Maes, Michael · Current opinion in psychiatry · 2009 · DOI
This review examines how inflammation and stress on cells (caused by harmful molecules) may explain ME/CFS symptoms. The authors argue that various triggers—like infections, stress, intense exercise, and a 'leaky gut'—can activate these inflammatory pathways inside cells, leading to the pain, fatigue, muscle tension, and other symptoms that ME/CFS patients experience. They suggest that treating these inflammatory pathways could help develop new medicines for ME/CFS.
This review synthesizes biological mechanisms that could explain why ME/CFS symptoms are 'real' and organic rather than purely psychological, potentially shifting clinical and research perspectives. Understanding these inflammatory and oxidative pathways may guide development of targeted therapeutic interventions beyond symptomatic treatment.
As a mechanistic review article from 2009, this does not provide new primary data or direct causal proof that IO&NS pathways cause ME/CFS. The article does not establish which triggers are most important in individual patients, nor does it prove that targeting these pathways will be effective in clinical practice. The review conflates ME/CFS with somatization disorder, which remain distinct clinical entities.
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