16
Views
20
CrossRef citations to date
0
Altmetric
Original Article

Clinical Improvement in Chronic Fatigue Syndrome Is Associated with Enhanced Natural Killer Cell-Mediated Cytotoxicity: The Results of a Pilot Study with Isoprinosine®

, , , , &
Pages 71-95 | Received 14 Feb 2002, Accepted 16 Sep 2002, Published online: 04 Dec 2011

References

  • Fukuda K, Straus SE, Hickie I, Sharpe MC, Dobbins JG, Komaroff, A. The chronic fatigue syndrome: a comprehensive approach to its definition and study. Ann Intern Med 1994; 121:953–959.
  • Holmes G, Kaplan J, Gantz N, Komaroff AL, Schonberger LB, Strauss SE, et al. Chronic fatigue syndrome: a working case definition. Ann Intern Med 1988; 108: 387–389.
  • Cannon JG, Angel JB, Abad LW, Vannier E, Mileno MD, Fagioli L, et al. Interleukin-1 beta, interleukin-1 receptor antagonist, and soluble interleukin-1 recep-tor type II secretion in chronic fatigue syndrome. J Clin Immunol 1997; 17:253–261.
  • Gupta S, Vayuvegula B. A comprehensive immunological analysis in chronic fatigue syndrome. Scand J Immunol 1991; 33:319–327.
  • Landay AL, Jessop C, Lennette ET, Levy JA. Chronic fatigue syndrome: clini-cal condition associated with immune activation. Lancet 1991; 338:707–712.
  • Marshall GS. Report of a workshop on the epidemiology, natural history, and pathogenesis of chronic fatigue syndrome in adolescents. J Pediatr 1999; 134:395–405.
  • Ogawa M, Nishiura T, Yoshimura M, Horikawa H, Yoshida Y, Okajima I, et al. Decreased nitric oxide-mediated natural killer cell activation in chronic fatigue syn-drome. Eur J Clin Invest 1998; 28:937–943.
  • Straus SE, Fritz S, Dale JK, Gould B, Strober W. Lymphocyte phenotype and function in the chronic fatigue syndrome. J Clin Immunol 1993; 13:30–40.
  • Lloyd A, Hickie I, Wakefield D, Boughton C, Dwyer J. A double-blind, pla-cebo-controlled trial of intravenous immunoglobulin therapy in patients with chronic fatigue syndrome. Am J Med 1990; 89:561–568.
  • Meisler JG. Toward optimal health: The experts discuss chronic fatigue syn-drome. J Womens Health Gend Based Med 2000; 9:477–482.
  • Natelson BH, Cheu J, Pareja J, Ellis SP, Policastro T, Findley TW. Random-ized, double blind, controlled placebo-phase in trial of low dose phenelzine in the chronic fatigue syndrome. Psychopharmacology (Berl) 1996; 124:226–230.
  • Peterson PK, Shepard J, Macres M, Schenck C, Crosson J, Rechtman D, et al. A controlled trial of intravenous immunoglobulin G in chronic fatigue syndrome. Am J Med 1990; 89:554–560.
  • See DM, Tilles JG. Alpha-interferon treatment of patients with chronic fatigue syndrome. Immunol Invest 1996; 25:153–164.
  • Steinberg P, McNutt BE, Marshall P, Schenck C, Lurie N, Pheley A, et al. Dou-ble-blind placebo-controlled study of the efficacy of oral terfenadine in the treatment of chronic fatigue syndrome. J Allergy Clin Immunol 1996; 97:119–126.
  • Straus SE. Intravenous immunoglobulin treatment for the chronic fatigue syn-drome. Am J Med 1997; 89:551–553.
  • Strayer DR, Carter WA, Brodsky I, Cheney P, Peterson D, Salvato P, et al. A controlled clinical trial with a specifically configured RNA drug, polyI:polyCl2U, in chronic fatigue syndrome. Clin Infect Dis 1994; 18 (supp1.1): S 88–S95.
  • Vollmer-Conna U, Hickie I, Hadzi-Pavlovic D, Tymms K, Wakefield D, Dwyer J, et al. Intravenous immunoglobulin is ineffective in the treatment of patients with chronic fatigue syndrome. Am J Med 1997; 103:38–43.
  • Masihi KN. Immunomodulatory agents for prophylaxis and therapy of infec-tions. Int J Antimicrob Agents 2000; 14:181–191.
  • Femiano F, Gombos F, Scully C. Oral proliferative verrucous leukoplakia (PVL); open trial of surgery compared with combined therapy using surgery and methisoprinol in papillomavirus-related PVL. Int J Oral Maxillofac Surg 2001; 30: 318–322.
  • Lawton P, Walchshofer N, Sarciron ME. In vitro effects of isoprinosine and a dipeptide methyl ester on Echinococcus multilocularis protoscoleces. J Helminthol 2001; 75:251–257.
  • Litzman J, Lokaj J, Krejci M, Pesak S, Morgan G. Isoprinosine does not protect against frequent respiratory tract infections in childhood. Eur J Pediatr 1999; 158: 35–37.
  • De Simone C, Albertini F, Almaviva M, Angarano G, Chiodo F, Costigliola P, Delia S, et al. Clinical and immunological assessment in HIV+ subjects receiving inosine-pranobex, a randomised, multicentric study. Med Oncol Tumor Pharmacother 1989; 6:63–67.
  • Cillari E, Dieli M, Lo Campo P, Sireci G, Caffarelli A, Maltese E, Millott S, Milano S, Liew FY. Protective effect of isoprinosine in genetically susceptible BALB/c mice infected with Leishmania major. Immunology 1991; 74:25–30.
  • Hersey P, Edwards A. Effect of Isoprinosine on natural killer cell activity of blood mononuclear cells in vitro and in vivo. Int J Immunopharmacol 1984; 6:315–320.
  • Ginsberg T, Gordon J, Glasky A. Inosine pranobex in the treatment of immuno-deficiency. Presented at the 14th Int Congress Chemother, Kyoto 1985; 113:793–794.
  • Bekesi J, Tsang P, Wallace J, Roboz J. Immunorestorative properties of Isoprinosine in the treatment of patients at high risk of developing ARC or AIDS. J Clin Lab Immunol 1987; 24:155–161.
  • Tekgiil H, Tutuncuoglu S, Kutukculer N, Dizdarer G, Huseyinov A. Lympho-cyte subsets and inflammatory mediators in patients with subacute sclerosing panen-cephalitis. J Child Neurol 1999; 14:418–421.
  • Tsang PH, Sei Y, Bekesi JG. Isoprinosine-induced modulation of T-helper-cell subsets and antigen-presenting monocytes (Leu M3+ Ia+) resulted in improvement of T- and B-lymphocyte functions in vitro in ARC and AIDS patients. Clin Immunol Immunopathol 1987; 45:166–176.
  • Tsang PH, Zanjani MD, Warner N, Bekesi JG. Restoration of impaired B- and T-lymphocyte subsets and functions in vitro by isoprinosine in prodromal homosexu-als and AIDS patients. J Clin Lab Immunol 1986; 20:159–165.
  • Hersey P, Bindon C, Bradley M, Hasic E. Effect of Isoprinosine on interleukin 1 and 2 production and on suppressor cell activity in pokeweed mitogen stimulated cul-tures of B and T cells. Int J Immunopharmacol 1984; 6:321–328.
  • Tsang K, Boutin B, Pathak S, Donnelly R, Koopmann WR Jr, Fleck R, et al. Ef-fect of Isoprinosine on the sialylation of interleukin-2. Immunol Lett 1986; 12:195–200.
  • Milano S, Dieli M, Millott S, Dora Miceli M, Maltese E, Cillari E. Effect of Isoprinosine on IL-2, IFN-y, and IL-4 production in vivo and in vitro. Int J Immuno-pharmacol1991; 13:1013–1018.
  • Jones CE, Dyken PR, Huttenlocher PR, Jabbour JT, Maxwell KW. Inosiplex therapy in subacute sclerosing panencephalitis. A multicenter, non-randomized study in 98 patients. Lancet 1982; 1:1034–1037.
  • Pedersen C, Sandstrom E, Petersen CS. The efficacy of inosine pranobex in pre-venting the acquired immunodeficiency syndrome in patients with human immunode-ficiency virus infection. N Engl J Med 1990; 322:1757–1763.
  • Talbot D, Menday A. Inosine pranobex in mucocutaneous herpes. Lancet 1985;1(8433):877.
  • Thorsen S, Pedersen C, Sandstrom E, Petersen CS, Norkranss G, Gerstoft J, et al. One-year follow-up on the safety and efficacy of isoprinosine for human immuno-deficiency virus infection. J Intern Med 1992; 231:607–615.
  • Hanson SJ, Gause W, Natelson B. Detection of immunologically significant factors for chronic fatigue syndrome using neural-network classifiers. Clin Diagn Lab Immunol 2001; 8:658–662.
  • Gupta S, Aggarwal S, Starr A. Increased production of interleukin-6 by adher-ent and non-adherent mononuclear cells during 'natural fatigue' but not following 'ex-perimental fatigue' in patients with chronic fatigue syndrome. Int J Mol Med 1999; 3:209–213.
  • Wessely S, Hotopf M, Sharpe M. Chronic Fatigue and Its Syndromes. New York: Oxford University Press; 1999.
  • Friedberg F, Dechene L, McKenzie MJ, Fontanetta R. Symptom patterns in long duration chronic fatigue syndrome. J Psychosom Res 2000; 48:59–68.
  • DeLuca J, Johnson SK, Natelson BH. Information processing efficiency in chronic fatigue syndrome and multiple sclerosis. Arch Neurol 1993; 50:301–304.
  • Christodoulou C, DeLuca J, Lange G, Johnson SK, Sisto SA, Korn L, et al. Re-lation between neuropsychological impairment and functional disability in patients with chronic fatigue syndrome. J Neurol Neurosurg Psychiatry 1998; 64:431–434.
  • Lawrie SM, MacHale SM, Cavanagh JTO, O'Carroll RE, Goodwin GM. The difference in patterns of motor and cognitive function in chronic fatigue syndrome and severe depressive illness. Psychol Med 2000; 30:433–442.
  • Derogatis LR. SCL-90-R administration, scoring and procedures manual I. Bal-timore: Johns Hopkins University press; 1977.
  • O'Donnel WE, DeSoto CB, Reynolds DM. A cognitive deficit subscale of the SCL-90-R. J Clin Psychol 1984; 40:241–246.
  • Levin PH, Dale JK, Benson-Grigg E. A cluster of cases of chronic fatigue and chronic fatigue syndrome: clinical and immunologic studies. ClM Infect Dis 1996; 23:408–409.
  • Buchwald D, Sullivan IL, Komaroff AL. Frequency of 'chronic active Ep-stein-Barr virus infection' in a general medical practice. JAMA 1987; 257:2303–2307.
  • Kamiyama T, Muratani H, Kimura Y. Factors related to impairment of daily liv-ing. Intern Med 1999; 38:698–704.
  • Kroenke K, Wood DR, Mangelsdorff AD, Meier NJ, Powell JB. Chronic fa-tigue in primary care. Prevalence, patient characteristics, and outcome. JAMA 1988; 260:929–934.
  • Krupp LB, LaRocca NG, Muir-Nash J, Steinberg AD. The fatigue severity scale. Application to patients with multiple sclerosis and systemic lupus erythematosus. Arch Neurol 1989; 46:1121–1123.
  • Chalder T, Berelowitz G, Pawlikowska T, Watts L, Wessely S, Wright D, et al. Development of fatigue scale. J Psychosom Res 1993; 37:147–153.
  • Elkins LE, Krupp LB, Scherl W. The measurement of fatigue and contributing neuropsychiatric factors. Semin ClM Neuropsychiatry 2000; 5:58–61.
  • Fulcher KY, White PD. Strength and physiological response to exercise in pa-tients with chronic fatigue syndrome. J Neurol Neurosurg Psychiatry 2000; 69:302–307.
  • Gerber LH, Furst GP. Validation of the NIH activity record: a quantitative mea-sure of life activities. Arthritis Care Res 1992; 5:81–86.
  • Jason LA, Holden JG, Taylor SL, Melrose HJ. Monitoring energy levels in chronic fatigue syndrome. Psychol Rec 1995; 45:643–654.
  • Tryon WW, Williams R. Fully proportional actigraphy: a new instrument. Behav Res Methods Instrum Comput 1995; 28:392–403.
  • Collin C, Wade DT, Davies S, Horne V. The Barthel ADL index: a reliability study. Int Disabil Stud 1988; 10:61–63.
  • Gresham GE, Phillips TF, Labi ML. ADL status in stroke: relative merits of three standard indexes. Arch Phys Med Rehabil 1980; 61:335–338.
  • Laver A, Powell G. The structured observational test of function manual. Wind-sor, UK: The NFER-Nelson Publishing Company Ltd.; 1995.
  • Mahoney Fl, Barthel DW. Functional evaluation: the Barthel Index. Md Med J 1965; 14:61–65.
  • Kamofsky DA, Burchenal JH. The clinical evaluation of chemotherapeutic agents in cancer. In CM Macleod (ed.), Evaluation of Chemotherapeutic Agents: Sym-posium Microbiology Section, New York: Academy of Medicine (pp. 191–206). New York: Columbia University Press; 1949.
  • Bennett R. Fibromyalgia, chronic fatigue syndrome, and myofascial pain. Curr Opin Rheumatol 1998; 10:95–103.
  • Buchwald D. Fibromyalgia and chronic fatigue syndrome: similarities and dif-ferences. Rheum Dis C1M North Am 1996; 22:219–243.
  • Buchwald D, Garrity D. Comparison of patients with chronic fatigue syndrome, fibromyalgia, and multiple chemical sensitivities. Arch Intern Med 1994; 154:2049–2053.
  • Cote KA, Moldofsky H. Sleep, daytime symptoms, and cognitive performance in patients with fibromyalgia. J Rheumatol 1997; 24:2014–2023.
  • Goldenberg DL, Simms RW, Geiger A, Komaroff AL. High frequency of fibromyalgia in patients with chronic fatigue seen in a primary care practice. Arthritis Rheum 1990; 33:381–387.
  • Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, et al. The American College of Rheumatology 1990 criteria for the classification of fibromyalgia: report of the Multicenter Criteria for Committees. Arthritis Rheum 1990; 33:160–162.
  • Komaroff AL, Goldenberg D. The chronic fatigue syndrome: definition, current studies and lessons for fibromyalgia research. J Rheumatol 1989; 19:23–27.
  • Aaron LA, Burke MM, Buchwald D. Overlapping conditions among patients with chronic fatigue syndrome, fibromyalgia, and temporomandibular disorder. Arch Intern Med 2000; 160:221–227.
  • Buskila D. Fibromyalgia, chronic fatigue syndrome, and myofascial pain syn-drome. Curr Opin Rheumatol 2000; 12:113–123.
  • White KP, Speechley M, Harth M, Ostbye T. Co-existence of chronic fatigue syndrome with fibromyalgia syndrome in the general population. Scand J Rheumatol 2000; 29:44–51.
  • Chao CC, Janoff EN, Hu SX, Thomas K, Gallagher M, Tsang M, et al. Altered cytokine release in peripheral blood mononuclear cell cultures from patients with the chronic fatigue syndrome. Cytokine 1991; 3:292–298.
  • Ho-Yen D, Billington R, Urquhart J. Natural killer cells and the post-viral fa-tigue syndrome. Scand J Infect Dis 1991; 23:711–716.
  • Peakman M, Deale A, Field R, Mahalingam M, Wessely S. Clinical improve-ment in chronic fatigue syndrome is not associated with lymphocyte subsets of func-tion or activation. C1M Immunol Immunopathol 1997; 82:83–91.
  • Barker E, Fujimura SF, Fadem MB, Landay AL, Levy JA. Immunologic abnor-malities associated with chronic fatigue syndrome. C1M Infect Dis 1994; 18:S136–S141.
  • Behan PO, Behan WM, Bell EJ. The postviral fatigue syndrome-an analysis of the findings in 50 cases. J Infect Dis 1985; 10:211–222.
  • Caligiuri M, Murray C, Buchwald D, Levine H, Cheney P, Peterson D, et al. Phenotypic and functional deficiency of natural killer cells in patients with chronic fa-tigue syndrome. J Immunol 1987; 139:3306–3313.
  • Kibler R, Lucas DO, Hicks MJ, Poulos BT, Jones JF. Immune function in chronic active Epstein-Barr virus infection. J C1M Invest 1985; 5:46–54.
  • Klimas NG, Salvato FR, Morgan R, Fletcher MA. Immunologic abnormalities in chronic fatigue syndrome. J ClM Microbiol 1990; 28:1403–1410.
  • Masuda A, Nozoe SI, Matsuyama T, Tanaka H. Psychobehavioral and immuno-logical characteristics of adult people with chronic fatigue and patients with chronic fa-tigue syndrome. Psychosom Med 1994; 56:512–518.
  • Morrison LJ, Behan WH, Behan PO. Changes in natural killer cell phenotype in patients with post-viral fatigue syndrome. ClM Exp Immunol 1991; 83:441–446.
  • Patarca-Montero R, Antoni M, Fletcher MA, Klimas NG. Cytokine and other immunologic markers in chronic fatigue syndrome and their relation to neuropsy-chological factors. Appl Neuropsychol 2001; 8:51–64.
  • Whiteside TL, Friberg D. Natural killer cells and natural killer cell activity in chronic fatigue syndrome. Am J Med 1998; 105:27S–34S.
  • Gold D, Bowden R, Sixbey J, Riggs R, Katon WJ, Ashley R, et al. Chronic fa-tigue. A prospective clinical and virologic study. JAMA 1990; 264:48–53.
  • Russell J, Vipraio GA, Tovar Z, Michalek JE, Fletcher E. Abnormal natural killer cell activity in fibrositis syndrome is responsive in vitro to IL-2. Arthritis Rheum 1988; 31:S24.
  • Russell IJ, Vipraio GA, Michalek JE, Craig F, Kang YK, Richards AB. Lym-phocyte markers and natural killer cell activity in fibromyalgia syndrome: effects of low-dose, sublingual use of human interferon-alpha. J Interferon Cytokine Res 1999; 19:969–978.
  • Cruess SE, Klimas N, Antoni M, Helder L, Mahler K, Keller R, Fletcher MN. Immunologic status correlates with the severity of physical symptoms and perceived illness burden in chronic fatigue syndrome patients. JCFS 2000; 7:10–15.
  • Hilgers A, Frank J. Chronic fatigue syndrome: evaluation of the 30-crite-ria-score and correlation with immune activation. JCFS 1996; 2:35–47.

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.