Uhde, Melanie, Indart, Alyssa C, Green, Peter H R et al. · Brain, behavior, & immunity - health · 2023 · DOI
This study found that people with ME/CFS have a weakened immune response to bacteria that leak through a damaged gut lining, along with unusual changes in how their bodies process glucose and other nutrients. The immune system appears to be suppressed in some ways while overactive in others, and these patterns were linked to metabolic changes. These findings suggest that gut health and metabolic dysfunction may play important roles in ME/CFS symptoms.
This research identifies potential biomarkers and mechanistic pathways that could improve ME/CFS diagnosis and lead to targeted treatments addressing gut health and metabolic dysfunction. Understanding how immune suppression, metabolic changes, and intestinal damage are interconnected may explain why exertion worsens symptoms and could guide development of therapies that restore normal immune and metabolic function.
This study cannot establish causation—it remains unclear whether metabolic changes cause immune suppression, result from it, or are both consequences of a separate underlying process. The findings do not prove that gut damage is the primary cause of ME/CFS, nor do they demonstrate that correcting these abnormalities will relieve symptoms. The study does not establish these biomarkers as diagnostic on their own.
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
Uhde, Melanie, Indart, Alyssa C, Green, Peter H R, Yolken, Robert H, Cook, Dane B, Shukla, Sanjay K, et al. (2023). Suppressed immune and metabolic responses to intestinal damage-associated microbial translocation in myalgic encephalomyelitis/chronic fatigue syndrome.. Brain, behavior, & immunity - health. https://doi.org/10.1016/j.bbih.2023.100627
BibTeX
@article{mecfsatlas-uhde-2023-suppressed-immune,
author = {Uhde, Melanie and Indart, Alyssa C and Green, Peter H R and Yolken, Robert H and Cook, Dane B and Shukla, Sanjay K and Vernon, Suzanne D and Alaedini, Armin},
title = {Suppressed immune and metabolic responses to intestinal damage-associated microbial translocation in myalgic encephalomyelitis/chronic fatigue syndrome.},
journal = {Brain, behavior, & immunity - health},
year = {2023},
doi = {10.1016/j.bbih.2023.100627},
note = {PubMed: 37396339},
url = {https://www.mecfsatlas.com/evidence/uhde-2023-suppressed-immune},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/uhde-2023-suppressed-immune
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