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Clinical Trial
. 2023 Feb 2;18(2):e0280942.
doi: 10.1371/journal.pone.0280942. eCollection 2023.

Endothelial dysfunction in ME/CFS patients

Miriam Kristine Sandvik  1 , Kari Sørland  2 , Elisabeth Leirgul  3 , Ingrid Gurvin Rekeland  2   4 , Christina Særsten Stavland  4 , Olav Mella  2   4 , Øystein Fluge  2   4
Affiliations
Clinical Trial

Endothelial dysfunction in ME/CFS patients

Miriam Kristine Sandvik et al. PLoS One. .

Abstract

Objective: A few earlier studies have found impaired endothelial function in patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). The present study investigated large-vessel and small-vessel endothelial function in patients with ME/CFS.

Study design: The study was a substudy of the RituxME trial, a national, multicenter, randomized, double-blind, placebo-controlled phase III study on the effect of rituximab vs. placebo in ME/CFS patients in Norway. Flow-mediated dilation (FMD) and post-occlusive reactive hyperemia (PORH) was measured at baseline and after 18 months of treatment in 39 patients and compared with healthy controls. Other outcome measures were symptom severity and various physical function measures.

Results: ME/CFS patients had markedly reduced FMD compared to healthy controls at baseline (5.1% vs. 8.2%, p< 0.0001, adjusted for arterial diameter and sex), and significantly lower microvascular regulation measured by PORH than healthy controls (1354 PU vs. 2208 PU, p = 0.002). There were no differences between the treatment and placebo groups in symptom changes or vascular measures. As a group, the ME/CSF patients experienced a slight, but significant improvement in clinical symptoms after 18 months. PORH, but not FMD, was similarly improved (1360 to 1834 PU, p = 0.028). There was no significant correlation between FMD and PORH. There were non-significant tendencies towards associations between symptom severity/physical function measures and lower FMD and PORH, and a significant correlation between PORH and steps per 24 hours at baseline.

Conclusions: ME/CFS patients had reduced macro- and microvascular endothelial function, indicating that vascular homeostasis may play a role in the clinical presentation of this disease.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow-mediated dilation and post-occlusive reactive hyperemia in ME/CFS patients and healthy controls.
Fig 2
Fig 2. Associations between vascular measures and disease severity.
Fig 3
Fig 3. Vascular measures at baseline and 18 months.
See this image and copyright information in PMC

References

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