Chronic fatigue is a common, poorly understood and disabling phenomenon in many diseases. We aim to provide an overview of fatigue in chronic autoimmune and inflammatory disease. Fatigue measurement, prevalence and confounding factors such as depression, sleep disorders and pain are reviewed in the first half of the article. In the second half of the article, we describe explanatory models of fatigue and fatigue signalling, with an emphasis on cytokines and sickness behaviour, oxidative stress, mitochondrial dysfunction and the impact of certain genes on fatigue.

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Sheepshead minnows (Cyprinodon variegatus) were continuously exposed to two concentrations of polycyclic aromatic hydrocarbons (PAHs) dissolved in seawater (sigma PAH = 7.57 and 72.31 microg/L) for 36 d, followed by 8 d of depuration. The PAHs studied were naphthalene (NPH or C0-NPH), phenanthrene (PHE or C0-PHE), pyrene (PYR), 2-methylnaphthalene (C1-NPH), 1,3-dimethylnaphthalene (C2-NPH), 2-isopropylnaphthalene (C3-NPH), 9-methylphenanthrene (C1-PHE), and 9-ethylphenanthrene (C2-PHE). Uptake rate constants (k1) for NPHs increased with increasing degree of alkylation and log value of the octanol/water partition coefficient (Kow), whereas k1 values for three- and four-ring PAHs were lower despite their high log Kow values. Elimination rate constants (k2) for the homologue series of NPHs and PHEs generally increased with decreasing degree of alkylation and log Kow values. However, the depuration time did not directly correlate with the molecular size for nonalkylated PAHs. Bioconcentration factors (BCFs) were estimated from the ratio of k1 to k2 and also directly from PAH concentrations in fish tissue and water samples, and the factors generated by the two methods were very similar. A significant positive correlation was determined between log BCFs and log Kow values for the series of C0- through C3-NPH at both low (r2 = 0.985, p = 0.0077) and high (r2 = 0.956, p = 0.022) exposures, although this correlation was not determined for all the PAHs studied. As a result of increased metabolism and/ or reduced bioavailability with increasing lipophilic character, the estimated BCFs for C0- through C2-PHE and PYR were generally lower than those for C0- through C3-NPH. The two exposure levels revealed minor variations in k1 and k2 values for parent PAHs and in the temporal pattern of PAH metabolite concentrations in bile. The present results indicate that the presence and nature of alkyl groups have a significant influence on the kinetics and metabolism of PAHs in fish.

Within the frame of a large environmental study, we report on a research program that investigated the potential for bioaccumulation and subsequent effect responses in several marine organisms exposed to chronic levels of dispersed crude oil. Body burden can be estimated from kinetic parameters (rate constants for uptake and elimination), and appropriate body burden-effect relationships may improve assessments of environmental risks or the potential for such outcomes following chronic discharges at sea. We conducted a series of experiments in a flow-through system to describe the bioaccumulation kinetics of polycyclic aromatic hydrocarbons (PAH) at low concentrations of dispersed crude oils. Mussels (Mytilus edulis) and juvenile turbot (Scophthalmus maximus) were exposed for periods ranging from 8 to 21 d. Postexposure, the organisms were kept for a period of 9 to 10 d in running seawater to study elimination processes. Rate constants of uptake (k1) and elimination (k2) of the PAHs during and following exposure were calculated using a first-order kinetic model that assumed a decrease of the substances in the environment over time. The estimated bioconcentration factor was calculated from the ratio of k1/k2. The kinetic parameters of two-, three-, and four-ring PAHs in mussel and fish are compared with estimates based on hydrophobicity alone, expressed by the octanol-water partition coefficient, Kow (partitioning theory). A combination of reduced bioavailability of PAHs from oil droplets and degradation processes of PAHs in body tissues seems to explain discrepancies between kinetic rates based on Kow and actual kinetic rates measured in fish. Mussels showed a pattern more in compliance with the partitioning theory.