There is a really important point here about muscle research in general which I hope people will not miss.
This is that high quality research is at long last being carried out into the role of muscle abnormalities and mitochondrial dysfunction in ME/CFS - most of it being done here in the UK and being funded by the charity sector (and in this case co-funded by the MRC.
It is now over 30 years since I personally got involved with muscle research by working with Prof George Radda at Oxford on the MRS study that demonstrated early and excesive lactic acidosis in my own skeletal muscle during exercise:
Lancet, 1984 Jun 23;1(8391):1367-9.
Excessive intracellular acidosis of skeletal muscle on exercise in a patient with a post-viral exhaustion/fatigue syndrome. A 31P nuclear magnetic resonance study.
Abstract
A patient with prolonged post-viral exhaustion and excessive fatigue was examined by 31P nuclear magnetic resonance. During exercise, muscles of the forearm demonstrated abnormally early intracellular acidosis for the exercise performed. This was out of proportion to the associated changes in high-energy phosphates. This may represent excessive lactic acid formation resulting from a disorder of metabolic regulation. The metabolic abnormality in this patient could not have been demonstrated by traditional diagnostic techniques.
This was done in conjunction with removing a good slice of thigh muscle for electron microscopy - which revealed significant structural abnormalities in the mitochondria under electron miscroscopy.
Interestingly, at the time, I had been told by leading UK muscle expert, Professor John Morgan Hughes at Queens Square in London, that I probably had a post infectious mitochondrial myopathy. This was before I saw Dr Melvin Ramsay at the Royal Free....
Sadly, despite these findings being published in The Lancet, this was then followed by a prolonged absence of any significant muscle research taking place.
International medical opinion was persuaded that muscle fatigue and weakness in ME/CFS was due to inactivity and deconditioning. GET was therefore the safe and effective answer.
More recently, Julia Newton et al in Newcastle have started to look at muscle again, confirmed the metabolic dysfunction, and are now carrying out other research involving muscle.
The MEA Ramsay Research Fund will shortly be funding three studies involving muscle and mitochondria.
These results from Anne McArdle et al are preliminary, and this component of the study is providing the first evidence that there appears to be a cytokine mediated inflammatory component involving skeletal muscle.
So I think these findings are potentially important and I hope there will be more to interest people when the whole study is finished and published.
