Maes, Michael, Twisk, Frank N M, Kubera, Marta et al. · Journal of affective disorders · 2012 · DOI
This study examined whether people with ME/CFS have higher levels of inflammatory markers—substances in the blood that signal inflammation—compared to healthy people and those with regular fatigue. Researchers found that ME/CFS patients had significantly elevated levels of five different inflammatory markers, and these markers were linked to common ME/CFS symptoms like fatigue, brain fog, and flu-like feelings. The findings suggest that low-grade inflammation in the body may be contributing to ME/CFS symptoms.
This research provides objective biological evidence that ME/CFS involves measurable inflammation and immune activation, potentially validating patient experiences and supporting the biological nature of the illness. These findings could help distinguish ME/CFS from other fatigue conditions and may guide development of anti-inflammatory treatments.
This study shows correlation between inflammatory markers and symptoms, but does not prove that inflammation causes ME/CFS symptoms—the relationship could be bidirectional or indirect. The cross-sectional design cannot establish whether these inflammatory changes precede, follow, or are a consequence of ME/CFS development. Results are associational and do not establish that reducing these markers would improve symptoms.
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, Twisk, Frank N M, Kubera, Marta, & Ringel, Karl (2012). Evidence for inflammation and activation of cell-mediated immunity in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): increased interleukin-1, tumor necrosis factor-α, PMN-elastase, lysozyme and neopterin.. Journal of affective disorders. https://doi.org/10.1016/j.jad.2011.09.004
BibTeX
@article{mecfsatlas-maes-2012-evidence-inflammation,
author = {Maes, Michael and Twisk, Frank N M and Kubera, Marta and Ringel, Karl},
title = {Evidence for inflammation and activation of cell-mediated immunity in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): increased interleukin-1, tumor necrosis factor-α, PMN-elastase, lysozyme and neopterin.},
journal = {Journal of affective disorders},
year = {2012},
doi = {10.1016/j.jad.2011.09.004},
note = {PubMed: 21975140},
url = {https://www.mecfsatlas.com/evidence/maes-2012-evidence-inflammation},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/maes-2012-evidence-inflammation
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