Fan, Jin, Jiao, Jiao, Chang, Hai-Qing et al. · Journal of translational medicine · 2025 · DOI
This comprehensive review examines how ME/CFS is diagnosed and treated based on current medical knowledge. The authors found that ME/CFS is caused by problems with the immune system, energy production in cells, and brain inflammation, but there are currently no definitive blood tests to confirm the disease. Treatment options include both medication approaches (targeting immune dysfunction and cell energy) and non-medication strategies like activity pacing and cognitive behavioral therapy, though doctors now recognize that exercise programs can actually harm some patients.
This review provides clinicians and patients with current, evidence-based guidance on ME/CFS diagnosis and management at a time when prevalence is rising and overlap with post-COVID syndrome is increasing. The explicit recommendation against graded exercise therapy represents an important shift in clinical practice that protects patients from potentially harmful interventions. Understanding the multiple biological pathways involved (immune, mitochondrial, neuroinflammatory) supports the rationale for developing targeted, combination treatment approaches.
This review does not establish causal mechanisms—it summarizes associations between immune dysfunction, cellular energy problems, and ME/CFS symptoms without proving which mechanisms cause which symptoms. The absence of validated biomarkers means this review cannot determine how to definitively diagnose ME/CFS in individual patients or predict which treatments will work best for specific people. The review's recommendations reflect current evidence quality, which is still limited for many interventions, particularly combination therapies.
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
Fan, Jin, Jiao, Jiao, Chang, Hai-Qing, Zhong, Dong-Ling, Liu, Xiao-Bo, Li, Juan, et al. (2025). Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): diagnosis and management.. Journal of translational medicine. https://doi.org/10.1186/s12967-025-07506-y
BibTeX
@article{mecfsatlas-fan-2025-myalgic-encephalomyelitis,
author = {Fan, Jin and Jiao, Jiao and Chang, Hai-Qing and Zhong, Dong-Ling and Liu, Xiao-Bo and Li, Juan and Chen, Ling-Min and Jin, Rong-Jiang and Wu, Xi},
title = {Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): diagnosis and management.},
journal = {Journal of translational medicine},
year = {2025},
doi = {10.1186/s12967-025-07506-y},
note = {PubMed: 41366804},
url = {https://www.mecfsatlas.com/evidence/fan-2025-myalgic-encephalomyelitis},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/fan-2025-myalgic-encephalomyelitis
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