With the recent news from IiME 2015 conference that Fluge and Mella are reproducing the vascular/endothelial dysfunction findings from Newton et al as part of their RituxME clinical trial and that they've also filed two patents for using nitric oxide (NO) donors and sGC stimulators with and without B-cell depletion and found in a number of patients that this produced fairly immediate and drastic symptom remission, I started searching the literature to see how things might connect with other ME/CFS phenomena. So no one knows yet what exactly might be going on with our immune systems and how they are affecting vascular function, but it's definitely possible if not likely that for a big subset of us that the vascular dysfunction is driving most symptoms and other phenomena. I already posted in another thread that NO is essential for proper immune system function, in particular controlling and clearing viral infections. If you remember a number of studies have found sympathetic nervous system activation in PWME. I for certain have had clinical symptoms of sympathetic activation and it was verified by multiple 24-hr catecholamine labs. I am part of the ME subset that didn't get POTS or OI but ME gave me increased blood pressure and volume and a ton of circulatory problems. Well a number of papers also show that nitric oxide (NO) interacts and modulates the sympathetic nervous system and reduced NO results in sympathetic nervous system activation. Is this just a coincidence or a real connection? Interaction between nitric oxide and the cholinergic and sympathetic nervous system in cardiovascular control in humans. Sympathetic activation and nitric oxide function in early hypertension. Nitric oxide and sympathetic nerve activity in the control of blood pressure.