Post-exertion malaise in chronic fatigue syndrome: symptoms and gene expression

Abstract

Background: A primary complaint of chronic fatigue syndrome (CFS) patients is post-exertion malaise, which is a worsening of symptoms following activities such as exercise. Purpose: To examine the link between gene expression for metabolite, adrenergic, immune, and glucocorticoid receptors on leukocytes and symptoms (pain, fatigue, and mood) following a maximal exercise test. Methods: Thirteen CFS patients and 11 healthy participants matched on age and fitness underwent blood draws and completed questionnaires immediately before, and 15 minutes, 48 hours, and 72 hours following, maximal exercise. Symptom and genetic measures collected before and after exercise were compared using a doubly multivariate repeated-measures analysis of variance. Results: This comparison of CFS and healthy participants resulted in a significant multivariate main effect for Group (p < 0.05). Univariate analyses indicated group differences for adrenergic α-2A and glucocorticoid (NR3C1) receptor messenger ribonucleic acid and symptoms of fatigue and confusion. Changes in gene expression were significantly correlated with symptoms. Conclusions: Results suggest that increased glucocorticoid sensitivity may contribute to the symptoms of post-exertion malaise in CFS. As NR3C1 interacts with other transcription factors, investigating the resulting cascades may lead to greater understanding of the biological mechanism of post-exertion malaise. This finding, if confirmed, could lead to novel approaches to prevent symptom exacerbation in CFS.

Keywords:

• chronic fatigue
• exercise
• genomics
• metabolite
• post-exertion malaise
• psychobiology

Acknowledgements

This study was conducted at the University of Wisconsin – Madison and funded by the Virginia Horne Henry Fund, the CFIDS Association of America (grant number 44111) and the Marshfield Clinic Research Foundation. The authors declare that they have no competing interests. The contents do not represent the views of the Department of Veterans Affairs or the United States Government.

Additional information

Notes on contributors

Jacob D. Meyer

Jacob Meyer is a graduate student in Exercise Psychology at the University of Wisconsin - Madison.

Alan R. Light

Alan Light is a research professor of Anesthesiology at the University of Utah.

Sanjay K. Shukla

Sanjay Shukla is research scientist at the Marshfield Clinic Research Foundation.

Derek Clevidence

Derek Clevidence is a family medicine physician with Meriter Health Services.

Steven Yale

Steven Yale is the director of the Clinical Research Center at the Marshfield Clinic Research Foundation.

Aaron J. Stegner

Aaron Stegner is a research scientist at the University of Wisconsin - Madison.

Dane B. Cook

Dane Cook is an Associate Professor at the University of Wisconsin - Madison and holds a research position at the William S. Middleton Memorial Veterans Hospital.