title: Mechanisms Explaining Muscle Fatigue and Muscle Pain in Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): a Review of Recent Findings.
abstract: OBJECTIVE
  Here, we review potential causes of muscle dysfunction seen in many patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) such as the effects of oxidative and nitrosative stress (O&NS) and mitochondrial impairments together with reduced heat shock protein production and a range of metabolic abnormalities.
  
  
  RESULTS
  Several studies published in the last few years have highlighted the existence of chronic O&NS, inflammation, impaired mitochondrial function and reduced heat shock protein production in many patients with ME/CFS. These studies have also highlighted the detrimental effects of chronically elevated O&NS on muscle functions such as reducing the time to muscle fatigue during exercise and impairing muscle contractility. Mechanisms have also been revealed by which chronic O&NS and or impaired heat shock production may impair muscle repair following exercise and indeed the adaptive responses in the striated muscle to acute and chronic increases in physical activity. The presence of chronic O&NS, low-grade inflammation and impaired heat shock protein production may well explain the objective findings of increased muscle fatigue, impaired contractility and multiple dimensions of exercise intolerance in many patients with ME/CFS.
authors.affiliation: Tir Na Nog, Bryn Road seaside 87, Llanelli, SA15 2LW, Wales, UK.
authors.forename: Morris
authors.initials: M
authors.lastname: Gerwyn
authors.affiliation: IMPACT Strategic Research Centre, Deakin University, School of Medicine and Barwon Health, Geelong, VIC, Australia. dr.michaelmaes@hotmail.com.
authors.forename: Michael
authors.initials: M
authors.lastname: Maes
mesh_terms: D015444:Exercise / Q000502:physiology; D015673:Fatigue Syndrome, Chronic / Q000150:complications* / Q000503:physiopathology; D006360:Heat-Shock Proteins / Q000096:biosynthesis; D006801:Humans; D018763:Muscle Fatigue / Q000502:physiology*; D018482:Muscle, Skeletal / Q000378:metabolism / Q000503:physiopathology; D063806:Myalgia / Q000209:etiology* / Q000503:physiopathology; D015538:Nitrosation / Q000502:physiology; D018384:Oxidative Stress / Q000502:physiology
chemical_list: D006360:Heat-Shock Proteins
keywords: Chronic fatigue; Cytokines; Disability; Muscle; Nitrosative; Oxidative