Dr Snell, University of the Pacific, California: ME/CFS patients have a reduced capacity to exercise when they repeat a maximum exercise test one day on – unlike healthy controls

@ pubmed

Phys Ther. 2013 Jun 27. [Epub ahead of print]

Discriminative Validity of Metabolic and Workload Measurements to Identify Individuals With Chronic Fatigue Syndrome.

Snell CR, Stevens SR, Davenport TE, Van Ness JM.

Source

C.R. Snell, Department of Sport Sciences, University of the Pacific, Stockton, California.

Abstract

Objectives

Reduced functional capacity and post-exertional fatigue following physical activity are hallmark symptoms of chronic fatigue syndrome (CFS) and may even qualify for biomarker status. That these symptoms are often delayed may explain the equivocal results for clinical cardiopulmonary exercise testing among individuals with CFS. Test reproducibility in healthy subjects is well documented. This may not be the case with CFS due to delayed recovery symptoms. The objectives for this study was to determine the discriminative validity of objective measurements obtained during CPET to distinguish individuals with CFS from non-disabled sedentary individuals.MethodsGas exchange data, workloads and related physiological parameters were compared between 51 individuals with CFS and 10 control subjects, all females, for two maximal exercise tests separated by 24 hours.ResultsMultivariate analysis showed no significant differences between controls and CFS for Test 1. However, for Test 2 the individuals with CFS achieved significantly lower values for oxygen consumption and workload at peak exercise and at the ventilatory/anaerobic threshold. Follow-up classification analysis differentiated between groups with an overall accuracy of 95.1%.

Conclusions

The lack of any significant differences between groups for the first exercise test would appear to support a deconditioning hypothesis for CFS symptoms. However, results from the second test indicate the presence of a CFS related post-exertional fatigue. It might be concluded that a single exercise test is insufficient to reliably demonstrate functional impairment in individuals with CFS. A second test may be necessary to document the atypical recovery response and protracted fatigue possibly unique to CFS, which can severely limit productivity in the home and workplace.

PMID:

 

23813081

 

[PubMed - as supplied by publisher]

PS: Dr Snell's healthy controls were couchpatatoes to eliminate the effect of exercise.
With this study he proofs again that deconditioning does not play a role or is not the cause of relapses. There is simply an underlying physical problem.

Rest in peace Theda (Myint)

Wendy said: "So very tragic because Theda's life could have been much different if Drs would shut down the psycho babble and acknowledge this disease as the debilitating physical torture that it is."

A bloodspot-based diagnostic test for fibromyalgia syndrome: changes in tryptophan catabolism pathway differentiate patients with FM from those with RA or OA

Paper

A bloodspot-based diagnostic test for fibromyalgia syndrome and related disorders

Kevin V. Hackshaw,^a   Luis Rodriguez-Saona,^b   Marçal Plans,^b  Lauren N. Bell^d and   C. A. Tony Buffington*^c  

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Analyst, 2013,138, 4453-4462

DOI: 10.1039/C3AN36615D
Received 05 Nov 2012, Accepted 03 Apr 2013
First published online 04 Apr 2013

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The aim of this study was to investigate the ability of a rapid biomarker-based method for diagnosis of fibromyalgia syndrome (FM) using mid-infrared microspectroscopy (IRMS) to differentiate patients with FM from those with osteoarthritis (OA) and rheumatoid arthritis (RA), and to identify molecular species associated with the spectral patterns. Under IRB approval, blood samples were collected from patients diagnosed with FM (n = 14), RA (n = 15), or OA (n = 12). Samples were prepared, placed onto a highly reflective slide, and spectra were collected using IRMS. Spectra were analyzed using multivariate statistical modeling to differentiate groups. Aliquots of samples also were subjected to metabolomic analysis. IRMS separated subjects into classes based on spectral information with no misclassifications among FM and RA or OA patients. Interclass distances of 15.4 (FM vs. RA), 14.7 (FM vs. OA) and 2.5 (RA vs. OA) among subjects, demonstrating the ability of IRMS to achieve reliable resolution of unique spectral patterns specific to FM. Metabolomic analysis revealed that RA and OA groups were metabolically similar, whereas biochemical differences were identified in the FM that were quite distinctive from those found in the other two groups. Both IRMS and metabolomic analysis identified changes in tryptophan catabolism pathway that differentiated patients with FM from those with RA or OA.

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Dr. Michael Knops, Charité, Berlin: chronic immune activation in ME/CFS

Haupttitel	Charakterisierung des phänotypischen und funktionellen Immunstatus bei Patienten mit Chronischem Erschöpfungssyndrom
Titelvariante	Phenotypical and functional characterisation of immune status in patients with chronic fatigue syndrome
Autor	Knops, Michael Geburtsort: Köln
Gutachter	Prof. Dr. med. C. Scheibenbogen
weitere Gutachter	Priv.-Doz. Dr. S. Engeli Priv.-Doz. Dr. med. W. Jabs
Freie Schlagwörter	chronic fatigue syndrome; t-cell activation; immune dysregulation; immunoglobuline deficiency; cytokine deviation

Zusammenfassend zeigen die vorliegenden Ergebnisse, dass Patienten mit einem chronischen Erschöpfungssyndrom eine chronische Immunaktivierung und eine Immundeviation zeigen, die eine Einteilung in vier immunologische Subgruppen zulassen. Diese Subgruppen sollten in prospektiven Studien weiter untersucht werden. Zudem wurde festgestellt, dass ein oxidativer und/oder nitrosativer Stress bei CFS-Patienten offenbar eine Rolle spielt, was im Rahmen weiterer Studien genauer untersucht werden sollte. Die neu gewonnenen Erkenntnisse tragen zum Verständnis der Pathogenese von CFS bei und sind Grundlage für die Entwicklung neuer Behandlungskonzepte.

google translated:

 In summary, the present results demonstrate that patients with chronic fatigue syndrome is a chronic immune activation and immune deviation show that allow a classification into four immunological subgroups.

These subgroups should be investigated in prospective studies. It was also noted that an oxidative and / or nitrosative stress in CFS patients appears to play a role, which should be further investigated as part of future studies. The newly gained knowledge contribute to understanding the pathogenesis of CFS and are the basis for the development of new treatment concepts.

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