When the 'Holiday Season' Is No Holiday at all for Those With ME/CFS
Is December getting to you? Jody Smith shares some thoughts on some of the struggles that all too often attend this time of year ...
Discuss the article on the Forums.

PEM & the role of elastase, complement C4a and interleukin-1β

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

  1. leelaplay

    leelaplay member

    Tate Mitchell posted this to co-cure today

    [if: Another Metzger study. Love that they found PEM in all CFS subjects, but am not sure how they measured it. I can't access the full text. I'm a bit confused as they said "neither exercise bout altered elastase activity, IL-1β or complement C4a split product levels", but also said, "Postexercise complement C4a level was identified as a clinically important biomarker for postexertional malaise in people with ME/CFS."

    I'm also not clear what the difference is between the 2 types of exercise and when they measured for PEM. Look forward to the full text.

    Love the use of the word "biomarker"

    Love that they're calling for more research into measuring PEM. ]

    Unravelling the nature of postexertional malaise in myalgic encephalomyelitis/chronic fatigue syndrome: the role of elastase, complement C4a and interleukin-1β

    Journal of Internal Medicine, Volume 267, Number 4, April 2010 , pp. 418-435(18)

    Nijs, J.; Van Oosterwijck, J.; Meeus, M.; Lambrecht, L.1; Metzger,
    K.2; Frmont, M.2; Paul, L.3

    (Vrije Universiteit Brussel, Brussels; University College
    Antwerp, Antwerp; University Hospital Brussels, Brussels; Private
    Practice for Internal Medicine, Gent/Aalst; and RED Laboratories N.V.,
    Zellik; Belgium, and University of Glasgow, Glasgow, UK).



    Objectives. Too vigorous exercise or activity increase frequently
    triggers postexertional malaise in people with myalgic
    encephalomyelitis/chronic fatigue syndrome (ME/CFS), a primary
    characteristic evident in up to 95% of people with ME/CFS. The present
    study aimed at examining whether two different types of exercise
    results in changes in health status, circulating elastase activity,
    interleukin (IL)-1β and complement C4a levels.

    Design. Comparative experimental design.

    Setting. University.

    Subjects. Twenty-two women with ME/CFS and 22 healthy sedentary
    controls Interventions: participants were subjected to a submaximal
    exercise (day 8) and a self-paced, physiologically limited exercise
    (day 16). Each bout of exercise was preceded and followed by blood
    sampling, actigraphy and assessment of their health status.

    Results. Both submaximal exercise and self-paced, physiologically
    limited exercise resulted in postexertional malaise in people with

    However, neither exercise bout altered elastase activity,
    IL-1β or complement C4a split product levels in people with ME/CFS or
    healthy sedentary control subjects (P > 0.05).

    Postexercise complement C4a level was identified as a clinically important biomarker for
    postexertional malaise in people with ME/CFS.

    Conclusions. Submaximal exercise as well as self-paced,
    physiologically limited exercise triggers postexertional malaise in
    people with ME/CFS, but neither types of exercise alter acute
    circulating levels of IL-1β, complement C4a split product or elastase
    activity. Further studying of immune alterations in relation to
    postexertional malaise in people with ME/CFS using multiple
    measurement points postexercise is required.

    Keywords: chronic fatigue syndrome; exercise; fibromyalgia; immunity;
    pain; postexertional malaise

    Document Type: Research article

    DOI: 10.1111/j.1365-2796.2009.02178.x

    Affiliations: 1: Private Practice for Internal Medicine, Gent/Aalst 2:
    RED Laboratories N.V., Zellik, Belgium 3: Nursing and Health Care,
    Faculty of Medicine, University of Glasgow, Glasgow, UK
  2. Hope123

    Hope123 Senior Member

    Yes, I'd like to see it as well. One problem with cytokine research in CFS is that the researchers often don't have the money to look at a full panel of cytokines -- there are many, many cytokines. Klimas does some good work in this area but even her studies only cover about 10-20 whereas a small paper I saw about Sjgoren's tested for 25 different ones.
  3. lostinthedesert

    lostinthedesert Killer, Clown, Priestess

    Not just what but when

    I'm wondering when they took their post-exercise samples. I think that if they took several samples going out at least as far as 48 hours, they may have seen some changes.
  4. lono


    I wanted to point out a couple of interesting things about C4a that they found in this paper:

    1. Sorensen tested patients 6 hours after exercise and found a steep rise in C4a that corresponded with PEM. In the Nijs paper they tested participants 1 hour after exercise (for whatever reason) and didn't find an increase of C4a. However, they explicitly state in the paper that they didn't test after 6 hours so there's no evidence in their findings that C4a won't rise 6 hours after exercise. What makes their findings most interesting is that -

    2. They tracked C4a levels 24 hours after exercise and found that an increase in "complement C4a level was strongly related to the increase in pain and fatigue 24 hours following the [exercise]." Additionally (and most interestingly) they found, "The level of complement C4a following submaximal exercise was identified as a clinically important biomarker in people with ME/CFS."

    We need all the biomarkers we can get in the CFS/ME world, so bravo.
  5. Jerry S

    Jerry S Senior Member

    Thanks for your comments and welcome to the forum, lono. Very interesting, indeed!
  6. ramakentesh

    ramakentesh Senior Member

  7. V99


    ME research UK study - Exercise, immunology and pain

    Journal of Internal Medicine: http://www3.interscience.wiley.com/journal/122649385/abstract?CRETRY=1&SRETRY=0

  8. Cort

    Cort Phoenix Rising Founder

    Thanks for the analysis - bump!

See more popular forum discussions.

Share This Page