Cfs- New Study Shows Oxidative Stress May Be The Culprit

[juliegee]

The term Chronic Fatigue Syndrome/CFS is often used interchangeably with dysautonomia. A new study shows that oxidative stress may be behind our symptoms as measured by increased cerebral spinal fluid lactate:

Increased ventricular lactate in chronic fatigue syndrome. III. Relationships to cortical glutathione and clinical symptoms implicate oxidative stress in disorder pathophysiology

• Dikoma C. Shungu^1,*,
  
• Nora Weiduschat¹,
  
• James W. Murrough²,
  
• Xiangling Mao¹,
  
• Sarah Pillemer²,
  
• Jonathan P. Dyke¹,
  
• Marvin S. Medow³,
  
• Benjamin H. Natelson⁴,
  
• Julian M. Stewart³,
  
• Sanjay J. Mathew^2,5
  

Article first published online: 27 JAN 2012

Chronic fatigue syndrome (CFS) is a complex illness, which is often misdiagnosed as a psychiatric illness. In two previous reports, using¹H MRSI, we found significantly higher levels of ventricular cerebrospinal fluid (CSF) lactate in patients with CFS relative to those with generalized anxiety disorder and healthy volunteers (HV), but not relative to those with major depressive disorder (MDD). In this third independent cross-sectional neuroimaging study, we investigated a pathophysiological model which postulated that elevations of CSF lactate in patients with CFS might be caused by increased oxidative stress, cerebral hypoperfusion and/or secondary mitochondrial dysfunction. Fifteen patients with CFS, 15 with MDD and 13 HVs were studied using the following modalities: (i) ¹H MRSI to measure CSF lactate; (ii) single-voxel ¹H MRS to measure levels of cortical glutathione (GSH) as a marker of antioxidant capacity; (iii) arterial spin labeling (ASL) MRI to measure regional cerebral blood flow (rCBF); and (iv) ³¹P MRSI to measure brain high-energy phosphates as objective indices of mitochondrial dysfunction. We found elevated ventricular lactate and decreased GSH in patients with CFS and MDD relative to HVs. GSH did not differ significantly between the two patient groups. In addition, we found lower rCBF in the left anterior cingulate cortex and the right lingual gyrus in patients with CFS relative to HVs, but rCBF did not differ between those with CFS and MDD. We found no differences between the three groups in terms of any high-energy phosphate metabolites. In exploratory correlation analyses, we found that levels of ventricular lactate and cortical GSH were inversely correlated, and significantly associated with several key indices of physical health and disability. Collectively, the results of this third independent study support a pathophysiological model of CFS in which increased oxidative stress may play a key role in CFS etiopathophysiology. Copyright © 2012 John Wiley & Sons, Ltd.

http://onlinelibrary...m.2772/abstract

[juliegee]

Wow, the more I read- pretty exciting. This is the 3rd independent study to get the same results. Adds credibility to theories like Martin Pall's:

http://www.thetenthparadigm.org/

[ramakentesh]

Ah yes the No cycle stuff. Well he was kind of right on the money since some POTS patients definately have too much NO - just not inductible NO, rather endothelial and neuronal.

This is some fascinating work. between this, the recent stuff on cognitive function in CFS with POTS, ritiximab and the spinal fluid stuff the future is looking bright. But the question is finding where you fit in this all. In some ways its all a bit contradictory when considered against the basic POTS research.

[sue1234]

What is ritiximab? Did I miss a conversation on what this is?

[jangle]

I know CFS has some carryover with POTS, however in my personal case I don't really suffer from fatigue during the day so I don't know how applicable this is to me. Still, I wonder if there's been any studies about antioxidants for CFS patients?

[juliegee]

Numerous studies have found over 90% of CFS sufferers have an autonomic dysfunction- either POTS or NMH. If you don't experience fatigue, Jangle, you are VERY lucky

http://www.nymc.edu/fhp/centers/syncope/cfs.htm

[McBlonde]

I know CFS has some carryover with POTS, however in my personal case I don't really suffer from fatigue during the day so I don't know how applicable this is to me. Still, I wonder if there's been any studies about antioxidants for CFS patients?

Oh my!! You don't have the fatigue? Count your lucky stars on that! Is it because your HR and BP are controlled?

[issie]

Jangle, I don't have the fatigue either. In fact, even though I don't sleep very well - at all. I don't really feel extremely tired. My sister - does have the fatigue and constantly says how tired she is. But, she sleeps pretty much through the whole night. I think we are fortunate to be able to say this. Those with CFS really suffer to function at all through the day. I do have a life with POTS and I think those who have POTS and CFS are suffering so much with limited abilities. I hope there is an answer on the near horizon for those with this.

Issie

[McBlonde]

That is so interesting! I don't know why I thought everyone had the fatigue. My doctor explained to me that my fatigue is caused from the constant up and down of my HR and BP. When I was little, I used to faint a lot. Then lived a fairly normal life until 2003 when I woke up one morning and out of the blue I was struck with this unrelenting fatigue... hardly able to make it to the kitchen that day. Crushing fatigue even after a solid 10 hours of sleep. An endocrinologist measured my aldosterone and renin first while lying in a quiet room and then when standing up. Both aldosterone and renin were low. I did ok (off and on) until 2009 when I was driving home from work and got a terrible headache and nausea which they FINALLY pinned down on my HR which was 166 sitting down... very disabling unfortunately.

[HopeSprings]

Sue - (i think this was the story) -- there were some lymphoma people who were being treated with this drug and I guess they also had CFS and found those symptoms improved with the drug. So then they did a trial with the drug on CFS people and found it can help. Here's a little excerpt from an article about this and the link is below:

An Auto-immune Disorder?

Rituximab is now being used effectively in a variety of autoimmune disorders and is being studied in even more. Could Rituximab’s success mean that CFS is, in fact, an autoimmune disorder in which some as yet unidentified tissues are being attacked? The purported Th2 shift in the immune response found in CFS which may result in increased antibody production - could be interpreted as being on a step on the road to an autoimmune disorder.

http://esme-eu.com/treatment/a-drug-for-me-cfs-the-rituximab-story-article468-110.html

[sue1234]

Naomi, thanks for clueing me in! I hand't seen this.

McBlonde, did all of your replacement meds for hypopit. help a little, somewhat or alot since you were diagnosed in 2003? What all are you on?

[jangle]

I know CFS has some carryover with POTS, however in my personal case I don't really suffer from fatigue during the day so I don't know how applicable this is to me. Still, I wonder if there's been any studies about antioxidants for CFS patients?

Oh my!! You don't have the fatigue? Count your lucky stars on that! Is it because your HR and BP are controlled?

Neither are well controlled. My BP oscillates like crazy 90-120/60-80 and my HR goes up to 120 on standing.

[Maiysa]

That was an interesting article Naomi. Thanks for posting. I noticed they studied a lot of people with EBV. It sounds like this is a very common virus. I never had a cold sore or anything or mono and my numbers were very high for EBV. I had one doctor tell me in the early 2000 that it is the disease of the year and it will fade out. He said it means nothing. I guess I don't know one way or the other, but it seems to be a topic of testing in the study posted by Naomi. Although this drug for chronic fatigue sounds promising, the side affects were pretty harsh and most people on here are already having heart problems. Any type of chemo therapy wipes out your good cells, I would want this one to be on the market for a while. In the meantime, I would rather deal with the fatigue. Although, I wish it would go away. I can't imagine why some POTS patients would not have CFS while other would. Jangle, I know you struggle, so that's so good to hear you don't have CFS. I don't have POTS, but when my blood pressure is fluctuating I get so tired, the doctor read my HR and BP and said, just from standing, it's like you're running a marathon, no wonder you're tired. If only it was a marathon. And even when my blood pressure isn't fluctuating, I'm still very very tired. But I've never been diagnosed with CFS, but I think I have "IAST", short for "I'm Always Soooooooooo Tired." But I've also had constant anemia for the past five years. Anyhow, thanks for the great articles girls!

[kmichaelson]

Can anyone explain what ventricular lactate means? Sorry, this sounds interesting, but I can't figure out the meaning of that!

[martiz]

Rituximab

http://phoenixrising.me/archives/1977

[POTLUCK]

A lot of info on these subjects in this article.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3022475/

Including....

Oxidative Stress Theory

Martin Pall (2007) has suggested that oxidative stress might help explain the pathophysiology among patients with ME/CFS. According to Pall’s theory, when NMDA receptors on neurons are activated by a virus, bacteria, mold, toxin, microbe or allergy, they trigger nitric oxide production.

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Other aspects of the circulatory system also seem to be involved in ME/CFS. In response to postural stress, 81% of patients with ME/CFS and no controls experienced ejection fraction decreases, suggesting left ventricular dysfunction in the heart

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Also, discharges of the type one associates with epilepsy were seen in the temporal lobes.

In a later study, Duffy et al. (2009) found that factors derived from the EEG data were able to discriminate with nearly 90% accuracy patients with ME/CFS from healthy controls and from those with major depression.

[ramakentesh]

Some of the newer stuff coming out of the Stewart Medows team is looking at this right now.

[POTLUCK]

Some of the newer stuff coming out of the Stewart Medows team is looking at this right now.

I am not clear on what you meant they are looking at now. The article is a Stewart/Medows publication. Are they doing something since then that you are aware of? I would like to stay up on it.

I was looking at this thread again as it seems the oxidative stress ties in with both of the illnesses ( Temporal Lobe Epilepsy and POTS ) that I have, and they connect. Also many of the herbal/supplemental meds seem to work via oxidative stress reduction mechanisms.