Glaser, R, Kiecolt-Glaser, J K · The American journal of medicine · 1998 · DOI
This review examines whether ME/CFS might be triggered by viruses interacting with stress and the immune system. While doctors had noticed that people with ME/CFS often have signs of viral infection, previous research hadn't found a clear virus-to-ME/CFS connection. The authors explore how stress, dormant viruses like Epstein-Barr, and the body's immune response could work together to cause ME/CFS symptoms.
This study is important because it shifted thinking away from the idea that ME/CFS is simply caused by a single virus, toward a more complex model involving immune dysregulation, stress, and viral reactivation. Understanding these interconnected systems helps researchers and clinicians appreciate why ME/CFS is difficult to diagnose and treat, and it validates the role of biological stress responses in disease development.
This review does not establish that any specific virus directly causes ME/CFS, nor does it prove that stress alone causes the disease. It cannot demonstrate causation from the immune system changes to ME/CFS symptoms—the relationship may be correlational or bidirectional. The paper is also a theoretical overview rather than original research presenting new empirical data.
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 →
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