α-1 Antitrypsin and Chronic Fatigue Syndrome: A Case Study from Pathophysiology to Clinical Practice

Abstract

SUMMARY Background: Several lines of evidence support the involvement of inflammatory and immunologic abnormalities in chronic fatigue syndrome (CFS). Since recent studies have shown that α-1 antitrypsin (AAT) possesses anti-inflammatory properties, the potential therapeutic effect of AAT treatment on CFS has been investigated. Case presentation: A 49-year-old woman diagnosed with CFS was treated with intravenous infusions of a human plasma-derived AAT concentrate (60 mg/kg body weight weekly for 8 consecutive weeks). The patient‘s monocyte elastase, a regulator of inflammatory processes, was 1170 U/mg. At completion of treatment, improvement in maximal workload was observed (54.0–71.7% of predicted). Additionally, amelioration in working memory (scores: 83–94) and perceptual organization (scores: 75–83) were detected on the Wechsler Adult Intelligence Scale-III test. Monocyte elastase decreased to a normal range (<150 U/mg). Improvement in functional capacity allowed the patient to work in part-time employment. Conclusion: These findings suggest a possible role for AAT in the treatment of CFS.

Acknowledgements

The authors thank J Bozzo at Grifols for providing writing assistance, careful review of the text and helpful comments for the production of the manuscript. Content Ed Net, Madrid is acknowledged for editorial assistance.

Financial & competing interests

S Camprubí is an employee of Grifols. J Alegre and A García-Quintana are the inventors of the use of α-1 antitrypsin for the preparation of effective drugs for the treatment of chronic fatigue syndrome (Patent assignee to Grifols; EU patent number 2289540B1 and US patent number 2010/0331261A1). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Writing assistance from J Bozzo at Grifols was utilized in the production of this manuscript.

Ethical disclaimer

The authors have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, informed consent has been obtained from the participant involved. The study was not approved by an institutional review board because according to the Spanish legislation it was not needed in case of compassionate use.