion in Myalgic Encephalopathy/ Chronic Fatigue Syndrome. An Open-Label Phase II Study with Rituximab Maintenance Treatment. PLoS One. 2015;10(7):e0129898. https://www.ncbi.nlm.nih.gov/pubmed/26132314