bims-misrem 2021-02-21 papers

bims-misrem

Biomed News

on Mitochondria and sarcoplasmic reticulum in muscle mass

Issue of 2021–02–21
fourteen papers selected by
Rafael Antonio Casuso Pérez, University of Granada

A cold-stress-inducible PERK/OGT axis controls TOM70-assisted mitochondrial protein import and cristae formation.
Exercise rescues mitochondrial coupling in aged skeletal muscle: a comparison of different modalities in preventing sarcopenia.
Mitochondrial and Sarcoplasmic Reticulum Interconnection in Cardiac Arrhythmia.
Molecular Basis for the Therapeutic Effects of Exercise on Mitochondrial Defects.
Changes in mitochondrial morphology modulate LPS-induced loss of calcium homeostasis in BV-2 microglial cells.
Role of mitochondrial calcium in hypochlorite induced oxidative damage of cells.
Quantifying the relationship and contribution of mitochondrial respiration to systemic exercise limitation in heart failure.
Pharmacological but not physiological GDF15 suppresses feeding and the motivation to exercise.
The Interplay Between Mitochondrial Reactive Oxygen Species, Endoplasmic Reticulum Stress, and Nrf2 Signaling in Cardiometabolic Health.
Long-term physical inactivity exacerbates hindlimb unloading-induced muscle atrophy in young rat soleus muscle.
Intercellular mitochondrial transfer as a means of tissue revitalization.
Mechanism of membrane-tethered mitochondrial protein synthesis.
Characterization of mitochondrial calpain-5.
A systematic review of nutraceutical interventions for mitochondrial dysfunctions in myalgic encephalomyelitis/chronic fatigue syndrome.

Cell Metab. 2021 Feb 09. pii: S1550-4131(21)00013-9. [Epub ahead of print]

A cold-stress-inducible PERK/OGT axis controls TOM70-assisted mitochondrial protein import and cristae formation.

Pedro Latorre-Muro, Katherine E O'Malley, Christopher F Bennett, Elizabeth A Perry, Eduardo Balsa, Clint D J Tavares, Mark Jedrychowski, Steven P Gygi, Pere Puigserver.

  The architecture of cristae provides a spatial mitochondrial organization that contains functional respiratory complexes. Several protein components including OPA1 and MICOS complex subunits organize cristae structure, but upstream regulatory mechanisms are largely unknown. Here, in vivo and in vitro reconstitution experiments show that the endoplasmic reticulum (ER) kinase PERK promotes cristae formation by increasing TOM70-assisted mitochondrial import of MIC19, a critical subunit of the MICOS complex. Cold stress or β-adrenergic stimulation activates PERK that phosphorylates O-linked N-acetylglucosamine transferase (OGT). Phosphorylated OGT glycosylates TOM70 on Ser94, enhancing MIC19 protein import into mitochondria and promoting cristae formation and respiration. In addition, PERK-activated OGT O-GlcNAcylates and attenuates CK2α activity, which mediates TOM70 Ser94 phosphorylation and decreases MIC19 mitochondrial protein import. We have identified a cold-stress inter-organelle PERK-OGT-TOM70 axis that increases cell respiration through mitochondrial protein import and subsequent cristae formation. These studies have significant implications in cellular bioenergetics and adaptations to stress conditions.

Keywords:  MIC19; PERK-OGT axis; TOM70; brown adipocytes; cold stress; cristae biogenesis; mitochondrial protein import; respiration

DOI:  https://doi.org/10.1016/j.cmet.2021.01.013
J Transl Med. 2021 Feb 16. 19(1): 71

Exercise rescues mitochondrial coupling in aged skeletal muscle: a comparison of different modalities in preventing sarcopenia.

Colin Harper, Venkatesh Gopalan, Jorming Goh.

  Skeletal muscle aging is associated with a decline in motor function and loss of muscle mass- a condition known as sarcopenia. The underlying mechanisms that drive this pathology are associated with a failure in energy generation in skeletal muscle, either from age-related decline in mitochondrial function, or from disuse. To an extent, lifelong exercise is efficacious in preserving the energetic properties of skeletal muscle and thus may delay the onset of sarcopenia. This review discusses the cellular and molecular changes in skeletal muscle mitochondria during the aging process and how different exercise modalities work to reverse these changes. A key factor that will be described is the efficiency of mitochondrial coupling-ATP production relative to O2 uptake in myocytes and how that efficiency is a main driver for age-associated decline in skeletal muscle function. With that, we postulate the most effective exercise modality and protocol for reversing the molecular hallmarks of skeletal muscle aging and staving off sarcopenia. Two other concepts pertinent to mitochondrial efficiency in exercise-trained skeletal muscle will be integrated in this review, including- mitophagy, the removal of dysfunctional mitochondrial via autophagy, as well as the implications of muscle fiber type changes with sarcopenia on mitochondrial function.

Keywords:  Aging; Exercise; Mitochondria; Skeletal muscle

DOI:  https://doi.org/10.1186/s12967-021-02737-1
Front Cell Dev Biol. 2020 ;8 623381

Mitochondrial and Sarcoplasmic Reticulum Interconnection in Cardiac Arrhythmia.

Felipe Salazar-Ramírez, Roberto Ramos-Mondragón, Gerardo García-Rivas.

  Ca2+ plays a pivotal role in mitochondrial energy production, contraction, and apoptosis. Mitochondrial Ca2+-targeted fluorescent probes have demonstrated that mitochondria Ca2+ transients are synchronized with Ca2+ fluxes occurring in the sarcoplasmic reticulum (SR). The presence of specialized proteins tethering SR to mitochondria ensures the local Ca2+ flux between these organelles. Furthermore, communication between SR and mitochondria impacts their functionality in a bidirectional manner. Mitochondrial Ca2+ uptake through the mitochondrial Ca2+ uniplex is essential for ATP production and controlled reactive oxygen species levels for proper cellular signaling. Conversely, mitochondrial ATP ensures the proper functioning of SR Ca2+-handling proteins, which ensures that mitochondria receive an adequate supply of Ca2+. Recent evidence suggests that altered SR Ca2+ proteins, such as ryanodine receptors and the sarco/endoplasmic reticulum Ca2+ ATPase pump, play an important role in maintaining proper cardiac membrane excitability, which may be initiated and potentiated when mitochondria are dysfunctional. This recognized mitochondrial role offers the opportunity to develop new therapeutic approaches aimed at preventing cardiac arrhythmias in cardiac disease.

Keywords:  arrhythmia; calcium; heart failure; ischemia/reperfusion injury; mitochondria; sarcoplasmic reticulum

DOI:  https://doi.org/10.3389/fcell.2020.623381
Front Physiol. 2020 ;11 615038

Molecular Basis for the Therapeutic Effects of Exercise on Mitochondrial Defects.

Jonathan M Memme, David A Hood.

  Mitochondrial dysfunction is common to many organ system disorders, including skeletal muscle. Aging muscle and diseases of muscle are often accompanied by defective mitochondrial ATP production. This manuscript will focus on the pre-clinical evidence supporting the use of regular exercise to improve defective mitochondrial metabolism and function in skeletal muscle, through the stimulation of mitochondrial turnover. Examples from aging muscle, muscle-specific mutations and cancer cachexia will be discussed. We will also examine the effects of exercise on the important mitochondrial regulators PGC-1α, and Parkin, and summarize the effects of exercise to reverse mitochondrial dysfunction (e.g., ROS production, apoptotic susceptibility, cardiolipin synthesis) in muscle pathology. This paper will illustrate the breadth and benefits of exercise to serve as "mitochondrial medicine" with age and disease.

Keywords:  aging; cancer; exercise as medicine; mitochondrial quality control; skeletal muscle

DOI:  https://doi.org/10.3389/fphys.2020.615038
J Bioenerg Biomembr. 2021 Feb 14.

Changes in mitochondrial morphology modulate LPS-induced loss of calcium homeostasis in BV-2 microglial cells.

O R Pereira, V M Ramos, J V Cabral-Costa, A J Kowaltowski.

  Microglial activation involves both fragmentation of the mitochondrial network and changes in cellular Ca2+ homeostasis, but possible modifications in mitochondrial calcium uptake have never been described in this context. Here we report that activated microglial BV-2 cells have impaired mitochondrial calcium uptake, including lower calcium retention capacity and calcium uptake rates. These changes were not dependent on altered expression of the mitochondrial calcium uniporter. Respiratory capacity and the inner membrane potential, key determinants of mitochondrial calcium uptake, are both decreased in activated microglial BV-2 cells. Modified mitochondrial calcium uptake correlates with impaired cellular calcium signaling, including reduced ER calcium stores, and decreased replenishment by store operated calcium entry (SOCE). Induction of mitochondrial fragmentation through Mfn2 knockdown in control cells mimicked this effect, while inhibiting LPS-induced mitochondrial fragmentation by a dominant negative form of Drp1 prevented it. Overall, our results show that mitochondrial fragmentation induced by LPS promotes altered Ca2+ homeostasis in microglial cells, a new aspect of microglial activation that could be a key feature in the inflammatory role of these cells.

Keywords:  Calcium handling; Inflammation; Metabolism; Mitochondrial morphology

DOI:  https://doi.org/10.1007/s10863-021-09878-4
Biochimie. 2021 Feb 16. pii: S0300-9084(21)00047-X. [Epub ahead of print]

Role of mitochondrial calcium in hypochlorite induced oxidative damage of cells.

Vitali T Cheshchevik, Nina G Krylova, Nina G Сheshchevik, Elena A Lapshina, Galina N Semenkova, Ilya B Zavodnik.

  Hypochlorite (HOCl) is one of the most important mediators of inflammatory processes. Recent evidence demonstrates that changes in intracellular calcium pool play a significant role in the damaging effects of hypochlorite and other oxidants. Mitochondria are shown to be one of the intracellular targets of hypochlorite. But little is known about mitochondrial calcium pool changes under HOCl-induced mitochondrial dysfunction. Using isolated rat liver mitochondria, we showed oxidative damage of mitochondria (GSH oxidation and mixed protein-glutathione formation without membrane lipid peroxidation) and alterations in mitochondrial functional parameters (decrease of respiratory activity and efficiency of oxidative phosphorylation, NADH and FADH coenzyme levels, and membrane potential) during hypochlorite exposure (50-300 μM). Simultaneously, mitochondrial calcium release and swelling were demonstrated. In the presence of EGTA, the damaging effects of HOCl were less pronounced, reflecting direct involvement of mitochondrial Ca2+ in mechanisms of oxidant-induced injury. Furthermore, exposure of HeLa cells to hypochlorite resulted in a considerable increase in cytoplasmic calcium concentrations and a decrease in mitochondrial ones. Applying specific inhibitors of calcium transfer systems we demonstrated that mitochondria play a key role in the redistribution of cytoplasmic Ca2+ ions under hypochlorite treatment and act as mediators of calcium release from the endoplasmic reticulum into the cytoplasm.

Keywords:  Endoplasmic reticulum (ER); Hypochlorite; Mitochondria; Mitochondria-associated membranes (MAMs); Mitochondrial calcium

DOI:  https://doi.org/10.1016/j.biochi.2021.02.009
ESC Heart Fail. 2021 Feb 20.

Quantifying the relationship and contribution of mitochondrial respiration to systemic exercise limitation in heart failure.

Pim Knuiman, Sam Straw, John Gierula, Aaron Koshy, Lee D Roberts, Klaus K Witte, Carrie Ferguson, Thomas Scott Bowen.

   AIMS: Heart failure with reduced ejection fraction (HFrEF) induces skeletal muscle mitochondrial abnormalities that contribute to exercise limitation; however, specific mitochondrial therapeutic targets remain poorly established. This study quantified the relationship and contribution of distinct mitochondrial respiratory states to prognostic whole-body measures of exercise limitation in HFrEF.
METHODS AND RESULTS: Male patients with HFrEF (n = 22) were prospectively enrolled and underwent ramp-incremental cycle ergometry cardiopulmonary exercise testing to determine exercise variables including peak pulmonary oxygen uptake (V̇O2peak ), lactate threshold (V̇O2LT ), the ventilatory equivalent for carbon dioxide (V̇E /V̇CO2LT ), peak circulatory power (CircPpeak ), and peak oxygen pulse. Pectoralis major was biopsied for assessment of in situ mitochondrial respiration. All mitochondrial states including complexes I, II, and IV and electron transport system (ETS) capacity correlated with V̇O2peak (r = 0.40-0.64; P < 0.05), V̇O2LT (r = 0.52-0.72; P < 0.05), and CircPpeak (r = 0.42-0.60; P < 0.05). Multiple regression analysis revealed that combining age, haemoglobin, and left ventricular ejection fraction with ETS capacity could explain 52% of the variability in V̇O2peak and 80% of the variability in V̇O2LT , respectively, with ETS capacity (P = 0.04) and complex I (P = 0.01) the only significant contributors in the model.
CONCLUSIONS: Mitochondrial respiratory states from skeletal muscle biopsies of patients with HFrEF were independently correlated to established non-invasive prognostic cycle ergometry cardiopulmonary exercise testing indices including V̇O2peak , V̇O2LT , and CircPpeak . When combined with baseline patient characteristics, over 50% of the variability in V̇O2peak could be explained by the mitochondrial ETS capacity. These data provide optimized mitochondrial targets that may attenuate exercise limitations in HFrEF.

Keywords:  Exercise; HFrEF; Lactate threshold; Skeletal muscle; V̇O2peak

DOI:  https://doi.org/10.1002/ehf2.13272
Nat Commun. 2021 02 15. 12(1): 1041

Pharmacological but not physiological GDF15 suppresses feeding and the motivation to exercise.

Anders B Klein, Trine S Nicolaisen, Niels Ørtenblad, Kasper D Gejl, Rasmus Jensen, Andreas M Fritzen, Emil L Larsen, Kristian Karstoft, Henrik E Poulsen, Thomas Morville, Ronni E Sahl, Jørn W Helge, Jens Lund, Sarah Falk, Mark Lyngbæk, Helga Ellingsgaard, Bente K Pedersen, Wei Lu, Brian Finan, Sebastian B Jørgensen, Randy J Seeley, Maximilian Kleinert, Bente Kiens, Erik A Richter, Christoffer Clemmensen.

Growing evidence supports that pharmacological application of growth differentiation factor 15 (GDF15) suppresses appetite but also promotes sickness-like behaviors in rodents via GDNF family receptor α-like (GFRAL)-dependent mechanisms. Conversely, the endogenous regulation of GDF15 and its physiological effects on energy homeostasis and behavior remain elusive. Here we show, in four independent human studies that prolonged endurance exercise increases circulating GDF15 to levels otherwise only observed in pathophysiological conditions. This exercise-induced increase can be recapitulated in mice and is accompanied by increased Gdf15 expression in the liver, skeletal muscle, and heart muscle. However, whereas pharmacological GDF15 inhibits appetite and suppresses voluntary running activity via GFRAL, the physiological induction of GDF15 by exercise does not. In summary, exercise-induced circulating GDF15 correlates with the duration of endurance exercise. Yet, higher GDF15 levels after exercise are not sufficient to evoke canonical pharmacological GDF15 effects on appetite or responsible for diminishing exercise motivation.

DOI: https://doi.org/10.1038/s41467-021-21309-x
Antioxid Redox Signal. 2021 Feb 16.

The Interplay Between Mitochondrial Reactive Oxygen Species, Endoplasmic Reticulum Stress, and Nrf2 Signaling in Cardiometabolic Health.

Sarah Hartwick Bjorkman, Renata Oliveira Pereira.

  Significance: Mitochondria-derived reactive oxygen species (mtROS) are by-products of normal physiology that may disrupt cellular redox homeostasis on a regular basis. Nonetheless, failure to resolve sustained mitochondrial stress to mitigate high levels of mtROS might contribute to the etiology of numerous pathological conditions, such as obesity, insulin resistance, and cardiovascular disease (CVD). Recent Advances: Notably, recent studies have demonstrated that moderate mitochondrial stress might result in the induction of different stress response pathways that ultimately improve the organism's ability to deal with subsequent stress, a process termed mitohormesis. mtROS have been shown to play a key role in regulating this adaptation. Critical Issue: mtROS regulate the convergence of different signaling pathways that, when disturbed, might impair cardiometabolic health. Conversely, mtROS seem to be required to mediate activation of prosurvival pathways, contributing to improved cardiometabolic fitness. In the present review, we will primarily focus on the role of mtROS in the activation of the nuclear factor erythroid 2-related factor 2 (Nrf2) antioxidant pathway and examine the role of endoplasmic reticulum (ER) stress in coordinating the convergence of ER stress and oxidative stress signaling through activation of Nrf2 and activating transcription factor 4 (ATF4). Future Directions: The mechanisms underlying cardiometabolic protection in response to mitochondrial stress have only started to be investigated. Integrated understanding of how mtROS and ER stress cooperatively promote activation of prosurvival pathways might shed mechanistic insight into the role of mitohormesis in mediating cardiometabolic protection and might inform future therapeutic avenues for the treatment of metabolic diseases contributing to CVD.

Keywords:  ER stress; ROS; cardiometabolic health; mitochondria; mitohormesis

DOI:  https://doi.org/10.1089/ars.2020.8220
J Appl Physiol (1985). 2021 Feb 18.

Long-term physical inactivity exacerbates hindlimb unloading-induced muscle atrophy in young rat soleus muscle.

Toshinori Yoshihara, Toshiharu Natsume, Takamasa Tsuzuki, Shuo-Wen Chang, Ryo Kakigi, Shuichi Machida, Takao Sugiura, Hisashi Naito.

  This study investigated the effects of long-term physical inactivity in adolescent on subsequent hindlimb unloading-induced muscle atrophy in rat soleus muscle. First, 3-week-old male Wistar rats were assigned to an age-matched control (n=6) or a physical inactivity (n=8) group. Rats in the physical inactivity group were housed in narrow cages with approximately half the usual floor space for 8 weeks to limit range of movement. Whole body energy consumption was measured and the blood, organs, femoral bone, and hindlimb muscles were removed. We found that long-term physical inactivity did not affect the metabolic and physiological characteristics of growing rats. Then, fifty-six 3-week-old male Wistar rats were assigned randomly into control (n=28) and physical inactivity (n=28) groups. After 8 weeks, the rats in both groups underwent hindlimb unloading. The soleus muscles were removed before unloading (0-day), and 1, 3, and 7 days after unloading (n=7 for each). Although the soleus muscle weight was significantly decreased after 7 days of hindlimb unloading in both groups, the decrease was drastic in the inactive group. A significant interaction between inactivity and unloading (p<0.01) was observed according to the 4-hydroxynonenal-conjugated protein levels and the histone deacetylase 4 (HDAC4) and NF-kB protein levels. HDAC4 and NF-kB p65 protein levels in the physical inactivity group increased significantly 1 day after hindlimb unloading, along with the mRNA levels of their downstream targets myogenin and muscle RING finger protein 1 (MuRF1). Subsequent protein ubiquitination was upregulated by long-term physical inactivity (p<0.05).

Keywords:  histone deacetylase 4; nuclear factor-κβ; oxidative stress; physical inactivity; sedentary lifestyle

DOI:  https://doi.org/10.1152/japplphysiol.00494.2020
Signal Transduct Target Ther. 2021 Feb 16. 6(1): 65

Intercellular mitochondrial transfer as a means of tissue revitalization.

Delin Liu, Youshui Gao, Jiao Liu, Yigang Huang, Junhui Yin, Yuyao Feng, Linjing Shi, Bruno P Meloni, Changqing Zhang, Minghao Zheng, Junjie Gao.

As the crucial powerhouse for cell metabolism and tissue survival, the mitochondrion frequently undergoes morphological or positional changes when responding to various stresses and energy demands. In addition to intracellular changes, mitochondria can also be transferred intercellularly. Besides restoring stressed cells and damaged tissues due to mitochondrial dysfunction, the intercellular mitochondrial transfer also occurs under physiological conditions. In this review, the phenomenon of mitochondrial transfer is described according to its function under both physiological and pathological conditions, including tissue homeostasis, damaged tissue repair, tumor progression, and immunoregulation. Then, the mechanisms that contribute to this process are summarized, such as the trigger factors and transfer routes. Furthermore, various perspectives are explored to better understand the mysteries of cell-cell mitochondrial trafficking. In addition, potential therapeutic strategies for mitochondria-targeted application to rescue tissue damage and degeneration, as well as the inhibition of tumor progression, are discussed.

DOI: https://doi.org/10.1038/s41392-020-00440-z
Science. 2021 Feb 19. 371(6531): 846-849

Mechanism of membrane-tethered mitochondrial protein synthesis.

Yuzuru Itoh, Juni Andréll, Austin Choi, Uwe Richter, Priyanka Maiti, Robert B Best, Antoni Barrientos, Brendan J Battersby, Alexey Amunts.

Mitochondrial ribosomes (mitoribosomes) are tethered to the mitochondrial inner membrane to facilitate the cotranslational membrane insertion of the synthesized proteins. We report cryo-electron microscopy structures of human mitoribosomes with nascent polypeptide, bound to the insertase oxidase assembly 1-like (OXA1L) through three distinct contact sites. OXA1L binding is correlated with a series of conformational changes in the mitoribosomal large subunit that catalyze the delivery of newly synthesized polypeptides. The mechanism relies on the folding of mL45 inside the exit tunnel, forming two specific constriction sites that would limit helix formation of the nascent chain. A gap is formed between the exit and the membrane, making the newly synthesized proteins accessible. Our data elucidate the basis by which mitoribosomes interact with the OXA1L insertase to couple protein synthesis and membrane delivery.

DOI: https://doi.org/10.1126/science.abe0763
Biochim Biophys Acta Mol Cell Res. 2021 Feb 16. pii: S0167-4889(21)00043-4. [Epub ahead of print] 118989

Characterization of mitochondrial calpain-5.

Yusaku Chukai, Takeshi Iwamoto, Ken Itoh, Hiroshi Tomita, Taku Ozaki.

  Calpain, a Ca2+-dependent cysteine protease, plays a significant role in gene expression, signal transduction, and apoptosis. Mutations in human calpain-5 cause autosomal dominant neovascular inflammatory vitreoretinopathy and the inhibition of calpain-5 activity may constitute an effective therapeutic strategy for this condition. Although calpain-5 is ubiquitously expressed in mammalian tissues and was recently found to be present in the mitochondria as well as in the cytosol, its physiological function and enzymological properties require further elucidation. The objective of the current study was to determine the characteristics of mitochondrial calpain-5 in porcine retinas, human HeLa cells, and C57BL/6J mice using subcellular fractionation. We found that mitochondrial calpain-5 was proteolyzed/autolyzed at low Ca2+ concentrations in mitochondria isolated from porcine retinas and by thapsigargin-induced endoplasmic reticulum (ER) stress in HeLa cells. Further, mitochondrial calpain-5, as opposed to cytosolic calpain-5, was activated during the early stages of ER stress in C57BL/6J mice. These results showed that mitochondrial calpain-5 was activated at low Ca2+ concentrations in vitro and in response to ER stress in vivo. The present study provides new insights into a novel calpain system in the mitochondria that includes stress responses during the early phases of ER stress. Further, activation of mitochondrial calpain-5 by treatment using low-molecular-weight compounds may have therapeutic potential for diseases related to ER stress, including neurodegenerative diseases, metabolic syndromes, diabetes, and cancer.

Keywords:  Autolysis; Calpain-5; ER stress; Liver; Mitochondria; Retina

DOI:  https://doi.org/10.1016/j.bbamcr.2021.118989
J Transl Med. 2021 Feb 17. 19(1): 81

A systematic review of nutraceutical interventions for mitochondrial dysfunctions in myalgic encephalomyelitis/chronic fatigue syndrome.

Rebekah Maksoud, Cassandra Balinas, Sean Holden, Hélène Cabanas, Donald Staines, Sonya Marshall-Gradisnik.

   BACKGROUND: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a debilitating illness, characterised by persistent fatigue that is unrelieved by rest, in combination with a range of other disabling symptoms. There is no diagnostic test nor targeted treatment available for this illness. The pathomechanism also remains unclear. Mitochondrial dysfunctions have been considered a possible underlying pathology based on reported differences including structural and functional changes in ME/CFS patients compared to healthy controls. Due to the potential role that mitochondria may play in ME/CFS, mitochondrial-targeting nutraceutical interventions have been used to potentially assist in improving patient outcomes such as fatigue. The aim of this systematic review is to appraise literature assessing these nutraceuticals as a possible intervention for treating ME/CFS.
METHODS: A systematic search of Pubmed, Embase, Medline (EBSCO host) and Web of Science (via Clarivate Analytics) for journal articles published between January 1995 and 10th November 2020 was conducted. Articles assessing nutraceutical interventions and ME/CFS patient outcomes were retrieved. Using specific inclusion and exclusion criteria, the list of articles was further refined. Quality was measured using the Rosendal scale.
RESULTS: Nine intervention studies were included in this review. The studies investigated patient symptom severity changes such as altered fatigue levels in response to mitochondrial-targeting nutraceuticals. Improvements in fatigue levels were observed in six of the nine studies. Secondary outcomes assessed include biochemical, psychological, and quality of life parameters.
CONCLUSION: There is insufficient evidence on the effectiveness of mitochondria- targeting nutraceuticals in ME/CFS patients. Future well-designed studies are required to elucidate both the involvement of mitochondria in the pathomechanism of ME/CFS and the effect of mitochondrial-modifying agents on illness severity.

Keywords:  Chronic fatigue syndrome; Intervention; Mitochondria; Myalgic encephalomyelitis; Nutraceuticals

DOI:  https://doi.org/10.1186/s12967-021-02742-4