Microvascular Dysfunction in PEM
Microvascular endothelial injury either related to endothelial dysfunction versus viral induced vasculitis may lead to limited delivery of oxygen and nutrients to tissues during and after exertion. x.com
Microvascular endothelial injury either related to endothelial dysfunction versus viral induced vasculitis may lead to limited delivery of oxygen and nutrients to tissues during and after exertion. x.com
Mechanisms of endothelial injury, and dysfunction
1. Increased vascular permeability
2. Microthrombi
3. Vasodilation or vasoconstriction
1. Increased vascular permeability
2. Microthrombi
3. Vasodilation or vasoconstriction
Mechanisms of viral infection and endothelial damage
1. Inflammation leading to vasculitis
2. Activation of cytokines such as INF and TNF-a lead to expression of adhesion molecules on endothelial cells
1. Inflammation leading to vasculitis
2. Activation of cytokines such as INF and TNF-a lead to expression of adhesion molecules on endothelial cells
Management strategies include pentoxifylline (see 11/3 post), phosphodiesterase inhibitors, sulodexide (where available) and antivirals (see 11/7 post). Nattokinase, lumbrokinase, and streptokinase may be useful adjuncts as well.
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