HRONIC FATIGUE SYNDROME (CFS) is a complex disorder characterized by long-term disability. The rate of spontaneous recovery in CFS is low 1 and no consistently effective treatment is available. Hypoactivity of the hypothalamicpituitary-adrenal axis has been demonstrated in some patients with CFS and fibromyalgia. 2-7 Some evidence suggests that CFS patients may have enhanced sensitivity of the peripheral cholinergic vascular system and an exaggerated pyridostigmine-stimulated growth hormone release response. 8 Acetylcholine is implicated in vagal tone, baroreceptor reflexes, and in transmission at the nicotinic sympathetic ganglia and at the neuromuscular junctions. Patients with CFS are often intolerant of the anticholinergic adverse effects of tricyclic antidepressants and these symptoms are similar to the symptoms of CFS. The frequent complaint of cognitive impairment in CFS also is consistent with the cholinergic hypothesis of cognition. A functional deficiency of cholinergic neurotransmission offers one possible explanation for the findings of a hypoactive hypothalamic-pituitary-adrenal axis; under conditions of stress, acetylcholine facilitates the release of corticotrophin-releasing hormone. Cholinergic stimulation also releases
The alpha 2-adrenergic receptor antagonist SL 84.0418 dose dependently reduced the increase in blood glucose after glucose load without modification of plasma insulin. It may represent an alternative to sulfonylureas in the treatment of non-insulin-dependent diabetes mellitus. Further studies are needed to assess its efficacy and tolerability in non-insulin-dependent patients.
We developed a RIA for the beta-core fragment of hCG that is excreted in the urine of pregnant women and some patients with cancer. We purified beta-core from crude commercial preparations of hCG (of which beta-core is a major constituent) derived from pregnancy urine and used this purified beta-core material to immunize rabbits. One antiserum (RW25) was particularly useful in that a RIA with purified beta-core as both radioligand and reference preparation had high sensitivity for beta-core detection and low cross-reactivity with other hCG-related molecules and glycoprotein hormones. The cross-reactivities of purified hCG (CR125), hCG beta (CR125), and hCG alpha (CR125) preparations were in each instance less than 3 x 10(-3) (wt/wt). The cross-reactivities of purified pituitary glycoprotein hormones were in each instance less than 2 x 10(-4) (wt/wt). Using the RW25 RIA, virtually all beta-core immunoreactivity in pregnancy urine eluted from Sephadex G-100 in a position coincident with that of purified beta-core. Urine from men and nonpregnant women contained very low levels of beta-core immunoreactivity (less than 6.5 micrograms/L), while urine from pregnant women and patients with testicular cancer or other neoplasms had levels of beta-core immunoreactivity ranging as high as 26,000 micrograms/L. We conclude that the improved specificity of our beta-core RIA will facilitate studies of the physiology and cancer biology of beta-core molecules.
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