How peptic ulcer disease could potentially lead to the lifelong, debilitating effects of chronic fatigue syndrome: an insight

Kuo, Chien Feng; Shi, Leiyu; Lin, Cheng Li; Yao, Wei; Chen, Hsiang Ting; Lio, Chon Fu; Wang, Yu Ting Tina; Su, Ching Huang; Hsu, Nan‐Yung; Tsai, Shin‐Yi

doi:10.1038/s41598-021-87018-z

Cited by 13 publications

(11 citation statements)

References 60 publications

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“…They suggested a three-step progression where excessive use of antibiotics in childhood might lead to typical abdominal symptoms of IBS and, years later, to the development of chronic inflammatory diseases possibly including ME/CFS ( 192 ). A similar hypothesis was stated by Kuo et al., who showed a significantly increased risk in women of developing ME/CFS following Helicobacter pylori associated peptic ulcer disease in a recent retrospective cohort study ( 193 ).…”

Section: The Role Of the Gut Microbiome In Me/cfssupporting

confidence: 79%

The Gut Microbiome in Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS)

et al. 2022

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Myalgic encephalomyelitis (ME) or Chronic Fatigue Syndrome (CFS) is a neglected, debilitating multi-systemic disease without diagnostic marker or therapy. Despite evidence for neurological, immunological, infectious, muscular and endocrine pathophysiological abnormalities, the etiology and a clear pathophysiology remains unclear. The gut microbiome gained much attention in the last decade with manifold implications in health and disease. Here we review the current state of knowledge on the interplay between ME/CFS and the microbiome, to identify potential diagnostic or interventional approaches, and propose areas where further research is needed. We iteratively selected and elaborated on key theories about a correlation between microbiome state and ME/CFS pathology, developing further hypotheses. Based on the literature we hypothesize that antibiotic use throughout life favours an intestinal microbiota composition which might be a risk factor for ME/CFS. Main proposed pathomechanisms include gut dysbiosis, altered gut-brain axis activity, increased gut permeability with concomitant bacterial translocation and reduced levels of short-chain-fatty acids, D-lactic acidosis, an abnormal tryptophan metabolism and low activity of the kynurenine pathway. We review options for microbiome manipulation in ME/CFS patients including probiotic and dietary interventions as well as fecal microbiota transplantations. Beyond increasing gut permeability and bacterial translocation, specific dysbiosis may modify fermentation products, affecting peripheral mitochondria. Considering the gut-brain axis we strongly suspect that the microbiome may contribute to neurocognitive impairments of ME/CFS patients. Further larger studies are needed, above all to clarify whether D-lactic acidosis and early-life antibiotic use may be part of ME/CFS etiology and what role changes in the tryptophan metabolism might play. An association between the gut microbiome and the disease ME/CFS is plausible. As causality remains unclear, we recommend longitudinal studies. Activity levels, bedridden hours and disease progression should be compared to antibiotic exposure, drug intakes and alterations in the composition of the microbiota. The therapeutic potential of fecal microbiota transfer and of targeted dietary interventions should be systematically evaluated.

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Section: The Role Of the Gut Microbiome In Me/cfssupporting

confidence: 79%

The Gut Microbiome in Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS)

et al. 2022

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“…A total of 105 and 79 individuals were included in the patient and control groups, respectively. The female-to-male ratio was 77: 28 1).…”

Section: Resultsmentioning

confidence: 94%

“…Fatigue is a common complaint in other chronic diseases and gastrointestinal diseases besides MS. Thus, H. pylori may need to be investigated as a cause of fatigue, especially in patients with chronic diseases, who were selected in our study (28).…”

Section: Discussionmentioning

confidence: 99%

Relationship Between Fatigue and Helicobacter pylori Infection in Patients with Multiple Sclerosis

Çam¹,

Akcalı²

2022

jmrs

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Objective: One of the common complaints in patients with multiple sclerosis (MS) is fatigue. Studies have reported that 75-87% of patients complain of fatigue. In our study, the possible relationship between fatigue severity and Helicobacter pylori (H. pylori) infection in patients with MS was investigated. Materials and Methods:The fatigue severity scale was applied to patients who presented to the neurology clinic during the study to assess fatigue. The Beck Depression Inventory was used to evaluate depression, and the Epworth sleepiness scale was used to assess sleepiness. Serum quantitative Immunoglobulin G (IgG) levels for H. pylori were measured using the enzyme-linked immunoassay. IBM SPSS Statistics version 26.0 was used for analysis. Results:The MS and control groups consisted of 105 and 79 people, respectively. H. pylori seropositivity was not significant in the intergroup analysis. In the MS group, H. pylori IgG level was significantly higher in patients with fatigue than in patients without fatigue. The Beck Depression Scale and Expanded Disability Status Scale scores were significantly higher in the MS group. Conclusion:Individual, environmental, and developmental factors were thought to play a role in fatigue, which is common in patients with MS. Another factor could be depression. In our study, H. pylori IgG levels were significantly higher in patients with fatigue in the MS group. This result suggests that H. pylori may be a factor in the pathophysiology of fatigue.

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“…The etiologies of chronic fatigue syndrome involve multiple factors. Current studies revealed the etiologies are related to infection [ 8 ], immune system differences [ 9 ], endocrine-metabolic dysfunction [ 10 ], or some specific disease such as peptic ulcer disease [ 11 ]. Multiple infectious agents have been linked to CFS, such as the varicella zoster virus [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

How mycobacterium tuberculosis infection could lead to the increasing risks of chronic fatigue syndrome and the potential immunological effects: a population-based retrospective cohort study

et al. 2022

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Background Chronic fatigue syndrome (CFS) has been shown to be associated with infections. Tuberculosis (TB) is a highly prevalent infectious disease. Patients with chronic fatigue syndrome and post-tuberculosis experience similar symptoms. Furthermore, chronic fatigue syndrome and tuberculosis share similar plasma immunosignatures. This study aimed to clarify the risk of chronic fatigue syndrome following the diagnosis of Mycobacterium tuberculosis infection (MTI), by analyzing the National Health Insurance Research Database of Taiwan. Methods 7666 patients aged 20 years or older with newly diagnosed Mycobacterium tuberculosis infection during 2000–2011 and 30,663 participants without Mycobacterium tuberculosis infection were identified. Both groups were followed up until the diagnoses of chronic fatigue syndrome were made at the end of 2011. Results The relationship between Mycobacterium tuberculosis infection and the subsequent risk of chronic fatigue syndrome was estimated through Cox proportional hazards regression analysis, with the incidence density rates being 3.04 and 3.69 per 1000 person‐years among the non‐Mycobacterium tuberculosis infection and Mycobacterium tuberculosis infection populations, respectively (adjusted hazard ratio [HR] = 1.23, with 95% confidence interval [CI] 1.03–1.47). In the stratified analysis, the Mycobacterium tuberculosis infection group were consistently associated with a higher risk of chronic fatigue syndrome in the male sex (HR = 1.27, 95% CI 1.02–1.58) and age group of ≥ 65 years old (HR = 2.50, 95% CI 1.86–3.38). Conclusions The data from this population‐based retrospective cohort study revealed that Mycobacterium tuberculosis infection is associated with an elevated risk of subsequent chronic fatigue syndrome.

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How peptic ulcer disease could potentially lead to the lifelong, debilitating effects of chronic fatigue syndrome: an insight

Cited by 13 publications

References 60 publications

The Gut Microbiome in Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS)

The Gut Microbiome in Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS)

Relationship Between Fatigue and Helicobacter pylori Infection in Patients with Multiple Sclerosis

How mycobacterium tuberculosis infection could lead to the increasing risks of chronic fatigue syndrome and the potential immunological effects: a population-based retrospective cohort study

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