Jose G. Montoya, Tyson H. Holmes, Jill N. Anderson et al. · Proceedings of the National Academy of Sciences (PNAS) · 2017 · DOI
Stanford researchers measured 51 cytokines in 192 ME/CFS patients and 392 healthy controls. Seventeen cytokines were significantly elevated in ME/CFS, with TGF-beta most strongly associated with disease severity. More severe patients had higher cytokine levels, suggesting immune activation scales with illness burden.
This is one of the largest cytokine studies in ME/CFS and provides strong evidence for immune dysregulation correlated with symptom severity. The dose-response relationship between cytokine levels and severity strengthens the biological case for immune involvement.
Elevated cytokines are a feature of many inflammatory conditions. This study cannot show whether cytokine dysregulation causes ME/CFS or is a secondary response to the illness.
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
Jose G. Montoya, Tyson H. Holmes, Jill N. Anderson, Holden T. Maecker, Yael Rosenberg-Hasson, Ian J. Valencia, et al. (2017). Cytokine signature associated with disease severity in chronic fatigue syndrome patients. Proceedings of the National Academy of Sciences (PNAS). https://doi.org/10.1073/pnas.1710519114
BibTeX
@article{mecfsatlas-montoya-2017-cytokines,
author = {Jose G. Montoya and Tyson H. Holmes and Jill N. Anderson and Holden T. Maecker and Yael Rosenberg-Hasson and Ian J. Valencia and Lily Chu and Jarred W. Younger and Cristina M. Tato and Mark M. Davis},
title = {Cytokine signature associated with disease severity in chronic fatigue syndrome patients},
journal = {Proceedings of the National Academy of Sciences (PNAS)},
year = {2017},
doi = {10.1073/pnas.1710519114},
url = {https://www.mecfsatlas.com/evidence/montoya-2017-cytokines},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/montoya-2017-cytokines
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