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Chronic fatigue syndrome （CFS） is a heterogeneous disease with dysfunction in multiple systems and multiple organs. Its etiology and pathogenesis have not been fully clarified， and its treatment also lacks specificity. The key to studying CFS is developing animal models that reflect the underlying mechanisms and etiology of CFS. The existing CFS modeling methods are complicated and not unified. By sorting out relevant literature，the present study evaluated the modeling methods，modeling standards，mechanisms， and clinical coincidence of the immune model，the stress model， and the disease-syndrome combination model in traditional Chinese medicine （TCM）. The immune model is mainly constructed from the perspective of pathophysiology， with easy operation and wide investigation， which can simulate the pathological characteristics of CFS to ensure pathogenesis research，but the experimental repeatability is general. Stress modeling is a common method for a variety of neuropsychiatric diseases，including CFS. Many different stressors can be employed to investigate the etiology of CFS， but their effects are unpredictable. Compared with the two western medicine models mentioned above，the TCM disease-syndrome combination model integrates modern medicine with TCM theory，with high clinical coincidence and great practical value. However，the TCM disease-syndrome combination model of CFS is still in the exploratory stage with a few types of models，which needs to be further improved， aiming to establish scientific，reasonable，simple， and efficient animal models to provide support for exploring the etiology，pathogenesis， and new treatment ideas of CFS.
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OBJECTIVE@#To observe the clinical efficacy of bamboo-based medicinal moxibustion for chronic fatigue syndrome (CFS), and to preliminarily explore its action mechanism.@*METHODS@#Sixty-four patients with CFS were randomly divided into a moxibustion group (32 cases, 1 case dropped off, 1 case excluded) and an acupuncture group (32 cases, 2 cases dropped off). The patients in the moxibustion group were treated with bamboo-based medicinal moxibustion, while the patients in the acupuncture group were treated with routine acupuncture. Both groups were treated once a day, 6 days as a course of treatment with 1 day interval, for a total of 2 courses of treatment. Before treatment, 1 and 2 courses into treatment and in the follow-up of 14 days after treatment, the fatigue scale-14 (FS-14) and somatic and psychological health report (SPHERE) scores were observed in the two groups. Before and after treatment, the contents of CD+3, CD+4, CD+8 of peripheral blood T lymphocyte subsets were measured and CD+4/CD+8 ratio was calculated; the clinical efficacy of the two groups was compared.@*RESULTS@#Compared before treatment, the FS-14 and SPHERE scores in the two groups were decreased 1 and 2 courses into treatment and in the follow-up (P<0.01), and the FS-14 and SPHERE scores in the moxibustion group were lower than those in the acupuncture group (P<0.01, P<0.05). Compared before treatment, the contents of CD+3, CD+4 and CD+4/CD+8 ratio in the moxibustion group were increased after treatment (P<0.01). There was no significant difference of CD+3, CD+4, CD+8 and CD+4/CD+8 ratio between before and after treatment in the acupuncture group (P>0.05). After treatment, the contents of CD+3 and CD+4 in the moxibustion group were higher than those in the acupuncture group (P<0.05). The total effective rate was 93.3% (28/30) in the moxibustion group, which was higher than 73.3% (22/30) in the acupuncture group (P<0.05).@*CONCLUSION@#Bamboo-based medicinal moxibustion could improve the physical and mental fatigue symptoms and psychological status in patients with CFS. Its effect may be related to regulating the contents of CD+3, CD+4 of peripheral blood T lymphocyte subsets and CD+4/CD+8 ratio.
Subject(s)
Humans , Moxibustion , Fatigue Syndrome, Chronic/therapy , Acupuncture Therapy , Physical ExaminationABSTRACT
INTRODUCTION@#Chronic Fatigue Syndrome (CFS) is a collection of symptoms from a substantial reduction in the ability to engage in preillness levels of occupational, educational, social, or personal activities that persists for more than six months and is accompanied by fatigue, post-exertional malaise, and unrefreshing sleep. One of the effects of heavy metal exposure is the occurrence of CFS among workers. Artisanal and Small-scale Gold Mining (ASGM) workers used mercury in their work, and this leads to a higher risk of chronic mercury poisoning. One of the health problems dueto mercury exposure is the occurrence of CFS and this has not been studied among ASGM workers.@*OBJECTIVE@#This study intended to discover the prevalence of CFS among ASGM workers and the factors associated with it.@*METHOD@#This study used a cross-sectional design to find the relationship between independent variables such as age, sex, working period as a miner, type of work activities in ASGM, and cumulative urinary mercury levels with CFS in ASGM workers in West Nusa Tenggara and Banten province. CFS was measured using standardized questionnaire on effect on mercury released by WHO-UNEP, and creatinine-corrected urinary mercury levels.@*RESULTS@#The prevalence of CFS in ASGM workers in West Nusa Tenggara and Banten provinces was 17.9%. Based on the results, the factors of age, sex, work period, type of work, province of origin and cumulative urinary mercury levels did not have a statistically significant relationship with CFS (p> 0.05).@*CONCLUSION@#There was no significant relationship between age, sex, work period, type of work, urinary mercury level and cumulative urinary mercury levels with CFS in ASGM workers.
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Based on the theory of "brain-gut communication" and "heart-stomach disease simultaneously", the thinking and method of treating chronic fatigue syndrome (CFS) from yangming meridian were discussed. CFS is related to brain and heart. Based on the analysis of meridian circulation, zang-fu function and the indication characteristics of yangming meridian, the indications of yangming meridian are closely related to brain and heart, so it is proposed to start from yangming meridian and use Chinese herbs combined with acupuncture to treat CFS, including the four methods of clearing away heat and moisturizing dryness, cooling blood and removing blood stasis, promoting qi to clear the organs, and strengthening and replenishing deficiency. It has certain guiding and reference significance for clinical treatment of CFS.
Subject(s)
Humans , Acupuncture , Acupuncture Points , Acupuncture Therapy , Fatigue Syndrome, Chronic/therapy , MeridiansABSTRACT
Objectives: A previous study has shown that schizophrenia (SCZ) is accompanied by lowered levels of trace/metal elements, including cesium. However, it is not clear whether changes in cesium, rubidium, and rhenium are associated with activated immune-inflammatory pathways, cognitive impairments, and the symptomatology of SCZ. Methods: This study measured cesium, rubidium, and rhenium, cognitive impairments (using the Brief Assessment of Cognition in Schizophrenia [BACS]), and the levels of cytokines/chemokines interleukin (IL)-1β, tumor necrosis factor (TNF)-α, and eotaxin (CCL11) in 120 patients with SCZ and 54 healthy controls. Severity of illness was assessed using the Brief Psychiatric Rating Scale (BPRS), the Scale for the Assessment of Negative Symptoms (SANS), the Fibromyalgia and Chronic Fatigue Syndrome Rating (FF) Scale, and the Hamilton Depression Rating Scale (HAM-D). Results: Serum cesium was significantly lower in patients with SCZ as compared with controls. Further, serum cesium was significantly and inversely associated with CCL11 and TNF-α, but not IL-1β, in patients with SCZ; significant inverse associations were also noted between serum cesium levels and BPRS, FF, HAM-D, and SANS scores. Finally, cesium was positively correlated with neurocognitive probe results including the Tower of London, Symbol Coding, Controlled Word Association, Category Instances, Digit Sequencing Task, and List Learning tests. Conclusion: The results suggest that lowered serum cesium levels may play a role in the pathophysiology of SCZ, contributing to specific symptom domains including negative, depressive and fatigue symptoms, neurocognitive impairments (spatial working, episodic, and semantic memory and executive functions), and neuroimmune pathways.
Subject(s)
Humans , Schizophrenia , Cognitive Dysfunction , Schizophrenic Psychology , Biomarkers , Cesium , LondonABSTRACT
Resumen Introducción: Las manifestaciones clínicas más frecuentes causadas por el Herpes Virus Humano Tipo 6 (HHV-6) ocurren en niños menores de 2 años, presentan lesiones en piel tipo roséola o exantema súbito. En adultos, las manifestaciones clínicas relacionadas a HHV-6 son muy variables, y pueden sobreponerse con otras afecciones. Objetivo: Presentar una serie de casos de pacientes diagnosticados con infección activa por HHV-6, quienes mostraban manifestaciones neurológicas, dermatológicas y de fatiga crónica. Materiales y métodos: Se realizó análisis de historias clínicas de 6 pacientes que fueron diagnosticados con infección activa por HHV-6, a través de métodos moleculares. Resultados: Se reportan 6 pacientes que fueron diagnosticados con infección activa por HHV-6 mediante métodos moleculares, quienes presentaron manifestaciones clínicas comunes tales como: fiebre, cefalea, depresión, decaimiento, pérdida de memoria y concentración, dolor fibromuscular, dolor poliarticular, sueño no reparador, exantema, nevus rubí, liquen plano y parestesias. Conclusiones: A través de esta serie de casos se espera resaltar la importancia de identificar la infección activa por HHV-6 a través de métodos moleculares, y sensibilizar a la comunidad médica sobre el papel que juega el virus en la evolución de diversas patologías.
Abstract Introduction: The most frequent clinical manifestations of Human Herpesvirus 6 (HHV-6) in children under 2 years of age are roseola-like skin lesions and sudden rash. In adults, the clinical manifestations associated with HHV-6 are highly variable and can overlap with other conditions. Objective: To present a case series of patients diagnosed with active HHV-6 infection, who showed neurological, dermatological and chronic fatigue manifestations. Materials and methods: An analysis of medical records of 6 patients who were diagnosed with active HHV-6 infection through molecular methods was performed. Results: 6 patients were diagnosed with active HHV-6 infection using molecular methods, who had common clinical manifestations such as fever, headache, depression, tiredness, loss of memory and concentration, fibromuscular pain, polyarticular pain, nonrestorative sleep, rash, ruby nevus, lichen planus and paresthesia. Conclusions: This case series highlights the importance of identifying active HHV-6 infection through molecular methods and creating awareness in the medical community of the role that the virus plays on the development of diverse pathologies.
Subject(s)
Herpesvirus 6, Human , Skin Diseases , Fatigue Syndrome, Chronic , Viral LoadABSTRACT
OBJECTIVE@#To observe the effect of ginger-separated moxibustion on fatigue state and intestinal flora in patients with chronic fatigue syndrome (CFS).@*METHODS@#A total of 62 patients with CFS were randomly divided into an observation group (31 cases, 3 cases dropped off) and a control group (31 cases, 2 cases dropped off). The patients in the control group were treated with normal diet and moderate exercise; on the basis of the control group, the patients in the observation group were treated with ginger-separated moxibustion at Zhongwan (CV 12), Shenque (CV 8) and Guanyuan (CV 4), 30 min each time, once every other day, three times a week. Both groups were intervened for 4 weeks. Before and after treatment, the fatigue scale-14 (FS-14) was used to observe the improvement of fatigue state, and 16S rRNA detection technology was used to detect the distribution of intestinal flora.@*RESULTS@#Compared before treatment, the FS-14 score was reduced after treatment in the observation group (@*CONCLUSION@#The ginger-separated moxibustion could significantly improve the fatigue state in CFS patients, which may be related to the regulation of intestinal flora structure and the repair of intestinal barrier.
Subject(s)
Humans , Acupuncture Points , Fatigue Syndrome, Chronic/therapy , Gastrointestinal Microbiome , Ginger , Moxibustion , RNA, Ribosomal, 16SABSTRACT
OBJECTIVE@#To evaluate the quality of the existing studies and summarize evidence of important outcomes of meta-analyses/systematic reviews (MAs/SRs) of CFS.@*METHODS@#Potentially eligible studies were searched in the following electronic databases from inception to 1 September, 2019: Chinese Biomedical Literature Database (CBM), China Science and Technology Journal Database (VIP), China National Knowledge Infrastructure (CNKI), WanFang Database (WF), Web of Science, Embase, PubMed and Cochrane Library. Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) was used to evaluate the quality of evidence. The methodological quality of the literature was evaluated by A Measure Tool to Assess Systematic Reviews-2 (AMSTAR-2) and the quality of the report was assessed by Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). The intra-class correlation coefficient was used to assess the consistency of the reviewers, with an overall intraclass correlation coefficient score of 0.967.@*RESULTS@#Ten MAs/SRs were included. The overall conclusions were that acupuncture had good safety and efficacy in the treatment of CFS, but some of these results were contradictory. The GRADE indicated that out of the 17 outcomes, high-quality evidence was provided in 0 (0%), moderate in 3 (17.65%), low in 10 (58.82%), and very low in 4 (23.53%). The results of AMSTAR-2 showed that the methodological quality of all included studies was critically low. The PRISMA statement revealed that 8 articles (80%) were in line with 20 of the 27-item checklist, and 2 articles (20%) matched with 10-19 of the 27 items.@*CONCLUSION@#We found that acupuncture on treating CFS has the advantage for efficacy and safety, but the quality of SRs/MAs of acupuncture for CFS need to be improved.
Subject(s)
Humans , Acupuncture Therapy , China , Fatigue Syndrome, Chronic/therapy , Research ReportABSTRACT
RESUMEN Introducción: La fibromialgia es una causa común de dolor crónico en el mundo, con una prevalencia en la población general del 0,2% al 6,4%. Estos pacientes tienen una mayor probabilidad de presentar trastornos neuropsiquiátricos. El objetivo fue describir el perfil sociodemográfico y clínico de pacientes con fibromialgia y comorbilidad neuropsiquiátrica. Métodos: Estudio transversal, descriptivo. Se recolectó información de las historias clínicas de pacientes con fibromialgia y comorbilidad neuropsiquiátrica, de una institución especializada en Antioquia, durante los años 2010 al 2016. Se aplicaron herramientas de estadística descriptiva. Resultados: De 1.106 registros médicos con diagnóstico confirmado de fibromialgia, 497 presentaban comorbilidad neuropsiquiátrica. La mediana de edad fue de 54 años (RIC 15), la mayoría eran mujeres, residían en zona urbana y estaban casados o convivían con su pareja. Estatus socioeconómico bajo-medio y nivel educativo básico-medio, fueron los más reportados. Los síntomas más frecuentes fueron alteraciones del sueño (70,6%), mialgias (66,4%) y fatiga crónica (55,9%). Los trastornos neuropsiquiátricos más frecuentes fueron depresión (85,7%), migraña (35%) y ansiedad (14,7%). Los fármacos más utilizados fueron los inhibidores de la recaptación de serotonina y duales, acetaminofén y gabaérgicos. Manejo con terapias complementarias e intervención psicológica se observaron en baja proporción. Conclusiones: La fibromialgia y las enfermedades neuropsiquiátricas son patologías que coexisten con frecuencia; la presentación sociodemográfica y clínica es similar a lo descrito en la literatura, sin embargo, la presencia de depresión en esta población fue mayor. Un enfoque terapéutico transdisciplinario, favorecería la calidad de vida de los pacientes y el curso de la enfermedad.
ABSTRACT Introduction: Fibromyalgia is a common cause of chronic pain in the world, with a prevalence of 0.2% to 6.4% in the general population. These patients are more likely to have neuropsychiatric disorders. The objective of this study was to describe the sociodemographic and clinical profile of patients with fibromyalgia and neuropsychiatric comorbidity. Methods: A cross-sectional, descriptive study was conducted in which Information was collected from the medical records of patients with fibromyalgia and neuropsychiatric comorbidity, from specialist institution in Antioquia, during the years 2010 to 2016. Descriptive statistics tools were applied. Results: Of the 1,106 medical records with a confirmed diagnosis of fibromyalgia, 497 had neuropsychiatric comorbidity. The median age was 54 years (IQR 15), and the majority were women, residing in an urban area, and were married or living with their partner. Low-medium socioeconomic status and basic-medium educational level were the most reported. The most frequent symptoms were sleep disturbances (70.6%), myalgia (66.4%), and chronic fatigue (55.9%). The most frequent neuropsychiatric disorders were depression (85.7%), migraine (35%), and anxiety (14.7%). The most commonly used drugs were serotonin and dual reuptake inhibitors, acetaminophen, and GABAergic drugs. A low percentage was managed with complementary therapies and psychological intervention. Conclusions: Fibromyalgia and neuropsychiatric diseases are diseases that frequently coexist. Although the sociodemographic and clinical presentation is as described in the literature, the presence of depression was greater in this population. A multidisciplinary therapeutic approach would favour the quality of life of the patients and the course of the disease.
Subject(s)
Humans , Male , Female , Fibromyalgia , Comorbidity , Diagnosis, Dual (Psychiatry) , Neuropsychiatry , Demography , Chronic PainABSTRACT
RESUMEN Se supone que aproximadamente 80 millones de personas a nivel mundial están infectadas con el virus de la hepatitis C. Un aproximado del 60 % de dichos pacientes aqueja síndrome de fatiga crónica. Se presentó un paciente portador de hepatitis crónica de tipo C, con manifestaciones clínicas de síndrome de fatiga crónica por más de dos años. Se han reportado estudios internacionales que han demostrado la relación existente entre el desarrollo de la respuesta inmune y el daño que ocasiona en el tejido cerebral la infección por virus de hepatitis C. Este trabajo tiene como objetivo la presentación del primer caso que se tiene referencia (AU).
ABSTRACT It is believed that almost 80 million persons are infected with the Hepatitis C virus around the world, and 60 % of them suffer the chronic fatigue syndrome. For that reason we present the case of a patient who is a carrier of the chronic fatigue syndrome for more than two years. Reports of international research have showed the relation between the immune answer and the damage caused by the infection of the hepatitis C virus in the brain tissues. The aim of this work is presenting the first case reported in Cuba (AU).
Subject(s)
Humans , Male , Fatigue Syndrome, Chronic/etiology , Hepatitis C/complications , Antiviral Agents/therapeutic use , Quality of Life , Fatigue Syndrome, Chronic/drug therapy , Interferons/adverse effects , Interferons/therapeutic use , Hepatitis C/drug therapy , Hepatitis C/epidemiology , Antibody FormationABSTRACT
Background: Chronic fatigue syndrome (CFS) holds a mystery for researchers due to its multifactorialnature; hence, its diagnosis is still based on symptoms and aetiology remains obscured. Number ofscientific evidences regarding the role of oxidative stress, immune dysfunction in CFS and alleviation ofsymptoms with the help of nutritional supplements guided us to study effect of ethanolic extract ofSpilanthes oleracea (SPE) in CFS.Objectives: Present study was designed to evaluate antioxidant, immunomodulatory properties of S.oleracea flower to ameliorate CFS infirmity in mice.Materials and method: In order to induce fatigue, experimental animals were stressed by chronic water eimmersion stress model. Meanwhile, parameters like immobility period and tail withdrawal latencywere assessed. On the 21st day, mice blood was collected and they were immediately sacrificed forbiochemical estimations.Results: Biochemical analysis results revealed that CFS elevates lipid peroxidation, nitrite level and diminishes the endogenous antioxidant enzyme like catalase level in stressed animal’s brain homogenate.Stressful condition developed muscle fatigue leading in alteration of lactate dehydrogenase level (LDH),Blood urea nitrogen (BUN) and Triglycerides (TG) levels. Concurrent and chronic treatment of SPE for 21days restored all these behavioural despairs and associated biochemical adaptation in mice in dosedependent manner.Conclusion: The outcome of this study indicates ability of SPE in amelioration of CFS by mitigating theoxidative stress and thus provide a powerful combat against CFS which may be due to its antioxidant andimmunomodulatory properties.© 2017 Transdisciplinary University, Bangalore and World Ayurveda Foundation. Publishing Services byElsevier B.V
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OBJECTIVE@#To observe the effect of ginger-separated moxibustion on fatigue, sleep quality and depression in the patients with chronic fatigue syndrome.@*METHODS@#A total of 62 patients with chronic fatigue syndrome were randomized into an observation group (31 cases, 3 cases dropped off) and a control group (31 cases, 2 cases dropped off). In the control group, the patients had normal diet and proper physical exercise. In the observation group, on the basis of the control group, the ginger-separated moxibustion was added at Zhongwan (CV 12), Shenque (CV 8) and Guanyuan (CV 4), 30 min each time, once every two days, 3 times weekly. Separately, before treatment and after 4 weeks of treatment, the MOS item short form health survey (SF-36), the Pittsburgh sleep quality index (PSQI) scale and the self-rating depression scale (SDS) were adopted to evaluate the degrees of fatigue, sleep quality and depression in the patients of the two groups.@*RESULTS@#In the observation group, the score of each item of SF-36, the score of each item of PSQI and SDS score after treatment were all improved significantly as compared with those before treatment respectively (<0.05, <0.01). In the control group, the scores of overall health, vitality and mental health in SF-36 and the score of sleep time of PSQI after treatment were improved as compared with those before treatment respectively (<0.05). After treatment, the score of each item of SF-36, the scores of sleep quality, sleep time, sleep efficiency and sleep disorders of PSQI, as well as SDS score in the observation group were all better than those in the control group respectively (<0.01, <0.05). The score of SF-36 was relevant to the scores of PSQI and SDS in the patients of chronic fatigue syndrome ( =0.331, <0.05; =-0.706, <0.01). The improvement value of SF-36 score was closely related to the improvement value of SDS score in the observation group ( =-0.657, <0.01).@*CONCLUSION@#The ginger-separated moxibustion effectively relieves fatigue and depression condition and improves sleep quality in the patients with chronic fatigue syndrome. The fatigue condition is relevant with sleep quality and depression condition to a certain extent in the patients.
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Objective: To observe the therapeutic efficacy of tuina plus cupping on chronic fatigue syndrome (CFS). Methods: A total of 100 CFS patients meeting the inclusion criteria were randomly divided into a treatment group and a control group according to the random number table in the sequence of visit, with 50 patients in each group. The treatment group was treated with tuina plus cupping therapy, 3 times a week. The control group was given oral tablets of wild American ginseng lozenges. After 3 months of treatment, the score of fatigue questionnaire scale (FS-14) was observed and the efficacy was evaluated. Results: The total effective rate was 92.0％ in the treatment group, versus 76.0％ in the control group and the difference between the two groups was statistically significant (P<0.05). After treatment, the FS-14 scores of the two groups decreased, and the intra-group differences were statistically significant (both P<0.05). The change of FS-14 score after treatment in the treatment group was more significant than that in the control group (P<0.05). Conclusion: Tuina plus cupping is effective for CFS, and can improve fatigue symptoms significantly.
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Nessa dissertação foi realizada uma scoping review com objetivo de buscar na literatura o que existe, até o presente momento, para explicar a relação entre o metabolismo mitocondrial com a síndrome da fadiga crônica (SFC). A SFC se apresenta de forma diferente para cada indivíduo, o que torna complexo seu entendimento, uma vez que não foram identificados biomarcadores específicos para auxiliar em um diagnóstico definitivo que favoreça uma intervenção adequada e tratamentos mais eficazes. Diferentes mecanismos biológicos são estudados, sendo que alterações no metabolismo mitocondrial têm sido foco de pesquisas recentes. Tais alterações podem ser a causa de fadiga severa e estudos sobre SFC mostraram que entre os principais indicadores da disfunção mitocondrial, envolvidos com a menor produção de ATP, está o comprometimento das vias de fosforilação oxidativa. O método utilizado nessa revisão, scoping review, é utilizado para investigar conceitos-chave subjacentes a uma nova área de pesquisa, bem como esclarecer definições de trabalhos, analisando o título e resumo de artigos para seleciona-los. Como critérios de inclusão ficaram determinados: (1) estudos clínicos que registram pacientes adultos (>= 18 anos de idade); (2) mostram uma relação entre questões do metabolismo e bioenergética mitocondrial com síndrome da fadiga crônica; (3) são escritos em português, inglês ou espanhol; (4) artigos publicados nos últimos 10 anos. E de exclusão: (1) utilizaram modelos animai; (2) relatos de casos, editoriais, cartas, revisões de literatura, resumos e dissertações de reuniões; (3) literatura cinzenta. Entre os descritores comuns, utilizados para realizar a busca nas bases de dados estão: mitochondria OR mitochondrial, fatigue, bioenergy OR bioenergetic OR energy metabolism. O estudo foi guiado pela seguinte questão: ""Alterações no metabolismo energético mitocondrial estão relacionados com a origem e prevalência da síndrome da fadiga crônica?". Após utilizar a estratégia de busca, específica para cada uma das quatro bases de dados (PubMed, EMBASE, SCOPUS e Web of Science), foram encontrados 228 artigos, os quais foram exportados para o software Rayyan QCRI e removidos aqueles que se encontravam em duplicata. Este software permitiu que dois revisores executassem, de forma independente, a leitura dos títulos e resumos de 150 artigos e 27 foram selecionados para a leitura na íntegra, por atenderem aos critérios supracitados. Dentre esses últimos, apenas 10 relatavam alterações no metabolismo mitocondrial relacionadas à SFC. As alterações compreendem modificações nas vias de transporte mitocondrial e na cadeia respiratória; mutações no DNA mitocondrial e, até mesmo, disfunções energéticas em células do sistema imune, como as natural-killer. Foram encontrados dados de pesquisas em diversas áreas clínicas, tais como: cardiologia, oncologia e distúrbios musculares, os quais podem colaborar para trazer luz às causas biológicas dessa síndrome. Desta forma, tornou-se ainda mais evidente a conexão entre distúrbios na bioenergética mitocondrial, como uma menor capacidade de transporte de oxigênio por meio das vias de transporte, ou até mesmo, a insuficiência mitocondrial para produção de ATP, com a SFC. De acordo com os estudos que compuseram a amostra final desta revisão (n=10), o metabolismo mitocondrial e suas principais atividades, como a produção e transporte de ATP, são um alvo potencial para auxiliar na compreensão de incógnitas existentes sobre a SFC. Esses resultados são promissores para a enfermagem, sobretudo na área da ciência dos sintomas, com impacto na qualidade de vida e no manejo personalizado de sintomas em diferentes condições crônicas, especialmente na SFC
In this dissertation a scoping review was carried out with the objective of searching in the literature what exists to date to explain the relationship between mitochondrial metabolism and chronic fatigue syndrome (CFS). SFC presents itself differently for each individual, which makes complex their understanding, since no specific biomarkers were identified to aid in a definitive diagnosis that favors an appropriate intervention and more effective treatments. Different biological mechanisms are studied, and changes in mitochondrial metabolism have been the focus of recent research. Such alterations may be the cause of severe fatigue and studies on CFS have shown that among the main indicators of mitochondrial dysfunction, involved in the lower production of ATP, is the involvement of oxidative phosphorylation pathways. The method used in this review, scoping review, is used to investigate key concepts underlying a new research area, as well as clarifying definitions of papers, analyzing the title and abstract articles to select them. As inclusion criteria were determined: (1) clinical studies that register adult patients (>= 18 years of age); (2) show a relationship between metabolism and bioenergetic mitochondrial issues with chronic fatigue syndrome; (3) written in Portuguese, English or Spanish; (4) articles published in the last 10 years. The exclusion criteria: (1) used animal models; (2) case reports, editorials, letters, literature reviews, abstracts and dissertations; (3) gray literature. Among the common descriptors used to perform the search in the databases are: mitochondria OR mitochondrial, fatigue, bioenergy OR bioenergetic OR energy metabolism. The study was guided by the following question: "" Changes in mitochondrial energy metabolism are related to the origin and prevalence of chronic fatigue syndrome? ". After using the search strategy, specific to each of the four databases (PubMed, EMBASE, SCOPUS and Web of Science), 228 articles were found, which were exported to the Rayyan QCRI software and removed from those that were in duplicate. This software allowed two reviewers to independently perform the reading of the titles and abstracts of 150 articles and 27 were selected for reading in full, because they meet the aforementioned criteria. Among the latter, only 10 reported changes in mitochondrial metabolism related to CFS. The changes comprise modifications in mitochondrial transport pathways and respiratory chain; mutations in mitochondrial DNA, and even energy dysfunctions in cells of the immune system, such as natural killer. Research data have been found in several clinical areas, such as: cardiology, oncology and muscular disorders, which can collaborate to bring light to the biological causes of this syndrome. Thus, the connection between disturbances in mitochondrial bioenergetics, such as reduced oxygen transport capacity, or even mitochondrial insufficiency for ATP production, with CFS became even more evident. According to the studies that compose the final sample of this review (n = 10), mitochondrial metabolism and its main activities, such as the production and transport of ATP, are a potential target to aid in the understanding of existing unknowns about CFS. These results are promising for nursing, especially in the area of symptom science, with an impact on quality of life and personalized management of symptoms in different chronic conditions, especially CFS
Subject(s)
Oxidative Phosphorylation , Fatigue Syndrome, Chronic/diagnosis , Energy Metabolism , MitochondriaABSTRACT
Objective: To observe the effect of Bushen Kangshuai tablets combined with abdominal massage on chronic fatigue syndrome (CFS) with syndrome of spleen and kidney deficiency, and investigate its antioxidant stress and immune regulation effects. Method: One hundred and sixty patients were randomly divided into control group and observation group by random number table, 80 cases in each group. Patients in control group got abdominal massage, 1 time/day, 5 times/week, for a total of 3 treatment courses, 15 times in one course. Based on the treatment in control group, patients in observation group also received Bushen Kangshuai tablets, 6 tablets/time, 3 times/days, for a total of 12 weeks in treatment. Before and after treatment, symptom scores of spleen and kidney deficiency, fatigue scale-14 (SF-14), self-rating anxiety scale (SAS), self-rating depression scale (SDS) and Pittsburgh sleep quality index (PSQI) were graded; and levels of serum immunoglobulin (IgG, IgA and IgM), natural killer cells (NK), T lymphocyte subsets (CD3+, CD4+, CD8+ and CD4+/CD8+), malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) were detected. Result: In the rank sum test, the clinical efficacy in observation group was better than that in control group (Z=1.982, PPPP+, CD4+, CD4+/CD8+ were also higher then those in control group (PP+ (PPConclusion: Bushen Kangshuai tablets combined with abdominal massage to CFS with syndrome of spleen and kidney deficiency can significantly relieve fatigue, improve spleen and kidney deficiency, and improve immune function and antioxidant stress, superior to abdominal massage therapy alone in the clinical Efficacy.
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OBJECTIVE@#To observe the effects of acupuncture on the fatigue symptoms of chronic fatigue syndrome, the potential symptoms and cytokines on the base of the theory as "interaction of brain and kidney" and explore its clinical therapeutic effects and the potential mechanism.@*METHODS@#A total of 68 patients were randomized into an observation group and a control group, 34 cases in each one. In the control group, oryzanol and vitamin B1 were prescribed for oral administration and the patients were required to have a proper rest and physical exercise. In the observation group, on the base of the theory as "interaction of brain and kidney", acupuncture was added to Baihui (BL 20), Fengchi (GB 20), Pishu (BL 20), Shenshu (BL 23), Sanyinjiao (SP 6) and Taixi (KI 3). The treatment was given once a day, 5 treatments a week, with 2 days break. The consecutive treatment for 4 weeks was required. Before and after treatment, the score of the fatigue scale-14 (FS-14), the score of the somatic and psychological health report (SPHERE) and the score of the Pittsburgh sleep quality index (PSQI) were observed in the patients of the two groups separately. The enzyme-linked immunosorbent assay (ELISA) was adopted to determine the levels of serum interleukin-6 (IL-6) and interferon-γ (INF-γ) before and after treatment.@*RESULTS@#After treatment, FS-14 scores, SPHERE scores and PSQI scores were all reduced as compared with the scores before treatment in the two groups (<0.05, <0.01). After treatment, the levels of IL-6 and INF-γ in the serum in the observation group were reduced as compared with the levels before treatment (both <0.01). After treatment, the scores of FS-14, SPHERE and PSQI as well as the levels of serum IL-6 and INF-γ in the observation group were all lower than the results in the control group (<0.05, <0.01).@*CONCLUSION@#On the base of the theory as "interaction of brain and kidney", acupuncture therapy relieves the fatigue symptoms and the potential symptoms and improves the sleep quality in the patients of chronic fatigue syndrome. The effect mechanism is probably related to the decrease of the levels of IL-6 and INF-γ in serum.
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Humans , Acupuncture Therapy , Brain , Fatigue Syndrome, Chronic , Therapeutics , Treatment OutcomeABSTRACT
OBJECTIVE@#To observe the clinical therapeutic effects of auricular gold-needle therapy on chronic fatigue syndrome of deficiency constitution and explore its potential mechanism.@*METHODS@#A total of 120 patients were randomized into an auricular gold-needle therapy group, an auricular point pressure therapy group and a Chinese herb group, 40 cases in each one. Additionally, a health control group (40 cases) was set up, without any intervention. In the auricular gold-needle therapy group, the gold needle was used to stimulate the auricular points on one side and the cowherb seed pressure therapy on the other side. In the auricular point pressure therapy group, the cowherb seed pressure therapy was adopted only on one side. The auricular points were shen (CO), xin (CO), fei (CO), pizhixia (AT), etc. in the two groups. The auricular points on both sides were used alternatively. The treatment was given once a week, 4 treatments as one course and the consecutive 3 courses of treatment were required. In the Chinese herb group, was prescribed for oral administration, 6 g, twice a day, the medication for 1 month was as one session and the consecutive 3 sessions of medication were required. Before and after treatment, separately, the clinical symptom score, the levels of the serum immunoglobulins, i.e. IgA, IgG and IgM were observed in the patients of the three groups. The therapeutic effects were evaluated in the three groups.@*RESULTS@#The total effective rate was 90.0% (36/40) in the auricular gold-needle therapy group, better than 80.0% (32/40) in the auricular point pressure therapy group and 82.5% (33/40) in the Chinese herb group (both <0.05). Before treatment, the clinical symptom scores of the patients in the three groups were obviously higher than the health control group (all <0.001). After treatment, the symptom scores were all reduced as compared the scores before treatment in the three groups (all <0.001) and the symptom scores in the auricular gold-needle therapy group were better than the auricular point pressure therapy group and the Chinese herb group (both <0.01). Before treatment, the levels of serum IgA, IgG and IgM of the patients in the three groups were lower than the health control group (all <0.001). The levels were all improved after treatment in the three groups (all <0.01), and the levels in the auricular gold-needle therapy group was better than the auricular point pressure therapy group and the Chinese herb group (all <0.05).@*CONCLUSION@#The auricular gold-needle therapy achieves the significant therapeutic effects on chronic fatigue syndrome of deficiency constitution and its mechanism is probably related to the regulation of immune function.
Subject(s)
Humans , Acupuncture Therapy , Fatigue Syndrome, Chronic , Gold , Qi , Treatment OutcomeABSTRACT
OBJECTIVE: To observe the effect of electroacupuncture (EA) of "Zusanli" (ST 36) on mitochondrial oxidative stress of skeletal muscle in rats with chronic fatigue syndrome (CFS) based on adenosine 5'-monophosphate (AMP)-activated protein kinase (AMPK)/ peroxlsome proliferator-activated receptor-γ coactivator-1 α (PGC-1 α) signaling, in order to reveal its mechanism underlying improvement of CFS. METHODS: Forty SD rats were randomly divided into normal control, CFS model, EA-Zusanli (ST 36) and EA-non-acupoint groups (n=10 rats in each group). The CFS model was established by forced exhausted load-bearing swimming (twice daily), chronic constraint (1 h) and sleep deprivation (20 h/day) for 14 days. Following modeling, EA (2 Hz/100 Hz, 2 V) was applied to bilateral Zusanli (ST 36) or non-acupoint (about 10-15 mm superior to the bilateral Iliac creast and about 20 mm lateral to the posterior median line) for 20 min, once a day for 10 days. The expression levels of ATP synthase, AMPK, phosphorylated (p)-AMPK, silent mating type information regulation 2 homolog-1 (SIRT 1) and PGC-1 α proteins, and ATP synthase, SIRT 1 and PGC-1 α mRNAs of the quadriceps femoris muscle were detected by Western blot and fluorescence quantitative PCR, respectively. The rats' grabbing force was detected by using a grabbing-force detector. RESULTS: Compared with the normal group, the grabbing force, and the expression levels of ATP synthase and PGC-1 α proteins and mRNAs were significantly decreased (P<0.05, P<0.01), while the expression of SIRT 1 protein was significantly up-regulated (P<0.05) in the CFS model group. Following EA intervention, the grabbing force and the expression levels of ATP synthase mRNA, SIRT 1 and PGC-1 α proteins and mRNAs, and p-AMPK/AMPK were significantly up-regulated in the EA-Zusanli (ST 36) group (P<0.05, P<0.01). CONCLUSION: EA of ST 36 can raise the grabbing force of CFS rats, which may be related to its effects in up-regulating the expression of ATP synthase mRNA, SIRT 1 and PGC-1 α proteins and mRNAs, and p-AMPK/AMPK to reduce mitochondrial oxidative stress reaction and in increasing ATP synthesis.
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BACKGROUND: Recently, despite the high prevalence of fatigue in patients, there is a lack of research on the quality of life (QoL) in unexplained fatigue patients, indicating that they are not properly diagnosed and treated. The aim of this study was to compare fatigue severity and QoL between patients with explained and unexplained fatigue. METHODS: The study consisted of 200 Korean adults who complained of fatigue without underlying disease. Fatigue Severity Scale, Short Form Health Survey-36 version 2 (SF-36v2), and Beck Depression Inventory-II (BDI-II) self-questionnaires were administered. Participants were dichotomized to two groups, namely, patients with unexplained or explained fatigue, sorted according to laboratory examination results. The chi-square test, t-test, and Wilcoxon rank-sum test were used, and analysis of covariance was calculated after adjusting for age, sex, body mass index, smoking status, and physical component summary (PCS) of SF-36v2 or BDI-II. RESULTS: PCS of SF-36v2 between the two groups showed significant difference. Compared to patients with explained fatigue, those with unexplained fatigue showed lower physical component scores of QoL. CONCLUSION: QoL of patients with unexplained fatigue could largely diminish than those with explained fatigue. The primary clinician should be aware of poor QoL in patients with unexplained fatigue to identify who is in need of more attention and intervention.
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Adult , Humans , Body Mass Index , Depression , Fatigue Syndrome, Chronic , Fatigue , Prevalence , Primary Health Care , Quality of Life , Smoke , SmokingABSTRACT
OBJECTIVE@#To study the differential metabolites in urine and the characteristics of metabolic pathway of middle school students with chronic fatigue syndrome (CFS) before and after exercise, and then explain the metabolic mechanism of CFS.@*METHODS@#Eight male middle school students (age:17-19) with CFS were selectedas the CFS group according to CFS screening criteria of the U.S. centers.At the same time, 8 male health students of the same age from the same school were selected as the control group. They were administrated to do one-time exercise on the improved Harvard step (up and down steps 30 times/min for 3minutes). Their urinewascollected before and after exercise, and the differential metabolitesin urine were detected by liquid chromatography-mass spectrometry (LC-MS). The multidimensional statistical methods were used to analyze the metabolites by principal component analysis (PCA) and orthogonal projections to latent structures-discriminant analysis (OPLS-DA). Finally, MetPA database was used to analyze the metabolites and to construct the correlativemetabolic pathways.@*RESULTS@#Compared with the control group, the creatine, indoleacetaldehyde, phytosphingosine and pyroglutamic acid were selected as differential metabolites and the contents of those were decreased significantly (<0.05 or <0.01) in CFS groupbefore the step movement. However, 11 differential metabolitesin CFS group were selected out after exercise, which were nonanedioic acid, methyladenosine, acetylcarnitine, capric acid, corticosterone, creatine, levonorgestrel, pantothenic acid, pyroglutamic acid, xanthosine and xanthurenic acid in sequence, the contents of methyladenosine and creatinewere significantly increased (<0.05) and the contents of the other 9 differentialmetabolites were significantly decreased (<0.05 or <0.01)compared with the control group.The 15 differential metabolites mentioned above were input MetPA database in order to analyze the metabolic pathways weighted score.The results showed that the arginine-proline metabolism pathway disordersweredetected in theCFS group before exercise, the marker metabolite wascreatine. And 3 metabolic pathwaysdisorder weredetectedin the CFS groupafter exercise, which were arginine-proline metabolism, biosynthesis of pantothenic acid and CoA, steroid hormone biosynthesis, and the marker metabolites, in turn, werecreatine, pantothenic acid and corticosterone.@*CONCLUSIONS@#The disorder of arginine-proline metabolic pathway is detected in CFS middle school students before exercise intervention. After exercise, it can be detected that the steroid hormone biosynthetic metabolic pathway, pantothenic acid and CoA metabolic pathways also have metabolic disorders.