Mandarano, Alexandra H, Maya, Jessica, Giloteaux, Ludovic et al. · The Journal of clinical investigation · 2020 · DOI
This study looked at how immune cells (T cells) work differently in people with ME/CFS compared to healthy people. Researchers found that T cells from ME/CFS patients use energy less efficiently—they have trouble both producing energy at rest and responding when activated. These metabolic problems in immune cells may help explain why ME/CFS patients experience severe fatigue and other symptoms.
Understanding T cell metabolic dysfunction provides a potential biological mechanism for ME/CFS symptoms and could guide development of targeted therapeutic interventions. This work strengthens the scientific basis for recognizing ME/CFS as an immune-mediated disease with measurable cellular abnormalities, validating patient experiences of fatigue and post-exertional malaise.
This study identifies metabolic abnormalities but does not prove they cause ME/CFS symptoms or are specific to this disease. It cannot establish whether T cell dysfunction is a primary cause or a consequence of disease processes. The correlation between metabolism and cytokines does not establish causation, and findings require validation in larger, prospective studies.
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
Mandarano, Alexandra H, Maya, Jessica, Giloteaux, Ludovic, Peterson, Daniel L, Maynard, Marco, Gottschalk, C Gunnar, et al. (2020). Myalgic encephalomyelitis/chronic fatigue syndrome patients exhibit altered T cell metabolism and cytokine associations.. The Journal of clinical investigation. https://doi.org/10.1172/JCI132185
BibTeX
@article{mecfsatlas-mandarano-2020-myalgic-encephalomyelitis,
author = {Mandarano, Alexandra H and Maya, Jessica and Giloteaux, Ludovic and Peterson, Daniel L and Maynard, Marco and Gottschalk, C Gunnar and Hanson, Maureen R},
title = {Myalgic encephalomyelitis/chronic fatigue syndrome patients exhibit altered T cell metabolism and cytokine associations.},
journal = {The Journal of clinical investigation},
year = {2020},
doi = {10.1172/JCI132185},
note = {PubMed: 31830003},
url = {https://www.mecfsatlas.com/evidence/mandarano-2020-myalgic-encephalomyelitis},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/mandarano-2020-myalgic-encephalomyelitis
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