Department of Biochemistry and Physiology, School of Pharmacy and Food Sciences, University of Barcelona, 08028 Barcelona, Spain.
Department of Nutrition, Food Science and Gastronomy, Food Science Torribera Campus, University of Barcelona, 08921 Barcelona, Spain.
Int J Mol Sci. 2023 Mar 2;24(5):4835. doi: 10.3390/ijms24054835.
There is accumulating evidence of autonomic dysfunction in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS); however, little is known about its association with circadian rhythms and endothelial dysfunction. This study aimed to explore the autonomic responses through an orthostatic test and analysis of the peripheral skin temperature variations and vascular endothelium state in ME/CFS patients. Sixty-seven adult female ME/CFS patients and 48 healthy controls were enrolled. Demographic and clinical characteristics were assessed using validated self-reported outcome measures. Postural changes in blood pressure, heart rate, and wrist temperature were recorded during the orthostatic test. Actigraphy during one week was used to determine the 24-h profile of peripheral temperature and activity. Circulating endothelial biomarkers were measured as indicators of endothelial functioning. Results showed that ME/CFS patients presented higher blood pressure and heart rate values than healthy controls in the supine and standing position ( < 0.05 for both), and also a higher amplitude of the activity rhythm ( < 0.01). Circulating levels of endothelin-1 (ET-1) and vascular cell adhesion molecule-1 (VCAM-1) were significantly higher in ME/CFS ( < 0.05). In ME/CFS, ET-1 levels were associated with the stability of the temperature rhythm ( < 0.01), and also with the self-reported questionnaires ( < 0.001). This suggests that ME/CFS patients exhibited modifications in circadian rhythm and hemodynamic measures, which are associated with endothelial biomarkers (ET-1 and VCAM-1). Future investigation in this area is needed to assess dysautonomia and vascular tone abnormalities, which may provide potential therapeutic targets for ME/CFS.
越来越多的证据表明，慢性疲劳综合征（ME/CFS）患者存在自主神经功能障碍；然而，人们对其与昼夜节律和内皮功能障碍的关系知之甚少。本研究旨在通过直立试验探讨自主神经反应，并分析 ME/CFS 患者的外周皮肤温度变化和血管内皮功能状态。共纳入 67 名成年女性 ME/CFS 患者和 48 名健康对照者。使用经过验证的自我报告结果测量工具评估人口统计学和临床特征。在直立试验中记录血压、心率和手腕温度的体位变化。通过一周的活动记录仪确定外周温度和活动的 24 小时分布。测量循环内皮生物标志物作为内皮功能的指标。结果显示，与健康对照组相比，ME/CFS 患者在仰卧位和站立位时的血压和心率值更高（均<0.05），且活动节律的幅度也更高（<0.01）。ME/CFS 患者的内皮素-1（ET-1）和血管细胞黏附分子-1（VCAM-1）水平显著升高（均<0.05）。在 ME/CFS 中，ET-1 水平与温度节律的稳定性相关（<0.01），并与自我报告的问卷相关（<0.001）。这表明 ME/CFS 患者表现出昼夜节律和血液动力学测量的变化，这些变化与内皮生物标志物（ET-1 和 VCAM-1）相关。未来需要在该领域进行进一步研究，以评估自主神经功能障碍和血管张力异常，这可能为 ME/CFS 提供潜在的治疗靶点。
