Tomljenovic, Dejan, Baudoin, Tomislav, Megla, Zeljka Bukovec et al. · Medical hypotheses · 2018 · DOI
This study looked at how men and women with seasonal allergies respond differently to nasal irritants. Researchers found that women had stronger burning sensations and higher levels of a nerve-signaling chemical called substance P compared to men when exposed to salt water or allergen challenges. This suggests that women's bodies may process nasal irritation through a different biological pathway involving both immune cells and nerve signals.
ME/CFS shares several features with the conditions discussed in this study—including female predominance, neurogenic inflammation, and abnormal mast cell activation. Understanding gender-specific differences in neurogenic inflammatory pathways and substance P regulation may help explain why ME/CFS predominantly affects women and could inform development of gender-tailored therapeutic approaches targeting nerve-immune interactions.
This study does not establish causation between estrogen and the observed neurogenic differences; it is a mechanistic hypothesis study in a specific respiratory condition (allergic rhinitis) that may not directly translate to ME/CFS. The findings are correlational and the study does not directly test ME/CFS patients, so applicability to ME/CFS pathophysiology remains speculative. Small sample sizes and lack of detailed demographic/hormonal data limit generalizability.
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
Tomljenovic, Dejan, Baudoin, Tomislav, Megla, Zeljka Bukovec, Geber, Goran, Scadding, Glenis, & Kalogjera, Livije (2018). Females have stronger neurogenic response than males after non-specific nasal challenge in patients with seasonal allergic rhinitis.. Medical hypotheses. https://doi.org/10.1016/j.mehy.2018.04.021
BibTeX
@article{mecfsatlas-tomljenovic-2018-females-have,
author = {Tomljenovic, Dejan and Baudoin, Tomislav and Megla, Zeljka Bukovec and Geber, Goran and Scadding, Glenis and Kalogjera, Livije},
title = {Females have stronger neurogenic response than males after non-specific nasal challenge in patients with seasonal allergic rhinitis.},
journal = {Medical hypotheses},
year = {2018},
doi = {10.1016/j.mehy.2018.04.021},
note = {PubMed: 29857893},
url = {https://www.mecfsatlas.com/evidence/tomljenovic-2018-females-have},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/tomljenovic-2018-females-have
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