Rohrhofer, Johanna, Ebner, Lilian, Schweighardt, Johannes et al. · Diagnostics (Basel, Switzerland) · 2025 · DOI
This study looked at whether mast cells—immune cells that release chemicals causing inflammation—play a role in ME/CFS. Researchers surveyed 687 ME/CFS patients and reviewed records from 383 others, finding that about 25% had signs of problematic mast cell activation. Importantly, patients with mast cell problems who received targeted treatment reported better symptom relief than those without mast cell involvement, suggesting this might be a treatable subtype of ME/CFS.
ME/CFS lacks effective targeted treatments, and identifying mast cell activation as a common, treatable comorbidity could enable personalized treatment strategies for a significant subset of patients. This work provides evidence that stratifying patients by MCA status may improve clinical outcomes and guide therapeutic selection.
This study does not prove that mast cell activation causes ME/CFS—it only shows an association. The observational design cannot establish causality, and the primary dataset relied on patient surveys rather than objective laboratory measurements. The study also cannot determine whether mast cell-targeted treatments would benefit all ME/CFS patients or only those with confirmed MCA.
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
Rohrhofer, Johanna, Ebner, Lilian, Schweighardt, Johannes, Stingl, Michael, & Untersmayr, Eva (2025). The Clinical Relevance of Mast Cell Activation in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.. Diagnostics (Basel, Switzerland). https://doi.org/10.3390/diagnostics15222828
BibTeX
@article{mecfsatlas-rohrhofer-2025-clinical-relevance,
author = {Rohrhofer, Johanna and Ebner, Lilian and Schweighardt, Johannes and Stingl, Michael and Untersmayr, Eva},
title = {The Clinical Relevance of Mast Cell Activation in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.},
journal = {Diagnostics (Basel, Switzerland)},
year = {2025},
doi = {10.3390/diagnostics15222828},
note = {PubMed: 41300853},
url = {https://www.mecfsatlas.com/evidence/rohrhofer-2025-clinical-relevance},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/rohrhofer-2025-clinical-relevance
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