Maksoud Rebekah, Balinas Cassandra, Holden Sean, Cabanas Hélène, Staines Donald, Marshall-Gradisnik Sonya
National Centre for Neuroimmunology and Emerging Diseases (NCNED), Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.
Consortium Health International for Myalgic Encephalomyelitis, Griffith University, Gold Coast, Australia.
J Transl Med. 2021 Feb 17;19(1):81. doi: 10.1186/s12967-021-02742-4.
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a debilitating illness, characterised by persistent fatigue that is unrelieved by rest, in combination with a range of other disabling symptoms. There is no diagnostic test nor targeted treatment available for this illness. The pathomechanism also remains unclear. Mitochondrial dysfunctions have been considered a possible underlying pathology based on reported differences including structural and functional changes in ME/CFS patients compared to healthy controls. Due to the potential role that mitochondria may play in ME/CFS, mitochondrial-targeting nutraceutical interventions have been used to potentially assist in improving patient outcomes such as fatigue. The aim of this systematic review is to appraise literature assessing these nutraceuticals as a possible intervention for treating ME/CFS.
A systematic search of Pubmed, Embase, Medline (EBSCO host) and Web of Science (via Clarivate Analytics) for journal articles published between January 1995 and 10th November 2020 was conducted. Articles assessing nutraceutical interventions and ME/CFS patient outcomes were retrieved. Using specific inclusion and exclusion criteria, the list of articles was further refined. Quality was measured using the Rosendal scale.
Nine intervention studies were included in this review. The studies investigated patient symptom severity changes such as altered fatigue levels in response to mitochondrial-targeting nutraceuticals. Improvements in fatigue levels were observed in six of the nine studies. Secondary outcomes assessed include biochemical, psychological, and quality of life parameters.
There is insufficient evidence on the effectiveness of mitochondria- targeting nutraceuticals in ME/CFS patients. Future well-designed studies are required to elucidate both the involvement of mitochondria in the pathomechanism of ME/CFS and the effect of mitochondrial-modifying agents on illness severity.
肌痛性脑脊髓炎/慢性疲劳综合征（ME/CFS）是一种使人衰弱的疾病，其特征是持续疲劳，休息后也无法缓解，并伴有一系列其他使人丧失能力的症状。目前尚无针对该疾病的诊断测试或靶向治疗方法。其发病机制也仍不清楚。基于报告的差异，包括ME/CFS患者与健康对照相比的结构和功能变化，线粒体功能障碍被认为是一种可能的潜在病理。由于线粒体可能在ME/CFS中发挥的潜在作用，针对线粒体的营养补充剂干预已被用于潜在地帮助改善患者的预后，如疲劳症状。本系统评价的目的是评估将这些营养补充剂作为治疗ME/CFS的可能干预措施的相关文献。
对PubMed、Embase、Medline（EBSCO主机）和Web of Science（通过科睿唯安分析）进行系统检索，以查找1995年1月至2020年11月10日期间发表的期刊文章。检索评估营养补充剂干预和ME/CFS患者预后的文章。使用特定的纳入和排除标准，进一步筛选文章列表。使用Rosendal量表评估质量。
本评价纳入了9项干预研究。这些研究调查了患者症状严重程度的变化，如针对线粒体的营养补充剂对疲劳水平改变的影响。9项研究中有6项观察到疲劳水平有所改善。评估的次要结果包括生化、心理和生活质量参数。
关于针对线粒体的营养补充剂对ME/CFS患者有效性的证据不足。未来需要设计良好的研究来阐明线粒体在ME/CFS发病机制中的作用以及线粒体修饰剂对疾病严重程度的影响。
