Smith, Alicia K, Maloney, Elizabeth M, Falkenberg, Virginia R et al. · Psychoneuroendocrinology · 2009 · DOI
This study looked at whether a specific genetic variation in a gene called ACE affects how people's bodies respond to stress and illness. Researchers measured multiple stress-related markers (inflammation, immune system activity, and cortisol levels) in people with and without ME/CFS. They found that people carrying a particular version of the ACE gene tended to have higher stress responses and more inflammation, suggesting genes may play a role in how severely someone's body reacts to stress.
Understanding genetic factors that influence stress-response physiology and inflammation could help explain why ME/CFS patients show abnormal immune and neuroendocrine function, and may eventually enable personalized risk stratification or treatment approaches. This research bridges immunology, genetics, and stress biology—three central domains in ME/CFS pathophysiology.
This study does not prove that the ACE gene variant *causes* ME/CFS or high allostatic load; it only shows association in a cross-sectional sample. It does not establish mechanism (how the variant alters ACE function or E2F1 binding) and cannot determine whether the genetic effect is primary or mediated by other factors. Findings are also limited to Caucasian populations and may not generalize to other ethnic backgrounds.
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
Smith, Alicia K, Maloney, Elizabeth M, Falkenberg, Virginia R, Dimulescu, Irina, & Rajeevan, Mangalathu S (2009). An angiotensin-1 converting enzyme polymorphism is associated with allostatic load mediated by C-reactive protein, interleukin-6 and cortisol.. Psychoneuroendocrinology. https://doi.org/10.1016/j.psyneuen.2008.10.022
BibTeX
@article{mecfsatlas-smith-2009-angiotensin-converting,
author = {Smith, Alicia K and Maloney, Elizabeth M and Falkenberg, Virginia R and Dimulescu, Irina and Rajeevan, Mangalathu S},
title = {An angiotensin-1 converting enzyme polymorphism is associated with allostatic load mediated by C-reactive protein, interleukin-6 and cortisol.},
journal = {Psychoneuroendocrinology},
year = {2009},
doi = {10.1016/j.psyneuen.2008.10.022},
note = {PubMed: 19081678},
url = {https://www.mecfsatlas.com/evidence/smith-2009-angiotensin-converting},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/smith-2009-angiotensin-converting
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