Endothelial dysfunction

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Endothelial dysfunction is a dysfunction in the endothelium, which is a thin layer that covers the inner surface of all blood vessels.[1] The endothelium separates the circulating blood from the tissues, and vascular endothelium has a key role in maintaining vascular homeostasis by releasing vasodilators and vasoconstrictors which either tighten or relax muscles in order to increase or reduce the size of blood vessels.[1][2][3]

Sympathetic nervous system[edit | edit source]

Endothelial function is linked to the sympathetic nervous system (SNS), since the SNS provides the nerves for the blood vessels.[4]

Prevalence[edit | edit source]

Symptom recognition[edit | edit source]

Endothelial dysfunction has only very recently been recognized within ME/CFS patients.

ME/CFS neurological symptoms hypothesis[edit | edit source]

In 2021 a group of EUROMENE researchers investigating ME/CFS published a hypothesis stating that endothelial dysfunction may be the cause of the neurological symptoms found in ME/CFS, although they hypothesized that other factors that described accounted for the other symptoms of ME/CFS.[5]

Notable studies[edit | edit source]

  • 2022, Decreased NO production in endothelial cells exposed to plasma from ME/CFS patients[6] - (Abstract)
  • 2021, An attempt to explain the neurological symptoms of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome[5] - (Full text)
  • 2021, Reduced Endothelial Function in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome–Results From Open-Label Cyclophosphamide Intervention Study[7] - (Full text)
  • 2021, Pathophysiology of skeletal muscle disturbances in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)[8] - (Full text)
  • 2021, Persistent endotheliopathy in the pathogenesis of long COVID syndrome[9] - (Full text)
  • 2020, Endothelial Dysfunction Driven by Hypoxia—The Influence of Oxygen Deficiency on NO Bioavailability[10] - (Full text)
  • 2020, Endothelial senescence and chronic fatigue syndrome, a COVID-19 based hypothesis[11] - (Full text)
  • 2020, Peripheral endothelial dysfunction in myalgic encephalomyelitis/chronic fatigue syndrome[12] - (Full text)
  • 2017, Hypothalamic-Pituitary-Adrenal Hypofunction in Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS) as a Consequence of Activated Immune-Inflammatory and Oxidative and Nitrosative Pathways[13] - (Abstract)

Possible causes[edit | edit source]

See also[edit | edit source]

Learn more[edit | edit source]

References[edit | edit source]

  1. ↑ 1.0 1.1 Esper, Ricardo J.; Nordaby, Roberto A.; Vilariño, Jorge O.; Paragano, Antonio; Cacharrón, José L.; Machado, Rogelio A. (February 23, 2006). "Endothelial dysfunction: a comprehensive appraisal". Cardiovascular Diabetology. 5 (1): 4. doi:10.1186/1475-2840-5-4. ISSN 1475-2840. PMC 1434727. PMID 16504104.
  2. ↑ Kwaifa, Ibrahim Kalle; Bahari, Hasnah; Yong, Yoke Keong; Noor, Sabariah Md (February 2020). "Endothelial Dysfunction in Obesity-Induced Inflammation: Molecular Mechanisms and Clinical Implications". Biomolecules. 10 (2): 291. doi:10.3390/biom10020291.
  3. ↑ "Vasoconstriction: What Is It, Symptoms, Causes & Treatment". Cleveland Clinic. Retrieved December 26, 2021.
  4. ↑ Tucker, William D.; Arora, Yingyot; Mahajan, Kunal (2022). Anatomy, Blood Vessels. Treasure Island (FL): StatPearls Publishing. PMID 29262226.
  5. ↑ 5.0 5.1 Wirth, Klaus J.; Scheibenbogen, Carmen; Paul, Friedemann (November 22, 2021). "An attempt to explain the neurological symptoms of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome". Journal of Translational Medicine. 19 (1): 471. doi:10.1186/s12967-021-03143-3. ISSN 1479-5876. PMC 8607226. PMID 34809664.
  6. ↑ Bertinat, Romina; Villalobos-Labra, Roberto; Hofmann, Lidija; Blauensteiner, Jennifer; Sepúlveda, Nuno; Westermeier, Francisco (April 1, 2022). "Decreased NO production in endothelial cells exposed to plasma from ME/CFS patients". Vascular Pharmacology. 143: 106953. doi:10.1016/j.vph.2022.106953. ISSN 1537-1891.
  7. ↑ Sørland, Kari; Sandvik, Miriam Kristine; Rekeland, Ingrid Gurvin; Ribu, Lis; Småstuen, Milada Cvancarova; Mella, Olav; Fluge, Øystein (2021). "Reduced Endothelial Function in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome–Results From Open-Label Cyclophosphamide Intervention Study". Frontiers in Medicine. 8: 294. doi:10.3389/fmed.2021.642710. ISSN 2296-858X. PMC 8019750. PMID 33829023.
  8. ↑ Wirth, Klaus J.; Scheibenbogen, Carmen (April 21, 2021). "Pathophysiology of skeletal muscle disturbances in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)". Journal of Translational Medicine. 19 (1): 162. doi:10.1186/s12967-021-02833-2. ISSN 1479-5876. PMC 8058748. PMID 33882940.
  9. ↑ Fogarty, Helen; Townsend, Liam; Morrin, Hannah; Ahmad, Azaz; Comerford, Claire; Karampini, Ellie; Englert, Hanna; Byrne, Mary; Bergin, Colm; O'Sullivan, Jamie M.; Martin‐Loeches, Ignacio (October 2021). "Persistent endotheliopathy in the pathogenesis of long COVID syndrome". Journal of Thrombosis and Haemostasis. 19 (10): 2546–2553. doi:10.1111/jth.15490. ISSN 1538-7933. PMC 8420256. PMID 34375505.
  10. ↑ Janaszak-Jasiecka, Anna; Siekierzycka, Anna; Płoska, Agata; Dobrucki, Iwona T.; Kalinowski, Leszek (July 2021). "Endothelial Dysfunction Driven by Hypoxia—The Influence of Oxygen Deficiency on NO Bioavailability". Biomolecules. 11 (7): 982. doi:10.3390/biom11070982.
  11. ↑ Sfera, Adonis; Osorio, Carolina; Zapata Martín del Campo, Carlos M.; Pereida, Shaniah; Maurer, Steve; Maldonado, Jose Campo; Kozlakidis, Zisis (June 25, 2021). "Endothelial Senescence and Chronic Fatigue Syndrome, a COVID-19 Based Hypothesis". Frontiers in Cellular Neuroscience. 15: 673217. doi:10.3389/fncel.2021.673217. ISSN 1662-5102. PMC 8267916. PMID 34248502.
  12. ↑ Scherbakov, Nadja; Szklarski, Marvin; Hartwig, Jelka; Sotzny, Franziska; Lorenz, Sebastian; Meyer, Antje; Grabowski, Patricia; Doehner, Wolfram; Scheibenbogen, Carmen (2020). "Peripheral endothelial dysfunction in myalgic encephalomyelitis/chronic fatigue syndrome". ESC Heart Failure. 7 (3): 1064–1071. doi:10.1002/ehf2.12633. ISSN 2055-5822. PMC 7261521. PMID 32154656.
  13. ↑ Morris, Gerwyn; Anderson, George; Maes, Michael (November 2017). "Hypothalamic-Pituitary-Adrenal Hypofunction in Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS) as a Consequence of Activated Immune-Inflammatory and Oxidative and Nitrosative Pathways". Molecular Neurobiology. 54 (9): 6806–6819. doi:10.1007/s12035-016-0170-2. ISSN 1559-1182. PMID 27766535.

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myalgic encephalomyelitis (M.E.) - A disease often marked by neurological symptoms, but fatigue is sometimes a symptom as well. Some diagnostic criteria distinguish it from chronic fatigue syndrome, while other diagnostic criteria consider it to be a synonym for chronic fatigue syndrome. A defining characteristic of ME is post-exertional malaise (PEM), or post-exertional neuroimmune exhaustion (PENE), which is a notable exacerbation of symptoms brought on by small exertions. PEM can last for days or weeks. Symptoms can include cognitive impairments, muscle pain (myalgia), trouble remaining upright (orthostatic intolerance), sleep abnormalities, and gastro-intestinal impairments, among others. An estimated 25% of those suffering from ME are housebound or bedbound. The World Health Organization (WHO) classifies ME as a neurological disease.

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