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Open Access Highly Accessed Research article

Humoral and cellular immune responses after influenza vaccination in patients with chronic fatigue syndrome

Hetty Prinsen1*, I Jolanda M de Vries12, Ruurd Torensma2, Jeanette M Pots2, Sasja F Mulder1, Carla M L van Herpen1, Lammy D Elving3, Gijs Bleijenberg4, Foekje F Stelma5 and Hanneke W M van Laarhoven16

Author Affiliations

1 Department of Medical Oncology, Radboud University Nijmegen Medical Centre, Geert Grooteplein Zuid 8, 6525, GA, Nijmegen, the Netherlands

2 Department of Tumor Immunology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands

3 Department of General Internal Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands

4 Expert Centre for Chronic Fatigue, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands

5 Department of Medical Microbiology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands

6 Department of Medical Oncology, Academic Medical Center University of Amsterdam, Amsterdam, the Netherlands

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BMC Immunology 2012, 13:71  doi:10.1186/1471-2172-13-71

Published: 17 December 2012

Abstract

Background

Chronic fatigue syndrome (CFS) is a clinical condition characterized by severe and disabling fatigue that is medically unexplained and lasts longer than 6 months. Although it is possible to effectively treat CFS, the nature of the underlying physiology remains unclear. Various studies have sought evidence for an underlying disturbance in immunity. The aim of this study was to compare the humoral and cellular immune responses upon influenza vaccination in CFS patients and healthy controls.

Results

Identical antibody titers were observed in CFS patients and healthy controls. Patients and controls demonstrated similar seroprotection rates against all three virus-strains of the influenza vaccine, both pre- and post-vaccination. Functional T cell reactivity was observed in both CFS patients and healthy controls. CFS patients showed a non-significant, numerically lower cellular proliferation at baseline compared to controls. Vaccination induced a significant increase in cellular proliferation in CFS patients, but not in healthy controls. Cytokine production and the number of regulatory T cells were comparable in patients and controls.

Conclusions

The humoral and cellular immune responses upon influenza vaccination were comparable in CFS patients and healthy controls. Putative aberrations in immune responses in CFS patients were not evident for immunity towards influenza. Standard seasonal influenza vaccination is thus justified and, when indicated, should be recommended for patients suffering from CFS.

Keywords:
Chronic fatigue syndrome; Influenza; Vaccination; Humoral immunity; Cellular immunity