A Study of Sauna Therapy in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Patients Shows Sauna Action via Raised Tetrahydrobiopterin and Confirms Three Predictions of the NO/ONOO- Cycle.

SAUNA; CHRONIC fatigue syndrome; TETRAHYDROBIOPTERIN; PEROXYNITRITE; NITROTYROSINE

A series of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) patients have been studied to test two previous predictions: (1) Sauna therapy acts, at least in part, by raising the availability of tetrahydrobiopterin (BH4); and (2) ME/CFS is caused by a biochemical vicious cycle mechanism known as the NO/ONOO-cycle. Sauna therapy is shown here to increase BH4 synthesis, acting by raising the rate-limiting enzyme in BH4 synthesis, GPCH. This confirms, then, the first prediction. ME/CFS patients have very high levels of peroxynitrite as measured by the peroxynitrite marker 3-nitrotyrosine, averaging 5.43 times the levels of healthy controls with no overlap with those controls, and also have low levels of BH4, confirming predictions of the NO/ONOO- cycle mechanism. Sauna treatment, presumably acting via increased BH4 availability, lowers peroxynitrite levels, again in agreement with prediction. Sauna treatment also lowers the very high levels of neopterin found in these patients, possibly by stimulating the signaling of the IL-lb cytokine. Several important conclusions can be drawn here. First, sauna therapy does not act solely via detoxification, as has been widely assumed, but acts, at least in part, by raising BH4 levels. Second, three important predictions of the NO/ONOO- cycle mechanism are confirmed for the first time in ME/CFS patients, providing support for this mechanism as the etiologic mechanism of this disease. Third, three biochemical parameters are partially normalized by sauna treatment, BH4 levels, peroxynitrite levels and neopterin levels, suggesting that ME/CFS is fundamentally biochemical in nature. The very high, nonoverlapping levels of 3-nitrotyrosine (marker for peroxynitrite) in ME/CFS patients, as compared with healthy controls, suggest that this may be a very useful objective test for severity in ME/CFS patients. [ABSTRACT FROM AUTHOR]

Copyright of Townsend Letter is the property of Townsend Letter Group and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)