Eaton, Natalie, Cabanas, Hélène, Balinas, Cassandra et al. · BMC pharmacology & toxicology · 2018 · DOI
This study examined how a drug called Rituximab affects natural killer (NK) cells—immune cells that help fight infections—in people with ME/CFS. Researchers tested blood samples from 8 ME/CFS patients and 9 healthy people in a lab dish. When exposed to Rituximab, NK cells from ME/CFS patients became less effective at killing infected cells and showed signs of stress, suggesting the drug might harm these already-weakened immune cells.
ME/CFS patients already have impaired NK cell function, and this study raises safety concerns about Rituximab as a potential treatment. Understanding how proposed therapies affect immune cells is critical for patient safety and for developing treatments that don't inadvertently worsen immune dysfunction.
This study does not prove that Rituximab causes harm in ME/CFS patients in clinical practice—it only examines isolated cells in a lab dish at specific drug concentrations. The findings cannot be directly translated to what would happen in a patient's body, and the study does not assess clinical outcomes or long-term effects. Laboratory findings at high concentrations may not occur at therapeutic doses used in patients.
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
Eaton, Natalie, Cabanas, Hélène, Balinas, Cassandra, Klein, Anne, Staines, Donald, & Marshall-Gradisnik, Sonya (2018). Rituximab impedes natural killer cell function in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis patients: A pilot in vitro investigation.. BMC pharmacology & toxicology. https://doi.org/10.1186/s40360-018-0203-8
BibTeX
@article{mecfsatlas-eaton-2018-rituximab-impedes,
author = {Eaton, Natalie and Cabanas, Hélène and Balinas, Cassandra and Klein, Anne and Staines, Donald and Marshall-Gradisnik, Sonya},
title = {Rituximab impedes natural killer cell function in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis patients: A pilot in vitro investigation.},
journal = {BMC pharmacology & toxicology},
year = {2018},
doi = {10.1186/s40360-018-0203-8},
note = {PubMed: 29587879},
url = {https://www.mecfsatlas.com/evidence/eaton-2018-rituximab-impedes},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/eaton-2018-rituximab-impedes
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