Arron, Hayley E, Marsh, Benjamin D, Kell, Douglas B et al. · Frontiers in immunology · 2024 · DOI
This review examines what we know about ME/CFS by looking at how the disease develops from a combination of genetic factors, infections, and immune problems. The researchers found that ME/CFS appears to result from multiple body systems going wrong at the same time—including the immune system, inflammation, digestive health, and energy production. The study argues that doctors and scientists need to stop looking at ME/CFS as a single problem and instead understand it as a complex condition involving many interconnected issues.
This review is important because it provides a comprehensive framework for understanding ME/CFS complexity, which may help guide future research and clinical approaches. By demonstrating how genetic, immune, inflammatory, and metabolic factors interconnect, it could lead to better diagnostic strategies and more targeted therapeutic interventions. This holistic model validates the experiences of patients who recognize their condition as multisystem illness rather than a single defect.
This review does not establish causation for any specific ME/CFS mechanism—it synthesizes existing evidence rather than generating new experimental data. It cannot determine which factors are primary drivers versus secondary consequences of disease, nor does it provide definitive diagnostic biomarkers or proven treatments. The authors acknowledge that diagnostic criteria variation across studies limits the strength of evidence for any single pathway.
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
Arron, Hayley E, Marsh, Benjamin D, Kell, Douglas B, Khan, M Asad, Jaeger, Beate R, & Pretorius, Etheresia (2024). Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: the biology of a neglected disease.. Frontiers in immunology. https://doi.org/10.3389/fimmu.2024.1386607
BibTeX
@article{mecfsatlas-arron-2024-myalgic-encephalomyelitis,
author = {Arron, Hayley E and Marsh, Benjamin D and Kell, Douglas B and Khan, M Asad and Jaeger, Beate R and Pretorius, Etheresia},
title = {Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: the biology of a neglected disease.},
journal = {Frontiers in immunology},
year = {2024},
doi = {10.3389/fimmu.2024.1386607},
note = {PubMed: 38887284},
url = {https://www.mecfsatlas.com/evidence/arron-2024-myalgic-encephalomyelitis},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/arron-2024-myalgic-encephalomyelitis
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