Immunologic status correlates with severity of physical symptoms and perceived illness burden in chronic fatigue syndrome patients

Stacy E. Cruess, Michael H Antoni, Nancy Klimas, Kevin Maher, Maryann Fletcher, Lynn Helder, Robert Keller

Research output: Contribution to journalArticle

7 Scopus citations


The purpose of the present study was to investigate the relationship between immunologic status and physical symptoms in Chronic Fatigue Syndrome (CFS) patients. Twenty-seven patients diagnosed with CFS were included. Participants completed a questionnaire including selected subscales of the Sickness Impact Profile, the Cognitive Difficulties Scale, and frequency and severity of CFS-related physical symptoms. Cellular immune markers measured included number and percent of T-helper/inducer cells (CD3+CD4+), T-cytotoxic/suppressor cells (CD3+CD8+), activated T-lymphocytes (CD26+CD2+CD3+), activated T cytotoxic/suppressor cells (CD38+HLA-DR+CD8+), and CD4/CD8 ratio. Spearman's correlation coefficients revealed significant associations between a number of immunologic measures and severity of illness suggesting that the degree of cellular immune activation was associated with the severity of CFS-related physical symptoms, cognitive complaints, and perceived impairment secondary to CFS. Specifically, elevations in T-helper/inducer cells, activated T-cells, activated cytotoxic/suppressor T-cells, and CD4/CD8 ratio were associated with greater severity of several symptoms. Furthermore, reductions in T-suppressor/cytotoxic cells also appeared related to greater severity of some CFS-related physical symptoms and illness burden. Multiple regression analyses demonstrated that decreased percentage of CD3+CD8+ cells and increased number of CD38+HLA-DR+CD8+ cells were the strongest predictors of total illness burden and fatigue severity, accounting for almost 30% of the variance in these measures.

Original languageEnglish
Pages (from-to)39-52
Number of pages14
JournalJournal of Chronic Fatigue Syndrome
Issue number1
StatePublished - Nov 15 2000



  • Chronic fatigue syndrome
  • Immune activation
  • Symptom severity

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology

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