Pereira, Gerard, Gillies, Hunter, Chanda, Sanjay et al. · Frontiers in systems neuroscience · 2021 · DOI
Researchers tested a new drug called CT38s that targets a receptor in the brain called CRFR2, which they believe may be overactive in ME/CFS. Fourteen ME/CFS patients received a single infusion of this drug, and most experienced symptom improvement that lasted at least 28 days. Side effects were mild and similar to typical ME/CFS symptoms, suggesting the drug was working on systems related to the disease.
This study provides preliminary evidence for a specific biological mechanism in ME/CFS (CRFR2 upregulation) and demonstrates that targeting this mechanism with a single drug dose may produce meaningful, sustained symptom improvement. These findings could redirect ME/CFS research toward a mechanistically-informed treatment approach and justify larger controlled trials.
This study does not prove CT38s is an effective treatment for ME/CFS, as it lacks a control group and relies on patient self-reported symptoms in an open-label design susceptible to placebo effects. It does not establish that CRFR2 upregulation is the sole or primary cause of ME/CFS, only that it may play a role in symptom generation. Results in 14 patients cannot be generalized to the broader ME/CFS population without larger controlled trials.
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
Pereira, Gerard, Gillies, Hunter, Chanda, Sanjay, Corbett, Michael, Vernon, Suzanne D, Milani, Tina, et al. (2021). Acute Corticotropin-Releasing Factor Receptor Type 2 Agonism Results in Sustained Symptom Improvement in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.. Frontiers in systems neuroscience. https://doi.org/10.3389/fnsys.2021.698240
BibTeX
@article{mecfsatlas-pereira-2021-acute-corticotropin,
author = {Pereira, Gerard and Gillies, Hunter and Chanda, Sanjay and Corbett, Michael and Vernon, Suzanne D and Milani, Tina and Bateman, Lucinda},
title = {Acute Corticotropin-Releasing Factor Receptor Type 2 Agonism Results in Sustained Symptom Improvement in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.},
journal = {Frontiers in systems neuroscience},
year = {2021},
doi = {10.3389/fnsys.2021.698240},
note = {PubMed: 34539356},
url = {https://www.mecfsatlas.com/evidence/pereira-2021-acute-corticotropin},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/pereira-2021-acute-corticotropin
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