Germain, Arnaud, Glass, Katherine A, Eckert, Melissa A et al. · Molecular & cellular proteomics : MCP · 2025 · DOI
Researchers studied what happens in the blood of ME/CFS patients during and after exercise to understand post-exertional malaise (PEM)—the worsening of symptoms that occurs after physical activity. They measured over 6,000 different proteins in 79 ME/CFS patients and 53 healthy controls before exercise, immediately after, and during recovery. They found that ME/CFS patients have abnormal protein changes during recovery that suggest their immune system and energy-producing cells are not working properly after exertion.
This is the first large-scale longitudinal proteomics study specifically designed to capture the molecular mechanisms of PEM in real-time. By identifying specific immune and metabolic abnormalities that occur during post-exertional symptom flares, the findings provide concrete targets for developing treatments and diagnostic biomarkers for ME/CFS—potentially moving beyond symptom management toward disease-modifying interventions.
This study does not prove that these protein changes *cause* PEM or that correcting them will cure ME/CFS—only that they are associated with exertion-induced symptom worsening. The findings are correlative, not mechanistic, and require functional studies to determine whether these proteins are drivers or consequences of the dysregulation. Sex-specific differences are observed but not explained by underlying mechanisms in this study.
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
Germain, Arnaud, Glass, Katherine A, Eckert, Melissa A, Giloteaux, Ludovic, & Hanson, Maureen R (2025). Temporal Dynamics of the Plasma Proteomic Landscape Reveals Maladaptation in ME/CFS Following Exertion.. Molecular & cellular proteomics : MCP. https://doi.org/10.1016/j.mcpro.2025.101467
BibTeX
@article{mecfsatlas-germain-2025-temporal-dynamics,
author = {Germain, Arnaud and Glass, Katherine A and Eckert, Melissa A and Giloteaux, Ludovic and Hanson, Maureen R},
title = {Temporal Dynamics of the Plasma Proteomic Landscape Reveals Maladaptation in ME/CFS Following Exertion.},
journal = {Molecular & cellular proteomics : MCP},
year = {2025},
doi = {10.1016/j.mcpro.2025.101467},
note = {PubMed: 41237904},
url = {https://www.mecfsatlas.com/evidence/germain-2025-temporal-dynamics},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/germain-2025-temporal-dynamics
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