[ME/CFS]: From Pathophysiological Insights to Novel Therapeutic Opportunities, 2019, Berk et al

[Andy]

Abstract
Myalgic 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.

Paywall, https://www.sciencedirect.com/science/article/abs/pii/S1043661819308011
Not currently available on Sci hub.

 

[mariovitali]

..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.

Regarding NAC (N-AcetylCysteine) : I did try it and within one hour i felt as i couldn't breathe easily. Upon trying to walk on stairs i got very fatigued and my pulse rate went quite up.

Perhaps one of the best things i heard on the latest symposium was about personalised interventions that address each patient individually.

 

[Trish]

It's available on Sci-hub now as a Journal Pre-proof.
https://sci-hub.se/https://doi.org/10.1016/j.phrs.2019.104450

I've only had a quick glance through and this is my impression:

It's about 38 pages plus a very long list of references.

It that looks at various kinds of evidence for biological abnormalities in ME first.

Most of the focus is on various nutriceutical treatments they think might be worth testing. They look at their biological effects using evidence of their effects on animals, and on people with other conditions.

Then it ends with a section on CBT and GET, concluding they only have slight short term effects and GET can be harmful.

I imagine the purpose is to try to get funding for some nutriceutical trials.