Stewart, Carleton C, Cookfair, Diane L, Hovey, Kathleen M et al. · Cytometry. Part B, Clinical cytometry · 2003 · DOI
This study compared immune system cells called natural killer (NK) cells and cytotoxic T cells between people with ME/CFS and healthy controls. Researchers found that people with ME/CFS had different patterns of these immune cells compared to healthy people, but interestingly, healthy people living in the same town as ME/CFS cases had immune cell patterns that looked more similar to ME/CFS patients. This suggests that living in an area where ME/CFS is common might affect how people's immune systems work.
This study highlights that immune cell abnormalities are measurable in ME/CFS and suggests that environmental or geographic factors may influence both disease susceptibility and immune status in unaffected individuals. Understanding these differences is crucial for developing reliable biomarkers and identifying preventive mechanisms in communities where ME/CFS clusters occur.
This study does not prove that NK cell differences cause ME/CFS—it only shows an association. It also does not establish what environmental or infectious factors in the cluster area might affect immune cell counts, nor does it demonstrate whether these immune changes precede disease development or result from it. The cross-sectional design prevents determination of causality.
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
Stewart, Carleton C, Cookfair, Diane L, Hovey, Kathleen M, Wende, Karl E, Bell, David S, & Warner, Carolyn L (2003). Predictive immunophenotypes: disease-related profile in chronic fatigue syndrome.. Cytometry. Part B, Clinical cytometry. https://doi.org/10.1002/cyto.b.10034
BibTeX
@article{mecfsatlas-stewart-2003-predictive-immunophenotypes,
author = {Stewart, Carleton C and Cookfair, Diane L and Hovey, Kathleen M and Wende, Karl E and Bell, David S and Warner, Carolyn L},
title = {Predictive immunophenotypes: disease-related profile in chronic fatigue syndrome.},
journal = {Cytometry. Part B, Clinical cytometry},
year = {2003},
doi = {10.1002/cyto.b.10034},
note = {PubMed: 12717688},
url = {https://www.mecfsatlas.com/evidence/stewart-2003-predictive-immunophenotypes},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/stewart-2003-predictive-immunophenotypes
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