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Peripheral endothelial dysfunction in myalgic encephalomyelitis/chronic fatigue syndrome.

Nadja Scherbakov1,2,3,4, Marvin Szklarski5, Jelka Hartwig5

  • 1Berlin-Brandenburg Center for Regenerative Therapies (BCRT), Augustenburger Platz 1, 13353, Berlin, Germany.

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Peripheral endothelial dysfunction (ED) is common in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), affecting 51% of patients. This dysfunction is linked to more severe disease and immune symptoms, highlighting potential cardiovascular risks.

Keywords:
Cardiovascular risk factorChronic fatigue syndromeImmune scorePeripheral endothelial dysfunctionReactive hyperaemia index

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Area of Science:

  • Investigates vascular regulation in complex multisystem diseases.
  • Focuses on peripheral endothelial function in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).

Background:

  • Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex multisystem disease.
  • Previous evidence suggests disturbed vascular regulation, including cerebral hypoperfusion and orthostatic intolerance.
  • Peripheral endothelial dysfunction (ED) in ME/CFS remains under-investigated.

Purpose of the Study:

  • To examine peripheral endothelial function in patients diagnosed with ME/CFS.
  • To assess the association between peripheral ED and disease severity and immune symptoms.

Main Methods:

  • Peripheral endothelial function was assessed using peripheral arterial tonometry (EndoPAT2000) in 35 ME/CFS patients and 20 healthy controls.
  • ME/CFS diagnosis was based on Canadian Criteria.
  • Nine patients with elevated anti-β2-adrenergic receptor antibodies underwent immunoadsorption, with endothelial function measured pre- and post-treatment.

Main Results:

  • Peripheral ED was identified in 51% of ME/CFS patients, significantly higher than in controls (20%).
  • Patients with ED reported more severe disease (Bell score) and fatigue-related symptoms, and showed correlations with immune symptoms like sore throat and painful lymph nodes.
  • Endothelial function improved in 5 out of 6 patients after immunoadsorption treatment.

Conclusions:

  • Peripheral ED is prevalent in ME/CFS patients and correlates with increased disease severity and immune symptom burden.
  • The findings underscore the importance of investigating the link between peripheral ED and cardiovascular risks in ME/CFS.
  • Potential therapeutic benefits of immunoadsorption on endothelial function warrant further study.