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Biochemical and vascular aspects of pediatric chronic fatigue syndrome
Gwen Kennedy1, Faisel Khan, Alexander Hill
1Vascular and Inflammatory Diseases Research Unit, The Institute of Cardiovascular Research, Centre for Cardiovascular and Lung Biology, Division of Medical Sciences, Ninewells Hospital and Medical School, Dundee, Scotland, United Kingdom. g.y.kennedy@dundee.ac.uk
Insights
Pediatric chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) in children shows increased oxidative stress and white blood cell apoptosis, similar to adults. However, arterial stiffness was not significantly different in pediatric patients.
Area of Science:
- Biochemistry
- Immunology
- Pediatrics
- Cardiovascular Physiology
Background:
- Pediatric chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is a debilitating condition with complex underlying mechanisms.
- Previous research in adults suggests links to oxidative stress, apoptosis, and vascular dysfunction.
Purpose of the Study:
- To investigate biochemical and vascular markers in children diagnosed with CFS/ME.
- To compare these markers against healthy pediatric controls.
Main Methods:
- A cross-sectional study involving 25 children with CFS/ME and 23 healthy controls.
- Clinical examinations, symptom scoring, measurement of biochemical markers (oxidative stress, C-reactive protein, apoptosis), and assessment of arterial stiffness via wave reflection.
Main Results:
- Children with CFS/ME exhibited significantly higher levels of oxidative stress (isoprostanes, lower vitamin C and E) and increased white blood cell apoptosis (neutrophils and lymphocytes) compared to controls.
- No significant differences in arterial stiffness were observed between pediatric CFS/ME patients and controls.
- Arterial stiffness variables in CFS/ME patients correlated with total and LDL cholesterol levels.
Conclusions:
- Biochemical anomalies, including increased oxidative stress and white blood cell apoptosis, are present in pediatric CFS/ME, mirroring findings in adult patients.
- Unlike adults, pediatric CFS/ME patients in this study did not show significant arterial stiffness, suggesting potential age-related differences in vascular involvement.
Objective:
To evaluate the biochemical and vascular aspects of pediatric chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME).
Design:
Cross-sectional clinical study.
Setting:
Tayside, Scotland, United Kingdom.
Participants:
Twenty-five children with CFS/ME and 23 healthy children recruited from throughout the United Kingdom.
Interventions:
Participants underwent a full clinical examination to establish a diagnosis of CFS/ME and were asked to describe and score their CFS/ME symptoms. Biochemical markers were measured. Arterial wave reflection was estimated to assess systemic arterial stiffness.
Main Outcome Measures:
Markers of oxidative stress and free radicals, C-reactive protein level, white blood cell apoptosis, and arterial wave reflection.
Results:
Children with CFS/ME had increased oxidative stress compared with control individuals (isoprostanes: 252.30 vs 215.60 pg/mL, P = .007; vitamin C, mean [SD]: 0.84 [0.26] vs 1.15 [0.28] mg/dL, P < .001; vitamin E, 8.72 [2.39] vs 10.94 [3.46] microg/mL, P = .01) and increased white blood cell apoptosis (neutrophils: 53.7% vs 35.7%, P = .005; lymphocytes: 40.1% vs 24.6%, P = .009). Arterial stiffness variables did not differ significantly between groups (mean augmentation index, -0.57% vs -0.47%, P = .09); however, the derived variables significantly correlated with total (r = 0.543, P = .02) and low-density lipoprotein (r = 0.631, P = .004) cholesterol in patients with CFS/ME but not in controls.
Conclusions:
Biomedical anomalies seen in adults with CFS/ME-increased oxidative stress and increased white blood cell apoptosis-can also be observed in children with clinically diagnosed CFS/ME compared with matched controls. Unlike in their adult counterparts, however, arterial stiffness remained within the reference range in these pediatric patients.
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