Maes, Michael, Mihaylova, Ivana, Kubera, Marta et al. · Neuro endocrinology letters · 2007
This study found that people with ME/CFS have higher levels of two inflammatory molecules (COX-2 and iNOS) in their white blood cells compared to healthy people. The levels of these inflammatory markers were directly linked to how severe their symptoms were, including fatigue, pain, brain fog, and feeling like they have an infection. This suggests ME/CFS involves real inflammation in the body, not just psychological factors.
This study provides biological evidence that ME/CFS involves measurable inflammatory abnormalities in immune cells, supporting the view that the condition has a physical, not purely psychological, basis. The findings suggest potential therapeutic targets through anti-inflammatory approaches and may help validate patients' experiences of genuine infection-like symptoms.
This study does not prove that COX-2 and iNOS elevation causes ME/CFS; it only shows correlation. It cannot establish whether these inflammatory markers are primary drivers of disease or secondary consequences of other pathological processes. The small sample size and cross-sectional design limit generalizability and preclude causal inference.
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
Maes, Michael, Mihaylova, Ivana, Kubera, Marta, & Bosmans, Eugene (2007). Not in the mind but in the cell: increased production of cyclo-oxygenase-2 and inducible NO synthase in chronic fatigue syndrome.. Neuro endocrinology letters. https://pubmed.ncbi.nlm.nih.gov/17693978/
BibTeX
@article{mecfsatlas-maes-2007-mind-but,
author = {Maes, Michael and Mihaylova, Ivana and Kubera, Marta and Bosmans, Eugene},
title = {Not in the mind but in the cell: increased production of cyclo-oxygenase-2 and inducible NO synthase in chronic fatigue syndrome.},
journal = {Neuro endocrinology letters},
year = {2007},
note = {PubMed: 17693978},
url = {https://www.mecfsatlas.com/evidence/maes-2007-mind-but},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/maes-2007-mind-but
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