Skowera, A, Stewart, E, Davis, E T et al. · Clinical and experimental immunology · 2002 · DOI
This study looked for a specific type of immune protein called antinuclear autoantibodies (ANAs) in people with ME/CFS and Gulf War veterans with multiple symptoms. Researchers compared blood samples from ME/CFS patients, symptomatic Gulf War veterans, and healthy controls. They found no significant differences in ANA levels between any of the groups, and none of the patients had the specific nuclear envelope ANA type that had been suggested as a possible ME/CFS marker.
This study addresses an important hypothesis that autoimmune mechanisms might underlie ME/CFS by directly testing whether a specific autoimmune marker could help explain the condition. The findings help clarify that ANA autoimmunity is unlikely to be a primary disease mechanism in ME/CFS, redirecting research focus toward other pathophysiological pathways. Understanding what is not driving ME/CFS is valuable for narrowing down diagnostic approaches and therapeutic targets.
This study does not prove that autoimmunity plays no role in ME/CFS overall—only that ANAs specifically are not a characteristic feature. The negative ANA findings do not exclude other types of autoimmune or immune dysfunction in ME/CFS. The cross-sectional design cannot determine whether ANA absence is a cause or consequence of health status, nor does it address other potential immune biomarkers.
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
Skowera, A, Stewart, E, Davis, E T, Cleare, A J, Unwin, C, Hull, L, et al. (2002). Antinuclear autoantibodies (ANA) in Gulf War-related illness and chronic fatigue syndrome (CFS) patients.. Clinical and experimental immunology. https://doi.org/10.1046/j.1365-2249.2002.01912.x
BibTeX
@article{mecfsatlas-skowera-2002-antinuclear-autoantibodies,
author = {Skowera, A and Stewart, E and Davis, E T and Cleare, A J and Unwin, C and Hull, L and Ismail, K and Hossain, G and Wessely, S C and Peakman, M},
title = {Antinuclear autoantibodies (ANA) in Gulf War-related illness and chronic fatigue syndrome (CFS) patients.},
journal = {Clinical and experimental immunology},
year = {2002},
doi = {10.1046/j.1365-2249.2002.01912.x},
note = {PubMed: 12165094},
url = {https://www.mecfsatlas.com/evidence/skowera-2002-antinuclear-autoantibodies},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/skowera-2002-antinuclear-autoantibodies
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