Al-Rawaf, Hadeel A, Alghadir, Ahmad H, Gabr, Sami A · Pain practice : the official journal of World Institute of Pain · 2019 · DOI
This study looked at tiny molecules called microRNAs in the blood of adolescents with ME/CFS to see if they could help explain why these patients experience pain. Researchers found that five specific microRNAs were lower in ME/CFS patients compared to healthy teens, and these changes were linked to higher levels of inflammatory chemicals that are known to cause pain. Interestingly, girls with ME/CFS had even lower microRNA levels and higher inflammation markers than boys with the condition.
This research provides potential biological markers that could help objectively measure pain intensity in ME/CFS, a symptom that is often invisible and subjective. Understanding the role of microRNAs and their relationship to inflammation may eventually lead to new treatments targeting these pathways to reduce pain in ME/CFS patients. The finding of sex differences in both microRNA expression and inflammation suggests that ME/CFS may manifest differently in girls versus boys, which could improve personalized treatment approaches.
This study does not prove that microRNA changes *cause* pain in ME/CFS—only that they are associated with it; causation would require mechanistic studies and intervention trials. The findings are limited to adolescents and may not apply to adults with ME/CFS. The study does not establish whether microRNA changes are primary drivers of ME/CFS pathology or secondary consequences of the disease.
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 →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Al-Rawaf, Hadeel A, Alghadir, Ahmad H, & Gabr, Sami A (2019). MicroRNAs as Biomarkers of Pain Intensity in Patients With Chronic Fatigue Syndrome.. Pain practice : the official journal of World Institute of Pain. https://doi.org/10.1111/papr.12817
BibTeX
@article{mecfsatlas-al-rawaf-2019-micrornas-biomarkers,
author = {Al-Rawaf, Hadeel A and Alghadir, Ahmad H and Gabr, Sami A},
title = {MicroRNAs as Biomarkers of Pain Intensity in Patients With Chronic Fatigue Syndrome.},
journal = {Pain practice : the official journal of World Institute of Pain},
year = {2019},
doi = {10.1111/papr.12817},
note = {PubMed: 31282597},
url = {https://www.mecfsatlas.com/evidence/al-rawaf-2019-micrornas-biomarkers},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/al-rawaf-2019-micrornas-biomarkers
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