Published online October 2, 2006
PEDIATRICS Vol. 118 No. 4 October 2006, pp. 1799-1800 (doi:10.1542/peds.2006-1664)

This Article Extract Full Text (PDF) Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services E-mail this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My File Cabinet Download to citation manager Request Permissions Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Schikler, K. N. Search for Related Content PubMed PubMed Citation Articles by Schikler, K. N. Related Collections Office Practice Social Bookmarking                         What's this?

LETTER TO THE EDITOR

Potential Polygenic Influences on Chronic Fatigue Syndrome

Kenneth N. Schikler, MD, FAAP, FACR
Section of Pediatric Rheumatology and Adolescent Medicine
Department of Pediatrics
University of Louisville School of Medicine
Louisville, KY 40202
Center for Pediatric Fatiguing and Painful Conditions
Frazier Rehab Institute
Louisville, KY 40202

To the Editor.—

I found the article by van de Putte et al¹ to be most interesting and insightful in construct design and in the conclusions drawn from their study of 40 adolescents with chronic fatigue syndrome (CFS), one of the many syndromes that fit into the category of central pain-processing disorders (along with other disturbing conditions such as fibromyalgia, irritable bowel syndrome, and complex regional pain syndrome type I). Their study results led them to conclude that the shared symptom complex of mother and child suggested an interplay between genetic variability and environmental factors. They, in fact, suggested the potential for a polygenic rather than monogenic inheritance pattern and made reference to an article by Torpy et al² regarding an association of CFS and the serine allele of the CBG gene. This article was obviously prepared and accepted for publication long before the recently published findings of Goertzel et al,³ who found that combinations of single-gene polymorphisms had a 76.3% predictive accuracy for CFS in studying 43 adults and 58 control subjects. The 3 genes with the highest accumulated importance were neuronal tryptophan hydroxylase (TPH2, involved in serotonin metabolism), catechol-O-methyltransferase (COMT, involved in methylation of norepinephrine), and nuclear receptor subfamily 3, group C member 1 glucocorticoid receptor (NR3C1, involved in corticosteroid sensitivity via signal transduction and transcription of RNA polymerase II promoter). This adds supportive evidence to the concept of a polygenic predisposition to the development of CFS and possibly other central pain-perception processes,⁴ such as fibromyalgia, that have been felt to have alterations in serotonin,⁵ norepinephrine,⁶ and response to stress or allostasis.⁷

REFERENCES

1. van de Putte EM, van Doornen LJ, Engelbert RH, Kuis W, Kimpen JL, Uiterwaal CS. Mirrored symptoms in mother and child with chronic fatigue syndrome. Pediatrics. 2006;117 :2074 –2079[Abstract/Free Full Text]
2. Torpy DF, Bachmann AW, Gartside M, et al. Association between chronic fatigue syndrome and the corticosteroid-binding globulin gene ALA SER²²⁴ polymorphism. Endocr Res. 2004;30 :417 –429[CrossRef][Web of Science][Medline]
3. Goertzel BN, Pennachin C, de Souza Coehlo L, Gurbaxani B, Maloney EM, Jones JF. Combinations of single nucleotide polymorphisms in neuroendocrine effector and receptor genes predict chronic fatigue syndrome. Pharmacogenomics. 2006;7 :475 –483[CrossRef][Web of Science][Medline]
4. Diatchenko L, Slade GD, Nackley AG, et al. Genetic basis for individual variation in pain perception and the development of a chronic pain condition. Hum Mol Genet. 2005;14 :135 –143[Abstract/Free Full Text]
5. Russell IJ. Advances in fibromyalgia: possible role for central neurochemicals. Am J Med Sci. 1998;315 :377 –384[CrossRef][Web of Science][Medline]
6. Legangneux E, Mora JJ, Spreux-Varoquaux O, et al. Cerebrospinal fluid biogenic amine metabolites, plasma-rich platelet serotonin and [³H]imipramine reuptake in the primary fibromyalgia syndrome. Rheumatology (Oxford). 2001;40 :290 –296
7. Maloney EM, Gurbaxani BM, Jones JF, de Souza Coelho L, Pennachin C, Goertzel BN. Chronic fatigue syndrome and high allostatic load. Pharmacogenomics. 2006;7 :467 –473[CrossRef][Web of Science][Medline]

---

PEDIATRICS (ISSN 1098-4275). ©2006 by the American Academy of Pediatrics

CiteULike    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This Article Extract Full Text (PDF) Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services E-mail this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My File Cabinet Download to citation manager Request Permissions Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Schikler, K. N. Search for Related Content PubMed PubMed Citation Articles by Schikler, K. N. Related Collections Office Practice Social Bookmarking                         What's this?