Van Booven, Derek J, Gamer, Jackson, Joseph, Andrew et al. · International journal of molecular sciences · 2023 · DOI
This study looked at how the bodies of women with ME/CFS respond to exercise compared to healthy women. Researchers collected blood samples at three points: before exercise, during maximum effort, and during recovery. While healthy women's immune cells showed normal changes during exercise, women with ME/CFS showed unusual immune system activity specifically during the recovery period—the time when post-exertional malaise (worsening of symptoms) typically occurs.
Understanding what happens at the molecular level during post-exertional malaise is crucial because it's one of ME/CFS's defining features, yet its biological basis remains poorly understood. This study provides concrete genetic and immune system evidence that could help explain why patients get worse after activity and potentially guide the development of targeted treatments. Identifying these specific dysregulated pathways gives researchers actionable targets for future therapeutic interventions.
This study does not prove that the identified immune dysregulation is the sole cause of post-exertional malaise—only that it is associated with it during recovery. The small sample size and inclusion of only female patients means findings cannot be assumed to apply to male patients or larger populations. Correlation between gene expression changes and symptom worsening does not establish a direct causal 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
Van Booven, Derek J, Gamer, Jackson, Joseph, Andrew, Perez, Melanie, Zarnowski, Oskar, Pandya, Meha, et al. (2023). Stress-Induced Transcriptomic Changes in Females with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Reveal Disrupted Immune Signatures.. International journal of molecular sciences. https://doi.org/10.3390/ijms24032698
BibTeX
@article{mecfsatlas-van-booven-2023-stress-induced,
author = {Van Booven, Derek J and Gamer, Jackson and Joseph, Andrew and Perez, Melanie and Zarnowski, Oskar and Pandya, Meha and Collado, Fanny and Klimas, Nancy and Oltra, Elisa and Nathanson, Lubov},
title = {Stress-Induced Transcriptomic Changes in Females with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Reveal Disrupted Immune Signatures.},
journal = {International journal of molecular sciences},
year = {2023},
doi = {10.3390/ijms24032698},
note = {PubMed: 36769022},
url = {https://www.mecfsatlas.com/evidence/van-booven-2023-stress-induced},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/van-booven-2023-stress-induced
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