Tirelli, U, Marotta, G, Improta, S et al. · Scandinavian journal of immunology · 1994 · DOI
Researchers studied 265 ME/CFS patients and found unusual patterns in their immune cells compared to healthy people. They discovered that certain types of white blood cells called natural killer (NK) cells and B cells were abnormally increased, and these cells showed signs of being overly activated. These immune abnormalities appeared consistent with what other researchers had found in different countries.
This study provides objective immunological evidence that ME/CFS involves dysregulation of multiple immune cell populations, supporting the biological basis of the disease rather than a purely psychological explanation. These findings could help guide future diagnostic tests and suggest potential therapeutic targets aimed at normalizing immune function.
This study does not establish whether the observed immune abnormalities are a cause of ME/CFS symptoms or a consequence of the illness; causality cannot be determined from cross-sectional case-control data. It also does not prove these immune markers alone can diagnose ME/CFS or predict treatment response. The findings describe association, not mechanism.
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
Tirelli, U, Marotta, G, Improta, S, & Pinto, A (1994). Immunological abnormalities in patients with chronic fatigue syndrome.. Scandinavian journal of immunology. https://doi.org/10.1111/j.1365-3083.1994.tb03511.x
BibTeX
@article{mecfsatlas-tirelli-1994-immunological-abnormalities,
author = {Tirelli, U and Marotta, G and Improta, S and Pinto, A},
title = {Immunological abnormalities in patients with chronic fatigue syndrome.},
journal = {Scandinavian journal of immunology},
year = {1994},
doi = {10.1111/j.1365-3083.1994.tb03511.x},
note = {PubMed: 7997849},
url = {https://www.mecfsatlas.com/evidence/tirelli-1994-immunological-abnormalities},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/tirelli-1994-immunological-abnormalities
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