Middleton, D, Savage, D A, Smith, D G · Disease markers · 1991
This study examined whether certain immune system markers called HLA class II antigens were associated with ME/CFS. Researchers compared these markers in people with ME/CFS and healthy controls. The study found no link between these particular immune markers and ME/CFS, suggesting that HLA class II antigens are not a defining feature of the condition.
Understanding the immunological basis of ME/CFS is crucial for developing effective treatments. This study helps clarify which immune system factors are and are not involved in ME/CFS, narrowing the focus for future research on the disease mechanisms and potential biomarkers.
A negative association does not exclude immune system involvement in ME/CFS through other mechanisms (HLA class I, other immune genes, or acquired immune dysfunction). This study cannot determine whether HLA markers might be relevant in specific ME/CFS subgroups or whether other genetic factors contribute to disease susceptibility.
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
Middleton, D, Savage, D A, & Smith, D G (1991). No association of HLA class II antigens in chronic fatigue syndrome.. Disease markers. https://pubmed.ncbi.nlm.nih.gov/1683826/
BibTeX
@article{mecfsatlas-middleton-1991-association-hla,
author = {Middleton, D and Savage, D A and Smith, D G},
title = {No association of HLA class II antigens in chronic fatigue syndrome.},
journal = {Disease markers},
year = {1991},
note = {PubMed: 1683826},
url = {https://www.mecfsatlas.com/evidence/middleton-1991-association-hla},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/middleton-1991-association-hla
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