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Tryptophan depletion in chronic fatigue syndrome, a pilot cross-over study

BACKGROUND: Chronic fatigue syndrome (CFS) is still an enigmatic disorder. CFS can be regarded as a complex disorder with tremendous impact on lives of CFS-patients. Full recovery without treatment is rare. A somatic explanation for the fatigue is lacking. There is clinical and experimental evidence...

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Autores principales: The, Gerard KH, Verkes, Robbert J, Fekkes, Durk, Bleijenberg, Gijs, van der Meer, Jos WM, Buitelaar, Jan K
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4176591/
https://www.ncbi.nlm.nih.gov/pubmed/25227994
http://dx.doi.org/10.1186/1756-0500-7-650
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author The, Gerard KH
Verkes, Robbert J
Fekkes, Durk
Bleijenberg, Gijs
van der Meer, Jos WM
Buitelaar, Jan K
author_facet The, Gerard KH
Verkes, Robbert J
Fekkes, Durk
Bleijenberg, Gijs
van der Meer, Jos WM
Buitelaar, Jan K
author_sort The, Gerard KH
collection PubMed
description BACKGROUND: Chronic fatigue syndrome (CFS) is still an enigmatic disorder. CFS can be regarded as a complex disorder with tremendous impact on lives of CFS-patients. Full recovery without treatment is rare. A somatic explanation for the fatigue is lacking. There is clinical and experimental evidence implicating enhanced serotonergic neurotransmission in CFS. Genetic studies and imaging studies support the hypothesis of upregulated serotonin system in CFS. In line with the hypothesis of an increased serotonergic state in CFS, we performed a randomised clinical trial investigated the effect of 5-HT3 receptor antagonism in CFS. No benefit was found of the 5-HT3 receptor antagonist ondansetron compared to placebo. To further investigate the involvement of serotonin in CFS we performed a placebo controlled cross over pilot study investigating the effect of Acute Tryptophan Depletion. FINDINGS: Five female CFS-patients who met the US Center for Disease Control and Prevention criteria for CFS were recruited. There were two test days, one week apart. Each participant received placebo and ATD. To evaluate the efficacy of the ATD procedure tryptophan and the large neutral amino acids were measured. The outcome measures were fatigue severity, concentration and mood states. ATD resulted in a significant plasma tryptophan to large neutral amino acid ratio reduction of 96%. There were no significant differences in fatigue-, depression and concentration between the placebo- and ATD condition. CONCLUSIONS: These first five CFS-patients did not respond to the ATD procedure. However, a much larger sample size is needed to draw final conclusions on the hypothesis of an increased serotonergic state in the pathophysiology of CFS. TRIAL REGISTRATION: ISRCTN07518149
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spelling pubmed-41765912014-09-28 Tryptophan depletion in chronic fatigue syndrome, a pilot cross-over study The, Gerard KH Verkes, Robbert J Fekkes, Durk Bleijenberg, Gijs van der Meer, Jos WM Buitelaar, Jan K BMC Res Notes Short Report BACKGROUND: Chronic fatigue syndrome (CFS) is still an enigmatic disorder. CFS can be regarded as a complex disorder with tremendous impact on lives of CFS-patients. Full recovery without treatment is rare. A somatic explanation for the fatigue is lacking. There is clinical and experimental evidence implicating enhanced serotonergic neurotransmission in CFS. Genetic studies and imaging studies support the hypothesis of upregulated serotonin system in CFS. In line with the hypothesis of an increased serotonergic state in CFS, we performed a randomised clinical trial investigated the effect of 5-HT3 receptor antagonism in CFS. No benefit was found of the 5-HT3 receptor antagonist ondansetron compared to placebo. To further investigate the involvement of serotonin in CFS we performed a placebo controlled cross over pilot study investigating the effect of Acute Tryptophan Depletion. FINDINGS: Five female CFS-patients who met the US Center for Disease Control and Prevention criteria for CFS were recruited. There were two test days, one week apart. Each participant received placebo and ATD. To evaluate the efficacy of the ATD procedure tryptophan and the large neutral amino acids were measured. The outcome measures were fatigue severity, concentration and mood states. ATD resulted in a significant plasma tryptophan to large neutral amino acid ratio reduction of 96%. There were no significant differences in fatigue-, depression and concentration between the placebo- and ATD condition. CONCLUSIONS: These first five CFS-patients did not respond to the ATD procedure. However, a much larger sample size is needed to draw final conclusions on the hypothesis of an increased serotonergic state in the pathophysiology of CFS. TRIAL REGISTRATION: ISRCTN07518149 BioMed Central 2014-09-16 /pmc/articles/PMC4176591/ /pubmed/25227994 http://dx.doi.org/10.1186/1756-0500-7-650 Text en © The et al.; licensee BioMed Central Ltd. 2014 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.
spellingShingle Short Report
The, Gerard KH
Verkes, Robbert J
Fekkes, Durk
Bleijenberg, Gijs
van der Meer, Jos WM
Buitelaar, Jan K
Tryptophan depletion in chronic fatigue syndrome, a pilot cross-over study
title Tryptophan depletion in chronic fatigue syndrome, a pilot cross-over study
title_full Tryptophan depletion in chronic fatigue syndrome, a pilot cross-over study
title_fullStr Tryptophan depletion in chronic fatigue syndrome, a pilot cross-over study
title_full_unstemmed Tryptophan depletion in chronic fatigue syndrome, a pilot cross-over study
title_short Tryptophan depletion in chronic fatigue syndrome, a pilot cross-over study
title_sort tryptophan depletion in chronic fatigue syndrome, a pilot cross-over study
topic Short Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4176591/
https://www.ncbi.nlm.nih.gov/pubmed/25227994
http://dx.doi.org/10.1186/1756-0500-7-650
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