Yamamura, Takashi, Ono, Hirohiko, Sato, Wakiro · Brain and nerve = Shinkei kenkyu no shinpo · 2018 · DOI
This study found that people with ME/CFS have unusual patterns of immune system chemicals (cytokines) in their blood and spinal fluid, and some patients have antibodies that attack their own bodies. When researchers treated some ME/CFS patients with a medication that removes certain immune cells called B cells, patients improved. This suggests that ME/CFS may be caused by the immune system mistakenly attacking the body.
This work supports the emerging understanding that ME/CFS has a biological, immune-mediated basis rather than a purely psychological etiology—an important validation for patients. The demonstration that a targeted immunological treatment (rituximab) shows efficacy provides a proof-of-concept for disease-modifying therapies and opens new avenues for clinical trials.
This study does not establish that autoimmunity is the primary cause of ME/CFS in all patients, as autoimmune markers are found only in subgroups. It does not prove that cytokine elevation is pathogenic rather than a consequence of disease, nor does it clarify whether B cell depletion works through reducing autoantibodies specifically or through other immune mechanisms.
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
Yamamura, Takashi, Ono, Hirohiko, & Sato, Wakiro (2018). [Immunopathogenesis of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)].. Brain and nerve = Shinkei kenkyu no shinpo. https://doi.org/10.11477/mf.1416200947
BibTeX
@article{mecfsatlas-yamamura-2018-immunopathogenesis-myalgic,
author = {Yamamura, Takashi and Ono, Hirohiko and Sato, Wakiro},
title = {[Immunopathogenesis of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)].},
journal = {Brain and nerve = Shinkei kenkyu no shinpo},
year = {2018},
doi = {10.11477/mf.1416200947},
note = {PubMed: 29348373},
url = {https://www.mecfsatlas.com/evidence/yamamura-2018-immunopathogenesis-myalgic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/yamamura-2018-immunopathogenesis-myalgic
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