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 →
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
Bastos, Victoria C, Greene, Kerrie A, Tabachnikova, Alexandra, Bhattacharjee, Bornali, Sjögren, Per, Bertilson, Bo, et al. (2025). Cerebrospinal fluid immune phenotyping reveals distinct immunotypes of myalgic encephalomyelitis/chronic fatigue syndrome.. Journal of immunology (Baltimore, Md. : 1950). https://doi.org/10.1093/jimmun/vkaf087
BibTeX
@article{mecfsatlas-bastos-2025-cerebrospinal-fluid,
author = {Bastos, Victoria C and Greene, Kerrie A and Tabachnikova, Alexandra and Bhattacharjee, Bornali and Sjögren, Per and Bertilson, Bo and Reifert, Jack and Zhang, Minlu and Kamath, Kathy and Shon, John and Gehlhausen, Jeff R and Guan, Leying and VanElzakker, Michael and Proal, Amy and Bragée, Björn and Iwasaki, Akiko},
title = {Cerebrospinal fluid immune phenotyping reveals distinct immunotypes of myalgic encephalomyelitis/chronic fatigue syndrome.},
journal = {Journal of immunology (Baltimore, Md. : 1950)},
year = {2025},
doi = {10.1093/jimmun/vkaf087},
note = {PubMed: 40373264},
url = {https://www.mecfsatlas.com/evidence/bastos-2025-cerebrospinal-fluid},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/bastos-2025-cerebrospinal-fluid
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