Bastos, Victoria C, Greene, Kerrie A, Tabachnikova, Alexandra et al. · Journal of immunology (Baltimore, Md. : 1950) · 2025 · DOI
Researchers studied cerebrospinal fluid (the fluid around the brain and spinal cord) from people with ME/CFS and found that the immune system appears to work differently in different patients. They discovered two distinct patient groups with different immune patterns and pathogen exposure histories, even though both groups had similar symptoms. This suggests that ME/CFS may not be a single disease, but rather several related conditions with different underlying causes.
ME/CFS patients have long struggled with the lack of biological diagnostic markers and recognition that different patients may need different treatments. This study provides evidence for biological subtypes within ME/CFS, which could eventually lead to more targeted, effective treatments tailored to individual immune profiles rather than a one-size-fits-all approach.
This study does not establish that the identified immunotypes cause ME/CFS symptoms or that they are stable over time—only that they exist at a single time point. It also does not determine whether these immune patterns are unique to ME/CFS or shared with other conditions, and it does not yet predict which treatments would work best for each immunotype.
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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