Hornig, M, Gottschalk, C G, Eddy, M L et al. · Translational psychiatry · 2017 · DOI
This study examined fluid from around the brain and spinal cord in people with ME/CFS to look for immune system differences. Researchers found that people whose ME/CFS started differently (without a clear infection trigger) had different patterns of immune molecules compared to those with typical ME/CFS that started after a viral-like illness. The atypical group had lower levels of certain inflammatory markers and less coordinated immune activity in their central nervous system.
This research suggests ME/CFS may involve distinct immune mechanisms depending on how the illness begins, which could explain why patients present differently and may require different diagnostic approaches. Understanding these immune signatures in the central nervous system could eventually lead to better classification and targeted treatments for different ME/CFS subtypes.
This study does not prove that immune differences cause ME/CFS or that these markers directly cause symptoms—it only shows associations in cerebrospinal fluid at a single time point. The cross-sectional design cannot establish whether these immune patterns develop before, during, or after symptom onset, nor can it determine if they are unique to ME/CFS or shared with other conditions.
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
Hornig, M, Gottschalk, C G, Eddy, M L, Che, X, Ukaigwe, J E, Peterson, D L, et al. (2017). Immune network analysis of cerebrospinal fluid in myalgic encephalomyelitis/chronic fatigue syndrome with atypical and classical presentations.. Translational psychiatry. https://doi.org/10.1038/tp.2017.44
BibTeX
@article{mecfsatlas-hornig-2017-immune-network,
author = {Hornig, M and Gottschalk, C G and Eddy, M L and Che, X and Ukaigwe, J E and Peterson, D L and Lipkin, W I},
title = {Immune network analysis of cerebrospinal fluid in myalgic encephalomyelitis/chronic fatigue syndrome with atypical and classical presentations.},
journal = {Translational psychiatry},
year = {2017},
doi = {10.1038/tp.2017.44},
note = {PubMed: 28375204},
url = {https://www.mecfsatlas.com/evidence/hornig-2017-immune-network},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/hornig-2017-immune-network
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