Martín, Franz, Blanco-Suárez, Manuel, Zambrano, Paola et al. · Frontiers in immunology · 2023 · DOI
This study found that people with ME/CFS and fibromyalgia may have a 'leaky gut'—where the intestinal barrier doesn't work as well as it should. Researchers measured several substances in the blood that indicate gut barrier problems and inflammation, and found higher levels in both patient groups compared to healthy people. These findings suggest that gut dysfunction might play a role in these conditions and could eventually help doctors identify and understand these diseases better.
This study provides objective, measurable biomarkers that may help validate gut barrier dysfunction in ME/CFS—a finding that could explain some GI symptoms and guide future treatment strategies. Identifying specific biomarkers could accelerate diagnostic development and reveal pathophysiological mechanisms underlying both conditions. The correlation between biomarkers and autonomic symptoms (COMPASS-31) offers new insight into potential mechanisms linking gut dysfunction to systemic ME/CFS features.
This study does not prove that gut barrier dysfunction causes ME/CFS or fibromyalgia—it only shows they occur together (correlation, not causation). The cross-sectional design means we cannot determine whether barrier dysfunction precedes symptom onset or develops as a consequence. Results are preliminary and require validation in larger, longitudinal studies before these biomarkers can be used clinically.
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
Martín, Franz, Blanco-Suárez, Manuel, Zambrano, Paola, Cáceres, Oscar, Almirall, Miriam, Alegre-Martín, José, et al. (2023). Increased gut permeability and bacterial translocation are associated with fibromyalgia and myalgic encephalomyelitis/chronic fatigue syndrome: implications for disease-related biomarker discovery.. Frontiers in immunology. https://doi.org/10.3389/fimmu.2023.1253121
BibTeX
@article{mecfsatlas-martn-2023-increased-gut,
author = {Martín, Franz and Blanco-Suárez, Manuel and Zambrano, Paola and Cáceres, Oscar and Almirall, Miriam and Alegre-Martín, José and Lobo, Beatriz and González-Castro, Ana Maria and Santos, Javier and Domingo, Joan Carles and Jurek, Joanna and Castro-Marrero, Jesús},
title = {Increased gut permeability and bacterial translocation are associated with fibromyalgia and myalgic encephalomyelitis/chronic fatigue syndrome: implications for disease-related biomarker discovery.},
journal = {Frontiers in immunology},
year = {2023},
doi = {10.3389/fimmu.2023.1253121},
note = {PubMed: 37744357},
url = {https://www.mecfsatlas.com/evidence/martn-2023-increased-gut},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/martn-2023-increased-gut
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