Changes in gut and plasma microbiome following exercise challenge in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)
Open accessAbstract
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a disease characterized by intense and debilitating fatigue not due to physical activity that has persisted for at least 6 months, post-exertional malaise, unrefreshing sleep, and accompanied by a number of secondary symptoms, including sore throat, memory and concentration impairment, headache, and muscle/joint pain. In patients with post-exertional malaise, significant worsening of symptoms occurs following physical exertion and exercise challenge serves as a useful method for identifying biomarkers for exertion intolerance. Evidence suggests that intestinal dysbiosis and systemic responses to gut microorganisms may play a role in the symptomology of ME/CFS. As such, we hypothesized that post-exertion worsening of ME/CFS symptoms could be due to increased bacterial translocation from the intestine into the systemic circulation. To test this hypothesis, we collected symptom reports and blood and stool samples from ten clinically characterized ME/CFS patients and ten matched healthy controls before and 15 minutes, 48 hours, and 72 hours after a maximal exercise challenge. Microbiomes of blood and stool samples were examined. Stool sample microbiomes differed between ME/CFS patients and healthy controls in the abundance of several major bacterial phyla. Following maximal exercise challenge, there was an increase in relative abundance of 6 of the 9 major bacterial phyla/genera in ME/CFS patients from baseline to 72 hours post-exercise compared to only 2 of the 9 phyla/genera in controls (p = 0.005). There was also a significant difference in clearance of specific bacterial phyla from blood following exercise with high levels of bacterial sequences maintained at 72 hours post-exercise in ME/CFS patients versus clearance in the controls. These results provide evidence for a systemic effect of an altered gut microbiome in ME/CFS patients compared to controls. Upon exercise challenge, there were significant changes in the abundance of major bacterial phyla in the gut in ME/CFS patients not observed in healthy controls. In addition, compared to controls clearance of bacteria from the blood was delayed in ME/CFS patients following exercise. These findings suggest a role for an altered gut microbiome and increased bacterial translocation following exercise in ME/CFS patients that may account for the profound post-exertional malaise experienced by ME/CFS patients.
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Maximal bicycle ergometer test showed an increase in abundance of 7 out of 9 major taxa in patients with myalgic encephalomyelitis/chronic fatigue syndrome compared to 2 of 9 in healthy controls.
“Acute effects of exercise have also been studied using maximal bicycle ergometer test that showed an increase in the abundance of 7 out of 9 major taxa in patients with myalgic encephalomyelitis/chronic fatigue syndrome compared to 2 of 9 in healthy controls (Shukla et al., 2015).”
From Six-Week Endurance Exercise Alters Gut Metagenome That Is not Reflected in Systemic Metabolism in Over-weight Women (2018) · cites this paper as Shukla et al., 2015
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- Authors
- Shukla, S. K., Cook, D., Meyer, J., Vernon, S. D., Le, T., Clevidence, D., Robertson, C. E., Schrodi, S. J., Yale, S., & Frank, D. N.
- Affiliations
- Marshfield Clinic Research Foundation (US)
- University of Wisconsin–Madison (US)
- William S. Middleton Memorial Veterans Hospital (US)
- Bateman Horne Center (US)
- University of Colorado Anschutz (US)
- Marshfield Clinic (US)
- Corresponding author
- Shukla, Sanjay K.
- ORCID
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2015-12-18
- Volume
- 10
- Issue
- 12
- Pages
- e0145453
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC4684203
- OpenAlex
- W2218212850
- Cited by
- 137
- References
- 58
- Citations by year
- 2026: 6 · 2025: 8 · 2024: 13 · 2023: 19 · 2022: 15 · 2021: 9 · 2020: 21 · 2019: 14 · 2018: 11 · 2017: 15 · 2016: 6
- FWCI
- 4.63
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Keywords
- chronic fatigue syndrome, gut microbiota, exercise challenge, post-exertional malaise, bacterial translocation, gut dysbiosis, bacterial clearance
- MeSH terms
- Bacillota, Gastrointestinal Microbiome, Adult, Bacillus, Physical Exertion, Feces, Female, Humans, Male, Middle Aged, Fatigue Syndrome, Chronic, Case-Control Studies, Bacteremia
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