Perturbations in immune processes play an important role in chronic fatigue
syndrome/myalgic encephalomyelitis (CFS/ME), a multifactorial disorder mainly characterized by
severe and prolonged fatigue and tipically affecting a variety of bodily systems including the immune
system. Recent reports have shown that CFS/ME is an inflammatory disorder may be associated with
autoimmune responses, mainly characterized by reduced functional activity of most immune cells,
including neutrophils, natural killer cells, monocytes/macrophage and dendritic cells, together with dysregulations in
cytokine levels, responsible for changes in the adaptive immune system. Interactions between gut microorganisms and
host immune function have been shown to contribute to aberrant inflammation in CFS/ME patients. Commensal and/or
pathogen-associated molecular patterns detected by Toll-like receptors (TLRs) expressed on intestinal epithelial cells
appear to trigger inflammatory signaling cascade leading to neuroinflammation and neurodegeneration. This paper
examines the role of TLR-mediated innate immunity in CFS/ME with evaluation of the current literature, also discussing
about innovative therapeutic approaches represented by immunomodulators TLR-targeting.
Keywords: Chronic fatigue syndrome/myalgic encephalomyelitis, inflammation, immune response dysregulation, toll-like
receptors, toll-like receptor-targeting compounds.
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