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Type: Journal article
Title: Cytokine dysregulation in the post-Q-fever fatigue syndrome
Author: Pentilla, I.
Harris, R.
Storm, P.
Haynes, D.
Worswick, D.
Marmion, B.
Citation: QJM: an international journal of medicine, 1998; 91(8):549-560
Publisher: Oxford University Press
Issue Date: 1998
ISSN: 1460-2725
Statement of
I. A. Penttila, R. J. Harris, P. Storm, D. Haynes, D. A. Worswick and B. P. Marmion
Abstract: The post-Q-fever fatigue syndrome (QFS) (inappropriate fatigue, myalgia and arthralgia, night sweats, changes in mood and sleep patterns) follows about 20% of laboratory-proven, acute primary Q-fever cases. Cytokine dysregulation resulting from chronic immune stimulation and modulation by persistence of Coxiella burnetii cells or their antigens is hypothesized. We studied cytokine release patterns of peripheral blood mononuclear cells (PBMC) stimulated with various ligands in short-term culture, from 18 patients with active QFS, and 27 controls: six with resolving QFS, five who had had acute primary Q-fever without subsequent QFS, eight healthy Q-fever vaccinees and eight healthy subjects without Q-fever antibody. Conditioned media (CM) from PBMC stimulated in short-term culture with Q-fever antigens, PHA or measles antigen (as an unrelated antigen) were assayed for IL-2, IL-4, IL-5, IL-6, IL-10 and IFN gamma by AgEIA, and for IL-1 and TNF alpha/beta by bioassay. Aberrant cytokine release patterns were observed with PBMC from QFS patients when stimulated with Q-fever antigens: an accentuated release of IL-6 which was significantly [p = 0.01, non-parametric one-way analysis of variance (ANOVA)] in excess of medians for all four control groups. With IL-2, the number of responders in the active QFS group was decreased relative to control groups (Fisher's exact test, p = 0.01) whereas the number of IFN gamma responders was increased (Fisher's exact test, p = 0.0008). Significant correlations were observed between concentrations of IL-6 in CM, total symptom scores, and scores for other key symptoms.
Keywords: Leukocytes, Mononuclear
Coxiella burnetii
Q Fever
Fatigue Syndrome, Chronic
Acute Disease
Antigens, Bacterial
Culture Media, Conditioned
Cell Culture Techniques
Middle Aged
Rights: © Oxford University Press 1998
DOI: 10.1093/qjmed/91.8.549
Published version:
Appears in Collections:Aurora harvest 5
Pathology publications

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