Abou-Donia, Mohamed B, Krengel, Maxine H, Lapadula, Elizabeth S et al. · Brain sciences · 2021 · DOI
Researchers found that Gulf War veterans with Gulf War illness have abnormal immune proteins in their blood that attack brain cells, and these patterns differ between men and women. The study also found that these same immune markers can help distinguish Gulf War illness from other similar conditions like ME/CFS and IBS. This discovery is important because it offers a possible objective blood test that doctors could use to identify and diagnose these difficult-to-recognize illnesses.
ME/CFS patients often struggle with diagnostic confirmation and disease validation; this research demonstrates that objective biological markers (autoantibodies) can differentiate ME/CFS from GWI and other conditions, potentially supporting broader efforts to establish biomarkers for post-viral illnesses. The identification of sex-specific immune patterns may also inform personalized treatment approaches and help explain why ME/CFS and related conditions present differently across populations.
This study does not prove that autoantibodies are the cause of GWI or ME/CFS—only that they are associated with these conditions. The cross-sectional design cannot establish causality or whether these autoantibodies appear before symptom onset. The study also does not demonstrate that these biomarkers predict treatment response or prognosis.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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Primary citation
Abou-Donia, Mohamed B, Krengel, Maxine H, Lapadula, Elizabeth S, Zundel, Clara G, LeClair, Jessica, Massaro, Joseph, et al. (2021). Sex-Based Differences in Plasma Autoantibodies to Central Nervous System Proteins in Gulf War Veterans versus Healthy and Symptomatic Controls.. Brain sciences. https://doi.org/10.3390/brainsci11020148
BibTeX
@article{mecfsatlas-abou-donia-2021-sex-based,
author = {Abou-Donia, Mohamed B and Krengel, Maxine H and Lapadula, Elizabeth S and Zundel, Clara G and LeClair, Jessica and Massaro, Joseph and Quinn, Emily and Conboy, Lisa A and Kokkotou, Efi and Nguyen, Daniel D and Abreu, Maria and Klimas, Nancy G and Sullivan, Kimberly},
title = {Sex-Based Differences in Plasma Autoantibodies to Central Nervous System Proteins in Gulf War Veterans versus Healthy and Symptomatic Controls.},
journal = {Brain sciences},
year = {2021},
doi = {10.3390/brainsci11020148},
note = {PubMed: 33498629},
url = {https://www.mecfsatlas.com/evidence/abou-donia-2021-sex-based},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/abou-donia-2021-sex-based
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