Lunde, Sigrid, Kristoffersen, Einar K, Sapkota, Dipak et al. · PloS one · 2016 · DOI
Researchers tested whether a drug called rituximab, which removes B cells (a type of immune cell) from the blood, helps ME/CFS patients by examining immune system changes. They found that some ME/CFS patients had higher levels of a substance called BAFF that activates B cells, but this didn't predict who would improve with treatment. While some patients did get better with rituximab in earlier trials, the immune cell changes measured in this study didn't fully explain why.
This study helps researchers understand how rituximab works in ME/CFS by ruling out certain immune mechanisms, narrowing the focus for future investigations. The finding that B-cell removal improves symptoms without major T-cell or NK-cell changes suggests ME/CFS immune dysfunction involves different mechanisms than previously hypothesized, potentially opening new treatment avenues.
This study does not prove that rituximab is effective for all ME/CFS patients—it only describes immune markers in previous trial participants. It also does not establish why rituximab helped some patients, since the measured immune changes didn't correlate with clinical improvement. Finally, the lack of functional antibody assays means the study cannot determine whether remaining immunoglobulins were adequately protective.
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
Lunde, Sigrid, Kristoffersen, Einar K, Sapkota, Dipak, Risa, Kristin, Dahl, Olav, Bruland, Ove, et al. (2016). Serum BAFF and APRIL Levels, T-Lymphocyte Subsets, and Immunoglobulins after B-Cell Depletion Using the Monoclonal Anti-CD20 Antibody Rituximab in Myalgic Encephalopathy/Chronic Fatigue Syndrome.. PloS one. https://doi.org/10.1371/journal.pone.0161226
BibTeX
@article{mecfsatlas-lunde-2016-serum-baff,
author = {Lunde, Sigrid and Kristoffersen, Einar K and Sapkota, Dipak and Risa, Kristin and Dahl, Olav and Bruland, Ove and Mella, Olav and Fluge, Øystein},
title = {Serum BAFF and APRIL Levels, T-Lymphocyte Subsets, and Immunoglobulins after B-Cell Depletion Using the Monoclonal Anti-CD20 Antibody Rituximab in Myalgic Encephalopathy/Chronic Fatigue Syndrome.},
journal = {PloS one},
year = {2016},
doi = {10.1371/journal.pone.0161226},
note = {PubMed: 27536947},
url = {https://www.mecfsatlas.com/evidence/lunde-2016-serum-baff},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/lunde-2016-serum-baff
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