Cited by 62Fibromyalgia and Chronic Fatigue Syndrome ResearchLong-Term Effects of COVID-19Infectious Encephalopathies and Encephalitis

Myalgic encephalomyelitis/chronic fatigue syndrome—metabolic disease or disturbed homeostasis due to focal inflammation in the hypothalamus?

Hatziagelaki, Erifili, Adamaki, Maria, Tsilioni, Irene, Dimitriadis, George, Theoharides, Theoharis C.·2018·The Journal of Pharmacology and Experimental Therapeutics

Abstract

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex disease characterized by debilitating fatigue, lasting for at least 6 months, with associated malaise, headaches, sleep disturbance, and cognitive impairment, which severely impacts quality of life. A significant percentage of ME/CFS patients remain undiagnosed, mainly due to the complexity of the disease and the lack of reliable objective biomarkers. ME/CFS patients display decreased metabolism and the severity of symptoms appears to be directly correlated to the degree of metabolic reduction that may be unique to each individual patient. However, the precise pathogenesis is still unknown, preventing the development of effective treatments. The ME/CFS phenotype has been associated with abnormalities in energy metabolism, which are apparently due to mitochondrial dysfunction in the absence of mitochondrial diseases, resulting in reduced oxidative metabolism. Such mitochondria may be further contributing to the ME/CFS symptomatology by extracellular secretion of mitochondrial DNA, which could act as an innate pathogen and create an autoinflammatory state in the hypothalamus. We propose that stimulation of hypothalamic mast cells by environmental, neuroimmune, pathogenic and stress triggers activates microglia, leading to focal inflammation in the brain and disturbed homeostasis. This process could be targeted for the development of novel effective treatments.

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Crossref · 10.1124/jpet.118.250845

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Authors
Hatziagelaki, E., Adamaki, M., Tsilioni, I., Dimitriadis, G., & Theoharides, T. C.
Affiliations
Tufts University (US)
Venue
The Journal of Pharmacology and Experimental Therapeutics
Publisher
Elsevier BV
Published
2018-10
Volume
367
Issue
1
Pages
155-167
ISSN
0022-3565 (ISSN-L)
OpenAlex
W2885130212
Cited by
62
References
278
Citations by year
2026: 5 · 2025: 3 · 2024: 8 · 2023: 10 · 2022: 15 · 2021: 9 · 2020: 5 · 2019: 6 · 2018: 1
FWCI
0.81
Type
journal article
Language
en
Open access
closed
Locations
  • Journal of Pharmacology and Experimental Therapeutics (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
  • Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
  • Health Sciences › Medicine › Infectious Diseases › Infectious Encephalopathies and Encephalitis
Keywords
chronic fatigue syndrome, hypothalamic inflammation, mitochondrial dysfunction, energy metabolism, mitochondrial DNA release, mast cells, microglial activation, neuroinflammation, autoinflammation, homeostasis disruption, biomarkers, pathogenesis
MeSH terms
Animals, Energy Metabolism, Homeostasis, Humans, Hypothalamus, Inflammation, Metabolic Diseases, Mitochondria, Biomarkers, Fatigue Syndrome, Chronic

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