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Neth J Med. 2018 Sep;76(7):310-313.

Pitfalls in cytokine measurements - Plasma TGF-β1 in chronic fatigue syndrome.

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Department of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands.



Serum TGF-β1 concentrations are reported to be elevated in chronic fatigue syndrome (CFS). However, measurement of circulating cytokines is a complex procedure and control of pre-analytical procedures is essential. The objective of the current study was to measure circulating TGF-β1 concentrations in CFS patients compared to healthy controls, taking into account differences in pre-analytical procedures.


Two cohorts of female CFS patients were included. In both studies patients were asked to bring a healthy, age-matched control. At baseline, TGF-β1 levels were measured in plasma and additionally P-selectin, a marker of platelet activity, was determined in a subgroup of participants.


50 patients and 48 controls were included in cohort I, and 90 patients and 29 controls in cohort II. Within the cohorts there were no differences in TGF-β1 concentrations. However, between the cohorts there was a large discrepancy, which appeared to be caused by differences in g-force of the centrifuges used. The lower g-force used in cohort II (1361 g) caused more platelet activation, reflected by higher p-selectin concentrations, compared to cohort I (p < 0.0001), which was confirmed in a second independent experiment. There was a correlation between TGF-β1 and p-selectin concentrations (r 0.79, p < 0.0001).


These results demonstrate that control of pre-analytical procedures is an essential aspect when measuring circulating cytokines. No evidence for enhanced TGF-β1 in patients with CFS was found.

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