Frank, Joshua, Tehrani, Lily, Gamer, Jackson et al. · International journal of molecular sciences · 2025 · DOI
Researchers studied how the immune system responds to physical stress in Gulf War veterans with Gulf War Illness (GWI), a condition similar to ME/CFS with fatigue, brain fog, and exhaustion. They found that men and women with GWI have different patterns of immune system activation during and after exercise, suggesting their bodies handle stress differently. These differences could help doctors develop better tests and treatments tailored to each person's sex.
Understanding sex-specific immune dysregulation in GWI—a condition with striking parallels to ME/CFS—may identify biomarkers that distinguish the disease from other conditions and reveal sex-specific therapeutic targets. This work supports the growing recognition that ME/CFS and related post-exertional malaise conditions require sex-stratified research and treatment approaches.
This study does not establish causation for GWI or ME/CFS; it identifies correlations between gene expression patterns and disease status. The findings are preliminary mechanistic observations in a small population and do not yet translate to clinically validated diagnostic tests or approved therapies. Additionally, transcriptomic changes do not necessarily indicate which sex experiences worse outcomes or requires more urgent intervention.
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
Frank, Joshua, Tehrani, Lily, Gamer, Jackson, Van Booven, Derek J, Ballarin, Sarah, Rossman, Raquel, et al. (2025). Gulf War Illness Induced Sex-Specific Transcriptional Differences Under Stressful Conditions.. International journal of molecular sciences. https://doi.org/10.3390/ijms26083610
BibTeX
@article{mecfsatlas-frank-2025-gulf-war,
author = {Frank, Joshua and Tehrani, Lily and Gamer, Jackson and Van Booven, Derek J and Ballarin, Sarah and Rossman, Raquel and Edelstein, Abraham and Uppalati, Sadhika and Reuthebuck, Ana and Collado, Fanny and Klimas, Nancy G and Nathanson, Lubov},
title = {Gulf War Illness Induced Sex-Specific Transcriptional Differences Under Stressful Conditions.},
journal = {International journal of molecular sciences},
year = {2025},
doi = {10.3390/ijms26083610},
note = {PubMed: 40332133},
url = {https://www.mecfsatlas.com/evidence/frank-2025-gulf-war},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/frank-2025-gulf-war
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