Spence, V A, Khan, F, Kennedy, G et al. · Prostaglandins, leukotrienes, and essential fatty acids · 2004 · DOI
This study looked at how blood vessels in ME/CFS patients respond to acetylcholine, a chemical messenger in the body. Normally, blood vessels become less responsive to acetylcholine in disease, but researchers found the opposite in ME/CFS patients—their blood vessels were unusually sensitive to it. This unusual sensitivity might help explain why many ME/CFS patients experience problems with blood flow and circulation.
Understanding vascular dysfunction in ME/CFS is critical because circulatory problems contribute to symptoms like dizziness, exercise intolerance, and brain fog affecting many patients. This study uniquely identifies an anomalous vascular response that may be specific to ME/CFS, potentially opening new avenues for understanding why standard disease models don't apply. If validated, this finding could guide development of targeted therapies addressing the vascular component of the condition.
This study does not establish that abnormal acetylcholine sensitivity causes ME/CFS symptoms or is present in all patients with the condition. The mechanistic experiments did not definitively identify which specific mechanism explains the heightened sensitivity. Nor does it prove this finding is unique to ME/CFS or explain how it relates to other known abnormalities in the condition.
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
Spence, V A, Khan, F, Kennedy, G, Abbot, N C, & Belch, J J F (2004). Acetylcholine mediated vasodilatation in the microcirculation of patients with chronic fatigue syndrome.. Prostaglandins, leukotrienes, and essential fatty acids. https://doi.org/10.1016/j.plefa.2003.12.016
BibTeX
@article{mecfsatlas-spence-2004-acetylcholine-mediated,
author = {Spence, V A and Khan, F and Kennedy, G and Abbot, N C and Belch, J J F},
title = {Acetylcholine mediated vasodilatation in the microcirculation of patients with chronic fatigue syndrome.},
journal = {Prostaglandins, leukotrienes, and essential fatty acids},
year = {2004},
doi = {10.1016/j.plefa.2003.12.016},
note = {PubMed: 15041034},
url = {https://www.mecfsatlas.com/evidence/spence-2004-acetylcholine-mediated},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/spence-2004-acetylcholine-mediated
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