AHMF: 98 Conference: Roberts

Immunological and Haematological Parameters in Patients with CFS

Timothy K. Roberts, Neil R. McGregor, R. Hugh Dunstan, Mark Donohoe [1], Raymond N. Murdoch, D. Hope, S Zhang, Henry L. Butt [2], Jennifer A. Watkins, Warren G.Taylor

Collaborative Pain Research Unit:
Department of Biological Sciences
The University of Newcastle
Callaghan, NSW 2308, Australia.

Neurobiology Research Unit
Centre for Oral Health Research
University of Sydney
Westmead Hospital
Westmead, NSW 2084, Australia.

1 Environmental Medical Centre
Mosman
NSW 2088, Australia.
2 Division of Microbiology and Infectious Diseases
Hunter Area Pathology Service
John Hunter Hospital
Newcastle
NSW 2305, Australia.

Red and white cell profiles and pokeweed mitogen responses were investigated in 57 CDC-defined CFS patients and 34 age- and sex-matched control subjects. Multivariate analyses revealed that CFS patients had significantly different red and white blood cell profiles compared with control subjects. Haematological parameters and not immunological parameters were more important in differentiating CFS patients from healthy control subjects. The red cell distribution width (RDW) was the primary differentiating regression factor. RDW was positively associated with mean platelet volume (MPV) in control subjects, but negatively correlated with MPV in CFS patients, indicating a reversal of the functional relationship between these parameters in the CFS patients.

The study subjects were then divided into males and females to perform sex-based comparisons of controls and CFS patients. Female CFS patients had increases in RDW and MPV, and decreases in the numbers of T-helper cells, T-cells and lymphocytes compared with control females. These alterations were not observed in corresponding male comparisons.

Conflicting results have been reported in CFS patients for anaomalies in the lymphocyte mitogen response to phytohaemagglutinin, concanavalin A, pokeweed mitogen, staphylococcal enterotoxin B and soluble antigens. In this study, there were no differences in the pokeweed mitogen (PWM) responses between the CFS and the control groups. However, in control subjects, an association was observed between pokeweed mitogen responses and Rh(D) antigen status, whereas no similar association was measured in CFS patients. Rh(D)-negative control subjects had a increased mitogen response compared with Rh(D)-positive subjects, whereas in CFS patients, no difference was found.

These data suggest that CFS is manifested in a different manner in females compared with males and provides further evidence of heterogeneity amongst the CDC-defined CFS patients. It was concluded that future blood parameter and lymphocyte mitogen response studies in CFS patients should be controlled for sex and Rh status respectively.