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Many growth factors such as transforming growth factor (TGF)-, 2 platelet-derived growth factor (PDGF), 3 epidermal growth factor (EGF), 4 and fibroblast growth factor (FGF), 5 as well as interleukin (IL)-1 6 and tumor necrosis factor (TNF), 7 have been evaluated in a wide spectrum of in vivo and in vitro experiments to observe their effects on different elements included in the healing process

This study sheds some light on the complex processes involved

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the increase of sphingomyelins pathway products in GWS, and decrease in ME/CFS (Naviaux et al., 2016, 2019), may therefore contribute to the muscle fatigue experienced by patients with these conditions