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Nitric Oxide Metabolite Production During Exercise in CFS: A Case-Control Study

Discussion in 'Latest ME/CFS Research' started by leelaplay, May 18, 2010.

  1. leelaplay

    leelaplay member

    Tate Mitchell to CO-CURE today

    Nitric Oxide Metabolite Production During Exercise in Chronic Fatigue Syndrome: A Case-Control Study

    Surez A, Guillamo E, Roig T, Blzquez A, Alegre J, Bermdez J,
    Ventura JL, Garca-Quintana AM, Comella A, Segura R, Javierre C.
    J Womens Health (Larchmt). 2010 May 14. [Epub ahead of print]

    1 Department of Physiological Sciences II, Medical School, University
    of Barcelona , L'Hospitalet, Barcelona, Spain .



    Abstract Background: Chronic fatigue syndrome (CFS) is a disabling
    illness of unknown etiology that is characterized by fatigue
    associated with a reduced ability to work, lasting for more than 6
    months, and accompanied by a specific set of symptoms. The diagnosis
    remains difficult because of the absence of laboratory tests and is,
    therefore, made largely on the basis of the symptoms reported by the

    The aim of this study was to analyze differences in blood
    nitrate levels in CFS patients and a matched control group after a
    physical exercise test.

    Methods: Forty-four consecutive female
    patients with CFS and 25 healthy women performed an exercise test
    using a cycle ergometer with monitoring of cardiopulmonary response.
    Blood samples were obtained for biochemical analyses of glucose,
    lactate, and nitrates at the beginning (under resting conditions) and
    after the maximal and supramaximal tests.

    Results: Plasma nitrates
    differed between the groups, with higher values in the CFS group (F =
    6.93, p = 0.003). Nitrate concentration increased in relation to
    workload and reached higher values in the CFS group, the maximum
    difference with respect to the control group being 295% (t = 4.88, p <

    Conclusions: The main result of the present study is that
    nitric oxide (NO) metabolites (nitrates) showed a much higher increase
    after a maximal physical test in CFS patients than in a group of
    matched subjects. This combination (exercise plus NO response
    evaluation) may be useful in the assessment of CFS.

    PMID: 20469961 [PubMed - as supplied by publisher]
  2. Hi, I was forced to do exercise in a Gym when hospitalised after being diagnosed with POTS and being in hospital for 6 months. I've had ME for 19 years.(of ME).
    I was told POTS was a form of somatization disorder, due to my mother believing I had ME.

    So in the gym, I did what they commanded with obvious effects afterwards with someone who was bed ridden 22hrs a day.

    I had the presence of mind to get urine samples done post exercise (back in the ward I always become very unwell) and it showed elevated nitrites, which would confirm the research above - because of oxidative stress and Nitric Oxide being elevated in ME/CFS at rest, never mind after exercise. (I know I have that as I got tested and it showed tissue damage).

    Great research, thanks for posting it's good to see someone finding out at a research level in ME CFS , what I found out 5 years ago by guess work but was never listened to by doctors.
  3. lono


    Thanks for posting. This is interesting.

    This appears to be testing out Martin Pall's theory re: elevated levels of peroxynitrite being the cause of Chronic Fatigue Syndrome. I don't have access to the full text, but I'd be curious to know if they cited Dr. Pall. My understanding is that there have been a number of theoretical papers about nitric oxide (NO) being implicated as a cause of CFS, but that it's difficult to test this.

    Let's hope that some other researchers follow up with some further studies.

    ps: Here's a link to the abstract of one of Dr. Pall's theoretical articles re: nitric oxide and CFS/ME -

    Elevated, sustained peroxynitrite levels as the cause of chronic fatigue syndrome. Pall ML. Medical Hypotheses. 2000 Jan;54(1):115-25.
  4. Dolphin

    Dolphin Senior Member

    Most of the introduction

    Yes, they did reference Dr. Pall.

  5. Dolphin

    Dolphin Senior Member

    Link to another paper which explains why NO might be important

    In another thread, I've posted an extract from:
    which I found interesting (although I found the study less interesting as they didn't follow people after an exercise test).
  6. Dolphin

    Dolphin Senior Member

    Figure 1

    Figure 1:

    One doesn't have to know much about NO to realise that a difference like this in CFS might be interesting!
  7. alex3619

    alex3619 Senior Member

    Logan, Queensland, Australia
    Hi Dolphin, Marty is probably enjoying this paper. The nice thing about the graph is there is absolutely no overlap between patients and controls. This begs a follow-up study or three. Bye, Alex
  8. oceanblue

    oceanblue Guest

    This looks very interesting both because of the size of the difference and because it's based on an exercise challenge. Does the paper say how 'sedentary' the controls were relative to patients (eg SF36 PF for both)?
  9. Dolphin

    Dolphin Senior Member

    No SF-36 scores (I'm not sure they would be that useful for controls - I imagine most healthy controls would be 80+, possibly 90+ - i.e. they can go for walks, etc. without difficulty, they just don't do them)
    A VO2 max of 25.6 for the control group is quite a lot score - some CFS groups would score higher than that:
  10. WillowJ

    WillowJ คภภเє ɠรค๓թєl

    WA, USA
    this is really interesting :)
  11. oceanblue

    oceanblue Guest

    This looks really solid and could prove to be very important. As ever, what's needed is independent replication.

    I'd also like to see them testing under 'real world' exercise conditions: CFS patients don't normally push themselves to this kind of maximal exertion or close to it - and don't need to for PEM to emerge. Encouragingly, the authors write:

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