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Changes in Gut and Plasma Microbiome following Exercise Challenge in ME/CFS

Kyla

ᴀɴɴɪᴇ ɢꜱᴀᴍᴩᴇʟ
Messages
721
Location
Canada
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0145453
Open access


Changes in Gut and Plasma Microbiome following Exercise Challenge in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)
  • Sanjay K. Shukla ,
  • Dane Cook,
  • Jacob Meyer,
  • Suzanne D. Vernon,
  • Thao Le,
  • Derek Clevidence,
  • Charles E. Robertson,
  • Steven J. Schrodi,
  • Steven Yale,
  • Daniel N. Frank
logo.plos.95.png


  • Published: December 18, 2015
  • DOI: 10.1371/journal.pone.0145453
Abstract
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a disease characterized by intense and debilitating fatigue not due to physical activity that has persisted for at least 6 months, post-exertional malaise, unrefreshing sleep, and accompanied by a number of secondary symptoms, including sore throat, memory and concentration impairment, headache, and muscle/joint pain. In patients with post-exertional malaise, significant worsening of symptoms occurs following physical exertion and exercise challenge serves as a useful method for identifying biomarkers for exertion intolerance. Evidence suggests that intestinal dysbiosis and systemic responses to gut microorganisms may play a role in the symptomology of ME/CFS. As such, we hypothesized that post-exertion worsening of ME/CFS symptoms could be due to increased bacterial translocation from the intestine into the systemic circulation. To test this hypothesis, we collected symptom reports and blood and stool samples from ten clinically characterized ME/CFS patients and ten matched healthy controls before and 15 minutes, 48 hours, and 72 hours after a maximal exercise challenge. Microbiomes of blood and stool samples were examined. Stool sample microbiomes differed between ME/CFS patients and healthy controls in the abundance of several major bacterial phyla. Following maximal exercise challenge, there was an increase in relative abundance of 6 of the 9 major bacterial phyla/genera in ME/CFS patients from baseline to 72 hours post-exercise compared to only 2 of the 9 phyla/genera in controls (p = 0.005). There was also a significant difference in clearance of specific bacterial phyla from blood following exercise with high levels of bacterial sequences maintained at 72 hours post-exercise in ME/CFS patients versus clearance in the controls. These results provide evidence for a systemic effect of an altered gut microbiome in ME/CFS patients compared to controls. Upon exercise challenge, there were significant changes in the abundance of major bacterial phyla in the gut in ME/CFS patients not observed in healthy controls. In addition, compared to controls clearance of bacteria from the blood was delayed in ME/CFS patients following exercise. These findings suggest a role for an altered gut microbiome and increased bacterial translocation following exercise in ME/CFS patients that may account for the profound post-exertional malaise experienced by ME/CFS patients.
 

A.B.

Senior Member
Messages
3,780
Very interesting to see such a marked difference between patients and controls, but this is a small pilot study so results need to be interpreted with some caution.

Could a transient presence of bacteria in the blood explain the findings by Alan Light? (altered gene expression in white blood cells after exercise)
 

A.B.

Senior Member
Messages
3,780
I'm guessing that it probably has to do with exertion induced cytokine release. It looks like proinflammatory cytokines are known to disrupt epithelial barrier function.

I believe exercise increase intestinal permeability. Could anyone confirm this with a good source?

Then again this alone cannot explain the difference between patients and controls.
 

Crux

Senior Member
Messages
1,441
Location
USA
Exercise, stress,etc. increase catecholamines, such as, adrenaline and noradrenaline.

Bacteria use these and other hormones for growth.

It seems to explain, possibly, why we feel poorly, PEM, after exercise and stress of any sort.

It also seems to explain why stimulant type interventions can cause side effects. Stimulants increase adrenaline, noradrenaline, etc., then bacteria utilize them for growth, thereby producing toxic products, causing host disease.

http://www.microbemagazine.org/inde...crobial-endocrinology-comes-of-age&Itemid=263

http://www.hindawi.com/journals/scientifica/2013/361073/
 

alex3619

Senior Member
Messages
13,810
Location
Logan, Queensland, Australia
I would really like to see a better graph than the one shown. We should be well aware of outliers as a problem in CFS and ME research by now. If we had used scatter plots not neat lines, with perhaps neat lines superimposed, then we might have picked up on subgroup problems long ago.

However it is NOT normal for high levels of bacteria in the blood. It can cause cytokine and chemokine shifts, inducing immune cell migration and this includes drawing cells away from other places they are needed. Such changes can be persistent, or have persistent secondary effects.

If NK cells or other immune cells are constantly fighting this its no wonder they get exhausted.

The time frame is suggestive of a link with PEM, but we need more research to say much here.

This is only a small initial study. A larger better study might tell us a lot.

It might suggest that the use of NSAIDs is undesirable in us.
 

msf

Senior Member
Messages
3,650
It´s not surprising at all if you have been following Maes and De Meirleir´s work, or that of Montoya and Younger.

It´s good that other groups are confirming their findings now though.