Elfaitouri, Amal, Herrmann, Björn, Bölin-Wiener, Agnes et al. · PloS one · 2013 · DOI
This study looked at whether ME/CFS patients have different immune responses to heat shock protein 60 (HSP60), a protein found in both human cells and bacteria. Researchers tested blood samples from ME/CFS patients and healthy people, finding that some ME/CFS patients had specific antibodies against a bacterial version of this protein. This suggests that a past infection might trigger the immune system to attack proteins in the body, which could contribute to ME/CFS.
This work provides biological evidence supporting the hypothesis that ME/CFS may be triggered by infection-induced autoimmunity, a mechanism that could explain why many patients report symptom onset following infections. Identifying specific immune markers could eventually help develop diagnostic tests and guide treatment strategies for ME/CFS patients.
This study does not prove that HSP60 antibodies cause ME/CFS—the cross-sectional design cannot establish causation, only association. It also does not demonstrate that all ME/CFS patients have this immune abnormality, since the antibodies were found in only a subset of patients. Finally, it does not clarify whether these antibodies persist or fluctuate over time, or whether they directly contribute to illness severity.
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
Elfaitouri, Amal, Herrmann, Björn, Bölin-Wiener, Agnes, Wang, Yilin, Gottfries, Carl-Gerhard, Zachrisson, Olof, et al. (2013). Epitopes of microbial and human heat shock protein 60 and their recognition in myalgic encephalomyelitis.. PloS one. https://doi.org/10.1371/journal.pone.0081155
BibTeX
@article{mecfsatlas-elfaitouri-2013-epitopes-microbial,
author = {Elfaitouri, Amal and Herrmann, Björn and Bölin-Wiener, Agnes and Wang, Yilin and Gottfries, Carl-Gerhard and Zachrisson, Olof and Pipkorn, Rϋdiger and Rönnblom, Lars and Blomberg, Jonas},
title = {Epitopes of microbial and human heat shock protein 60 and their recognition in myalgic encephalomyelitis.},
journal = {PloS one},
year = {2013},
doi = {10.1371/journal.pone.0081155},
note = {PubMed: 24312270},
url = {https://www.mecfsatlas.com/evidence/elfaitouri-2013-epitopes-microbial},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/elfaitouri-2013-epitopes-microbial
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