kill you: disorders in the inflammatory and oxidative and nitrosative
stress (IO&NS) pathways may explain cardiovascular disorders in ME/CFS.
Journal: Neuro Endocrinol Lett. 2009 Dec 30;30(6). [Epub ahead of print]
Authors: Maes M, Twisk FN.
Maes Clinics, Antwerp, Belgium. <email@example.com>.
NLM Citation: PMID: 20038921
There is evidence that disorders in inflammatory and oxidative and
nitrosative (IO&NS) pathways and a lowered antioxidant status are
important pathophysiological mechanisms underpinning myalgic
encephalomyelitis / chronic fatigue syndrome (ME/CFS). Important
precipitating and perpetuating factors for ME/CFS are (amongst
others) bacterial and viral infections; bacterial translocation due
to an increased gut permeability; and psychological stress.
Recently, Jason et al (2006) reported that the mean age of patients
with myalgic encephalomyelitis/chronic fatigue syndrome dying from
heart failure, i.e. 58.7 years, is significantly lower than the age
of those dying from heart failure in the general US population, i.e.
83.1 years. These findings implicate that ME/CFS is a risk factor to
This review demonstrates that disorders in various IO&NS pathways
provide explanations for the earlier mortality due to cardiovascular
disorders in ME/CFS. These pathways are: a) chronic low grade
inflammation with extended production of nuclear factor kappa B and
COX-2 and increased levels of tumour necrosis factor alpha; b)
increased O&NS with increased peroxide levels, and phospholipid
oxidation including oxidative damage to phosphatidylinositol; c)
decreased levels of specific antioxidants, i.e. coenzyme Q10, zinc
and dehydroepiandrosterone-sulphate; d) bacterial translocation as a
result of leaky gut; e) decreased omega-3 polyunsatutared fatty acids
(PUFAs), and increased omega-6 PUFA and saturated fatty acid levels;
and f) the presence of viral and bacterial infections and
psychological stressors. The mechanisms whereby each of these factors
may contribute towards cardio-vascular disorder in ME/CFS are discussed.
ME/CFS is a multisystemic metabolic-inflammatory disorder. The
aberrations in IO&NS pathways may increase the risk for