Hollingsworth, Kieren G, Newton, Julia L, Taylor, Roy et al. · Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2008 · DOI
This study examined how muscles produce and use energy in patients with primary biliary cirrhosis (PBC), a liver disease where the immune system attacks mitochondria—the energy factories inside cells. Using a special MRI technique, researchers measured how quickly muscles recovered after exercise and found that PBC patients had problems with this energy recovery process. The study also included people with ME/CFS and found that how quickly muscles can clear acid buildup after exercise may determine whether patients feel severely fatigued.
This study provides mechanistic evidence linking antibody-mediated mitochondrial dysfunction to muscle energy metabolism abnormalities and fatigue in an autoimmune disease, offering a testable pathological model potentially applicable to ME/CFS. Understanding the relationship between impaired muscle acid clearance and fatigue severity could guide development of targeted interventions and biomarkers for ME/CFS patients. The inclusion of ME/CFS controls strengthens comparative understanding of mitochondrial dysfunction across different fatiguing illnesses.
This study does not prove that anti-PDC antibodies directly cause mitochondrial dysfunction in vivo—the in vitro evidence is shown but the causal mechanism in living muscle remains unconfirmed. The findings in PBC may not directly translate to ME/CFS, as the study shows ME/CFS patients have different mitochondrial patterns than PBC patients. This is a mechanistic observation study and cannot establish whether correcting the mitochondrial or pH recovery abnormalities would improve fatigue.
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
Hollingsworth, Kieren G, Newton, Julia L, Taylor, Roy, McDonald, Claire, Palmer, Jeremy M, Blamire, Andrew M, et al. (2008). Pilot study of peripheral muscle function in primary biliary cirrhosis: potential implications for fatigue pathogenesis.. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association. https://doi.org/10.1016/j.cgh.2008.04.013
BibTeX
@article{mecfsatlas-hollingsworth-2008-pilot-study,
author = {Hollingsworth, Kieren G and Newton, Julia L and Taylor, Roy and McDonald, Claire and Palmer, Jeremy M and Blamire, Andrew M and Jones, David E J},
title = {Pilot study of peripheral muscle function in primary biliary cirrhosis: potential implications for fatigue pathogenesis.},
journal = {Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association},
year = {2008},
doi = {10.1016/j.cgh.2008.04.013},
note = {PubMed: 18691944},
url = {https://www.mecfsatlas.com/evidence/hollingsworth-2008-pilot-study},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/hollingsworth-2008-pilot-study
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