Abnormalities in pH handling by peripheral muscle and potential regulation by the autonomic nervous system in chronic fatigue syndrome
Abnormalities in pH handling by peripheral muscle and potential regulation by the autonomic nervous system in chronic fatigue syndrome
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DOI：
10.1111/j.1365-2796.2009.02160.x
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发表时间：
2010-04-01
影响因子：
11.1
通讯作者：
Newton, J. L.
中科院分区：
文献类型：
--
作者：
Jones, D. E. J.;Hollingsworth, K. G.;Newton, J. L.
Jones DEJ，Hollingsworth KG，Taylor R，Blamire AM，Newton JL（来自纽卡斯尔磁共振中心细胞医学研究所和纽卡斯尔大学老龄化与健康研究所，英国）。慢性疲劳综合征患者外周肌肉对pH值的处理和自主神经系统的潜在调节能力增强《实习医学杂志》2010; 267：394- 401.目的.研究慢性疲劳综合征（CFS/ME）患者运动后的肌肉酸处理能力及其与自主神经功能障碍的关系.设计.观察性研究.设置.区域疲劳服务.受试者和干预措施.慢性疲劳综合征（n = 16）和年龄和性别匹配的正常对照（n = 8）进行磷磁共振波谱（MRS）以评估运动期间的pH值处理。受试者以固定的35%负荷最大自主收缩进行跖屈。结果：与正常对照组相比，CFS/ME组运动后即刻和运动后即刻的质子流出量均明显受到抑制，（CFS：1.1 +/- 0.5 mmol L-1 min-1 vs.正常：3.6 +/- 1.5 mmol L-1 min-1，P < 0.001）和最大（CFS：2.7 +/- 3.4 mmol L-1 min-1 vs.对照：3.8 +/- 1.6 mmol L-1 min-1，P < 0.05）。此外，患者达到最大质子流出所需的时间显著延长（CFS：25.6 +/- 36.1 s vs.正常：3.8 +/- 5.2 s，P < 0.05）。在对照组中，最大质子流出率与运动后最低肌pH呈强负相关（r2 = 0.6; P < 0.01）。相反，在CFS患者中，这种显著的正常关系消失（r2 = 0.003; P = ns）。在正常人中，运动后最大质子流出量与总心率变异性密切相关（r2 = 0.7; P = 0.007），而CFS/ME患者中这种关系消失（r2 < 0.001; P = ns）。本研究确定了CFS/ME患者的一种新的生物学异常，可能需要进行修改。
Jones DEJ, Hollingsworth KG, Taylor R, Blamire AM, Newton JL (From the Institute of Cellular Medicine, Newcastle Magnetic Resonance Centre, and Institute for Ageing and Health, Newcastle University, UK). Abnormalities in pH handling by peripheral muscle and potential regulation by the autonomic nervous system in chronic fatigue syndrome. J Intern Med 2010; 267: 394-401.Objectives.To examine muscle acid handling following exercise in chronic fatigue syndrome (CFS/ME) and the relationship with autonomic dysfunction.Design.Observational study.Setting.Regional fatigue service.Subjects & interventions.Chronic fatigue syndrome (n = 16) and age and sex matched normal controls (n = 8) underwent phosphorus magnetic resonance spectroscopy (MRS) to evaluate pH handling during exercise. Subjects performed plantar flexion at fixed 35% load maximum voluntary contraction. Heart rate variability was performed during 10 min supine rest using digital photophlethysmography as a measure of autonomic function.Results.Compared to normal controls, the CFS/ME group had significant suppression of proton efflux both immediately postexercise (CFS: 1.1 +/- 0.5 mmol L-1 min-1 vs. normal: 3.6 +/- 1.5 mmol L-1 min-1, P < 0.001) and maximally (CFS: 2.7 +/- 3.4 mmol L-1 min-1 vs. control: 3.8 +/- 1.6 mmol L-1 min-1, P < 0.05). Furthermore, the time taken to reach maximum proton efflux was significantly prolonged in patients (CFS: 25.6 +/- 36.1 s vs. normal: 3.8 +/- 5.2 s, P < 0.05). In controls the rate of maximum proton efflux showed a strong inverse correlation with nadir muscle pH following exercise (r2 = 0.6; P < 0.01). In CFS patients, in contrast, this significant normal relationship was lost (r2 = 0.003; P = ns). In normal individuals, the maximum proton efflux following exercise were closely correlated with total heart rate variability (r2 = 0.7; P = 0.007) this relationship was lost in CFS/ME patients (r2 < 0.001; P = ns).Conclusion.Patients with CFS/ME have abnormalities in recovery of intramuscular pH following standardised exercise degree of which is related to autonomic dysfunction. This study identifies a novel biological abnormality in patients with CFS/ME which is potentially open to modification.