Adrenergic dysfunction in patients with myalgic encephalomyelitis/chronic fatigue syndrome and fibromyalgia: A systematic review and meta-analysis.

Autor: Hendrix J; Pain in Motion (PiM) international research group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Rehabilitation Sciences & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.; Department of Public Health and Primary Care, Centre for Environment & Health, KU Leuven, Leuven, Belgium.; Flanders Research Foundation-FWO, Brussels, Belgium., Fanning L; Department of Public Health and Primary Care, Centre for Environment & Health, KU Leuven, Leuven, Belgium., Wyns A; Pain in Motion (PiM) international research group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Rehabilitation Sciences & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.; Department of Public Health and Primary Care, Centre for Environment & Health, KU Leuven, Leuven, Belgium., Ahmed I; Pain in Motion (PiM) international research group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Rehabilitation Sciences & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.; Faculty of Physical Education and Physiotherapy, Department Movement and Nutrition for Health and Performance, Vrije Universiteit Brussel, Brussels, Belgium., Patil MS; Department of Public Health and Primary Care, Centre for Environment & Health, KU Leuven, Leuven, Belgium., Richter E; Department of Public Health and Primary Care, Centre for Environment & Health, KU Leuven, Leuven, Belgium., Van Campenhout J; Pain in Motion (PiM) international research group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Rehabilitation Sciences & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium., Ickmans K; Pain in Motion (PiM) international research group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Rehabilitation Sciences & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.; Flanders Research Foundation-FWO, Brussels, Belgium.; Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium.; Movement & Nutrition for Health & Performance Research Group (MOVE), Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Brussels, Belgium., Mertens R; Department of Internal Medicine, Vrije Universiteit Brussel, University Hospital Brussels, Brussels, Belgium., Nijs J; Pain in Motion (PiM) international research group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Rehabilitation Sciences & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.; Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium.; Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden., Godderis L; Department of Public Health and Primary Care, Centre for Environment & Health, KU Leuven, Leuven, Belgium.; External Service for Prevention and Protection at Work, IDEWE, Heverlee, Belgium., Polli A; Pain in Motion (PiM) international research group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Rehabilitation Sciences & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.; Department of Public Health and Primary Care, Centre for Environment & Health, KU Leuven, Leuven, Belgium.; Flanders Research Foundation-FWO, Brussels, Belgium.
Jazyk: angličtina
Zdroj: European journal of clinical investigation [Eur J Clin Invest] 2025 Jan; Vol. 55 (1), pp. e14318. Date of Electronic Publication: 2024 Sep 25.
DOI: 10.1111/eci.14318
Abstrakt: Background: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and fibromyalgia (FM) are comorbid disorders with overlapping symptoms. Research highlights autonomic dysfunction compared to healthy individuals, particularly involving the sympathetic branch. While past reviews focused on neurophysiological assessments, this systematic review summarises biological adrenergic markers, offering deeper insights into the observed sympathetic dysfunction in ME/CFS and FM aiming to identify targetable pathophysiological mechanisms.
Methods: A systematic search was performed on PubMed, Web of Science, Embase and Scopus. Studies investigating peripheral biological markers of adrenergic function in patients with ME/CFS or FM compared to healthy controls at baseline were included. Meta-analyses were performed using R statistical software.
Results: This meta-analysis of 37 studies, encompassing 543 ME/CFS patients and 651 FM patients, compared with 747 and 447 healthy controls, respectively, revealed elevated adrenaline (SMD = .49 [.31-.67]; Z = 5.29, p < .01) and β1 adrenergic receptor expression (SMD = .79 [.06-1.52]; Z = 2.13; p = .03) in blood of ME/CFS patients at rest. Additionally, patients with ME/CFS had a greater increase in the expression of α2A adrenergic receptor (AR, SMD = .57 [.18-.97]; Z = 2.85, p < .01), β2 AR (SMD = .41 [.02-.81]; Z = 2.04; p = .04) and COMT (SMD = .42 [.03-.81]; Z = 2.11; p = .03) after exercise and an increased response of noradrenaline to an orthostatic test (SMD = .11 [-.47 to -.70]; Z = 2.10; p = .04), both found in blood. FM patients showed no significant differences at baseline but exhibited a diminished adrenaline response to exercise (SMD = -.79 [-1.27 to -.30]; Z = -3.14; p < .01).
Conclusion: This systematic review and meta-analysis revealed adrenergic dysfunction mainly in patients with ME/CFS. Higher baseline adrenaline levels and atypical responses to exercise in ME/CFS indicate that sympathetic dysfunction, underscored by adrenergic abnormalities, is more involved in the pathophysiology of ME/CFS rather than FM.
(© 2024 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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