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Abnormalities in pH handling by peripheral muscle and potential regulation by .......

Discussion in 'Latest ME/CFS Research' started by shrewsbury, Mar 29, 2010.

  1. shrewsbury

    shrewsbury member

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    Tate Mitchell posted this to co-cure today.

    [if: Thank goodness real science is continuing!]

    'Abnormalities in pH handling by peripheral muscle and potential
    regulation by the autonomic nervous system in chronic fatigue syndrome'


    Jones, D. E. J.1; Hollingsworth, K. G.2; Taylor, R.2; Blamire, A. M.2;
    Newton, J. L.

    Journal of Internal Medicine, Volume 267, Number 4, April 2010 , pp. 394-401(8)

    Affiliations: 1: From the Institute of Cellular Medicine 2: Newcastle
    Magnetic Resonance Centre

    Jones DEJ, Hollingsworth KG, Taylor R, Blamire AM, Newton JL (From the
    Institute of Cellular Medicine, Newcastle Magnetic Resonance Centre,
    and Institute for Ageing and Health, Newcastle University, UK).
    Abnormalities in pH handling by peripheral muscle and potential
    regulation by the autonomic nervous system in chronic fatigue
    syndrome. J Intern Med 2010; 267: 394-401.

    http://www.ingentaconnect.com/content/bsc/jint/2010/00000267/00000004/art00006


    Abstract:

    Objectives. To examine muscle acid handling following exercise in
    chronic fatigue syndrome (CFS/ME) and the relationship with autonomic
    dysfunction.


    Design. Observational study.

    Setting. Regional fatigue service.

    Subjects & interventions. Chronic fatigue syndrome (n = 16) and age
    and sex matched normal controls (n = 8) underwent phosphorus magnetic
    resonance spectroscopy (MRS) to evaluate pH handling during exercise.
    Subjects performed plantar flexion at fixed 35% load maximum voluntary
    contraction. Heart rate variability was performed during 10 min supine
    rest using digital photophlethysmography as a measure of autonomic
    function.

    Results. Compared to normal controls, the CFS/ME group had significant
    suppression of proton efflux both immediately postexercise (CFS: 1.1 
    0.5 mmol L−1 min−1 vs. normal: 3.6  1.5 mmol L−1 min−1, P < 0.001)
    and maximally (CFS: 2.7  3.4 mmol L−1 min−1 vs. control: 3.8  1.6
    mmol L−1 min−1, P < 0.05). Furthermore, the time taken to reach
    maximum proton efflux was significantly prolonged in patients (CFS:
    25.6  36.1 s vs. normal: 3.8  5.2 s, P < 0.05). In controls the rate
    of maximum proton efflux showed a strong inverse correlation with
    nadir muscle pH following exercise (r2 = 0.6; P < 0.01). In CFS
    patients, in contrast, this significant normal relationship was lost
    (r2 = 0.003; P = ns). In normal individuals, the maximum proton efflux
    following exercise were closely correlated with total heart rate
    variability (r2 = 0.7; P = 0.007) this relationship was lost in CFS/ME
    patients (r2 < 0.001; P = ns).

    Conclusion. Patients with CFS/ME have abnormalities in recovery of
    intramuscular pH following standardised exercise degree of which is
    related to autonomic dysfunction. This study identifies a novel
    biological abnormality in patients with CFS/ME which is potentially
    open to modification.


    Keywords: autonomic dysfunction; chronic fatigue syndrome; magnetic
    resonance spectroscopy; muscle bioenergetics

    Document Type: Research article

    DOI: 10.1111/j.1365-2796.2009.02160.x

    Affiliations: 1: From the Institute of Cellular Medicine 2: Newcastle
    Magnetic Resonance Centre
  2. Gerwyn

    Gerwyn Guest

    Is there any way of finding out how these patients were diagnosed
  3. lansbergen

    lansbergen Senior Member

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    Abnormalities in pH handling by peripheral muscle

    Abnormalities in pH handling by peripheral muscle and potential regulation by the autonomic nervous system in chronic fatigue syndrome

    Abstract:. 

    Jones DEJ, Hollingsworth KG, Taylor R, Blamire AM, Newton JL (From the Institute of Cellular Medicine, Newcastle Magnetic Resonance Centre, and Institute for Ageing and Health, Newcastle University, UK). Abnormalities in pH handling by peripheral muscle and potential regulation by the autonomic nervous system in chronic fatigue syndrome. J Intern Med 2010; 267: 394-401. Objectives. 

    To examine muscle acid handling following exercise in chronic fatigue syndrome (CFS/ME) and the relationship with autonomic dysfunction. Design. 

    Observational study. Setting. 

    Regional fatigue service. Subjects & interventions. 

    Chronic fatigue syndrome (n = 16) and age and sex matched normal controls (n = 8) underwent phosphorus magnetic resonance spectroscopy (MRS) to evaluate pH handling during exercise. Subjects performed plantar flexion at fixed 35% load maximum voluntary contraction. Heart rate variability was performed during 10 min supine rest using digital photophlethysmography as a measure of autonomic function. Results. 

    Compared to normal controls, the CFS/ME group had significant suppression of proton efflux both immediately postexercise (CFS: 1.1  0.5 mmol L−1 min−1 vs. normal: 3.6  1.5 mmol L−1 min−1, P < 0.001) and maximally (CFS: 2.7  3.4 mmol L−1 min−1 vs. control: 3.8  1.6 mmol L−1 min−1, P < 0.05). Furthermore, the time taken to reach maximum proton efflux was significantly prolonged in patients (CFS: 25.6  36.1 s vs. normal: 3.8  5.2 s, P < 0.05). In controls the rate of maximum proton efflux showed a strong inverse correlation with nadir muscle pH following exercise (r2 = 0.6; P < 0.01). In CFS patients, in contrast, this significant normal relationship was lost (r2 = 0.003; P = ns). In normal individuals, the maximum proton efflux following exercise were closely correlated with total heart rate variability (r2 = 0.7; P = 0.007) this relationship was lost in CFS/ME patients (r2 < 0.001; P = ns). Conclusion. 

    Patients with CFS/ME have abnormalities in recovery of intramuscular pH following standardised exercise degree of which is related to autonomic dysfunction. This study identifies a novel biological abnormality in patients with CFS/ME which is potentially open to modification.
  4. Koan

    Koan Be the change.

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    Thank you, lansbergen, for this most interesting paper!

    I am always happy to see the words: potentially open to modification!
  5. shrewsbury

    shrewsbury member

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    hi lansbergen & welcome to the forum

    me too - and I especially like that "This study identifies a novel biological abnormality in patients with CFS/ME which is potentially open to modification.

    ps - I'll let the admins know that there are 2 threads on this abstract now
  6. Koan

    Koan Be the change.

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    Whoa Nelly! What just happened?! A minute ago my post was the only reply.

    Ahhh, thanks If and Gerwyn, too.

    I gotta lie down.
    aimossy likes this.
  7. Koan

    Koan Be the change.

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    If, How did they merge them before you even let them know!

    Space/time continuum stuff always freaks me out!
    aimossy likes this.
  8. shrewsbury

    shrewsbury member

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    holy timewarp batwoman! What just happened?

    [​IMG]

    space/time continuum and/or psychic
    aimossy likes this.
  9. Dolphin

    Dolphin Senior Member

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    Apart from the technical data, we are not given much info:
  10. Dolphin

    Dolphin Senior Member

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    I'm not convinced:
    I like this idea:
    Rubbish subject outcome measures particularly for recovery are used in many trials in the field.
  11. WillowJ

    WillowJ Senior Member

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    ugh to the biofeedback producing normalization. Don't they realize that serious chronic disease + lack of serious intervention = sophisticated independent biofeedback all on one's own? (othewise maligned as inappriate attention to symptoms)

    If that were possible, we'd have done it already. Needs other intervention.

    Sigh. That's what I get for putting articles on my list without having access to the full text. Thanks for the better info. :)
  12. Bob

    Bob

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    MeSci, Sea, alex3619 and 1 other person like this.
  13. MeSci

    MeSci ME/CFS since 1995; activity level 6

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    Great - thanks for that, Bob.

    These bits are interesting:

    (Ouch - hope that bad grammar is a typo!)

    Hmm...Myhill and some others reckon, and claim to have evidence that, there are mitochondrial oxidative abnormalities, and to have identified some. Hmmmmm....

    Is one theory right and the other wrong, or is this an issue of subgroups? Or are the stats dodgy? (This study says no significant difference, but there is a difference.)
  14. Snow Leopard

    Snow Leopard Senior Member

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    Australia
    Most evidence suggests that the oxidative function of the mitochondria themselves is in fact normal. Such deficiencies would also lead to different kinetics involved (particularly a lack of PEM, but rather a more constant fatigue instead).

    Other evidence suggests that the problems are likely to be upstream of the mitochondria, with oxidative stress and issues with regulation of fatty acid metabolism before presentation across the mitochondrial membrane.
    MeSci and aimossy like this.
  15. alex3619

    alex3619 Senior Member

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    Logan, Queensland, Australia
    Its been a long time since I read Myhill's work. Wasn't the problem they were looking at something to do with transfer of substances across the mitochondrial membrane? So at rest or short activity it would look normal, but when stressed then critical deficiencies would start to appear?
    MeSci likes this.
  16. MeSci

    MeSci ME/CFS since 1995; activity level 6

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    Here's one of the Myhill team's papers.

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