Exploration of Immunology

Table 2. A comparative analysis of systemic immune activation (SIA) in three CMIRDs

Syndrome	SIA	Cytokines elevated	Neuroinflammation	Predominant cellular dysfunction
FMS	Moderate	IL-6, IL-8, TNF-α	Microglial activation	Reduced T-reg cells
CFS/ME	High	IL-1β, TNF-α, IFN-γ	Neuroinflammation and mitochondrial dysfunction	Reduced NK cell activity
IBS	Low	IL-6, IL-8	Localized (gut-brain axis)	Mast cell activation (localized)

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CMIRDs: chronic multisystem immune-related disorders; FMS: fibromyalgia syndrome; CFS/ME: chronic fatigue syndrome/myalgic encephalomyelitis; IBS: irritable bowel syndrome; NK: natural killer

Declarations

Acknowledgments

The authors wish to express their gratitude to colleagues of the Rheumatology Department and Clinical Psychology of the University of Verona for their valuable insights, constructive feedback, and critical discussions that greatly enhanced the quality of this review. Their expertise and thoughtful suggestions contributed to the refinement of the manuscript. Any remaining errors or omissions are solely the responsibility of the authors.

Author contributions

MN: Conceptualization, Investigation, Writing—original draft, Writing—review & editing. VS and GV: Conceptualization, Writing—review & editing. LG and EP: Validation, Writing—review & editing, Supervision. AM, SC, and GDB: Supervision, Writing—review & editing. LP: Investigation. ES: Writing—original draft. All authors read and approved the submitted version.

Conflicts of interest

Giustino Varrassi, who is the Editorial Board Member and a Guest Editor of Exploration of Immunology, had no involvement in the decision-making or the review process of this manuscript. The other authors declare that they have no conflicts of interest.

Ethical approval

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Copyright

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