Stein, Elisa, Heindrich, Cornelia, Wittke, Kirsten et al. · The Lancet regional health. Europe · 2025 · DOI
This study tested a blood-filtering treatment called immunoadsorption in 20 patients with post-COVID ME/CFS who had specific autoantibodies (immune proteins attacking their own bodies). After five treatment sessions, 70% of patients improved, with better physical function, reduced fatigue, and less post-exertional malaise lasting at least six months. The treatment removed harmful immune proteins from the blood and was generally well tolerated.
This is the first study demonstrating that removing specific autoimmune antibodies can produce sustained symptom improvement in post-COVID ME/CFS patients, providing evidence for an autoimmune mechanism in the disease. If validated in larger trials, immunoadsorption could become a targeted treatment option for the subset of ME/CFS patients with elevated β2-adrenergic receptor autoantibodies. The findings support the hypothesis that B-cell dysfunction and autoimmunity contribute significantly to post-COVID ME/CFS pathophysiology.
This study does not prove immunoadsorption works for all ME/CFS patients, only those with elevated β2 AR-AB, and the lack of a control group means improvements cannot definitively be attributed to the treatment rather than natural recovery or placebo effect. The small sample size (n=20) limits generalizability, and longer-term durability beyond six months remains unknown. Causation between β2 AR-AB and symptoms is inferred but not definitively established.
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
Stein, Elisa, Heindrich, Cornelia, Wittke, Kirsten, Kedor, Claudia, Rust, Rebekka, Freitag, Helma, et al. (2025). Efficacy of repeated immunoadsorption in patients with post-COVID myalgic encephalomyelitis/chronic fatigue syndrome and elevated β2-adrenergic receptor autoantibodies: a prospective cohort study.. The Lancet regional health. Europe. https://doi.org/10.1016/j.lanepe.2024.101161
BibTeX
@article{mecfsatlas-stein-2025-efficacy-repeated,
author = {Stein, Elisa and Heindrich, Cornelia and Wittke, Kirsten and Kedor, Claudia and Rust, Rebekka and Freitag, Helma and Sotzny, Franziska and Krüger, Anne and Tölle, Markus and Grabowski, Patricia and Scheibenbogen, Carmen and Kim, Laura},
title = {Efficacy of repeated immunoadsorption in patients with post-COVID myalgic encephalomyelitis/chronic fatigue syndrome and elevated β2-adrenergic receptor autoantibodies: a prospective cohort study.},
journal = {The Lancet regional health. Europe},
year = {2025},
doi = {10.1016/j.lanepe.2024.101161},
note = {PubMed: 39759581},
url = {https://www.mecfsatlas.com/evidence/stein-2025-efficacy-repeated},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/stein-2025-efficacy-repeated
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