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 cardiovascular disorder. 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 tumor necrosis factor alpha;
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b) Increased O&NS with increased peroxide levels, and phospholipid oxidation including oxidative damage to phosphatidylinositol;
c) Decreased levels of specific antioxidants – that is, coenzyme Q10, zinc, and dehydroepiandrosterone-sulphate (DHEAS); **
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 cardiovascular 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 cardiovascular disorders.
Source: Neuro Endocrinology Letters, Dec 30, 2009;30(6). PMID: 20038921, by Maes M, Twisk FN. Maes Clinics, Antwerp, Belgium. [E-mail: email@example.com]
* “Causes of death among patient with Chronic Fatigue Syndrome,” Health Care for Women International, Aug 2006, by Jason, et al.
** See also the authors’ paper, published as a companion to this one in Neuro Endocrinology Letters, “Coenzyme Q10 deficiency in ME/CFS is related to fatigue, autonomic and neurocognitive symptoms…”