Komaroff, Anthony L · JAMA · 2019 · DOI
This review article examines what scientists currently understand about how ME/CFS develops and affects the body at a cellular level. Researcher Anthony Komaroff synthesizes evidence suggesting that ME/CFS involves problems with energy production in cells, immune system dysfunction, and nervous system abnormalities. The article helps explain why ME/CFS causes such severe fatigue and why patients often feel worse after physical activity.
This authoritative review by a leading ME/CFS researcher consolidates evidence showing ME/CFS is a biological illness with measurable pathophysiological abnormalities, not a psychiatric condition. Understanding the biological mechanisms underlying ME/CFS is essential for developing targeted treatments and validating patient experiences.
This review article does not present new experimental data and therefore cannot establish causality—it synthesizes existing findings that may reflect correlation rather than direct cause-and-effect relationships. The article cannot identify which mechanism is primary or which abnormalities are consequences of illness rather than causes. It does not provide definitive proof of any single unified cause of ME/CFS.
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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Primary citation
Komaroff, Anthony L (2019). Advances in Understanding the Pathophysiology of Chronic Fatigue Syndrome.. JAMA. https://doi.org/10.1001/jama.2019.8312
BibTeX
@article{mecfsatlas-komaroff-2019-advances-understanding,
author = {Komaroff, Anthony L},
title = {Advances in Understanding the Pathophysiology of Chronic Fatigue Syndrome.},
journal = {JAMA},
year = {2019},
doi = {10.1001/jama.2019.8312},
note = {PubMed: 31276153},
url = {https://www.mecfsatlas.com/evidence/komaroff-2019-advances-understanding},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/komaroff-2019-advances-understanding
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