The Occurrence of Hyperactivated Platelets and Fibrinaloid Microclots in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)
Abstract
:1. Introduction
2. Results
3. Discussion
4. Materials and Methods
4.1. Ethical Statement
4.2. Sample Demographics and Blood Collection
4.3. Viscoelastic Analysis
4.4. Fibrinaloid Microclot Analysis of PPP
4.5. Amyloid Analysis of PPP Clots after Addition of Thrombin to Create Fibrin Networks
4.6. Assessment of Platelet Phenoptype
4.7. Statistical Analysis
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Demographics | ||
p value (parametric analysis) | 0.54 | |
Age of control population (n = 15; 9 females; 6 males) | 45.7 ± 6.9 | |
Age of ME/CFS population (n = 25; 20 females; 5 males) | 48.2 ± 14.1 | |
Comorbidities of ME/CFS Population | ||
Comorbidity | % Prevalence | |
Gut Dysbiosis | 40% | |
POTS | 16% | |
Fibromyalgia | 16% | |
Psoriasis | 16% | |
Gingivitis/Periodontitis | 16% | |
Hypercholesterolemia | 16% | |
Hypertension | 16% | |
Rheumatoid Arthritis | 12% | |
Cardiovascular Disease | 12% | |
Orthostatic Hypotension | 4% | |
Mast Cell Activation Syndrome | 4% | |
Rosacea | 4% | |
Dysautonomia | 4% | |
ICC Questionnaire Results | ||
Parameter | Average Score (out of 10) | % of Subjects Experiencing Severely (Score of 8–10) |
1. Post-Exertional Neuroimmune Exhaustion | 7.8 ± 1.6 | 60% |
a. Marked, rapid physical and/or cognitive fatigability in response to exertion | 7.9 ± 1.6 | 64% |
b. Post-exertional symptom exacerbation (worsening of other symptoms) | 7.8 ± 1.4 | 56% |
c. Post-exertional exhaustion | 8.1 ± 1.3 | 64% |
d. Recovery period is prolonged | 7.4 ± 2.0 | 48% |
e. Low threshold of physical and mental fatigability (lack of stamina) | 8.1 ± 1.7 | 68% |
2. Neurological Impairments | 6.6 ± 2.6 | 44% |
a. Difficulty processing information | 6.52 ± 2.00 | 32% |
b. Short-term memory loss | 6.64 ± 2.04 | 44% |
c. Headaches | 6.00 ± 3.27 | 40% |
d. Significant pain (in muscles, tendons, abdomen, or chest) | 6.68 ± 2.84 | 52% |
e. Disturbed sleep pattern (from the previous night, e.g., insomnia, sleeping most of the day and being awake most of the night) | 6.72 ± 2.82 | 48% |
f. Unrefreshing sleep (from the previous night) | 7.92 ± 2.08 | 60% |
g. Neurosensory and perceptual symptoms (e.g., inability to focus vision, sensitivity to light, noise, etc.) | 7.20± 1.87 | 56% |
h. Motor symptoms (e.g., twitching, poor coordination) | 5.12 ± 2.65 | 16% |
3. Immuno, Gastrointestinal, and Genitourinary Impairments | 5.9 ± 2.7 | 35% |
a. Flu-like symptoms (e.g., sore throat, sinusitis, enlarged or tender lymph nodes) | 5.48 ± 1.94 | 16% |
b. Gastrointestinal tract symptoms (e.g., nausea, abdominal pain, bloating, irritable bowel) | 6.32 ± 2.66 | 44% |
c. Genitourinary symptoms (e.g., urinary urgency, urinary frequency, nocturia or having to urinate two or more times a night) | 5.76 ± 2.96 | 32% |
d. Sensitivities to food, medications, odors, or chemicals | 6.16 ± 3.05 | 48% |
Energy Production/Transportation Impairments | 6.6 ± 2.6 | 45% |
a. Cardiovascular symptoms (e.g., orthostatic intolerance, postural orthostatic tachycardia syndrome or POTS, palpitations, light-headedness/dizziness) | 7.00 ± 2.38 | 52% |
b. Respiratory symptoms (e.g., air hunger, labored breathing, fatigue of chest wall muscles) | 5.64 ± 2.98 | 32% |
c. Loss of thermostatic stability (e.g., subnormal body temperature, sweating episodes, recurrent feelings of feverishness, cold extremities) | 7.28 ± 1.54 | 52% |
d. Intolerance of extremes of temperature | 6.44 ± 2.89 | 44% |
Data are represented as mean ± standard deviation. |
TEG® of WB | |||
Parameter | Standard WB Range | ME/CFS WB (n = 25) | Out of Standard Range |
R | 9–27 | 7.73 ± 2.31 | 16/64% (below) |
K | 2–9 | 2.39 ± 0.82 | 9/36% (below) |
α-Angle | 22–58 | 56.99 ± 10.25 | 13/52% (above) |
Maximum Amplitude | 44–64 | 65.64 ± 7.02 | 14/56% (above) |
MRTG | 0–10 | 10.05 [7.18–12.12] | 13/52% (above) |
TMRTG | 5–23 | 9.74 ± 2.73 | 0 |
TTG | 251–1041 | 787.50 ± 84.07 | 0 |
TEG® of PPP | |||
Parameter | Control PPP (n = 15) | ME/CFS PPP (n = 25) | p value |
R | 10.25 ± 1.97 | 8.54 ± 3.51 | 0.09 |
K | 3.10 [2.80–3.80] | 1.90 [1.40–4.75] | 0.05 |
α-Angle | 51.70 [45.00–57.10] | 61.80 [54.00–66.25] | 0.002 (**) |
Maximum Amplitude | 25.90 [23.00–27.10] | 29.30 [22.05–32.55] | 0.20 |
MRTG | 8.05 [6.80–8.93] | 12.17 [9.13–15.77] | 0.0009 (***) |
TMRTG | 11.30 ± 2.20 | 9.68 ± 3.71 | 0.13 |
TTG | 306.40 [283.30–324.10] | 350.90 [261.30–391.00] | 0.22 |
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Nunes, J.M.; Kruger, A.; Proal, A.; Kell, D.B.; Pretorius, E. The Occurrence of Hyperactivated Platelets and Fibrinaloid Microclots in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). Pharmaceuticals 2022, 15, 931. https://doi.org/10.3390/ph15080931
Nunes JM, Kruger A, Proal A, Kell DB, Pretorius E. The Occurrence of Hyperactivated Platelets and Fibrinaloid Microclots in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). Pharmaceuticals. 2022; 15(8):931. https://doi.org/10.3390/ph15080931
Chicago/Turabian StyleNunes, Jean M., Arneaux Kruger, Amy Proal, Douglas B. Kell, and Etheresia Pretorius. 2022. "The Occurrence of Hyperactivated Platelets and Fibrinaloid Microclots in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)" Pharmaceuticals 15, no. 8: 931. https://doi.org/10.3390/ph15080931