Evidence browser

Epigenetic modifications and glucocorticoid sensitivity in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS).

de Vega, Wilfred C, Herrera, Santiago, Vernon, Suzanne D et al.·BMC medical genomics·2017

This study looked at chemical tags attached to DNA in immune cells from ME/CFS patients and compared them to healthy people. Researchers found that ME/CFS patients had different patterns of these chemical tags, especially in genes related to how cells produce energy. Some of these differences were linked to patients' reported quality of life, suggesting that changes in how genes are regulated may contribute to ME/CFS symptoms.

E2 ModerateCohortPEM requiredCross-Sectional

Activin B is a novel biomarker for chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) diagnosis: a cross sectional study.

Lidbury, Brett A, Kita, Badia, Lewis, Donald P et al.·Journal of translational medicine·2017

Researchers tested blood samples from people with ME/CFS and compared them to healthy controls, looking for differences in proteins called activins. They found that people with ME/CFS had significantly higher levels of a protein called activin B, while activin A remained normal. This pattern could potentially be used as a blood test to help diagnose ME/CFS, since currently there is no reliable diagnostic test available.

Giardia-specific cellular immune responses in post-giardiasis chronic fatigue syndrome.

Hanevik, Kurt, Kristoffersen, Einar, Mørch, Kristine et al.·BMC immunology·2017

Researchers studied whether people who developed ME/CFS after a Giardia infection (a parasite that causes stomach illness) had different immune responses compared to those who recovered. They found that fatigued patients had higher levels of a specific immune protein called sCD40L, which correlated with how tired they felt. However, most immune markers tested were similar between those who developed ME/CFS and those who recovered, suggesting the answer may be more complex than initially expected.

Immune network analysis of cerebrospinal fluid in myalgic encephalomyelitis/chronic fatigue syndrome with atypical and classical presentations.

Hornig, M, Gottschalk, C G, Eddy, M L et al.·Translational psychiatry·2017

This study examined fluid from around the brain and spinal cord in people with ME/CFS to look for immune system differences. Researchers found that people whose ME/CFS started differently (without a clear infection trigger) had different patterns of immune molecules compared to those with typical ME/CFS that started after a viral-like illness. The atypical group had lower levels of certain inflammatory markers and less coordinated immune activity in their central nervous system.

RNA-Seq Analysis of Gene Expression, Viral Pathogen, and B-Cell/T-Cell Receptor Signatures in Complex Chronic Disease.

Bouquet, Jerome, Gardy, Jennifer L, Brown, Scott et al.·Clinical infectious diseases : an official publication of the Infectious Diseases Society of America·2017

Researchers used genetic testing to compare blood samples from people with ME/CFS and a similar condition called alternative Lyme disease to healthy controls and people with lupus. They looked for differences in gene activity, immune cell patterns, and viral infections. Surprisingly, they found no major differences in gene activity between ME/CFS patients and healthy people, though they did find differences in lupus patients as expected.

Immune SystemPost-Exertional Malaise

Cytokine responses to exercise and activity in patients with chronic fatigue syndrome: case-control study.

Clark, L V, Buckland, M, Murphy, G et al.·Clinical and experimental immunology·2017

This study examined whether people with ME/CFS have abnormal immune protein levels (cytokines) in their blood, especially after physical activity. Researchers compared 24 ME/CFS patients with 21 healthy controls and measured multiple immune markers at rest and after exercise. The study found no significant differences in immune protein levels between the two groups, and no link between post-exertional symptoms and increased cytokine levels.

Unperturbed Cytotoxic Lymphocyte Phenotype and Function in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Patients.

Theorell, Jakob, Bileviciute-Ljungar, Indre, Tesi, Bianca et al.·Frontiers in immunology·2017

Researchers tested whether immune cells called cytotoxic lymphocytes—which normally fight infections and respond to stress—work differently in ME/CFS patients compared to healthy people. They studied 48 ME/CFS patients and found that these immune cells looked and functioned normally, suggesting they are not responsible for ME/CFS symptoms. This means cytotoxic lymphocytes alone cannot be used as a simple blood test to diagnose the condition.

E2 ModerateCohortPEM not requiredCross-Sectional

Transforming growth factor beta (TGF-β) in adolescent chronic fatigue syndrome.

Wyller, Vegard Bruun, Nguyen, Chinh Bkrong, Ludviksen, Judith Anita et al.·Journal of translational medicine·2017

This study tested whether a protein called TGF-β, which helps regulate immune and stress responses, was elevated in adolescents with ME/CFS. Researchers compared blood levels of TGF-β in 120 young ME/CFS patients to 68 healthy controls and found the protein levels were actually the same in both groups. However, they discovered that in ME/CFS patients, TGF-β levels were connected to stress hormones and fatigue severity, suggesting it may play a role in how the illness affects the body even if it's not simply 'too high.'

Immune SystemPost-Exertional Malaise

Myalgic encephalomyelitis/chronic fatigue syndrome and gulf war illness patients exhibit increased humoral responses to the herpesviruses-encoded dUTPase: Implications in disease pathophysiology.

Halpin, Peter, Williams, Marshall Vance, Klimas, Nancy G et al.·Journal of medical virology·2017

This study looked at whether people with ME/CFS and Gulf War Illness have unusual immune responses to certain viruses, particularly Epstein-Barr virus, HHV-6, and varicella-zoster virus. Researchers found that people with these conditions are more likely than healthy people to produce antibodies (immune proteins) against proteins made by these viruses. These antibody patterns might eventually help doctors identify and diagnose these illnesses more accurately.

Impact of Rantes from jawbone on Chronic Fatigue Syndrome.

Lechner, J, Huesker, K, Von Baehr, V·Journal of biological regulators and homeostatic agents·2017

This study investigated whether inflammation in the jawbone might contribute to ME/CFS. Researchers compared jawbone tissue from 21 ME/CFS patients with tissue from 19 healthy people and found that ME/CFS patients had significantly higher levels of inflammatory proteins (RANTES and FGF-2) in areas of jawbone that had undergone incomplete healing. The authors suggest that this hidden jawbone inflammation might be a previously unknown trigger for ME/CFS.

E2 ModerateCohortPEM not requiredObservational

Current Safety Concerns with Human Papillomavirus Vaccine: A Cluster Analysis of Reports in VigiBase®.

Chandler, Rebecca E, Juhlin, Kristina, Fransson, Jonas et al.·Drug safety·2017

Researchers analyzed thousands of reports from a global database of side effects following HPV vaccination. They found that certain combinations of symptoms—headaches, dizziness, fatigue, and fainting—were reported more often after HPV vaccination than with other vaccines, particularly in young women. These symptom clusters resemble conditions like POTS, CRPS, and chronic fatigue syndrome, though most reports did not include an official diagnosis.

Immune SystemPost-Exertional Malaise

E2 ModeratePEM unclearBiobank-Resource

The UK ME/CFS Biobank for biomedical research on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Multiple Sclerosis.

Lacerda, Eliana M, Bowman, Erinna W, Cliff, Jacqueline M et al.·Open journal of bioresources·2017

The UK ME/CFS Biobank is a collection of blood samples and health information from 284 people with ME/CFS, 60 people with multiple sclerosis, and 135 healthy volunteers. Researchers created this resource to help scientists study what causes ME/CFS and find better ways to diagnose and treat it. The samples and detailed patient information can be used by researchers worldwide to search for biological markers of the disease.

BiomarkersImmune System

E2 ModerateCohortPEM unclearCase-Control

Illness progression in chronic fatigue syndrome: a shifting immune baseline.

Russell, Lindsey, Broderick, Gordon, Taylor, Renee et al.·BMC immunology·2016

This study looked at three inflammatory proteins (IL-1α, IL-6, and IL-8) in the blood of people with ME/CFS at different stages of illness—newly diagnosed teenagers, people in the middle of their illness, and those who had been sick for over a decade. The researchers found that the pattern of these proteins changes as the illness progresses, suggesting that the body's immune response shifts over time. By adjusting for how long someone has been ill, doctors might be able to use these three proteins together to identify ME/CFS with 75-88% accuracy.

BiomarkersImmune System

Natural killer cells and single nucleotide polymorphisms of specific ion channels and receptor genes in myalgic encephalomyelitis/chronic fatigue syndrome.

Marshall-Gradisnik, Sonya, Huth, Teilah, Chacko, Anu et al.·The application of clinical genetics·2016

This study looked at immune cells called natural killer cells in ME/CFS patients and compared them to healthy controls. Researchers found that ME/CFS patients had weaker natural killer cell function and carried genetic variations in genes related to calcium regulation and nerve signal transmission. These genetic differences were not found in the healthy control group, suggesting they may play a role in ME/CFS.

Extended B cell phenotype in patients with myalgic encephalomyelitis/chronic fatigue syndrome: a cross-sectional study.

Mensah, F, Bansal, A, Berkovitz, S et al.·Clinical and experimental immunology·2016

Researchers compared immune cells called B cells in people with ME/CFS and healthy people using specialized lab tests. While they didn't find major differences in the most common B cell types, they did discover subtle changes in how B cells are marked and organized in ME/CFS patients, particularly an increase in certain markers on specific B cell subsets. These findings suggest B cells may function differently in ME/CFS and could help explain why some patients improve with a drug that targets B cells.

E2 ModerateCohortPEM unclearCase-Control

Gene Expression Factor Analysis to Differentiate Pathways Linked to Fibromyalgia, Chronic Fatigue Syndrome, and Depression in a Diverse Patient Sample.

Iacob, Eli, Light, Alan R, Donaldson, Gary W et al.·Arthritis care & research·2016

Researchers studied blood cell genes from 261 people—including those with ME/CFS, fibromyalgia, depression, and healthy controls—to see if certain genes work together in patterns tied to these conditions. They found four distinct gene clusters, and two of these clusters showed opposite patterns in ME/CFS patients compared to those with depression, suggesting these conditions may involve different biological pathways even when they overlap.

BiomarkersImmune System

Cytokine network analysis of cerebrospinal fluid in myalgic encephalomyelitis/chronic fatigue syndrome.

Hornig, M, Gottschalk, G, Peterson, D L et al.·Molecular psychiatry·2016

Researchers examined fluid from around the spine (cerebrospinal fluid) in ME/CFS patients and compared it to healthy people and those with multiple sclerosis. They found that ME/CFS patients had unusual patterns of immune proteins called cytokines in this fluid, suggesting their immune system in the brain and spinal cord is activated differently. The most notable finding was higher levels of a protein called eotaxin, which typically helps recruit immune cells involved in allergic responses.

E2 ModerateMechanismPEM unclearMechanistic

ERK1/2, MEK1/2 and p38 downstream signalling molecules impaired in CD56 dim CD16+ and CD56 bright CD16 dim/- natural killer cells in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis patients.

Huth, Teilah Kathryn, Staines, Donald, Marshall-Gradisnik, Sonya·Journal of translational medicine·2016

This study looked at natural killer (NK) cells, which are immune cells that help fight infections and abnormal cells. Researchers found that NK cells in ME/CFS patients have problems with their internal signaling systems—the chemical pathways that tell these cells to attack threats. Specifically, certain types of NK cells showed abnormal activity in proteins called ERK, MEK, and p38 when compared to healthy people. These problems in cell signaling might explain why people with ME/CFS have weaker immune responses.

E2 ModerateCohortPEM unclearCase-Control

Genome-wide association analysis identifies genetic variations in subjects with myalgic encephalomyelitis/chronic fatigue syndrome.

Schlauch, K A, Khaiboullina, S F, De Meirleir, K L et al.·Translational psychiatry·2016

Researchers compared the genes of people with ME/CFS to healthy people and found 442 genetic differences that may be linked to the condition. While most of these differences were in non-coding parts of the genome, some were in actual genes that produce proteins, including two that change how proteins work. Some genetic differences were found in genes related to the immune system's T-cells, which fight infection.

Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis.

Ohanian, Diana, Brown, Abigail, Sunnquist, Madison et al.·Neurology (E-Cronicon)·2016

This study compared symptoms reported by people with ME/CFS to those with multiple sclerosis (MS) to find out which symptoms are most different between these conditions. Researchers used a computer learning method to analyze questionnaire responses and found that five specific symptoms—particularly flu-like feelings and swollen lymph nodes—were the best at telling these conditions apart. The computer correctly identified whether someone had MS or ME/CFS about 81% of the time, and people with ME/CFS reported having more severe symptoms overall.