Fernandez-Guerra, Paula, Gonzalez-Ebsen, Ana C, Boonen, Susanne E et al. · Biomolecules · 2021 · DOI
This study looked at how cells in ME/CFS patients produce and use energy differently than in healthy people. Researchers examined immune cells from six ME/CFS patients and found that these cells have lower efficiency in their mitochondria (the 'power plants' of cells) and struggle to produce enough energy to meet their needs. This energy shortage in cells may help explain why ME/CFS patients experience severe fatigue.
This study provides molecular evidence that mitochondrial dysfunction and impaired energy metabolism in immune cells are associated with ME/CFS pathology, potentially explaining the characteristic disabling fatigue. Understanding these cellular-level energy defects could guide development of targeted therapeutic interventions and biomarkers for diagnosis and treatment monitoring.
This study does not prove that mitochondrial dysfunction is the primary cause of ME/CFS or that it occurs uniformly across all ME/CFS patients or all cell types. The small sample size and exploratory design mean these findings require validation in larger cohorts before they can be considered definitive. Correlation between energy defects and fatigue does not establish causation.
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
Fernandez-Guerra, Paula, Gonzalez-Ebsen, Ana C, Boonen, Susanne E, Courraud, Julie, Gregersen, Niels, Mehlsen, Jesper, et al. (2021). Bioenergetic and Proteomic Profiling of Immune Cells in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Patients: An Exploratory Study.. Biomolecules. https://doi.org/10.3390/biom11070961
BibTeX
@article{mecfsatlas-fernandez-guerra-2021-bioenergetic-proteomic,
author = {Fernandez-Guerra, Paula and Gonzalez-Ebsen, Ana C and Boonen, Susanne E and Courraud, Julie and Gregersen, Niels and Mehlsen, Jesper and Palmfeldt, Johan and Olsen, Rikke K J and Brinth, Louise Schouborg},
title = {Bioenergetic and Proteomic Profiling of Immune Cells in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Patients: An Exploratory Study.},
journal = {Biomolecules},
year = {2021},
doi = {10.3390/biom11070961},
note = {PubMed: 34209852},
url = {https://www.mecfsatlas.com/evidence/fernandez-guerra-2021-bioenergetic-proteomic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/fernandez-guerra-2021-bioenergetic-proteomic
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