Mechanisms Explaining Muscle Fatigue and Muscle Pain in Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): a Review of Recent Findings

@article{Gerwyn2017MechanismsEM,
  title={Mechanisms Explaining Muscle Fatigue and Muscle Pain in Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): a Review of Recent Findings},
  author={M Jones Gerwyn and Michael Maes},
  journal={Current Rheumatology Reports},
  year={2017},
  volume={19},
  pages={1-10}
}
Purpose of ReviewHere, we review potential causes of muscle dysfunction seen in many patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) such as the effects of oxidative and nitrosative stress (O&NS) and mitochondrial impairments together with reduced heat shock protein production and a range of metabolic abnormalities.Recent FindingsSeveral studies published in the last few years have highlighted the existence of chronic O&NS, inflammation, impaired mitochondrial function… 

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References

SHOWING 1-10 OF 143 REFERENCES

Understanding Muscle Dysfunction in Chronic Fatigue Syndrome

TLDR
Evidence is shown for skeletal muscle biochemical abnormality in CFS/ME patients, particularly in relation to bioenergetic dysfunction, with a tendency towards an overutilisation of the lactate dehydrogenase pathway following low-level exercise, in addition to slowed acid clearance after exercise.

Changes in Gut and Plasma Microbiome following Exercise Challenge in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)

TLDR
A role for an altered gut microbiome and increased bacterial translocation following exercise in ME/CFS patients that may account for the profound post-exertional malaise experienced by patients is suggested.

Specific correlations between muscle oxidative stress and chronic fatigue syndrome: a working hypothesis

TLDR
New data collectively support the presence of specific critical points in the muscle that are affected by free radicals and in view of these considerations, the possible role of skeletal muscle oxidative imbalance in the genesis of CFS is discussed.

Central basis of muscle fatigue in chronic fatigue syndrome

TLDR
Patients with CFS have normal fatigability and metabolism at both the intracellular and systemic levels, normal muscle membrane function and excitation-contraction coupling, and an inability to fully activate skeletal muscle during intense, sustained exercise.

Oxidative and Nitrosative Stress and Immune-Inflammatory Pathways in Patients with Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS)

TLDR
It is proposed that once generated chronically activated O&NS and immune-inflammatory pathways conspire to generate a multitude of self-sustaining and self-amplifying pathological processes which are associated with the onset of ME/CFS.

Inability of myalgic encephalomyelitis/chronic fatigue syndrome patients to reproduce VO2peak indicates functional impairment

TLDR
ME/CFS participants were unable to reproduce most physiological measures at both maximal and ventilatory threshold intensities during a CPET performed 24 hours after a prior maximal exercise test, confirming that repeated CPETs warrant consideration as a clinical indicator for diagnosing ME/C FS.

Altered immune response to exercise in patients with chronic fatigue syndrome/myalgic encephalomyelitis: a systematic literature review.

TLDR
The literature review provides level B evidence for an altered immune response to exercise in patients with CFS, including an alteration in the immune cells' gene expression profile.

Metabolic features of chronic fatigue syndrome

TLDR
Targeted, broad-spectrum metabolomics of plasma showed that chronic fatigue syndrome is a highly concerted hypometabolic response to environmental stress that traces to mitochondria and was similar to the classically studied developmental state of dauer, opening a fresh path for the rational development of new therapeutics.
...