Rivas, Jose Luis, Palencia, Teresa, Fernández, Guerau et al. · Frontiers in immunology · 2018 · DOI
This study compared immune system cells in the blood of people with ME/CFS to healthy people. Researchers found that ME/CFS patients had different levels of certain immune cells, particularly lower regulatory T cells and higher NKT-like cells, along with changes in natural killer (NK) cells. Using these immune cell differences, researchers could correctly identify about 70% of ME/CFS patients versus healthy controls, suggesting these immune markers might someday help doctors diagnose the condition.
ME/CFS currently lacks objective diagnostic tests; diagnosis relies entirely on clinical criteria, delaying recognition and treatment. Identifying consistent immune cell abnormalities could lead to blood tests that objectively confirm ME/CFS and distinguish it from other conditions. This work supports the biological basis of ME/CFS and opens pathways for more targeted therapeutic development.
This study does not prove these immune cell changes cause ME/CFS or that they are specific to the disease—they may occur in other conditions. The 70% diagnostic accuracy, while promising, is not sufficient for clinical practice without validation in independent cohorts. Correlation between immune markers and disease cannot establish causation or explain the mechanism underlying ME/CFS pathology.
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
Rivas, Jose Luis, Palencia, Teresa, Fernández, Guerau, & García, Milagros (2018). Association of T and NK Cell Phenotype With the Diagnosis of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS).. Frontiers in immunology. https://doi.org/10.3389/fimmu.2018.01028
BibTeX
@article{mecfsatlas-rivas-2018-association-cell,
author = {Rivas, Jose Luis and Palencia, Teresa and Fernández, Guerau and García, Milagros},
title = {Association of T and NK Cell Phenotype With the Diagnosis of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS).},
journal = {Frontiers in immunology},
year = {2018},
doi = {10.3389/fimmu.2018.01028},
note = {PubMed: 29867995},
url = {https://www.mecfsatlas.com/evidence/rivas-2018-association-cell},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/rivas-2018-association-cell
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