Rheumatology Medical News about CFS-FMS, Metabolites, Exercise

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Moderate exercise increases expression for sensory, adrenergic, and immune genes in chronic fatigue syndrome patients but not in normal subjects
The Journal of Pain, 08/06/09

Light AR et al. – Muscle fatigue and pain are major symptoms of chronic fatigue syndrome (CFS). After moderate exercise, CFS and CFS-fibromyalgia syndrome (FMS) patients show enhanced gene expression for receptors detecting muscle metabolites and for sympathetic nervous system (SNS) and immune system (IS), which correlate with these symptoms, suggesting possible new causes, points for intervention, and objective biomarkers for these disorders.

Methods

Study aims to measure:
- Fatigue and pain and
- Some exercise physiological parameters
  to determine if the alterations in gene expression were related to fatigue and/or pain symptoms in CFS pts and control subjects
Hypotheses that 25 minutes of moderate exercise would increase the gene expression of:
- Acid sensing ion channel (probably ASIC3)
- Purinergic type 2X receptors (probably P2X4 and P2X5), and
- Transient receptor potential vanilloid type 1 (TRPV1)
  at 8, 24, and 48 hrs after exercise in CFS pts but not in normal subjects was tested

Results

RT-CR showed that 19 CFS pts had lower expression of β-2 adrenergic receptors but otherwise did not differ from 16 control subjects before exercise
After a sustained moderate exercise test, CFS pts showed greater increases in gene expression for:
- Metabolite detecting receptors ASIC3, P2X4, and P2X5
- SNS receptors α-2A, β-1, β-2, and
- COMT and IS genes for IL10 and TLR4
  lasting from 0.5 to 48 hours
These increases were also seen in the CFS subgroup with comorbid FMS
They were highly correlated with symptoms of physical fatigue, mental fatigue, and pain
These new findings suggest dysregulation of metabolite detecting receptors as well as SNS and IS in CFS and CFS-FMS

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