Glutathione in the brain in CFS/ME

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Hi, all.

Professor Basant Puri et al. recently published a paper in which they reported

measurement of glutathione in the cerebral cortex of the brain of patients with

chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) using proton

magnetic resonance spectroscopy.

The abstract of this paper is below. Their conclusion was that they found no

evidence that cerebral glutathione levels are decreased in CFS/ME relative to

normal levels.

I was surprised at this result, given the large number of test results I have

reviewed showing glutathione depletion in blood plasma, as well as some results

from red blood cells or whole blood. There are also publications reporting

glutathione depletion in CFS/ME patients, some of which were cited by these

authors.

On further examination of this paper, I noted that the mean values of the

parameter used to quantify glutathione in this study were 2.703 for 13 CFS/ME

patients, and 5.191 for 13 matched normal controls. (There are no units on this

derived parameter.) However, the standard deviations of the data for these two

mean values were 2.311 and 8.984, respectively. Because of these large standard

deviations, the difference between the mean values was not statistically

significant (p=0.361).

I wrote to Professor Puri and asked if it would be fair to say that their study

lacked sufficient statistical power to determine whether glutathione is indeed

depleted in the brains of CFS/ME patients. He responded that this potential

explanation of their results " does make sense. " He agreed that a further,

larger study with greater statistical power is needed to examine this question,

and expressed his willingness to carry out such a study if funding could be

found.

I very much appreciated his response.

In view of this, I think it is correct to say that this study does not provide

any evidence contradicting the hypothesis that glutathione is depleted in CFS/ME

patients, and in particular in the brains of these patients. I'm hopeful that a

larger study can be done in the future to test this hypothesis.

Rich Van Konynenburg

Prostaglandins Leukot Essent Fatty Acids. 2009 Nov 9

An in vivo proton neurospectroscopy study of cerebral oxidative stress in

myalgic encephalomyelitis (chronic fatigue syndrome).

Puri BK, Agour M, Gunatilake KD, KA, Gurusinghe AI, Treasaden IH.

MRI Unit, Imaging Sciences Department, MRC Clinical Sciences Centre, Imperial

College School of Medicine, Hammersmith Hospital, Du Cane Road, London W12 0HS,

England, UK.

A particularly important family of antioxidant defence enzymes in the body are

the glutathione peroxidases, which remove H(2)O(2) by coupling its reduction to

H(2)O with oxidation of reduced glutathione (GSH) to oxidised glutathione

(GSSG). There are suggestions that GSH in the peripheral blood may be reduced in

myalgic encephalomyelitis, which is a highly disabling neurological disease of

unknown aetiology. Since many of the symptoms relate to cerebral functioning, it

would seem probable that peripheral blood GSH findings would be reflected in

lower cerebral GSH levels. The aim of this study was to carry out the first

direct assessment of cerebral GSH levels in myalgic encephalomyelitis; the

hypothesis being tested was that cerebral GSH levels would be reduced in myalgic

encephalomyelitis. Cerebral proton neurospectroscopy was carried out at a

magnetic field strength of 3T in 26 subjects; spectra were obtained from

20x20x20mm(3) voxels using a point-resolved spectroscopy pulse sequence. The

mean cerebral GSH level in the myalgic encephalomyelitis patients was 2.703 (SD

2.311) which did not differ significantly from that in age- and gender-matched

normal controls who did not have any history of neurological or other major

medical disorder (5.191, SD 8.984; NS). Therefore our study does not suggest

that GSH is reduced in the brain in myalgic encephalomyelitis. At the present

time, based on the results of this study, there is no evidence to support the

suggestion that, by taking glutathione supplements, an improvement in the

brain-related symptomatology of myalgic encephalomyelitis may occur.

PMID: 19906518 [PubMed - as supplied by publisher]