Okamoto, Luis E, Raj, Satish R, Gamboa, Alfredo et al. · American journal of physiology. Heart and circulatory physiology · 2015 · DOI
This study looked at how an overactive nervous system relates to inflammation in the body. Researchers compared people with POTS (a condition causing increased heart rate when standing) to healthy controls, both lean and obese. They found that an overactive nervous system was linked to higher levels of IL-6, a marker of inflammation, even in people without obesity—but only obesity combined with nervous system overactivity produced high CRP, another inflammation marker.
Many ME/CFS patients experience dysautonomia (abnormal nervous system function) and abnormal inflammatory markers. This study provides evidence that nervous system overactivity can trigger specific inflammatory responses even without obesity, which may help explain inflammation patterns in lean ME/CFS patients with autonomic dysfunction. Understanding these mechanisms could guide treatment strategies targeting either sympathetic activation or downstream inflammatory pathways.
This study does not prove that sympathetic activation causes IL-6 elevation, only that they are associated in POTS. It does not establish whether this relationship applies to ME/CFS, as POTS and ME/CFS have different pathophysiologies. The cross-sectional design cannot determine whether nervous system changes precede inflammation or vice versa.
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
Okamoto, Luis E, Raj, Satish R, Gamboa, Alfredo, Shibao, Cyndya A, Arnold, Amy C, Garland, Emily M, et al. (2015). Sympathetic activation is associated with increased IL-6, but not CRP in the absence of obesity: lessons from postural tachycardia syndrome and obesity.. American journal of physiology. Heart and circulatory physiology. https://doi.org/10.1152/ajpheart.00409.2015
BibTeX
@article{mecfsatlas-okamoto-2015-sympathetic-activation,
author = {Okamoto, Luis E and Raj, Satish R and Gamboa, Alfredo and Shibao, Cyndya A and Arnold, Amy C and Garland, Emily M and Black, Bonnie K and Farley, Ginnie and Diedrich, André and Biaggioni, Italo},
title = {Sympathetic activation is associated with increased IL-6, but not CRP in the absence of obesity: lessons from postural tachycardia syndrome and obesity.},
journal = {American journal of physiology. Heart and circulatory physiology},
year = {2015},
doi = {10.1152/ajpheart.00409.2015},
note = {PubMed: 26453329},
url = {https://www.mecfsatlas.com/evidence/okamoto-2015-sympathetic-activation},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/okamoto-2015-sympathetic-activation
Contribute
Private, reviewed by a human. Not a public comment thread.