Loebel, Madlen, Grabowski, Patricia, Heidecke, Harald et al. · Brain, behavior, and immunity · 2016 · DOI
Researchers tested whether ME/CFS patients have unusually high levels of antibodies (immune proteins) that attack nerve signaling receptors in the body. They found that about 30% of ME/CFS patients had elevated antibodies against certain receptors involved in adrenaline and acetylcholine signaling—chemicals that control heart rate, breathing, and other automatic body functions. Importantly, patients who received rituximab (a treatment that depletes B cells) and improved showed decreases in these antibody levels, suggesting a possible link between these antibodies and disease activity.
This study provides evidence for an autoimmune mechanism in ME/CFS by identifying specific autoantibodies that correlate with immune activation and autonomic symptoms. The finding that antibody levels decline with effective B-cell depletion therapy suggests a potential biological marker for predicting treatment response, which could guide personalized clinical management and validate immunotherapeutic approaches in ME/CFS.
This study does not prove that these autoantibodies directly cause ME/CFS symptoms or dysfunction; it demonstrates correlation and association. The study is not a functional assay—it does not show that these antibodies functionally impair receptor signaling in vivo. The cross-sectional Berlin cohort design cannot establish causation, and the small rituximab sample (n=25) limits generalizability of treatment-response findings.
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
Loebel, Madlen, Grabowski, Patricia, Heidecke, Harald, Bauer, Sandra, Hanitsch, Leif G, Wittke, Kirsten, et al. (2016). Antibodies to β adrenergic and muscarinic cholinergic receptors in patients with Chronic Fatigue Syndrome.. Brain, behavior, and immunity. https://doi.org/10.1016/j.bbi.2015.09.013
BibTeX
@article{mecfsatlas-loebel-2016-antibodies-adrenergic,
author = {Loebel, Madlen and Grabowski, Patricia and Heidecke, Harald and Bauer, Sandra and Hanitsch, Leif G and Wittke, Kirsten and Meisel, Christian and Reinke, Petra and Volk, Hans-Dieter and Fluge, Øystein and Mella, Olav and Scheibenbogen, Carmen},
title = {Antibodies to β adrenergic and muscarinic cholinergic receptors in patients with Chronic Fatigue Syndrome.},
journal = {Brain, behavior, and immunity},
year = {2016},
doi = {10.1016/j.bbi.2015.09.013},
note = {PubMed: 26399744},
url = {https://www.mecfsatlas.com/evidence/loebel-2016-antibodies-adrenergic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/loebel-2016-antibodies-adrenergic
Contribute
Private, reviewed by a human. Not a public comment thread.