E2 ModerateModerate confidencePEM requiredCross-SectionalPeer-reviewedReviewed
Activin B is a novel biomarker for chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) diagnosis: a cross sectional study.
Lidbury, Brett A, Kita, Badia, Lewis, Donald P et al. · Journal of translational medicine · 2017 · DOI
Quick Summary
Researchers tested blood samples from people with ME/CFS and compared them to healthy controls, looking for differences in proteins called activins. They found that people with ME/CFS had significantly higher levels of a protein called activin B, while activin A remained normal. This pattern could potentially be used as a blood test to help diagnose ME/CFS, since currently there is no reliable diagnostic test available.
Why It Matters
Currently, ME/CFS lacks objective diagnostic biomarkers, making diagnosis difficult and often delayed. This study identifies activin B as a potential serum-based diagnostic tool that could enable faster, more definitive diagnosis and improve patient access to appropriate care and validation.
Observed Findings
- Serum activin B levels were significantly elevated in CFS/ME participants compared to healthy controls
- Serum activin B levels in CFS/ME patients exceeded established reference intervals
- Serum activin A levels remained within normal ranges in CFS/ME patients
- Serum follistatin levels were within normal ranges in CFS/ME patients
- No significant differences in routine pathology markers or major cytokines (IL-2, IL-4, IL-6, IL-10, IL-17A, TNF, IFN-γ) between CFS/ME and control groups
Inferred Conclusions
- Elevated activin B combined with normal activin A levels may serve as a novel serum-based diagnostic marker for CFS/ME
- Activin proteins capture the diverse physiological dysfunction underlying ME/CFS's complex symptom presentation
- Activin B elevation appears specific to CFS/ME, as it is not reflected in routine or cytokine-based pathology markers
Remaining Questions
- Do activin B levels correlate with symptom severity, disease duration, or post-exertional malaise response?
- Is activin B elevation present in other chronic illnesses, or is it truly specific to ME/CFS?
What This Study Does Not Prove
This study does not prove that activin B causes ME/CFS symptoms—elevated levels may be a consequence of the disease rather than its cause. The cross-sectional design cannot establish temporal relationships, and findings require validation in larger, independent cohorts before clinical implementation. The study also does not explain the biological mechanism linking activin B elevation to ME/CFS pathology.
Tags
Symptom:Post-Exertional MalaiseOrthostatic IntoleranceFatigue
Biomarker:CytokinesBlood Biomarker
Method Flag:Small SampleExploratory OnlyStrong Phenotyping
Metadata
- DOI
- 10.1186/s12967-017-1161-4
- PMID
- 28302133
- Review status
- Editor reviewed
- Evidence level
- Single-study or moderate support from human research
- Last updated
- 12 April 2026
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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