Nijs, Jo, De Meirleir, Kenny · In vivo (Athens, Greece) · 2005
This study looks at a specific immune system pathway called the 2-5A synthetase/RNase L pathway that may be broken in ME/CFS patients. Researchers found that in ME/CFS, this pathway is overactive but also working improperly—it's being broken down into unusual pieces instead of functioning normally. This abnormal pathway appears connected to reduced natural killer cell function and problems with how cells die when they should.
Understanding the 2-5A synthetase/RNase L pathway dysfunction may explain key ME/CFS features including immune dysregulation and exercise intolerance. If this pathway is central to ME/CFS pathophysiology, it could become a target for new treatments and a biomarker for diagnosis.
This review does not prove that 2-5A synthetase/RNase L pathway dysregulation causes ME/CFS—it shows association and mechanistic plausibility but not causation. It does not establish whether correcting this pathway would reverse ME/CFS symptoms, nor does it confirm these findings apply to all ME/CFS patients or explain the primary trigger of the dysregulation.
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
Nijs, Jo & De Meirleir, Kenny (2005). Impairments of the 2-5A synthetase/RNase L pathway in chronic fatigue syndrome.. In vivo (Athens, Greece). https://pubmed.ncbi.nlm.nih.gov/16277015/
BibTeX
@article{mecfsatlas-nijs-2005-impairments-synthetase,
author = {Nijs, Jo and De Meirleir, Kenny},
title = {Impairments of the 2-5A synthetase/RNase L pathway in chronic fatigue syndrome.},
journal = {In vivo (Athens, Greece)},
year = {2005},
note = {PubMed: 16277015},
url = {https://www.mecfsatlas.com/evidence/nijs-2005-impairments-synthetase},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/nijs-2005-impairments-synthetase
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