Theoharides, T C, Kavalioti, M · Journal of biological regulators and homeostatic agents · 2018
This study explores how stress and inflammation work together to cause several conditions including ME/CFS, fibromyalgia, and others. The researchers found that immune cells called mast cells and brain cells called microglia may communicate in ways that trigger inflammation during stress. They suggest that a natural supplement combining luteolin and Ashwagandha might help reduce this inflammation and benefit patients with these conditions.
Understanding the biological mechanisms linking stress and inflammation in ME/CFS is crucial for developing targeted treatments. This work provides a testable framework for how mast cell-microglia interactions might drive symptoms, and proposes a natural compound approach that may be more tolerable than conventional pharmaceuticals for patients who often have multiple comorbidities.
This study does not prove that luteolin and Ashwagandha are effective treatments for ME/CFS in humans—it is a mechanistic proposal, not a clinical trial. It does not establish causation between the proposed IL-33/substance P pathway and ME/CFS symptoms, nor does it demonstrate superiority over existing treatments. The theoretical model requires empirical validation through controlled clinical studies.
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
Theoharides, T C & Kavalioti, M (2018). Stress, inflammation and natural treatments.. Journal of biological regulators and homeostatic agents. https://pubmed.ncbi.nlm.nih.gov/30574737/
BibTeX
@article{mecfsatlas-theoharides-2018-stress-inflammation,
author = {Theoharides, T C and Kavalioti, M},
title = {Stress, inflammation and natural treatments.},
journal = {Journal of biological regulators and homeostatic agents},
year = {2018},
note = {PubMed: 30574737},
url = {https://www.mecfsatlas.com/evidence/theoharides-2018-stress-inflammation},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/theoharides-2018-stress-inflammation
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