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Cytokine
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===Chronic Fatigue Syndrome=== There is increasing evidence that cytokine expression is altered in CFS (ME). [[Mady Hornig]] et al (2015) indicates that there is a generally increased response in the first 3 years of illness.<ref name="Hornig, 2015" /> In 2017, a [[Jose Montoya|Montoya]], et al, study showed that "seventeen cytokines had a statistically significant upward linear trend that correlated with [[ME/CFS]] severity"..."thirteen of these are proinflammatory, likely contributing to many of the symptoms experienced by patients."<ref name=":11" /> Two large 2015 studies found a general pattern of down regulation in long term patients (Hornig, et al and Landi, et al). <ref name="Landi2015" /> It is worth noting that these differences can average each other out when data from newly diagnosed and long term patients are analysed together. More accurate data may necessitate patient groups being stratified by disease duration. In a 2017 study by Hornig, Lipkin et al, 51 Cytokines of cerebrospinal fluid were measured where they found Atypical and Classical cases of [[ME/CFS]]. There are differing immune signatures within the [[central nervous system]]. "Typically, symptoms of ME/CFS begin suddenly following a flu-like infection, but a subset of cases classified by the investigators as “atypical” follows a different disease course, either from triggers preceding symptoms by months or years, or accompanied by the later development of additional serious illnesses."<ref>{{Cite journal | last = Lipkin | first = W.I. | author-link = Ian Lipkin | last2 = Peterson | first2 = D.L. | author-link2 = Daniel Peterson | last3 = Ukaigwe | first3 = J. E. | author-link3 = J Ukaigwe | last4 = Che | first4 = X. | author-link4 = X Che | last5 = Eddy | first5 = M.L. | author-link5 = Meredith Eddy | last6 = Gottschalk | first6 = C.G. |last7 = Hornig | first7 = M. | date = Apr 2017 | title = Immune network analysis of cerebrospinal fluid in myalgic encephalomyelitis/chronic fatigue syndrome with atypical and classical presentations |url =https://www.nature.com/articles/tp201744|journal=Translational Psychiatry|language=en|volume=7|issue=4| pages = e1080|doi=10.1038/tp.2017.44|issn=2158-3188|quote=|via=}}</ref> When reading cytokine studies it is important to remember that with so many cytokines it is common to find some pattern and results can change quickly within individuals. In a small sample, if just a couple of people were fighting a cold then this could change the overall results.
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