Visser, J, Blauw, B, Hinloopen, B et al. · The Journal of infectious diseases · 1998 · DOI
This study looked at immune cells called CD4 T cells from ME/CFS patients and found they produced less of a protective immune protein called interferon-gamma compared to healthy people. Interestingly, these cells were also much more sensitive to dexamethasone, a steroid medication—it took 10-20 times less of the drug to suppress certain immune functions in ME/CFS patients than in controls. This suggests that the stress hormone system and immune system may be working abnormally together in ME/CFS.
This research provides evidence that ME/CFS involves both a dysregulated stress hormone system and abnormal immune responses at the cellular level. Understanding why ME/CFS immune cells are hypersensitive to glucocorticoids could help explain the characteristic post-exertional malaise and guide development of targeted immune therapies. These findings support the biological basis of ME/CFS rather than viewing it as purely psychological.
This study does not prove that altered glucocorticoid sensitivity causes ME/CFS symptoms or that it is the primary driver of disease. It cannot establish causation or explain why this abnormality develops. The findings are from cultured cells in a laboratory and may not fully reflect the complexity of immune dysfunction in living patients with ME/CFS.
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
Visser, J, Blauw, B, Hinloopen, B, Brommer, E, de Kloet, E R, Kluft, C, et al. (1998). CD4 T lymphocytes from patients with chronic fatigue syndrome have decreased interferon-gamma production and increased sensitivity to dexamethasone.. The Journal of infectious diseases. https://doi.org/10.1086/517373
BibTeX
@article{mecfsatlas-visser-1998-cd4-lymphocytes,
author = {Visser, J and Blauw, B and Hinloopen, B and Brommer, E and de Kloet, E R and Kluft, C and Nagelkerken, L},
title = {CD4 T lymphocytes from patients with chronic fatigue syndrome have decreased interferon-gamma production and increased sensitivity to dexamethasone.},
journal = {The Journal of infectious diseases},
year = {1998},
doi = {10.1086/517373},
note = {PubMed: 9466535},
url = {https://www.mecfsatlas.com/evidence/visser-1998-cd4-lymphocytes},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/visser-1998-cd4-lymphocytes
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