Coagulation and Vascular Pathology
1 Nunes et al. 2022 — Hyperactivated Platelets and Fibrinaloid Microclots in ME/CFS
Full Citation:: 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 (Basel). 2022;15(8):931. DOI:: 10.3390/ph15080931 PMID:: 36015078 Study Design:: Case-control study; ME/CFS patients vs. healthy controls; thromboelastography + fluorescent platelet microscopy Key Findings::
- Fibrinaloid microclot burden $>$ 10-fold greater in ME/CFS plasma than healthy controls
- $\sim$ 80% of ME/CFS participants showed platelet hyperactivation (mean spreading score 2.72 vs.\ 1.00)
- Thromboelastography revealed hypercoagulable state in $\sim$ 50% of participants
- Amyloid-resistant microclots may occlude microcapillaries, impairing tissue perfusionSignificance:: First direct demonstration of ME/CFS-specific coagulation pathology paralleling Long COVID findings; opens potential therapeutic avenue via anticoagulation.
2 Suárez et al. 2010 — Nitric Oxide Metabolites During Exercise in CFS
Full Citation:: Suárez A, Guillamó E, Roig T, et al. Nitric oxide metabolite production during exercise in chronic fatigue syndrome: a case-control study. Journal of Women’s Health. 2010;19(6):1073–1077. DOI:: 10.1089/jwh.2008.1255 PMID:: 20469961 Study Design:: Case-control; 44 female CFS patients vs. 25 healthy controls; maximal exercise testing Key Findings::
- Plasma nitrate concentrations significantly higher in CFS patients during exercise
- Maximum difference $\sim$ 295% above controls at maximal intensity
- Elevated NO metabolite response may indicate abnormal vascular regulation, not simple deficiency
- Authors suggest exercise-induced NO measurement as potential CFS biomarkerSignificance:: Demonstrates abnormal NO metabolism during exertion; challenges simple “endothelial NO deficiency” narrative; consistent with dysregulated vasoregulation rather than reduced production.