Tate, Warren P, Walker, Max O M, Peppercorn, Katie et al. · International journal of molecular sciences · 2023 · DOI
ME/CFS is a complex illness that typically starts after a viral infection, though other stressful events can also trigger it. This review explains that different patients experience different combinations of symptoms and respond differently to treatments—what helps one person may not help another. The authors discuss how the immune system may shift from a temporary response to a lasting problem, and how the brain's immune system may cause the neurological symptoms people experience.
This review is significant because it addresses a fundamental challenge in ME/CFS patient care: the lack of reliable biomarkers and the individual variation in treatment response. By framing ME/CFS as a heterogeneous condition with potentially distinct biological subtypes, it provides a rationale for developing personalized treatment strategies. The connection to Long COVID research opens new funding and research opportunities that may accelerate discovery of therapeutics beneficial to both conditions.
This review does not provide new experimental data or prove specific cause-and-effect relationships in ME/CFS pathogenesis. It cannot establish which susceptibility factors are necessary versus sufficient for disease development, nor does it demonstrate which treatment approaches are definitively effective for particular patient subgroups. The absence of an accessible molecular diagnostic test remains an unresolved limitation that the review acknowledges but does not overcome.
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
Tate, Warren P, Walker, Max O M, Peppercorn, Katie, Blair, Anna L H, & Edgar, Christina D (2023). Towards a Better Understanding of the Complexities of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Long COVID.. International journal of molecular sciences. https://doi.org/10.3390/ijms24065124
BibTeX
@article{mecfsatlas-tate-2023-towards-better,
author = {Tate, Warren P and Walker, Max O M and Peppercorn, Katie and Blair, Anna L H and Edgar, Christina D},
title = {Towards a Better Understanding of the Complexities of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Long COVID.},
journal = {International journal of molecular sciences},
year = {2023},
doi = {10.3390/ijms24065124},
note = {PubMed: 36982194},
url = {https://www.mecfsatlas.com/evidence/tate-2023-towards-better},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/tate-2023-towards-better
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