Tag: liver

Chronic Fatigue Syndrome, Viruses and Related Conditions in Women: The Liver Link

Abstract:

Chronic Fatigue Syndrome (CFS) can be triggered by different factors and create a complex health situation. In the last decades incidence has been increasing. This situation is a clear example of how humans, viruses, and the environment are all connected.
In the 90s cases related to CFS, complaints about a feeling of chronic fatigue, inability for everyday tasks, dull pain, cephalalgia, de-pression, anxiety, poor concentration. Clinical tests for EBV, HHV, CMV, IgG, IgM, T4 and T8 subsets were tested, along with hormones and hemogram tests. Most of the cases were women. The timeline of the medical history showed also myomas, breast lumps, premenstrual syndrome previously to CFS development. The nature of these conditions promoted the idea of a possible common link among them and CFS. Some cases also suffered from allergies, food intolerances, candidiasis, intestinal impairment, thyroid implications, endometriosis.
As an initial working hypothesis, The Liver Link (TLL) was proposed in order to understand those different conditions affecting body, mind and emotional wellbeing. Considering liver implication can make a difference in treatment and recovery. Low grade inflammatory conditions are related to Th2 predominance and liver functions. Functional disharmonies are very important because they usually still do not appear in any conventional tests.
In 2002, TLL was presented as a framework to explain the concomitance of CFS and other conditions and the relationship with some viruses such as EBV, HHV, CMV, as a lecture in a congress at the University of Westminster (London). When SARS-CoV-2 outbroke, TLL helped to warn about the post-covid syndrome more likely to occur in specific individuals.
Source: Lorite-Ayán, N. Chronic Fatigue Syndrome, Viruses and Related Conditions in Women: The Liver Link. Preprints 2024, 2024011654. https://doi.org/10.20944/preprints202401.1654.v1 https://www.preprints.org/manuscript/202401.1654/v1 (Full text available as PDF file)

The Renin-Angiotensin-System in COVID-19: Can Long COVID Be Predicted?

Abstract:

(1) Background: Co-morbidities such as hypertension and cardiovascular disease are major risk factors for severe COVID-19. The renin-angiotensin-system (RAS) is critically involved in their pathophysiology and is counterbalanced by both angiotensin-converting enzyme 2 (ACE2), the functional receptor of SARS-CoV-2, and the kallikrein-kinin-system (KKS). Considerable research interest with respect to COVID-19 treatment is, thus, currently directed towards the components of these systems. In an earlier study, we noticed significantly reduced carboxypeptidase N (CPN, KKS member) activity and partially excessive angiotensin-converting enzyme (ACE, RAS member) activity in the sera of both hospitalized (HoP) COVID-19 patients and a sub-group of covalescent patients, while in the majority of the probands recovering from the disease these values had returned to normal. The data had been obtained using bradykinin (BK) as a reporter peptide, which is a target of both CPN and ACE, and they were supplemented by serum proteomics of the same patient cohort. We hypothesized that the data could be indicative of Long COVID, which had not been fully appreciated at the time of our study.;

(2) Methods: The data were re-evaluated in the light of Long COVID. The recent literature on the RAS in COVID-19, antihypertensiva, and Long COVID was briefly reviewed.;

(3) Results: While the levels of the BK serum degradation products should return to normal concentrations during convalescence, this was not true for some patients. This could be due to persisting liver problems, because CPN is synthesized there, but also to a dysregulated RAS. This was not reflected in the levels of selected RAS/KKS serum proteins like angiotensinogen (AGT), although AGT correlated with disease severity in HoP. However, standard tests in routine patient care in Long COVID often come back normal, and it may be that BK degradation is specific in some pathophysiologies. Moreover, the HoP group was sub-divided based on the serum protein profiles and COVID-19 severity.;

(4) Conclusions: We point out two insights: 1) Sensitive technology such as omics methods might provide unexpected significant differences within the pre-defined patient groups of a clinical study. Those can only be explored, if the cohorts are large enough and properly matched with respect to the parameters known beforehand (e.g., age, gender, co-morbidities). 2) Results of the BK-reporter serum protease activity assay could be indicative of persisting liver problems and/or potentially of Long COVID. Clinical studies are required to test this hypothesis.

Source: König, S.; Vollenberg, R.; Tepasse, P. The Renin-Angiotensin-System in COVID-19: Can Long COVID Be Predicted?. Preprints.org 2023, 2023051298. https://doi.org/10.20944/preprints202305.1298.v1 (Full text available as PDF file)

Liver volume is lower and associates with resting and dynamic blood pressure variability in chronic fatigue syndrome

Abstract:

Background: Chronic fatigue syndrome (CFS) in many cases is characterised by abnormal autonomic function and lower blood pressure (BP). In animals the liver is a capacitance vessel for BP homeostasis. We developed a novel liver magnetic resonance (MR) imaging technique to compare liver volume in CFS to controls, and to explore its role in cardiovascular physiology.

Methods: Liver MR (single breath-hold, enhanced T1-weighted, high-resolution isotropic volume excitation 3-Tesla Achieva, NL) determined liver volume. Red cell and plasma volume were also measured. A 10 min resting cardiac autonomic assessment using beat-to-beat measurement (Taskforce; CNSystems) was followed by assessment of hemodynamic response to standing to determine blood pressure drop and return to baseline.

Results: Forty-four CFS patients (age = 45.5, 34f/10 m, Fukuda criteria) and 10 age, activity and sex matched controls (age = 49.4, 7f/3 m) participated. Adjusted for body size, CFS patients had significantly reduced liver volumes (775 (101) ml/m2 v 846 (96) ml/m2; p = 0.02). At rest, liver volume was unrelated to symptom severity, heart rate, BP or heart rate variability. Both increased systolic and diastolic low frequency (LF) BP variability (predominantly sympathetic) were associated with lower liver volumes. On standing, liver volume was unrelated to BP drop but was associated with successful BP return-to-baseline. Red cell and plasma volume were associated positively with liver volume. Multivariate analysis confirmed return-to-baseline BP on standing which was independently associated with liver volume.

Conclusion: Liver volumes were smaller in CFS compared to controls. The relationship between return-to-baseline BP after standing and liver volume suggests, as in animals, that the liver is involved in maintenance of BP.

Abbreviations: ACI: Accelerated cardiac index; BPV: Blood pressure variability; BRS: Baroreflex sensitivity; CFS: chronic fatigue syndrome; Chr: Chromium; CI: cardiac index; FIS: Fatigue impact scale; HF: High frequency; HRV: Heart rate variability; LF: Low frequency; MR: magnetic resonance; NU: normalised units; SD: Standardised deviation; PSD: power spectral density; SI: Stroke index; TPRI: Total peripheral resistance index

Source: Pawel Zalewski, Andreas Finkelmeyer, James Frith, Laura Maclachlan, Andrew Blamire & Julia L. Newton (2018) Liver volume is lower and associates with resting and dynamic blood pressure variability in chronic fatigue syndrome, Fatigue: Biomedicine, Health & Behavior, DOI: 10.1080/21641846.2018.1488525