Blomberg, Jonas, Gottfries, Carl-Gerhard, Elfaitouri, Amal et al. · Frontiers in immunology · 2018 · DOI
This study proposes that ME/CFS may develop when a person's immune system mistakenly attacks their own body after an infection, particularly affecting energy production in muscles and the brain. The researchers suggest that some people may have a genetic tendency to develop these harmful immune responses, especially when their gut bacteria are out of balance. When exposed to a triggering infection, the immune system can begin attacking proteins involved in energy metabolism and nerve function, leading to the exhaustion and post-exertion symptoms that characterize ME/CFS.
This study offers a unifying biological framework for understanding ME/CFS pathogenesis, moving beyond the longstanding characterization of the disease as primarily psychological. By proposing specific immunological mechanisms and testable hypotheses, the model provides direction for future research that could eventually lead to diagnostic biomarkers and targeted treatments. Understanding the autoimmune component may help validate ME/CFS as an organic disease and improve clinical recognition.
This model is theoretical and does not establish causation through direct experimental evidence—it synthesizes existing literature rather than presenting new data. The study does not prove that infection-triggered autoimmunity is the cause in all or even most ME/CFS cases, as it acknowledges multiple potential mechanisms. It also does not identify specific autoantigens definitively or explain why some exposed individuals develop disease while others do not.
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
Blomberg, Jonas, Gottfries, Carl-Gerhard, Elfaitouri, Amal, Rizwan, Muhammad, & Rosén, Anders (2018). Infection Elicited Autoimmunity and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: An Explanatory Model.. Frontiers in immunology. https://doi.org/10.3389/fimmu.2018.00229
BibTeX
@article{mecfsatlas-blomberg-2018-infection-elicited,
author = {Blomberg, Jonas and Gottfries, Carl-Gerhard and Elfaitouri, Amal and Rizwan, Muhammad and Rosén, Anders},
title = {Infection Elicited Autoimmunity and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: An Explanatory Model.},
journal = {Frontiers in immunology},
year = {2018},
doi = {10.3389/fimmu.2018.00229},
note = {PubMed: 29497420},
url = {https://www.mecfsatlas.com/evidence/blomberg-2018-infection-elicited},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/blomberg-2018-infection-elicited
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