The idea that the blood delivery system is causing the problems with
energy production is not new
By Cort Johnson • ProHealth.com • December 17, 2018
Shungu’s brain findings suggest
high levels of oxidative stress and low levels of antioxidants are constricting
the blood vessels.
The blood vessel constriction is
producing a low oxygen environment which forces the cells in the brain to rely
on anaerobic energy production.
High levels of oxidative stress
are amongst the most consistent findings in chronic fatigue syndrome (ME/CFS).
Our red blood cells provide the
oxygen our cells need to do their work. In order to flow properly through the
capillaries to our cells they must be round and elastic.
The SJSU/Stanford study overseeen
by Ron Davis suggests that ME/CFS patient’s red blood cells are often no longer
round and take longer than usual to enter the capillaries and flow through
them. Their membranes are stiffer than usual as well and they contain high
levels of free radicals.
The red blood cells still contain
normal levels of hemoglobin but their distorted shapes and inelastic and
damaged membranes may be keeping them from delivering normal amounts of oxygen
to the cells.
The red blood cell issues and
Shungu’s findings suggesting that narrowed blood vessels are creating a hypoxic
or low oxygen environment in the brain provide another possible way to explain
for the low energy problems in ME/CFS.
Three more grants by the Open
Medicine Foundation and Ron Davis will attempt to further characterize the red
blood issues in ME/CFS with an eye to producing a cost-effective biomarker.
Could the microvascular system –
the small capillaries and the red blood cells that run through them – hold the
key to energy problems in chronic fatigue syndrome (ME/CFS) and perhaps
fibromyalgia? The idea that the blood delivery system – not some metabolic
derangement per se – is causing the problems with energy production is not new.
At first Shungu thought ME/CFS
was a mitochondrial disorder but his studies convinced him it was probably more
a disease in which poor microcirculation impaired the ability of the
mitochondria to produce energy.
Over a decade ago, brain scans
from Dr. Cheney’s ME/CFS patients caught Dikoma Shungu’s eye. The only other time he’d seen lactate levels
like that before was in people with primary mitochondrial disorders.
Three vital seed grants from the
Solve ME/CFS Initiative allowed Shungu’s work to proceed – work that is still
going on today and that’s mushroomed into millions of dollars in funding from
the NIH. That work has produced one of the most consistent findings in all of
ME/CFS research: Shungu’s five studies have all found increased lactate levels
in ME/CFS patients’ brains.
Over time Shungu developed a
startling hypothesis. While ME/CFS brains may look like they have a
mitochondrial disease, they don’t. That doesn’t mean the mitochondria are
working well – they’re not – but they’re not underperforming because of a
metabolic problem. Instead, Shungu believes they’re getting pummeled by
oxidative stress, resulting, at least in part, from a dramatic decline in the
antioxidant system that’s designed to keep oxidative stress in check.
Shungu believes that an
immunological change or pathogen triggers the production of pro-inflammatory
cytokines and the potent free radical peroxynitrite. When the muffled
antioxidant system fails to mop up peroxynitrite, the free radical smashes into
and rips up the lipid membranes of cells, and in doing so forms a major menace
in ME/CFS – isoprostanes.
Potent vasoconstrictors, the
isoprostanes then compress the blood vessels, reducing blood flow and producing
a hypoxic or low oxygen environment. That low oxygen environment forces the
cells to rely on anaerobic energy production.
In Shungu’s view, then, ME/CFS is
not a mitochondrial or metabolic disease; its much simpler than that – it’s an
oxidative stress induced micro-circulatory disease. The oxygen the muscles and
other energy intensive tissues such as the brain need to produce abundant
amounts of energy? It’s there, but it’s just not getting through.
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