Chao, C C, Janoff, E N, Hu, S X et al. · Cytokine · 1991 · DOI
This study found that immune cells from people with ME/CFS respond differently to stimulation than cells from healthy people. Specifically, when researchers activated these immune cells in the lab, they released higher levels of inflammatory molecules (IL-1 beta, IL-6, and TNF-alpha), suggesting that ME/CFS patients' immune cells may be in a heightened state of readiness. The study also found unusual patterns in a molecule called TGF-beta, which normally helps regulate immune responses.
This study provides early mechanistic evidence that ME/CFS involves measurable immune dysregulation—specifically a primed innate immune response—rather than purely psychological causes. Understanding how immune cells behave abnormally in ME/CFS may eventually lead to biomarkers for diagnosis and targeted therapeutic interventions.
This study does not prove that immune cell dysregulation causes ME/CFS symptoms or that correcting these cytokine abnormalities will improve patient outcomes. The in vitro findings may not fully reflect what occurs in the body, and the cross-sectional design cannot establish temporal relationships or whether these immune changes persist over time.
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
Chao, C C, Janoff, E N, Hu, S X, Thomas, K, Gallagher, M, Tsang, M, et al. (1991). Altered cytokine release in peripheral blood mononuclear cell cultures from patients with the chronic fatigue syndrome.. Cytokine. https://doi.org/10.1016/1043-4666(91)90497-2
BibTeX
@article{mecfsatlas-chao-1991-altered-cytokine,
author = {Chao, C C and Janoff, E N and Hu, S X and Thomas, K and Gallagher, M and Tsang, M and Peterson, P K},
title = {Altered cytokine release in peripheral blood mononuclear cell cultures from patients with the chronic fatigue syndrome.},
journal = {Cytokine},
year = {1991},
doi = {10.1016/1043-4666(91)90497-2},
note = {PubMed: 1873478},
url = {https://www.mecfsatlas.com/evidence/chao-1991-altered-cytokine},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/chao-1991-altered-cytokine
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