P189 Fatigue in IBD patients is associated with differences in immune parameters
Bibliographic record
Abstract
Background: Fatigue contributes to the decreased quality of life of inflammatory bowel disease (IBD) patients.The immune system plays an important role in various cases of diseaseassociated fatigue.As such, we were interested whether there are detectable differences in immune parameters between fatigue and non-fatigue IBD patients.In this study only patients in clinical and biological remission were included to rule out inflammation-associated fatigue.Methods: After informed consent 78 IBD patients in clinical and biological remission, defined by a normal Harvey Bradshaw Index (<5) and Colitis activity index (<10), normal levels of hemoglobin, iron, CRP, liver enzymes and normal kidney function were included.All patients were phenotyped according to the Montreal classification and the Checklist Individual Strength (CIS) was used to assess fatigue.Other parameters included were: Quality of life scores and medication use.We used flow cytometry on peripheral blood samples to investigate the differences in leukocyte subsets.Furthermore, serum levels of IL-4, IL-5, IL-6, IL-8, IL-10, IL-12, TNF-a and IFN-g were measured using ELISA.Results: In total 54 fatigue patients (CIS score of 35) and 24 patients without fatigue were included.Significantly more females were included in the fatigue (F) group compared to the non-fatigue (NF) group (69% vs. 46%; p = 0.032).The other characteristics revealed no significant differences between the groups.Flow cytometry data showed a significant lower percentage of monocytes (5% vs. 7%; p = 0.010), higher percentage of memory T-cells (42% vs. 34%; p = 0.006) and higher percentage of neutrophils (75% vs. 68%; p = 0.043) in fatigue patients compared to non-fatigue patients.Mean serum levels of IL-5 (F: 57 pg/ml, NF: 2 pg/ml; p = 0.021) and IL-12 (F: 9 pg/ml, NF: 3 pg/ml; p = 0.003) were significantly higher in fatigue patients while IL-8 (F: 10 pg/ml, NF: 61 pg/ml; p = 0.012) was significantly lower in fatigue patients compared to non-fatigue patients.No other significant differences were seen in cytokines or leukocyte subsets.Conclusions: This study shows for the first time that there are immunological differences between fatigue and non-fatigue IBD patients in remission.The immune stimulation in fatigue could represent an on-going infection or autoimmune response that occurs without any clinical or histological signs of IBD.Further exploration of the underlying factors may uncover therapeutic targets for the treatment of fatigue in IBD patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".