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肌痛性脑脊髓炎/慢性疲劳综合征中的色氨酸代谢物、细胞因子和脂肪酸结合蛋白
发表日期:2021-11-30

Tryptophan Metabolites, Cytokines, and Fatty Acid Binding Protein 2 in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
肌痛性脑脊髓炎/慢性疲劳综合征中的色氨酸代谢物、细胞因子和脂肪酸结合蛋白 


Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) differ for triggers, mode of start, associated symptoms, evolution, and biochemical traits. Therefore, serious attempts are underway to partition them into subgroups useful for a personalized medicine approach to the disease. Here, we investigated clinical and biochemical traits in 40 ME/CFS patients and 40 sex- and age-matched healthy controls. Particularly, we analyzed serum levels of some cytokines, Fatty Acid Binding Protein 2 (FAPB-2), tryptophan, and some of its metabolites via serotonin and kynurenine. ME/CFS patients were heterogeneous for genetic background, trigger, start mode, symptoms, and evolution. ME/CFS patients had higher levels of IL-17A (p = 0.018), FABP-2 (p = 0.002), and 3-hydroxykynurenine (p = 0.037) and lower levels of kynurenine (p = 0.012) and serotonin (p = 0.045) than controls. Changes in kynurenine and 3-hydroxykynurenine were associated with increased kynurenic acid/kynurenine and 3-hydroxykynurenine/kynurenine ratios, indirect measures of kynurenine aminotransferases and kynurenine 3-monooxygenase enzymatic activities, respectively. No correlation was found among cytokines, FABP-2, and tryptophan metabolites, suggesting that inflammation, anomalies of the intestinal barrier, and changes of tryptophan metabolism may be independently associated with the pathogenesis of the disease. Interestingly, patients with the start of the disease after infection showed lower levels of kynurenine (p = 0.034) than those not starting after an infection. Changes in tryptophan metabolites and increased IL-17A levels in ME/CFS could both be compatible with anomalies in the sphere of energy metabolism. Overall, clinical traits together with serum biomarkers related to inflammation, intestine function, and tryptophan metabolism deserve to be further considered for the development of personalized medicine strategies for ME/CFS.

高效摇瓶5L
高效摇瓶5L

肌痛性脑脊髓炎/慢性疲劳综合征 (ME/CFS) 患者的触发因素、开始方式、相关症状、演变和生化特征各不相同。因此,正在认真尝试将它们划分为对疾病的个性化医学方法有用的亚组。在这里,我们调查了 40 ME/CFS 患者和 40 名性别和年龄匹配的健康对照的临床和生化特征。特别是,我们通过血清素和犬尿氨酸分析了一些细胞因子、脂肪酸结合蛋白 2 (FAPB-2)、色氨酸及其一些代谢物的血清水平。ME/CFS 患者在遗传背景、触发因素、开始模式、症状和进化方面具有异质性。ME/CFS 患者的 IL-17A ( p = 0.018)FABP-2 ( p= 0.002) 3-羟基犬尿氨酸 ( p = 0.037),犬尿氨酸 ( p = 0.012) 和血清素 ( p = 0.045) 水平低于对照组。犬尿氨酸和 3-羟基犬尿氨酸的变化分别与犬尿氨酸/犬尿氨酸和 3-羟基犬尿氨酸/犬尿氨酸比率的增加、犬尿氨酸氨基转移酶和犬尿氨酸 3-单加氧酶酶活性的间接测量相关。细胞因子、FABP-2和色氨酸代谢产物之间没有发现相关性,表明炎症、肠道屏障异常和色氨酸代谢变化可能与该疾病的发病机制独立相关。有趣的是,感染后发病的患者表现出较低水平的犬尿氨酸(p= 0.034)比感染后没有开始的那些。ME/CFS 中色氨酸代谢物的变化和 IL-17A 水平的增加都可能与能量代谢领域的异常相容。总体而言,临床特征以及与炎症、肠道功能和色氨酸代谢相关的血清生物标志物值得进一步考虑,以开发 ME/CFS 的个性化医疗策略。



We found substantial heterogeneity among patients with ME/CFS; however, in spite of many differences, patients shared traits of possible significance for the explanation of their symptoms. Our data suggest that clinical aspects and serum biomarkers related to inflammation, intestinal function, and tryptophan metabolism deserve to be further investigated, both for the identification of ME/CFS subtypes and as a way towards a personalized patient care approach. This implies, on one side, the use of larger patient samples and, on the other side, the use of all modern medical tools for the diagnosis and treatment of individual cases.

细胞转瓶2L
细胞转瓶2L


我们发现 ME/CFS 患者之间存在很大的异质性;然而,尽管存在许多差异,但患者的共同特征对于解释他们的症状可能具有重要意义。我们的数据表明,与炎症、肠道功能和色氨酸代谢相关的临床方面和血清生物标志物值得进一步研究,以识别 ME/CFS 亚型,并作为实现个性化患者护理方法的一种方式。这意味着,一方面,使用更大的患者样本,另一方面,使用所有现代医疗工具来诊断和治疗个别病例。


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关键词:ME/CFS heterogeneity,cytokines,intestinal permeability,tryptophan metabolism,kynurenine pathway,3-hydroxykynurenine,kynurenine,serotonin,biomarkers,personalized medicine,
                       ME/CFS 异质性,细胞因子,肠道通透性,色氨酸代谢,犬尿氨酸途径,3-羟基犬尿氨酸,犬尿氨酸,血清素,生物标志物,个性化医疗

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