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 →
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