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It emerges from two converging threads: 1

It could be suggested that CFS is an inflammatory condition with many patients in a prooxidant state and this could explain many of the pathological manifestations that underlie the illness

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Additionally, although the thiolactone form has not been unequivocally identified in vivo , homocysteine could undergo intracellular cyclization into homocysteine thiolactone, which could be a major by-product of impaired homocysteine metabolism (Jakubowski, 1997