Pukhal'skiĭ, A L, Shmarina, G V, Aleshkin, V A · Vestnik Rossiiskoi akademii meditsinskikh nauk · 2011
Your body has special immune cells called regulatory T-cells (Tregs) that normally help control inflammation and keep your immune system balanced. This article explains how long-term stress and aging can disrupt this balance—either causing too many Tregs to build up or too few to develop properly. The authors suggest that when Tregs become imbalanced, it may contribute to conditions like chronic fatigue syndrome, while also affecting allergy and cancer risk.
ME/CFS is characterized by abnormal immune activation and dysregulated cortisol response—both key factors in the Treg imbalance model proposed here. Understanding whether ME/CFS patients have excess Treg-mediated immunosuppression versus insufficient Treg development could guide future therapeutic approaches to restore immune tolerance and reduce symptom severity.
This is a theoretical review, not an original empirical study, so it does not present new experimental or clinical data from ME/CFS patients. The proposed link between Treg dysregulation and ME/CFS is conceptual; the review does not prove causation or quantify Treg abnormalities in ME/CFS populations. The mechanisms described are inferred from general immunology principles and may not directly translate to the specific pathophysiology of ME/CFS.
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 →
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Primary citation
Pukhal'skiĭ, A L, Shmarina, G V, & Aleshkin, V A (2011). [Regulatory T-cells: modern approaches to optimization of their numbers].. Vestnik Rossiiskoi akademii meditsinskikh nauk. https://pubmed.ncbi.nlm.nih.gov/21950132/
BibTeX
@article{mecfsatlas-pukhalski-2011-regulatory-cells,
author = {Pukhal'skiĭ, A L and Shmarina, G V and Aleshkin, V A},
title = {[Regulatory T-cells: modern approaches to optimization of their numbers].},
journal = {Vestnik Rossiiskoi akademii meditsinskikh nauk},
year = {2011},
note = {PubMed: 21950132},
url = {https://www.mecfsatlas.com/evidence/pukhalski-2011-regulatory-cells},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/pukhalski-2011-regulatory-cells
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