Maes, Michael, Twisk, Frank N M, Kubera, Marta et al. · Journal of affective disorders · 2012 · DOI
This study found that people with ME/CFS have higher levels of immune antibodies (IgA) that react to bacteria normally living in their gut. These elevated antibodies were connected to increased inflammation and immune system activation in the blood. The more of these antibodies patients had, the worse their symptoms—including fatigue, brain fog, and digestive problems—tended to be.
This research provides a mechanistic link between gut bacteria, immune dysfunction, and symptom severity in ME/CFS, suggesting that bacterial translocation and resulting immune responses may drive disease activity in a subset of patients. Understanding this pathway could lead to targeted diagnostic biomarkers and therapeutic interventions addressing intestinal barrier dysfunction.
This study does not prove that bacterial translocation causes ME/CFS, only that it is associated with the disease in some patients. The cross-sectional design cannot establish whether immune activation triggers bacterial translocation or results from it. Additionally, elevated antibodies alone do not demonstrate active bacterial translocation—they indicate immune recognition of bacterial components.
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, Leunis, Jean-Claude, & Geffard, Michel (2012). Increased IgA responses to the LPS of commensal bacteria is associated with inflammation and activation of cell-mediated immunity in chronic fatigue syndrome.. Journal of affective disorders. https://doi.org/10.1016/j.jad.2011.09.010
BibTeX
@article{mecfsatlas-maes-2012-increased-iga,
author = {Maes, Michael and Twisk, Frank N M and Kubera, Marta and Ringel, Karl and Leunis, Jean-Claude and Geffard, Michel},
title = {Increased IgA responses to the LPS of commensal bacteria is associated with inflammation and activation of cell-mediated immunity in chronic fatigue syndrome.},
journal = {Journal of affective disorders},
year = {2012},
doi = {10.1016/j.jad.2011.09.010},
note = {PubMed: 21967891},
url = {https://www.mecfsatlas.com/evidence/maes-2012-increased-iga},
}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-increased-iga
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