Missailidis, Daniel, Annesley, Sarah J, Fisher, Paul R · Diagnostics (Basel, Switzerland) · 2019 · DOI
ME/CFS is a complex condition affecting multiple body systems, and researchers are working to understand what causes it. This review shows that evidence points to problems in the immune system, nervous system, muscle function, metabolism, and gut health in ME/CFS patients. Because patients experience different symptoms and may develop the condition in different ways, finding reliable diagnostic tests remains a key challenge that researchers are actively pursuing.
This comprehensive overview validates that ME/CFS has measurable biological abnormalities across multiple organ systems, counteracting the perception that the condition lacks a biomedical basis. Identifying this multi-system pathology is essential for developing diagnostic tests and targeted treatments, and understanding how different triggers might cause similar disease presentations could improve patient care and research design.
As an editorial review rather than original research, this work does not present new experimental data or prove causality for any specific mechanism. It does not establish which pathological findings are primary drivers versus secondary consequences, nor does it demonstrate that a single unifying pathological process accounts for all ME/CFS cases. The variability in presentations across patients means that findings may not apply equally to all individuals with the condition.
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
Missailidis, Daniel, Annesley, Sarah J, & Fisher, Paul R (2019). Pathological Mechanisms Underlying Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.. Diagnostics (Basel, Switzerland). https://doi.org/10.3390/diagnostics9030080
BibTeX
@article{mecfsatlas-missailidis-2019-pathological-mechanisms,
author = {Missailidis, Daniel and Annesley, Sarah J and Fisher, Paul R},
title = {Pathological Mechanisms Underlying Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.},
journal = {Diagnostics (Basel, Switzerland)},
year = {2019},
doi = {10.3390/diagnostics9030080},
note = {PubMed: 31330791},
url = {https://www.mecfsatlas.com/evidence/missailidis-2019-pathological-mechanisms},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/missailidis-2019-pathological-mechanisms
Contribute
Private, reviewed by a human. Not a public comment thread.