Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): Where will the drugs come from?. (March 2021)

• Record Type: Journal Article
• Authors: Toogood, Peter L.; Clauw, Daniel J.; Phadke, Sameer; Hoffman, David
• Is Part Of: Pharmacological research. Volume 165(2021)
• Publication Date: 2021-03
• Subjects: Chronic fatigue syndrome -- Myalgic encephalomyelitis -- Systemic exertion intolerance disease -- Drug discovery -- COVID-19; AMPK5' -adenosine monophosphate activated kinase -- ACh Racetyl choline receptor -- AP Tadaptive pacing therapy -- ATP adenosine 5'-triphosphate -- AdR adrenergic receptor -- CDC Centers for Disease Control and Prevention -- CNS central nervous system -- CoQ10 co-enzyme Q-10 -- CBT cognitive behavioral therapy -- COVID-19 Coronavirus Disease 2019 -- COX2 cycloxygenase 2 -- DCA dichloroacetic acid -- EBVE pstein Barr virus -- FM fibromyalgia -- FDA Food and Drug Administration -- GET graded exercise therapy -- Hsp90 heat shock protein 90 -- HHV human herpes virus -- HPA hypothalamic-pituitary-adrenal -- IOM Institute of Medicine -- INF interferon -- IL- interleukin- -- ME/CFS myalgic encephalomyelitis/chronic fatigue syndrome -- NK natural killer -- NADH nicotinamide adenine dinucleotide (reduced) -- NMR nuclear magnetic resonance spectroscopy -- PBMC peripheral blood mononuclear cells -- PPAR peroxisome proliferator-activated receptor -- PEM post-exertional malaise -- POTS post-orthostatic tachycardia syndrome -- PDC pyruvate dehydrogenase complex -- PDHK pyruvate dehydrogenase kinase -- RCT randomized controlled trial -- ROS reactive oxygen species -- RNS reactive nitrogen species -- RA rheumatoid arthritis -- RNA ribonucleic acid -- SARS Severe Acute Respiratory Syndrome -- SARS-CoV-1/2 Severe Acute Respiratory Syndrome Coronavirus-1/2 -- SNP single nucleotide polymorphism -- SEID systemic exertion intolerance disease -- SLE systemic lupus erythematosus -- TORC1 target of rapamycin complex 1 -- TLR toll-like receptor -- TRPM3 transient receptor potential (melastatin) 3 -- TGF tumor growth factor -- TNF tumor necrosis factor -- T1D type 1 diabetes; Pharmacology -- Periodicals; Pharmacology -- Periodicals; Research -- Periodicals; Médicaments -- Recherche -- Périodiques; Pharmacologie -- Périodiques; 615.105
• DOI: 10.1016/j.phrs.2021.105465
• Languages: English
• ISSNs: 1043-6618

Abstract

Graphical abstract: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): Where will the drugs come from? P. Toogood, D. Clauw, S. Phadke, D. Hoffman. Abstract: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a chronic debilitating disease characterized by severe and disabling fatigue that fails to improve with rest; it is commonly accompanied by multifocal pain, as well as sleep disruption, and cognitive dysfunction. Even mild exertion can exacerbate symptoms. The prevalence of ME/CFS in the U.S. is estimated to be 0.5–1.5 % and is higher among females. Viral infection is an established trigger for the onset of ME/CFS symptoms, raising the possibility of an increase in ME/CFS prevalence resulting from the ongoing COVID-19 pandemic. Current treatments are largely palliative and limited to alleviating symptoms and addressing the psychological sequelae associated with long-term disability. While ME/CFS is characterized by broad heterogeneity, common features include immune dysregulation and mitochondrial dysfunction. However, the underlying mechanistic basis of the disease remains poorly understood. Herein, we review the current understanding, diagnosis and treatment of ME/CFS and summarize past clinical studies aimed at identifying effective therapies. We describe the current status of mechanistic studies, including the identification of multiple targets for potential pharmacological intervention, and ongoing efforts towards the discovery of new medicines for ME/CFS treatment.