The status of and future research into Myalgic Encephalomyelitis and Chronic Fatigue Syndrome: the need of accurate diagnosis, objective assessment, and acknowledging biological and clinical subgroups

doi:10.3389/fphys.2014.00109

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Front Physiol. 2014; 5: 109.

Published online 2014 Mar 27. doi: 10.3389/fphys.2014.00109

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Table 2

Abnormalities in ME/CFS.

Abnormality	References
Immunological aberrations (inflammation, immune activation, immunosuppression and immune dysfunction);	Klimas et al., 1990; Fletcher et al., 2009; Lorusso et al., 2009; Meeus et al., 2009; Brenu et al., 2011; Maes et al., 2012b
consistent with processes observed during (latent) infection;	Lloyd et al., 1993; Kerr et al., 2008a; Broderick et al., 2010
Intestinal dysbiosis, inflammation and hyperpermeability,	Maes et al., 2007a; Sheedy et al., 2009; Lakhan and Kirchgessner, 2010; De Meirleir et al., 2013; Frémont et al., 2013
associated with systemic immune system abnormalities;	Maes et al., 2012c; Groeger et al., 2013
(reactivating and/or persistent) infections;	Hilgers and Frank, 1996; Chia and Chia, 2003; Nicolson et al., 2003; Chia et al., 2010; Chapenko et al., 2012
Elevated oxidative and nitrosative stress;	Zhang et al., 1995; Kennedy et al., 2010; Maes and Twisk, 2010; Tomic et al., 2012
Mitochondrial dysfunction and damage to mitochondria;	Behan et al., 1991; Pietrangelo et al., 2009; Booth et al., 2012; Meeus et al., 2013
Hypovolemia, diminished cardiac output and	Streeten and Bell, 1998; Hurwitz et al., 2009; Miwa and Fujita, 2009; Hollingsworth et al., 2012
blood and oxygen supply deficits to muscles and brain,	McCully and Natelson, 1999; Biswal et al., 2011; Ocon, 2013
especially in an upright position and during exercise;	LaManca et al., 1999; Peckerman et al., 2003; Wyller et al., 2007; Patrick Neary et al., 2008
Reduced (maximum) oxygen uptake;	Farquhar et al., 2002; Weinstein et al., 2009; Vermeulen et al., 2010; Jones et al., 2012
Neurological abnormalities;	Lange et al., 2005; Chen et al., 2008; Puri et al., 2012; Natelson, 2013
Hypocortisolism/blunted hypothalamic-pituitary-adrenal (HPA) axis response;	Demitrack et al., 1991; Lorusso et al., 2009; Papadopoulos and Cleare, 2011; Tak et al., 2011
Ion channel dysfunction (channelopathy);	Watson et al., 1997; Whistler et al., 2005; Broderick et al., 2006; Cameron et al., 2007
A deviant physiological responses to exertion	Thambirajah et al., 2008; Jones et al., 2012; Light et al., 2012; Smylie et al., 2013; Snell et al., 2013