http://www.biomedcentral.com/1471-2377/10/73 The increase of alpha-melanocyte-stimulating hormone in the plasma of chronic fatigue syndrome patients Nobue Shishioh-Ikejima , Tokiko Ogawa , Kouzi Yamaguti , Yasuyoshi Watanabe , Hirohiko Kuratsune and Hiroshi Kiyama BMC Neurology 2010, 10:73doi:10.1186/1471-2377-10-73 Published: 23 August 2010 Abstract (provisional) Background Despite extensive research, no reliable biological marker for chronic fatigue syndrome (CFS) has yet been identified. However, hyperactivation of melanotrophs in the pituitary gland and increased levels of plasma alpha-melanocyte-stimulating hormone (alpha-MSH) have recently been detected in an animal model of chronic stress. Because CFS is considered to be caused partly by chronic stress events, increased alpha-MSH plasma levels may also occur in CFS patients. We therefore examined alpha-MSH levels in CFS patients. Methods Fifty-five CFS patients, who were previously diagnosed within 10 years of with the disease, were enrolled in this study. Thirty healthy volunteers were studied as controls. Fasting bloods samples were collected in the morning and evaluated for their plasma levels of alpha-MSH, adrenocorticotropic hormone (ACTH), serum cortisol and dehydroepiandrosterone sulfate (DHEA-S). Mean levels of alpha-MSH were compared between the CFS and control groups using Welch's t test. Results The mean plasma alpha-MSH concentration in the CFS group (17.9 +/- 1.0 pg/mL) was significantly higher than that in healthy controls (14.5 +/- 1.0 pg/mL, p=0.02). However, there was a wide range of values in the CFS group. The factors correlated with the plasma alpha-MSH values were analyzed using Spearman's rank correlation. A negative correlation was found between the duration of the CFS and the plasma alpha-MSH values (p=0.04, rs=-0.28), but no correlations with ACTH, cortisol or DHEA-S levels were identified (p=0.55, 0.26, 0.33, respectively). The CFS patients were divided into two groups: patients diagnosed for [less than or equal to]5 years' duration, and those diagnosed for 5-10 years' duration. They were compared with the healthy controls using one-way ANOVA and Tukey-Kramer multiple comparison tests. The mean alpha-MSH concentration in the [less than or equal to]5 years group was 20.8 +/- 1.2 pg/mL, which was significantly higher than that in the healthy controls (p<0.01). There was no significant difference between the 5-10 year group (15.6 +/- 1.4 pg/mL) and the healthy controls. Conclusions CFS patients with a disease duration of [less than or equal to]5 years had significantly higher levels of alpha-MSH in their peripheral blood. alpha-MSH could be a potent biological marker for the diagnosis of CFS, at least during the first 5 years after onset of the disease.