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Table 1 Activation of Na+/K+-ATPase by physiological transmitters and ATP in skeletal muscle: possible dysfunction and modulation in ME/CFS

From: Pathophysiology of skeletal muscle disturbances in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)

Mechanism Importance Na+/K+−ATPase function in ME/CFS
Acetylcholine At rest Enhanced by physostigmine (Mestinon™)
Insulin At rest Decreased by potential insulin resistance
ß2AdR-agonist Exercise Decreased by ß2AdR-dysfunction/downregulation
ccGRP Exercise Decreased by small fiber degeneration
Diminished due to low expression of TRPM3?
ATP Exercise mainly Decreased due to ATP depletion
ROS Exercise mainly Inhibition