Vojdani, A, Ghoneum, M, Choppa, P C et al. · Journal of internal medicine · 1997 · DOI
This study found that immune cells in ME/CFS patients are dying at higher rates than in healthy people. The researchers discovered that a molecule called PKR, which is produced in response to infections, is abnormally elevated in ME/CFS patients and may be triggering this excess cell death. When they blocked PKR in the lab, they were able to reduce cell death in about half of the ME/CFS samples, suggesting PKR might be a key player in ME/CFS disease.
This study identifies a potential molecular mechanism underlying ME/CFS—excessive immune cell death mediated by PKR—which could explain the persistent immune dysfunction and fatigue symptoms. If validated in larger studies, PKR inhibition could represent a novel therapeutic target for treating ME/CFS.
This study does not prove that PKR elevation causes ME/CFS, only that it is associated with the disease and may contribute to cell death. The cross-sectional design cannot establish temporal relationships or causality. Additionally, the in vitro PKR inhibition does not demonstrate that blocking PKR would improve clinical symptoms in ME/CFS patients, and the 50% response rate suggests PKR is not the sole mechanism of apoptosis in all patients.
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
Vojdani, A, Ghoneum, M, Choppa, P C, Magtoto, L, & Lapp, C W (1997). Elevated apoptotic cell population in patients with chronic fatigue syndrome: the pivotal role of protein kinase RNA.. Journal of internal medicine. https://doi.org/10.1111/j.1365-2796.1997.tb00019.x
BibTeX
@article{mecfsatlas-vojdani-1997-elevated-apoptotic,
author = {Vojdani, A and Ghoneum, M and Choppa, P C and Magtoto, L and Lapp, C W},
title = {Elevated apoptotic cell population in patients with chronic fatigue syndrome: the pivotal role of protein kinase RNA.},
journal = {Journal of internal medicine},
year = {1997},
doi = {10.1111/j.1365-2796.1997.tb00019.x},
note = {PubMed: 9437407},
url = {https://www.mecfsatlas.com/evidence/vojdani-1997-elevated-apoptotic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/vojdani-1997-elevated-apoptotic
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