Gravelsina, Sabine, Nora-Krukle, Zaiga, Vilmane, Anda et al. · Biomolecules · 2021 · DOI
Researchers tested whether a protein called activin B could be used as a simple blood test to diagnose ME/CFS. They compared activin B levels in 134 people with ME/CFS and 54 healthy people, but found no meaningful difference between the two groups. Based on these results, activin B does not appear to be a useful diagnostic tool for ME/CFS.
ME/CFS lacks objective diagnostic tests and relies on clinical criteria, making the search for reliable biomarkers essential for earlier and more accurate diagnosis. This negative finding helps guide future biomarker research away from less promising candidates and focuses efforts on more promising molecular targets.
This study does not prove that activin B plays no role in ME/CFS pathophysiology—only that blood levels do not reliably distinguish patients from healthy controls. The study's cross-sectional design cannot establish causation or whether activin B might be relevant in specific ME/CFS subtypes. The negative result does not eliminate the possibility that activin B could be useful in combination with other biomarkers.
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
Gravelsina, Sabine, Nora-Krukle, Zaiga, Vilmane, Anda, Svirskis, Simons, Vecvagare, Katrine, Krumina, Angelika, et al. (2021). Potential of Activin B as a Clinical Biomarker in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS).. Biomolecules. https://doi.org/10.3390/biom11081189
BibTeX
@article{mecfsatlas-gravelsina-2021-potential-activin,
author = {Gravelsina, Sabine and Nora-Krukle, Zaiga and Vilmane, Anda and Svirskis, Simons and Vecvagare, Katrine and Krumina, Angelika and Murovska, Modra},
title = {Potential of Activin B as a Clinical Biomarker in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS).},
journal = {Biomolecules},
year = {2021},
doi = {10.3390/biom11081189},
note = {PubMed: 34439855},
url = {https://www.mecfsatlas.com/evidence/gravelsina-2021-potential-activin},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/gravelsina-2021-potential-activin
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