Szklarski, Marvin, Freitag, Helma, Lorenz, Sebastian et al. · Frontiers in immunology · 2021 · DOI
This study looked at a protein called sCD26 in people with ME/CFS to understand how it relates to immune system problems and heart function issues. Researchers found that people with ME/CFS triggered by an infection had different patterns of immune problems linked to low sCD26 levels compared to people whose ME/CFS started without an infection. The findings suggest that infection-related and non-infection-related ME/CFS may involve different biological mechanisms.
This research provides evidence that infection-triggered and non-infection-triggered ME/CFS may have distinct biological pathways, which could eventually lead to personalized diagnostic or therapeutic approaches. Understanding these different mechanisms is crucial for developing targeted treatments and explaining why patients experience similar symptoms through different underlying processes.
This study does not prove that sCD26 is a reliable diagnostic marker for ME/CFS, as lower levels were only consistently found in females. The correlations identified do not establish causation—low sCD26 may be a consequence rather than a cause of ME/CFS pathology. The findings also cannot be generalized beyond the study population without replication in independent cohorts.
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
Szklarski, Marvin, Freitag, Helma, Lorenz, Sebastian, Becker, Sonya C, Sotzny, Franziska, Bauer, Sandra, et al. (2021). Delineating the Association Between Soluble CD26 and Autoantibodies Against G-Protein Coupled Receptors, Immunological and Cardiovascular Parameters Identifies Distinct Patterns in Post-Infectious vs. Non-Infection-Triggered Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.. Frontiers in immunology. https://doi.org/10.3389/fimmu.2021.644548
BibTeX
@article{mecfsatlas-szklarski-2021-delineating-association,
author = {Szklarski, Marvin and Freitag, Helma and Lorenz, Sebastian and Becker, Sonya C and Sotzny, Franziska and Bauer, Sandra and Hartwig, Jelka and Heidecke, Harald and Wittke, Kirsten and Kedor, Claudia and Hanitsch, Leif G and Grabowski, Patricia and Sepúlveda, Nuno and Scheibenbogen, Carmen},
title = {Delineating the Association Between Soluble CD26 and Autoantibodies Against G-Protein Coupled Receptors, Immunological and Cardiovascular Parameters Identifies Distinct Patterns in Post-Infectious vs. Non-Infection-Triggered Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.},
journal = {Frontiers in immunology},
year = {2021},
doi = {10.3389/fimmu.2021.644548},
note = {PubMed: 33889154},
url = {https://www.mecfsatlas.com/evidence/szklarski-2021-delineating-association},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/szklarski-2021-delineating-association
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