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Myalgic encephalomyelitis/chronic fatigue syndrome: from pathophysiological insights to novel therapeutic opportunities
journal contribution
posted on 2019-09-08, 00:00 authored by G Morris, B K Puri, Adam WalkerAdam Walker, M Maes, A F Carvalho, Ken WalderKen Walder, Catherine MazzaCatherine Mazza, Michael BerkMichael BerkMyalgic encephalomyelitis (ME) or chronic fatigue syndrome (CFS) is a common and disabling condition with a paucity of effective and evidence-based therapies, reflecting a major unmet need. Cognitive behavioural therapy and graded exercise are of modest benefit for only some ME/CFS patients, and many sufferers report aggravation of symptoms of fatigue with exercise. The presence of a multiplicity of pathophysiological abnormalities in at least the subgroup of people with ME/CFS diagnosed with the current international consensus “Fukuda” criteria, points to numerous potential therapeutic targets. Such abnormalities include extensive data showing that at least a subgroup has a pro-inflammatory state, increased oxidative and nitrosative stress, disruption of gut mucosal barriers and mitochondrial dysfunction together with dysregulated bioenergetics. In this paper, these pathways are summarised, and data regarding promising therapeutic options that target these pathways are highlighted; they include coenzyme Q10, melatonin, curcumin, molecular hydrogen and N-acetylcysteine. These data are promising yet preliminary, suggesting hopeful avenues to address this major unmet burden of illness.
History
Journal
Pharmacological researchVolume
148Article number
104450Pagination
1 - 20Publisher
ElseiverLocation
Amsterdam, The NetherlandsPublisher DOI
ISSN
1043-6618eISSN
1096-1186Language
engPublication classification
C1 Refereed article in a scholarly journalCopyright notice
2019, ElsevierUsage metrics
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Categories
Keywords
Science & TechnologyLife Sciences & BiomedicinePharmacology & PharmacyChronic fatigue syndromeMyalgic encephalomyelitisOxidative stressInflammationMitochondrial dysfunctionHYDROGEN-RICH SALINEHEART-RATE-VARIABILITYNF-KAPPA-BINDUCED OXIDATIVE STRESSSTATE FUNCTIONAL CONNECTIVITYCOGNITIVE-BEHAVIORAL THERAPYPRO-INFLAMMATORY CYTOKINESTRAUMATIC BRAIN-INJURYNITRIC-OXIDE SYNTHASEMAGNETIC-RESONANCE-SPECTROSCOPY