# Myalgic encephalomyelitis/chronic fatigue syndrome: From pathophysiological insights to novel therapeutic opportunities.
> 筋痛性脳脊髄炎／慢性疲労症候群における病態生理学的知見と新規介入の可能性


## Abstract

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) remains a debilitating condition with few evidence-supported interventions. Cognitive behavioural approaches and graded exercise provide only modest benefit for a subset of patients, and symptom exacerbation with physical activity is frequently reported. In patients meeting the Fukuda diagnostic criteria, multiple pathophysiological disturbances have been documented, including a pro-inflammatory milieu, elevated oxidative and nitrosative stress, compromised intestinal mucosal integrity, mitochondrial dysfunction, and dysregulated bioenergetics. This review systematically examines these mechanistic pathways and evaluates preliminary evidence for candidate interventions targeting them, specifically coenzyme Q, melatonin, curcumin, molecular hydrogen, and N-acetylcysteine. The authors conclude that while the data are encouraging, further rigorous investigation is required.

### Mechanism

In ME/CFS, elevated oxidative and nitrosative stress, mitochondrial dysfunction, intestinal barrier disruption, and a pro-inflammatory state have been identified. Molecular hydrogen is proposed as a candidate agent capable of targeting these interconnected pathological pathways.

## Bibliographic

- **Authors**: Morris G, Puri BK, Walker AJ, Maes M, Carvalho AF, Walder K, et al.
- **Journal**: Pharmacol Res
- **Year**: 2019
- **PMID**: [31509764](https://pubmed.ncbi.nlm.nih.gov/31509764/)
- **DOI**: [10.1016/j.phrs.2019.104450](https://doi.org/10.1016/j.phrs.2019.104450)
- **Study type**: review
- **Delivery route**: not specified
- **Effect reported**: not assessed

## Delivery context

The delivery route is not clearly identifiable from this paper. For hydrogen intake, inhalation is the most efficient route; inhalation, however, carries explosion risk (empirical LFL of 10%; high-concentration devices are not recommended).

## Safety notes

The delivery route is not clearly identifiable from this paper. For hydrogen intake, inhalation is the most efficient route; inhalation, however, carries explosion risk (empirical LFL of 10%; high-concentration devices are not recommended).

See also:
- [Inhalation concentration and LFL / UFL](https://h2-papers.org/en/safety-notes/inhalation-concentration)
- [Consumer Affairs Agency accident cases](https://h2-papers.org/en/safety-notes/accident-cases)

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> **Cite as**: H2 Papers — PMID 31509764. https://h2-papers.org/en/papers/31509764
> **Source**: PubMed PMID [31509764](https://pubmed.ncbi.nlm.nih.gov/31509764/)