Dr. Sarah Myhill en kollega's hebben een test ontwikkeld om
de (verstoorde) werking van de mitochondria (energiecentrales in de cellen:
klik hier)
in cijfers uit te drukken.
Uit hun onderzoek blijkt dat de ernst van de ziekte/invaliditeit sterk verband houdt
met de mate waarin de werking van de mitochondria ontregeld is.
Daartoe wordt de werking in 5 getallen uitgedrukt (zie afbeelding onder):
4 De mate waarin de toelevering van ADP aan de energiecentrale verstoord is.
3 De efficiëntie waarmee ADP (grondstof) omgezet wordt in ATP (drager van energie)
1 De beschikbaarheid van ATP in de mitochondria (gemeten in neutrofielen)
2 De hoeveelheid ATP die gebonden is aan magnesium.
Magnesium is nodig om energie vrij te maken (waarbij tevens ADP vrijkomt: zie 4)
5 De mate waarin de aflevering van ATP, de produktiefaciliteit,
aan de cytosol (waar de energie vrijkomt/verbruikt wordt) verstoord is.
De patiënten werden op basis van de mate van invaliditeit ingedeeld in drie groepen:
zware gevallen, gemiddelde ME/CVS-patiënten en (relatief) lichte gevallen.
Uit het onderzoek bleek dat de efficiëntie van het energie-produktieproces
van ME/CVS-patiënten direkt samenhangt met de ernst van de klachten/invaliditeit.
Dar wil overigens niet zeggen dat ME/CVS-patiënten op alle 5 terreinen slechts scoren.
De efficiëntie van het produktie wordt bepaald door het produkt van de 5 uitkomsten.
Voorbeeld: bijv. er wordt wel ATP geproduceerd wordt, maar de aflevering is verstoord.
Volgens de onderzoekers is het onaanvaardbaar dat mensen
inspanningstherapie (moeten) ondergaan terwijl de energiecentrales (motors van de auto) niet goed werken.
Zij vergelijken dit met het straffen van de chauffeur, terwijl zijn auto defekt is!
Dit is een doorbraak in het objektiveren/hard maken van de ernst van ME/CVS.
De vraag is natuurlijk: wat veroorzaakt die slechte werking van de mitochodria?
De auteurs doen twee suggesties: hypoxia (zuurstoftekort) en oxidatieve stress.
De laatste suggestie lijkt, gezien de bevindingen in talloze studies, de meest juiste.
Voor uitgebreide informatie over de (verstoorde) werking van mitochondria:
klik hier.
Voor de zeer edukatieve website van dr. Sarah Myhill:
klik hier.
Citaten uit het persbericht:
This test represents a huge breakthrough
in the diagnosis and management of Chronic Fatigue Syndrome/Myalgic Encephalomyelitis.
This illness has already been classified as a neurological disease
by the World Health Organisation under ICD 10 G93.3,
but many doctors continue to treat CFS/ME as if it were a psychological condition.
This has been enshrined in NICE Guidelines for treating CFS/ME
because their recommendations are for
psychological treatments
including antidepressants, cognitive behaviour therapy and graded exercise therapy.
This is completely inappropriate for patients who have
mitochondrial pathology and indeed is likely to make the mitochondrial pathology even worse.
A useful analogy is to compare your body with your the car.
The mitochondria represent the engine of that car,
the diet represents the fuel that goes in the tank,
the thyroid gland represents the accelerator pedal and
the adrenal gland the gearbox of that car.
Using cognitive behaviour therapy or graded exercise
to treat a patient with CFS/ME
is akin to beating up the driver of the car
when actually the car needs a re-conditioned engine,
suitable fuel in the tank,
resetting of the accelerator pedal,
a new gear box or whatever
This test invalidates the psychological model of CFS/ME
and clearly establishes this illness as having a physical basis.
Sufferers of CFS/ME have known this for many years
but now we have the biochemical basis to prove this.
This test can help distinguish between those
people fatigued because of a biochemical problem in their
mitochondria and those who are fatigued for other reasons. Other
reasons include dietary causes (allergy and carbohydrate intolerance),
hormonal reasons (such as borderline thyroid and adrenal function),
poor antioxidant status, chronic insomnia, psychosocial causes such
as anxiety and other causes.
bron:
http://www.theoneclickgroup.co.uk/news.php?start=2560&end=2580&view=yes&id=3177#newspost
Citaten uit de toelichting:
Mitochondria are a common biological unit across the animal kingdom.
Energy is supplied to cells by mitochondria
which I think of as little engines which power every cell in the body.
The job of mitochondria is to supply energy in the form of ATP (adenosine triphosphate).
This is the universal currency of energy.
It can be used for all sorts of biochemical jobs
from muscle contraction to hormone production.
When mitochondria fail, this results in poor supply of ATP,
so cells go slow because they do not have the energy supply to function at a normal speed.
This means that all bodily functions go slow.
If the CFS sufferer asks for energy faster than he can supply it,
(and actually most CFS sufferers are doing this most of the time!)
ATP is converted to ADP faster than it can be recycled.
However there is another problem.
If the body is very short of ATP,
it can make a very small amount of ATP directly
from glucose by converting it into lactic acid.
This is exactly what many CFS sufferers do
and indeed we know that CFS sufferers readily switch into anaerobic metabolism.
However this results in two serious problems
– lactic acid quickly builds up especially in muscles to cause
pain, heaviness, aching and soreness ("lactic acid burn"),
secondly no glucose is available in order to make D-ribose!
So new ATP cannot be easily made when you are really run down.
Recovery takes days!
The biological basis of treatment is therefore explained:
1. PACE – do not use up energy faster than your mitos can supply it.
2. FEED THE MITOCHONDRIA -
supply the raw material necessary for the mitochondria to heal themselves and work efficiently.
This means feeding the mitos correctly so they can heal and repair.
3. Address the underlying causes as to why mitochondria have been damaged.
This must also be put in place to prevent ongoing damage to mitos.
In order of importance this involves:
- Pacing activities to avoid undue stress to mitos
- Getting excellent sleep so mitos can repair
- Excellent nutrition with respect to:
- taking a good range of micronutrient supplements
- stabilising blood sugar levels
- identifying allergies to foods
- Detoxifying to unload heavy metals, pesticides,
drugs, social poisons (alcohol, tobacco etc) and volatile organic compounds,
all of which poison mitos.
- Optimising gut fermentation – HYPOCHLORHYDRIA and PANCREATIC FUNCTION, GUT DYSBIOSIS
- Addressing the common problem of hyperventilation
4. Address the secondary damage partly caused by mitochondrial failure
such as immune disturbances resulting in allergies and autoimmunity, poor digestive function, hormone gland failure, slow liver detoxification.
bron:
http://www.theoneclickgroup.co.uk/documents/ME-CFS_docs/NOTES%20TO%20EDITORS.pdf
Citaten uit het studierapport:
Our observations strongly implicate
mitochondrial dysfunction as the immediate cause of CFS symptoms.
However, we cannot tell whether the damage to mitochondrial function is a primary effect,
or a secondary effect to one or more of a number of primary conditions,
for example cellular hypoxia, or oxidative stress including excessive peroxynitrite.
We cannot overemphasize the importance of a careful diagnosis using the CDC criteria,
or even better the Canadian criteria which more precisely describe the symptoms.
There is mounting evidence that
the symptoms are due to dysfunctions on the cellular level.
Abnormalities have been seen in immune cells,
and gene expression studies have revealed abnormalities in genes
associated with immune cells, brain cells, skeletal muscle cells, the thyroid, and mitochondria.
bron:
http://www.ijcem.com/files/IJCEM812001.pdf
Chronic fatigue syndrome and mitochondrial dysfunction
Int J Clin Exp Med (2009) 2, 1-16
Myhill S, Booth NE, McLaren-Howard J.
This study aims
to improve the health of
patients suffering from chronic fatigue syndrome (CFS)
by interventions based on the biochemistry of the illness,
specifically the function of mitochondria in producing ATP
(adenosine triphosphate), the energy currency for all body functions,
and recycling ADP (adenosine diphosphate)
to replenish the ATP supply as needed.
Patients attending a private medical practice specializing in CFS
were diagnosed using the Centers for Disease Control criteria.
In consultation with each patient, an integer on the Bell Ability Scale was assigned,
and a blood sample was taken for the “ATP profile” test,
designed for CFS and other fatigue conditions.
Each test produced 5 numerical factors
which describe
- the availability of ATP in neutrophils,
- the fraction complexed with magnesium,
- the efficiency of oxidative phosphorylation, and
- the transfer efficiencies of ADP into the mitochondria and
- ATP into the cytosol where the energy is used.
With the consent of each of
71 patients and
53 normal, healthy controls
the 5 factors have been collated
and compared with the Bell Ability Scale.
The individual numerical factors show that
patients have different combinations of biochemical lesions.
When the factors are combined,
a remarkable correlation is observed
between the degree of mitochondrial dysfunction and
the severity of illness (P<0.001).
Only 1 of the 71 patients overlaps the normal region.
The “ATP profile” test is a powerful diagnostic tool and can differentiate
patients who have fatigue and other symptoms
as a result of energy wastage by stress and psychological factors
from those who have insufficient energy
due to cellular respiration dysfunction.
The individual factors indicate which remedial actions,
in the form of dietary supplements, drugs and detoxification,
are most likely to be of benefit,
and what further tests should be carried out.
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