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A chronic fatigue syndrome – related proteome in human cerebrospinal fluid

James N Baraniuk1*, Begona Casado12, Hilda Maibach1, Daniel J Clauw3, Lewis K Pannell45 and Sonja Hess S5

Author Affiliations

1 Georgetown University Proteomics Laboratory, Division of Rheumatology, Immunology & Allergy, Room B-105, Lower Level Kober-Cogan Building, Georgetown University, 3800 Reservoir Road, N.W., Washington DC 20007-2197, USA

2 Dipartimento di Biochimica A. Castellani, Universita di Pavia, Italy

3 Center for the Advancement of Clinical Research, The University of Michigan, Ann Arbor, MI, USA

4 Proteomics and Mass Spectrometry Facility, Cancer Research Institute, University of South Alabama, Mobile, AL, USA

5 Proteomics and Mass Spectrometry Facility, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland 20892-0508, USA

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BMC Neurology 2005, 5:22  doi:10.1186/1471-2377-5-22

Published: 1 December 2005



Chronic Fatigue Syndrome (CFS), Persian Gulf War Illness (PGI), and fibromyalgia are overlapping symptom complexes without objective markers or known pathophysiology. Neurological dysfunction is common. We assessed cerebrospinal fluid to find proteins that were differentially expressed in this CFS-spectrum of illnesses compared to control subjects.


Cerebrospinal fluid specimens from 10 CFS, 10 PGI, and 10 control subjects (50 μl/subject) were pooled into one sample per group (cohort 1). Cohort 2 of 12 control and 9 CFS subjects had their fluids (200 μl/subject) assessed individually. After trypsin digestion, peptides were analyzed by capillary chromatography, quadrupole-time-of-flight mass spectrometry, peptide sequencing, bioinformatic protein identification, and statistical analysis.


Pooled CFS and PGI samples shared 20 proteins that were not detectable in the pooled control sample (cohort 1 CFS-related proteome). Multilogistic regression analysis (GLM) of cohort 2 detected 10 proteins that were shared by CFS individuals and the cohort 1 CFS-related proteome, but were not detected in control samples. Detection of ≥1 of a select set of 5 CFS-related proteins predicted CFS status with 80% concordance (logistic model). The proteins were α-1-macroglobulin, amyloid precursor-like protein 1, keratin 16, orosomucoid 2 and pigment epithelium-derived factor. Overall, 62 of 115 proteins were newly described.


This pilot study detected an identical set of central nervous system, innate immune and amyloidogenic proteins in cerebrospinal fluids from two independent cohorts of subjects with overlapping CFS, PGI and fibromyalgia. Although syndrome names and definitions were different, the proteome and presumed pathological mechanism(s) may be shared.