Khan, Faisel, Kennedy, Gwen, Spence, Vance A et al. · Clinical science (London, England : 1979) · 2004 · DOI
Researchers tested how blood vessels in the forearm respond to acetylcholine (a chemical messenger in the body) in people with ME/CFS, Gulf War illness, and pesticide exposure. They found that people with ME/CFS had an unusually strong vascular response to acetylcholine, but people with the other two conditions had normal responses. This suggests ME/CFS may involve a specific problem with how the body breaks down acetylcholine in blood vessels.
This study provides objective physiological evidence of a specific biological abnormality in ME/CFS affecting how blood vessels process acetylcholine, distinguishing it mechanistically from similar-appearing conditions. Understanding this vascular cholinergic dysfunction could eventually lead to targeted diagnostic tests and novel therapeutic approaches for ME/CFS patients.
This study demonstrates an association between cholinesterase activity and ME/CFS but does not establish whether this abnormality causes ME/CFS symptoms or results from the disease process. The small sample size and cross-sectional design mean findings require replication, and the study cannot determine whether this peripheral vascular abnormality reflects broader systemic cholinergic dysfunction.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Khan, Faisel, Kennedy, Gwen, Spence, Vance A, Newton, David J, & Belch, Jill J F (2004). Peripheral cholinergic function in humans with chronic fatigue syndrome, Gulf War syndrome and with illness following organophosphate exposure.. Clinical science (London, England : 1979). https://doi.org/10.1042/CS20030246
BibTeX
@article{mecfsatlas-khan-2004-peripheral-cholinergic,
author = {Khan, Faisel and Kennedy, Gwen and Spence, Vance A and Newton, David J and Belch, Jill J F},
title = {Peripheral cholinergic function in humans with chronic fatigue syndrome, Gulf War syndrome and with illness following organophosphate exposure.},
journal = {Clinical science (London, England : 1979)},
year = {2004},
doi = {10.1042/CS20030246},
note = {PubMed: 14503920},
url = {https://www.mecfsatlas.com/evidence/khan-2004-peripheral-cholinergic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/khan-2004-peripheral-cholinergic
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