Normalization of leaky gut in chronic fatigue syndrome (CFS) is accompanied by a clinical improvement: effects of age, duration of illness and the translocation of LPS from gram-negative bacteria

Neuro Endocrinol Lett. 2008 Dec;29(6):902-10.

Abstract

Background: There is now evidence that an increased translocation of LPS from gram negative bacteria with subsequent gut-derived inflammation, i.e. induction of systemic inflammation and oxidative & nitrosative stress (IO&NS), is a new pathway in chronic fatigue syndrome (CFS).

Methods: The present study examines the serum concentrations of IgA and IgM to LPS of gram-negative enterobacteria, i.e. Hafnia Alvei; Pseudomonas Aeruginosa, Morganella Morganii, Pseudomonas Putida, Citrobacter Koseri, and Klebsielle Pneumoniae in CFS patients both before and after intake of natural anti-inflammatory and anti-oxidative substances (NAIOSs), such as glutamine, N-acetyl cysteine and zinc, in conjunction with a leaky gut diet during 10-14 months. We measured the above immune variables as well as the Fibromyalgia and Chronic Fatigue Syndrome Rating Scale in 41 patients with CFS before and 10-14 months after intake of NAIOSs.

Results: Subchronic intake of those NAIOSs significantly attenuates the initially increased IgA and IgM responses to LPS of gram negative bacteria. Up to 24 patients showed a significant clinical improvement or remission 10-14 months after intake of NAIOSs. A good clinical response is significantly predicted by attenuated IgA and IgM responses to LPS, the younger age of the patients, and a shorter duration of illness (< 5 years).

Discussion: The results show that normalization of the IgA and IgM responses to translocated LPS may predict clinical outcome in CFS. The results support the view that a weakened tight junction barrier with subsequent gut-derived inflammation is a novel pathway in CFS and that it is a new target for drug development in CFS. Meanwhile, CFS patients with leaky gut can be treated with specific NAIOSs and a leaky gut diet.

MeSH terms

  • Adult
  • Age Factors
  • Analysis of Variance
  • Anti-Inflammatory Agents / therapeutic use
  • Antibodies, Bacterial / blood*
  • Antioxidants / therapeutic use
  • Bacterial Translocation / immunology
  • Diet Therapy
  • Enterobacteriaceae / immunology*
  • Enterobacteriaceae / metabolism
  • Fatigue Syndrome, Chronic / blood
  • Fatigue Syndrome, Chronic / immunology*
  • Fatigue Syndrome, Chronic / microbiology
  • Fatigue Syndrome, Chronic / therapy
  • Female
  • Humans
  • Immunoglobulin A / blood
  • Immunoglobulin M / blood
  • Intestines / immunology*
  • Intestines / microbiology
  • Lipopolysaccharides / immunology
  • Lipopolysaccharides / metabolism
  • Male
  • Middle Aged
  • Oxidative Stress / immunology
  • Time Factors
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents
  • Antibodies, Bacterial
  • Antioxidants
  • Immunoglobulin A
  • Immunoglobulin M
  • Lipopolysaccharides