Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: From Pathophysiological Insights to Novel Therapeutic Opportunities

Publication date: Available online 8 September 2019Source: Pharmacological ResearchAuthor(s): Gerwyn Morris, Basant K. Puri, Adam J. Walker, Michael Maes, Andre F. Carvalho, Ken Walder, Catherine Mazza, Michael BerkAbstractMyalgic 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.Graphical abstract
Source: Pharmacological Research - Category: Drugs & Pharmacology Source Type: research

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CONCLUSIONS: Exercise therapy probably has a positive effect on fatigue in adults with CFS compared to usual care or passive therapies. The evidence regarding adverse effects is uncertain. Due to limited evidence it is difficult to draw conclusions about the comparative effectiveness of CBT, adaptive pacing or other interventions. All studies were conducted with outpatients diagnosed with 1994 criteria of the Centers for Disease Control and Prevention or the Oxford criteria, or both. Patients diagnosed using other criteria may experience different effects. PMID: 31577366 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
Purpose of review The current review aims to determine the recent evidence regarding cause, impact, effective treatment and prognosis of children and young people (CYP) affected by chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) at a time when the National Institute for Clinical Excellence guidelines in the United Kingdom are being reviewed and more research is called for worldwide. Recent findings CFS/ME is a debilitating illness with no clear cause. This review describes the heterogeneous clinical picture and the effects on the young person and family. Comorbidities such as mood disorders and pain are di...
Source: Current Opinion in Pediatrics - Category: Pediatrics Tags: ADOLESCENT MEDICINE: Edited by Sara F. Forman and Sarah Pitts Source Type: research
Authors: Janse A, Bleijenberg G, Knoop H PMID: 30741142 [PubMed - in process]
Source: The British Journal of Psychiatry for Mental Science - Category: Psychiatry Tags: Br J Psychiatry Source Type: research
How far is too far when it comes to the public directing research? There are concerns than a science journal may revise a paper amid pressure from activists. It raises the issue of what role the public should play and whether science should have boundaries to protect its integrity.Ian Sample presents.Chronic fatigue syndrome is a severe, long-term illness with a wide range of symptoms, the most common of which is extreme mental and physical fatigue. Scientists haven ’t been able to find the cause and current interventions focus on helping sufferers cope with the syndrome. These interventions are cognitive behavioural...
Source: Guardian Unlimited Science - Category: Science Authors: Tags: Science Medicine Source Type: news
Authors: Twisk F, Corsius L PMID: 30027882 [PubMed - in process]
Source: The British Journal of Psychiatry for Mental Science - Category: Psychiatry Tags: Br J Psychiatry Source Type: research
DiscussionIf FITNET-NHS is found to be feasible and acceptable (internal pilot) and effective and cost-effective (full trial), its provision by the NHS has the potential to deliver substantial health gains for the large number of young people suffering from CFS/ME but unable to access treatment because there is no local specialist service. This trial will provide further evidence evaluating the delivery of online CBT to young people with chronic conditions.Trial registrationISRCTN registry, registration number:ISRCTN18020851. Registered on 4 August 2016.
Source: Trials - Category: Research Source Type: clinical trials
Authors: Janse A, Worm-Smeitink M, Bleijenberg G, Donders R, Knoop H Abstract BACKGROUND: Face-to-face cognitive-behavioural therapy (CBT) leads to a reduction of fatigue in chronic fatigue syndrome (CFS). Aims To test the efficacy of internet-based CBT (iCBT) for adults with CFS. METHOD: A total of 240 patients with CFS were randomised to either iCBT with protocol-driven therapist feedback or with therapist feedback on demand, or a waiting list. Primary outcome was fatigue severity assessed with the Checklist Individual Strength (Netherlands Trial Register: NTR4013). RESULTS: Compared with a waiting list, ...
Source: The British Journal of Psychiatry for Mental Science - Category: Psychiatry Tags: Br J Psychiatry Source Type: research
Conclusion The results from this very small randomised controlled trial showed that people having LP therapy in addition to usual CFS/ME care had improved physical function, fatigue and anxiety symptoms at six months, and improved school attendance and depressive symptoms at 12 months. However, there are a number of limitations to this research that need to be considered: Participants in both groups improved, so both treatments were effective to some extent. This was a very small trial, and the results analysis involved fewer than the 100 people recruited. It would need to be repeated in a much larger group to demonstr...
Source: NHS News Feed - Category: Consumer Health News Tags: Medical practice Source Type: news
This article shows that the...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Commentary Source Type: news
Publication date: Available online 24 April 2017 Source:The Lancet Diabetes & Endocrinology Author(s): Juliane Menting, Cees J Tack, Arianne C van Bon, Henry J Jansen, Joop P van den Bergh, Marc J T M Mol, Martine M Goedendorp, Rogier Donders, Hans Knoop Background Fatigue in type 1 diabetes is prevalent and persistent, but so far, no evidence-based treatments are available. We aimed to investigate the efficacy of cognitive behavioural therapy (CBT) in reducing fatigue severity in patients with type 1 diabetes. Methods We did a multicentre randomised controlled trial at one university medical centre and four large tea...
Source: The Lancet Diabetes and Endocrinology - Category: Endocrinology Source Type: research
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