Post-COVID sequelae effect in chronic fatigue syndrome: SARS-CoV-2 triggers latent adenovirus in the oral mucosa.

The post-viral fatigue syndromes long COVID and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) have multiple, potentially overlapping, pathological processes. These include persisting reservoirs of virus, e.g., SARS-CoV-2 in long COVID patient's tissues, immune dysregulation with or without reactivation of underlying pathogens, such as Epstein-Barr virus (EBV) and human herpesvirus 6 (HHV6), as we recently described in ME/CFS, and possibly yet unidentified viruses. In the present study we tested saliva samples from two cohorts for IgG against human adenovirus (HAdV): patients with ME/CFS (n = 84) and healthy controls (n = 94), with either mild/asymptomatic SARS-CoV-2 infection or no infection. A significantly elevated anti-HAdV IgG response after SARS-CoV-2 infection was detected exclusively in the patient cohort. Longitudinal/time analysis, before and after COVID-19, in the very same individuals confirmed HAdV IgG elevation after. In plasma there was no HAdV IgG elevation. We conclude that COVID-19 triggered reactivation of dormant HAdV in the oral mucosa of chronic fatigue patients indicating an exhausted dysfunctional antiviral immune response in ME/CFS, allowing reactivation of adenovirus upon stress encounter such as COVID-19. These novel findings should be considered in clinical practice for identification of patients that may benefit from therapy that targets HAdV as well.

Body-composition development during early childhood and energy expenditure in response to physical activity in 1.5-y-old children.

BACKGROUND: The prevalence of childhood overweight and obesity has increased recently, but the mechanisms involved are incompletely known. Previous research has shown a correlation between the percentage of total body fat (TBF) and physical activity level (PAL). However, the PAL values used may involve a risk of spurious correlations because they are often based on predicted rather than measured estimates of resting energy metabolism. OBJECTIVES: We studied the development of body composition during early childhood and the relation between the percentage of TBF and PAL on the basis of the measured resting energy metabolism. DESIGN: Body composition was previously measured in 108 children when they were 1 and 12 wk old. When 44 of these children (21 girls and 23 boys) were 1.5 y old, their total energy expenditure and TBF were assessed by using the doubly labeled water method. Resting energy metabolism, which was assessed by using indirect calorimetry, was used to calculate PAL. RESULTS: Significant correlations were shown for TBF (r = 0.32, P = 0.035) and fat-free mass (r = 0.34, P = 0.025) between values (kg) assessed at 12 wk and 1.5 y of age. For TBF (kg) a significant interaction (P = 0.035) indicated a possible sex difference. PAL at 1.5 y was negatively correlated with the percentage of TBF (r = -0.40, P = 0.0076) and the increase in the percentage of TBF between 12 wk and 1.5 y (r = -0.38, P = 0.0105). CONCLUSIONS: The results indicate that body fatness and physical activity interact during early childhood and thereby influence obesity risk. Our results are based on a small sample, but nevertheless, they motivate additional studies in boys compared with girls regarding the development of body composition during early life.

Fat-free mass hydration in newborns: assessment and implications for body composition studies.

AIM: Equipment (Pea Pod) offering new possibilities to assess infant body composition has recently become available and has already been used in several studies. In the Pea Pod, body density is converted to body composition using one of two models ('Fomon' or 'Butte') with different water content in fat-free mass (hydration factor, HF). In healthy full-term infants, we assessed HF and its biological variability in 12 newborns and calculated body composition using the two models at 1 and 12 weeks in 108 infants. Body weight and volume were assessed in Pea Pod, and body water was assessed using isotope dilution. RESULTS: Hydration factor was 80.9% with low biological variability (0.8% of average HF). Body fat (%) was significantly lower at 1 and 12 weeks when calculated using the 'Butte' model than when using the 'Fomon' model. The difference was more pronounced at one than at 12 weeks. CONCLUSION: Our HF value agrees with that in the 'Fomon' model, its low biological variability can be reconciled with the statement that Pea Pod is accurate in newborns and 'Fomon' is the best available model for studies in Pea Pod.

A possible ethanol-catalyzed rearrangement of vitamin K(1) detected by gas chromatography/mass spectrometry.

We studied vitamin K(1)(20), vitamin K(1)(25), and vitamin K(1) epoxide in n-hexane and ethanol solutions by gas chromatography/mass spectrometry (GC/MS) utilizing a DB-5 MS fused-silica capillary column. In ethanol solutions of K(1), we observed an extra peak eluting from the GC column with somewhat longer retention time than K(1)(20). A similar peak following K(1)(25) was also found. These peaks were not found in n-hexane solutions of K(1). A close examination of the mass spectra of these peaks indicated that they were vitamin K(1) variants containing a base peak at m/z 225 characteristic of the methylnaphthoquinone ring with a four-carbon side chain. In addition, they contained the molecular ions of K(1)(20) and K(1)(25), respectively. We conclude that K(1)(20) and K(1)(25), but not K(1) epoxide, might undergo rearrangements in ethanol involving an intramolecular proton transfer and a shift of the beta,gamma-double bond on the phytyl side chain toward the ring. The conjugation of the phytyl double bond with the quinone ring is probably the driving force of the rearrangement. We emphasize, however, that our conclusion is based only on mass spectral analysis and would require further investigation by other spectroscopic methods.

beta-Alanine and gamma-aminobutyric acid in chronic fatigue syndrome.

BACKGROUND: Due to the occurrence of sleep disturbances and fatigue in chronic fatigue syndrome (CFS), an investigation was performed to examine if there is an abnormal excretion of gamma-aminobutyric acid (GABA) and/or its structural analogue beta-alanine in the urine from CFS patients. Both GABA and beta-alanine are inhibitory neurotransmitters in the mammalian central nervous system. METHODS: The 24 h urine excretion of GABA and beta-alanine was determined by isotope dilution gas chromatography mass spectrometry in 33 CFS patients and 43 healthy controls. The degree of symptoms in both patients and controls was measured by grading of three typical CFS symptoms using a Visual Analogue Scale. RESULTS: Men had a significantly higher excretion of both beta-alanine and GABA than women. Comparing CFS patients with healthy controls showed no significant difference in excretion of neither beta-alanine nor GABA. No correlation was found between the excretion of beta-alanine or GABA and any of the three characteristic CFS symptoms measured. However, two female and two male CFS patients excreted considerably higher amounts of beta-alanine in their 24 h urine samples than control subjects. CONCLUSIONS: Increased excretion of beta-alanine was found in a subgroup of CFS patients, indicating that there may be a link between CFS and beta-alanine in some CFS patients.

Atrophic gastritis is associated with increased sucrose permeability related to chronic inflammation.

BACKGROUND: Different theories have been presented to explain how atrophic gastritis may lead to gastric cancer development. One contributing factor could be impaired function of the gastric mucosal barrier. The aim of this study was to investigate if there are changes in gastric mucosal permeability to sucrose in atrophic gastritis. METHODS: The study comprised 22 patients with atrophic gastritis and 21 normal controls. Gastritis was classified according to the Sydney system from endoscopic biopsies of the gastric corpus and antrum. All subjects were exposed to oral sucrose load (100 g), and the fraction of sucrose excreted in urine was measured by gas chromatography-mass spectrometry. RESULTS: The fraction of sucrose excreted in urine after oral load was significantly increased in atrophic gastritis compared with controls (median 0.08 vs. 0.04%; p = 0.003). Sucrose excretion was positively related to the degree of chronic inflammation (median fraction excreted: mild inflammation 0.06%, moderate inflammation 0.08%, severe inflammation 0.18%; p = 0.04) rather than to the degree of atrophy in the gastric mucosa. Occurrence of intestinal metaplasia was also associated with significantly higher sucrose excretion. However, in multivariate analysis, including intestinal metaplasia, only the degree of inflammation was positively related to sucrose excretion. CONCLUSION: Atrophic gastritis is associated with increased sucrose permeability, suggesting paracellular leakage of the gastric mucosa. This leakage seems to be related to the degree of inflammation rather than the degree of atrophy. The findings may have implications for the diseases and complications associated with atrophic gastritis.

Comparison of commonly used procedures, including the doubly-labelled water technique, in the estimation of total energy expenditure of women with special reference to the significance of body fatness.

According to the report of the World Health Organization (1985), total energy expenditure (TEE) in human subjects can be calculated as BMR x physical activity level (PAL). However, other reports have pointed out limitations in the suggested procedure related to the % body fat of the subjects. The purpose of the present study was to evaluate the World Health Organization (1985) procedure in thirty-four healthy women with BMI 18-39 kg/m2. BMR and TEE were measured using indirect calorimetry (BMRmeas) and the doubly-labelled water method (TEEref) respectively. When assessed using the doubly-labelled water and skinfold-thickness methods, the women had 34 (SD 8) and 33 (SD 6) % body fat respectively. On the basis of guidelines provided by the World Health Organization (1985), 1.64 was selected to represent the average PAL of the women. Furthermore, PAL was also assessed by means of an accelerometer (PALacc), heart-rate recordings (PAL(HR)) and a questionnaire (PALq). These estimates were: PALacc 1.71 (SD 0.17), PAL(HR) 1.76 (SD 0.24), PALq 1.86 (SD 0.27). These values were lower than TEEref/BMRref, which was 1.98 (SD 0.21). BMR assessed using equations recommended by the World Health Organization (1985) (BMRpredicted) overestimated BMR by 594 (SD 431) kJ/24 h. However, when TEE was calculated as BMRpredicted x PALacc, BMRpredicted x PAL(HR) and BMRpredicted x PALq respectively, average results were in agreement with TEEref. Furthermore, TEE values based on BMRpredicted and PALacc, PAL(HR), PALq as well as on PAL = 1.64, minus TEEref, were significantly correlated with body fatness. When the same PAL value (1.64) was used for all subjects, this correlation was particularly strong. Thus, the World Health Organization (1985) procedure may give TEE results that are biased with respect to the body fatness of subjects.

Assessing physical activity of women of childbearing age. Ongoing work to develop and evaluate simple methods.

Simple methods were developed and evaluated to assess total energy expenditure in 24 healthy, Swedish women planning pregnancy. Total energy expenditure was measured by the doubly-labeled water method (reference method) and three simple methods: heart rate recording, movement registration by an accelerometer, and a questionnaire. Mean total energy expenditure obtained by the four methods varied between 2,530 kcal per 24 hours (10,570 kJ/24 hours) and 2,730 kcal per 24 hours (11,420 kJ/24 hours). No significant difference between the results obtained by the different methods was found. The mean difference between the simple method and the reference method was for the questionnaire 204 +/- 508 kcal per 24 hours (853 +/- 2,124 kJ/24 hours), for the heart rate recorder 58 +/- 338 kcal per 24 hours (241 +/- 1,416 kJ/24 hours) and for the accelerometer 6 +/- 325 kcal per 24 hours (25 +/- 1,360 kJ/24 hours). The heart rate recorder and the questionnaire overestimated high and underestimated low energy expenditures. The accelerometer and the heart rate recorder were able to assess mean total energy expenditure of groups. No systematic bias was found when the accelerometer was used.