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It was also suggested that exercise may induce a counterregulatory release of bradykinin in the dysfunctional vasculature of ME/CFS patients (Wirth et al., 2021), which would affect permeability of the BBB ( Any endothelial dysfunction after exercise may indeed not only affect the vascular system but also brain function through breaches in the BBB and subsequent induction of neuroglial reactivity from influx of serum components like fibrinogen, immune cells and inflammatory mediators

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SE leads to excessive ROS production and consequent mitochondrial dysfunction by increasing the opening of glutamate receptors and glucose hypermetabolism