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MCP-1 and the MCP-1 Stimulation Test
Monocyte chemotactic protein-1 (MCP-1) acts as a chemoattractant, promoting infiltration of immune cells, and as a basophil agonist, which leads to histamine release. MCP-1 is elevated in postviral CFS, MCS, HT, lupus, CU, some types of asthma, and during infections (EBV, HHV-6).39-46
In a study of patients with allergic rhinitis, submucosa had increased MCAF/MCP-1 and associated histamine release from basophils, suggesting that MCP-1 "is stored in human nasal mucosa, possibly participates in protracted histamine release from basophils and in the pathogenesis of perennial allergic rhinitis."47
While in one study of atopic asthmatics, who had increased total IgE and eosinophils, a significant association with MCP-1 was not found in all patients; in a different study of asthmatics, MCP-1 was elevated in the serum during asymptomatic periods and further elevated during acute attacks.44 In addition, when testing patients with chemically (dissocyanate)-induced asthma, one team found that MCP-1 stimulation assays (MSA) with dissocyanate-human serum albumin (DIISO-HSA) were more sensitive than DIISO-HSA antibody tests in identifying patients.48
Potentially, MSA might be positive in those who developed MCS from sick building syndrome or another lengthy exposure.
Other Potential Non-IgE-Mediated Immune Mechanisms
T cells or inflammatory cytokines may play a role in some patients. T cells have been associated with non-IgE-mediated delayed-type hypersensitivity reactions and with ADR. In one CFS study, in response to intradermal administration of common antigens such as Candida albicans and in vitro T cell activation tests, patients had a delayed-type hypersensitive (DTH) response, and "the intensity of the DTH response correlated with the number of T-cells activated in vitro."49
Increased inflammatory cytokines have been found in the blood in several CFS cohorts and an MCS cohort. However, preliminary tests did not find increased cytokines in nasal fluid in one CFS cohort with rhinitis.39,50,51
While the exact mechanisms in MCS and CFS have yet to be elucidated, research on these diseases is getting closer to answers and the above pathways have the potential to play a role.
As researchers begin to gain more understanding of non-IgE-mediated hypersensitivity pathways, doctors may eventually be able to more readily recognize patients with nonallergic hypersensitivity reactions. Once doctors become familiar with some of the associations in these diseases, including the increased frequency of HT-related autoantibodies in patients with hypersensitivities, maybe someday patients, especially female patients with concurrent Hashimoto's thyroiditis, will be able go to their doctors and say, "I have a hard time taking medicine because I tend to react to everything," and doctors will no longer tell them, as they have told me, "That's impossible!"
Notes
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© 2014 Laurie Dennison Busby, BEd
Laurie Busby received a BEd from the University of Missouri. At age 30, she developed chronic fatigue syndrome and the hypersensitivities that sometimes accompany it. Shortly thereafter, her aunt, a nurse anesthetist, handed her a huge medical dictionary and some studies, insisting that Laurie learn how to read them because she had something with no answers. Since that time, Laurie has asked for several tests that have given her incredible clues about her illness, conducted a family medical health survey among patients, testified before the CFS Advisory Committee to the US Department of Health and Human Services, and started a chronic illness blog, cfsfmmcsandrelatedstudies.tumblr.com, in an attempt to share what she has learned.
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