Evidence browser

Leveraging Prior Knowledge of Endocrine Immune Regulation in the Therapeutically Relevant Phenotyping of Women With Chronic Fatigue Syndrome.

Morris, Matthew C, Cooney, Katherine E, Sedghamiz, Hooman et al.·Clinical therapeutics·2019

This study used computer modeling to understand how hormones and immune system chemicals become unbalanced in ME/CFS. Researchers measured 17 immune markers in women with ME/CFS before, during, and after exercise, then created detailed mathematical models to predict what other hormones and chemicals might also be out of balance. The models suggested that two existing drugs (rintatolimod and rituximab) might help different subgroups of patients, depending on their specific hormone and immune profiles.

E3 PreliminaryCohortPEM not requiredCross-Sectional

"It's not one size fits all"; the use of videoconferencing for delivering therapy in a Specialist Paediatric Chronic Fatigue Service.

Haig-Ferguson, Andrew, Loades, Maria, Whittle, Charlotte et al.·Internet interventions·2019

This study looked at whether young people with ME/CFS could receive therapy through video calls (like Skype) instead of traveling to hospital appointments. Researchers interviewed 12 young patients, 6 parents, and 9 healthcare workers about their experiences. Most people found video appointments helpful for reducing travel, though some worried about privacy and felt that something was lost compared to face-to-face meetings.

Epstein-Barr virus (EBV) reactivation and therapeutic inhibitors.

Kerr, Jonathan R·Journal of clinical pathology·2019

This review examines how Epstein-Barr virus (EBV), a common virus that most people catch at some point in their lives, can become active again in the body—especially during stress—and may contribute to ME/CFS and other illnesses. The authors discuss ways to test for active EBV and review existing medications and supplements that might help prevent the virus from reactivating.

E3 PreliminaryMechanismPEM requiredMechanistic

Exercise challenge alters Default Mode Network dynamics in Gulf War Illness.

Rayhan, Rakib U, Washington, Stuart D, Garner, Richard et al.·BMC neuroscience·2019

This study looked at brain activity in Gulf War Illness patients before and after exercise to understand post-exertional malaise (PEM)—a condition where symptoms get worse after physical or mental effort. Using brain scans, researchers found that after exercise, patients showed unusual patterns of brain deactivation (regions that should 'turn off' during focused tasks) compared to healthy people. This suggests PEM may involve how the brain manages activity, providing a potential biological marker for the illness.

Post-Exertional Malaise

Energy MetabolismPost-Exertional Malaise

Understanding neuromuscular disorders in chronic fatigue syndrome.

Jammes, Yves, Retornaz, Frédérique·F1000Research·2019

This study examined how muscles work differently in people with ME/CFS. Researchers found that both the brain's ability to signal muscles and the muscles' ability to respond are impaired in ME/CFS patients. The muscles also appear to have trouble managing harmful molecules called free radicals, especially after exercise, and they may not be producing enough protective proteins that normally shield cells from damage.

Changes in circulating microRNA after recumbent isometric yoga practice by patients with myalgic encephalomyelitis/chronic fatigue syndrome: an explorative pilot study.

Takakura, Shu, Oka, Takakazu, Sudo, Nobuyuki·BioPsychoSocial medicine·2019

This small study tested whether a gentle form of yoga (practiced lying down with adjustable resistance) could help ME/CFS patients feel less tired. Nine patients with ME/CFS who hadn't improved with standard treatment practiced this yoga for 3 months. Their fatigue scores improved significantly, and their blood showed changes in tiny molecules called microRNAs that may be related to how the yoga helped reduce their tiredness.

Biomarkers

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Comprehensive Review.

Cortes Rivera, Mateo, Mastronardi, Claudio, Silva-Aldana, Claudia T et al.·Diagnostics (Basel, Switzerland)·2019

ME/CFS is a serious, long-lasting illness that affects the brain and causes extreme fatigue and other symptoms, but doctors don't yet know what causes it. The condition is three times more common in women than men, usually starts between ages 20 and 45, and currently has no specific cure. This review summarizes what scientists know about ME/CFS by looking at how it affects the nervous system, immune system, and hormones.

Diagnostics

Transient receptor potential melastatin 2 channels are overexpressed in myalgic encephalomyelitis/chronic fatigue syndrome patients.

Balinas, Cassandra, Cabanas, Helene, Staines, Donald et al.·Journal of translational medicine·2019

This study looked at immune cells called NK cells in people with ME/CFS, focusing on special channels on their surface called TRPM2 that control calcium flow. Researchers found that ME/CFS patients had higher levels of these TRPM2 channels compared to healthy people, and their NK cells were less effective at fighting infections. When researchers tried two different drugs to modify these channels, the drugs reduced TRPM2 levels but did not improve the cells' ability to fight infections.

E3 PreliminaryMechanismPEM not requiredMechanistic

Persistent fatigue induced by interferon-alpha: a novel, inflammation-based, proxy model of chronic fatigue syndrome.

Russell, Alice, Hepgul, Nilay, Nikkheslat, Naghmeh et al.·Psychoneuroendocrinology·2019

This study suggests that some people treated with interferon-alpha (a drug used for hepatitis C) develop persistent fatigue that continues even after treatment ends—similar to ME/CFS. Researchers found that people who later developed long-lasting fatigue had a stronger immune response early in treatment, with higher levels of certain immune molecules. Importantly, the fatigue persisted even after the immune trigger was gone, suggesting that something in the body's initial overreaction may set off a lasting problem.

NeuroinflammationImmune System

Neuroimmunology: What Role for Autoimmunity, Neuroinflammation, and Small Fiber Neuropathy in Fibromyalgia, Chronic Fatigue Syndrome, and Adverse Events after Human Papillomavirus Vaccination?

Ryabkova, Varvara A, Churilov, Leonid P, Shoenfeld, Yehuda·International journal of molecular sciences·2019

This review explores three interconnected biological processes that may cause fibromyalgia and chronic fatigue syndrome (ME/CFS): the immune system attacking the body's own tissues, inflammation in the nervous system, and damage to small nerve fibers. The authors propose that these three mechanisms work together and may explain why patients experience widespread pain, extreme fatigue, and other symptoms like brain fog and sleep problems. They also examine whether similar mechanisms might explain some adverse reactions to HPV vaccination.

NeuroinflammationImmune System

Epstein-Barr Virus dUTPase Induces Neuroinflammatory Mediators: Implications for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Williams PhD, Marshall V, Cox, Brandon, Lafuse PhD, William P et al.·Clinical therapeutics·2019

This study explores whether a protein from the Epstein-Barr virus (EBV) may trigger brain inflammation in ME/CFS patients. Researchers found that this viral protein can change how brain cells function and alter important chemical pathways involved in energy, mood, and pain processing. The findings suggest that in some ME/CFS patients, this viral protein might contribute to fatigue, pain, and thinking difficulties.

E3 PreliminaryDiagnosticPEM not requiredMethods-Paper

Obstacles to recruitment in paediatric studies focusing on mental health in a physical health context: the experiences of clinical gatekeepers in an observational cohort study.

Loades, Maria E, Smith, Lucie, Higson-Sweeney, Nina et al.·BMC medical research methodology·2019

This study looked at why it's hard to recruit young people with ME/CFS into research studies about mental health. Researchers interviewed doctors and nurses at a specialist ME/CFS clinic to understand what makes it difficult for them to invite patients to join studies. They found that busy schedules, emotional patient appointments, and competing studies all made recruitment harder.

E3 PreliminaryDiagnosticPEM requiredMethods-Paper

Assessment of Post-Exertional Malaise (PEM) in Patients with Myalgic Encephalomyelitis (ME) and Chronic Fatigue Syndrome (CFS): A Patient-Driven Survey.

Holtzman, Carly S, Bhatia, Shaun, Cotler, Joseph et al.·Diagnostics (Basel, Switzerland)·2019

This study worked directly with ME/CFS patients to create a better way to measure post-exertional malaise (PEM)—the symptom where activity makes you feel significantly worse. Over 1,500 patients completed a survey to help researchers understand what aspects of PEM are most important to measure, including what triggers it, how quickly symptoms start, and how long they last. The study shows that involving patients in designing assessment tools leads to more thorough and meaningful measurements.

Post-Exertional Malaise

Advances in Understanding the Pathophysiology of Chronic Fatigue Syndrome.

Komaroff, Anthony L·JAMA·2019

This review article examines what scientists currently understand about how ME/CFS develops and affects the body at a cellular level. Researcher Anthony Komaroff synthesizes evidence suggesting that ME/CFS involves problems with energy production in cells, immune system dysfunction, and nervous system abnormalities. The article helps explain why ME/CFS causes such severe fatigue and why patients often feel worse after physical activity.