Towards an understanding of physical activity-induced post-exertional malaise: Insights into microvascular alterations and immunometabolic interactions in post-COVID condition and myalgic encephalomyelitis/chronic fatigue syndrome.

IF 5.4 2区 医学 Q1 INFECTIOUS DISEASES
Simon Haunhorst, Diana Dudziak, Carmen Scheibenbogen, Martina Seifert, Franziska Sotzny, Carsten Finke, Uta Behrends, Konrad Aden, Stefan Schreiber, Dirk Brockmann, Paul Burggraf, Wilhelm Bloch, Claudia Ellert, Anuradha Ramoji, Juergen Popp, Philipp Reuken, Martin Walter, Andreas Stallmach, Christian Puta
{"title":"Towards an understanding of physical activity-induced post-exertional malaise: Insights into microvascular alterations and immunometabolic interactions in post-COVID condition and myalgic encephalomyelitis/chronic fatigue syndrome.","authors":"Simon Haunhorst, Diana Dudziak, Carmen Scheibenbogen, Martina Seifert, Franziska Sotzny, Carsten Finke, Uta Behrends, Konrad Aden, Stefan Schreiber, Dirk Brockmann, Paul Burggraf, Wilhelm Bloch, Claudia Ellert, Anuradha Ramoji, Juergen Popp, Philipp Reuken, Martin Walter, Andreas Stallmach, Christian Puta","doi":"10.1007/s15010-024-02386-8","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>A considerable number of patients who contracted SARS-CoV-2 are affected by persistent multi-systemic symptoms, referred to as Post-COVID Condition (PCC). Post-exertional malaise (PEM) has been recognized as one of the most frequent manifestations of PCC and is a diagnostic criterion of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Yet, its underlying pathomechanisms remain poorly elucidated.</p><p><strong>Purpose and methods: </strong>In this review, we describe current evidence indicating that key pathophysiological features of PCC and ME/CFS are involved in physical activity-induced PEM.</p><p><strong>Results: </strong>Upon physical activity, affected patients exhibit a reduced systemic oxygen extraction and oxidative phosphorylation capacity. Accumulating evidence suggests that these are mediated by dysfunctions in mitochondrial capacities and microcirculation that are maintained by latent immune activation, conjointly impairing peripheral bioenergetics. Aggravating deficits in tissue perfusion and oxygen utilization during activities cause exertional intolerance that are frequently accompanied by tachycardia, dyspnea, early cessation of activity and elicit downstream metabolic effects. The accumulation of molecules such as lactate, reactive oxygen species or prostaglandins might trigger local and systemic immune activation. Subsequent intensification of bioenergetic inflexibilities, muscular ionic disturbances and modulation of central nervous system functions can lead to an exacerbation of existing pathologies and symptoms.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4000,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Infection","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s15010-024-02386-8","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0

Abstract

Background: A considerable number of patients who contracted SARS-CoV-2 are affected by persistent multi-systemic symptoms, referred to as Post-COVID Condition (PCC). Post-exertional malaise (PEM) has been recognized as one of the most frequent manifestations of PCC and is a diagnostic criterion of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Yet, its underlying pathomechanisms remain poorly elucidated.

Purpose and methods: In this review, we describe current evidence indicating that key pathophysiological features of PCC and ME/CFS are involved in physical activity-induced PEM.

Results: Upon physical activity, affected patients exhibit a reduced systemic oxygen extraction and oxidative phosphorylation capacity. Accumulating evidence suggests that these are mediated by dysfunctions in mitochondrial capacities and microcirculation that are maintained by latent immune activation, conjointly impairing peripheral bioenergetics. Aggravating deficits in tissue perfusion and oxygen utilization during activities cause exertional intolerance that are frequently accompanied by tachycardia, dyspnea, early cessation of activity and elicit downstream metabolic effects. The accumulation of molecules such as lactate, reactive oxygen species or prostaglandins might trigger local and systemic immune activation. Subsequent intensification of bioenergetic inflexibilities, muscular ionic disturbances and modulation of central nervous system functions can lead to an exacerbation of existing pathologies and symptoms.

Abstract Image

了解体力活动诱发的劳累后不适:洞察后 COVID 状态和肌痛性脑脊髓炎/慢性疲劳综合征中的微血管改变和免疫代谢相互作用。
背景:相当多感染了 SARS-CoV-2 的患者会出现持续性多系统症状,即 "后 COVID 症状"(PCC)。劳累后乏力(PEM)被认为是 PCC 最常见的表现之一,也是肌痛性脑脊髓炎/慢性疲劳综合征(ME/CFS)的诊断标准。然而,其潜在的病理机制仍未得到充分阐明:在这篇综述中,我们描述了目前的证据,这些证据表明,PCC 和 ME/CFS 的主要病理生理特征与体力活动诱发的 PEM 有关:结果:受影响的患者在进行体力活动时会表现出全身氧萃取和氧化磷酸化能力下降。越来越多的证据表明,线粒体能力和微循环功能障碍是导致这些症状的原因,而潜伏的免疫激活又使线粒体能力和微循环功能障碍得以维持,同时损害了外周生物能。在活动过程中,组织灌注和氧气利用的不足会加剧运动不耐受,经常伴有心动过速、呼吸困难、活动过早停止,并引发下游代谢效应。乳酸、活性氧或前列腺素等分子的积累可能会引发局部和全身免疫激活。随之而来的生物能不灵活、肌肉离子紊乱和中枢神经系统功能调节的加剧会导致现有病症和症状的加重。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Infection
Infection 医学-传染病学
CiteScore
12.50
自引率
1.30%
发文量
224
审稿时长
6-12 weeks
期刊介绍: Infection is a journal dedicated to serving as a global forum for the presentation and discussion of clinically relevant information on infectious diseases. Its primary goal is to engage readers and contributors from various regions around the world in the exchange of knowledge about the etiology, pathogenesis, diagnosis, and treatment of infectious diseases, both in outpatient and inpatient settings. The journal covers a wide range of topics, including: Etiology: The study of the causes of infectious diseases. Pathogenesis: The process by which an infectious agent causes disease. Diagnosis: The methods and techniques used to identify infectious diseases. Treatment: The medical interventions and strategies employed to treat infectious diseases. Public Health: Issues of local, regional, or international significance related to infectious diseases, including prevention, control, and management strategies. Hospital Epidemiology: The study of the spread of infectious diseases within healthcare settings and the measures to prevent nosocomial infections. In addition to these, Infection also includes a specialized "Images" section, which focuses on high-quality visual content, such as images, photographs, and microscopic slides, accompanied by brief abstracts. This section is designed to highlight the clinical and diagnostic value of visual aids in the field of infectious diseases, as many conditions present with characteristic clinical signs that can be diagnosed through inspection, and imaging and microscopy are crucial for accurate diagnosis. The journal's comprehensive approach ensures that it remains a valuable resource for healthcare professionals and researchers in the field of infectious diseases.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信