Evidence browser

Altered TRPM7-Dependent Calcium Influx in Natural Killer Cells of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Patients.

Du Preez, Stanley, Eaton-Fitch, Natalie, Smith, Peter K et al.·Biomolecules·2023

This study looked at how calcium moves into immune cells called NK cells in ME/CFS patients compared to healthy people. Researchers found that calcium enters these cells differently in ME/CFS patients—it flows in more slowly when activated but responds more strongly when blocked. This suggests a problem with a specific calcium channel called TRPM7 that may be involved in why NK cells don't work properly in ME/CFS.

E3 PreliminaryReviewPEM unclearReview-Narrative

Long COVID: major findings, mechanisms and recommendations.

Davis, Hannah E, McCorkell, Lisa, Vogel, Julia Moore et al.·Nature reviews. Microbiology·2023

Long COVID is a serious illness affecting at least 10% of people who had COVID-19, with an estimated 65 million people worldwide experiencing it. The condition causes over 200 different symptoms affecting many body systems, similar to ME/CFS and other post-viral illnesses. This review examines what scientists have learned about Long COVID's causes and effects, though better diagnostic tests and treatments are still urgently needed.

Long COVID OverlapPost-Exertional Malaise

E3 PreliminaryReviewPEM unclearReview-Narrative

Mitochondria: It is all about energy.

Casanova, Amaloha, Wevers, Anne, Navarro-Ledesma, Santiago et al.·Frontiers in physiology·2023

This review explains that mitochondria—the energy-producing structures in our cells—do much more than just make energy. They also help control sleep-wake cycles, interact with gut bacteria, and regulate the immune system. When mitochondria don't work properly, it may contribute to several diseases including ME/CFS, and the authors suggest that specific lifestyle and physiological strategies might help restore mitochondrial health.

E3 PreliminaryCommentaryPEM requiredEditorial

Post-exertional malaise in daily life and experimental exercise models in patients with myalgic encephalomyelitis/chronic fatigue syndrome.

Vøllestad, Nina K, Mengshoel, Anne Marit·Frontiers in physiology·2023

This paper reviews how post-exertional malaise (PEM)—the worsening of symptoms after physical or mental activity—is experienced and studied in ME/CFS patients. Patients describe PEM in many different ways and report that it can start immediately or be delayed by days, lasting anywhere from a few days to months. When researchers use standardized exercise tests in laboratories, they see more immediate symptom worsening, but the duration still varies widely between patients.

Autonomic Nervous SystemPost-Exertional Malaise

E3 PreliminaryCommentaryPEM requiredEditorial

[Effect of transcutaneous electrical acupoint stimulation on learning and memory ability of chronic fatigue syndrome rats and its mechanisms].

Zhong, Xiao-Ling, Tong, Bo-Ying, Yang, Yi-Han et al.·Zhen ci yan jiu = Acupuncture research·2023

This study tested whether a non-invasive electrical stimulation treatment applied to specific acupuncture points could help rats with chronic fatigue improve their memory and learning. Researchers found that the treatment reduced fatigue symptoms and improved memory performance in fatigued rats, possibly by protecting brain cells in the memory center of the brain.

Neuroinflammation

The Role of Psychotherapy in the Care of Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Grande, Tilman, Grande, Bettina, Gerner, Patrick et al.·Medicina (Kaunas, Lithuania)·2023

This article discusses how talking therapy (psychotherapy) might help people with ME/CFS cope better, even though it cannot cure the disease itself. The authors emphasize that ME/CFS is a physical illness requiring physical treatments, and they highlight that post-exertional malaise (getting worse after activity) is a key symptom that therapists should understand. They propose a practical approach to therapy that respects these facts while still helping patients manage their emotional wellbeing.

Post-Exertional Malaise

Integrated 'omics analysis for the gut microbiota response to moxibustion in a rat model of chronic fatigue syndrome.

Chaoran, L I, Yan, Yang, Chuwen, Feng et al.·Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan·2023

This study tested whether moxibustion (a traditional Chinese medicine technique using heat) could help treat chronic fatigue syndrome in rats. Researchers found that moxibustion improved fatigue-like symptoms and restored balance to the gut bacteria and chemical levels that were abnormal in fatigued rats. The results suggest that moxibustion may work by fixing problems in the gut microbiome (bacteria) and the metabolites (chemical byproducts) they produce.

Gut Microbiome

Gut MicrobiomeImmune System

Astragalus polysaccharide ameliorated complex factor-induced chronic fatigue syndrome by modulating the gut microbiota and metabolites in mice.

Wei, Xintong, Xin, Jiayun, Chen, Wei et al.·Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie·2023

This study tested whether astragalus polysaccharide (APS), a compound from traditional Chinese medicine, could help with chronic fatigue syndrome in mice. The researchers found that APS improved fatigue-related symptoms by changing the bacteria in the gut, which led to more production of beneficial compounds called short-chain fatty acids that reduced inflammation and oxidative stress in the brain.

E3 PreliminaryMechanismPEM requiredObservational

WASF3 disrupts mitochondrial respiration and may mediate exercise intolerance in myalgic encephalomyelitis/chronic fatigue syndrome.

Wang, Ping-Yuan, Ma, Jin, Kim, Young-Chae et al.·Proceedings of the National Academy of Sciences of the United States of America·2023

Researchers found that a protein called WASF3 may be responsible for exercise intolerance in ME/CFS by interfering with how mitochondria (the energy-producing parts of cells) work in muscles. When WASF3 levels were high, both mice and cells from ME/CFS patients showed reduced energy production capacity. Lowering WASF3 in the patient's cells improved their mitochondrial function, suggesting this protein could be a potential treatment target.

Energy Metabolism

Exercise-induced changes in gene expression do not mediate post exertional malaise in Gulf War illness.

Boruch, Alexander E, Lindheimer, Jacob B, Ninneman, Jacob V et al.·Brain, behavior, & immunity - health·2023

This study looked at whether post-exertional malaise (PEM)—the worsening of symptoms after physical activity—is caused by changes in gene activity in Gulf War illness patients. Veterans with Gulf War illness and healthy controls exercised on stationary bikes, and researchers measured gene expression in blood samples before and after exercise. While the study found that certain genes did change after exercise in Gulf War illness patients, these gene changes did not explain why their symptoms got worse.

Post-Exertional Malaise

E3 PreliminaryCohortPEM not requiredCase-Control

Hypertension and Severe Hypokalemia Associated With Oral Ingestion of Topical Hydrocortisone Cream.

Saha, Arunava, Balakrishnan, Suryanarayanan, Trivedi, Nitin et al.·AACE clinical case reports·2023

This case report describes a woman with chronic fatigue syndrome who accidentally poisoned herself by swallowing topical hydrocortisone cream as a replacement for prescription prednisone. She developed dangerously high blood pressure and a severe drop in potassium levels, which can cause life-threatening heart problems. The key lesson is that over-the-counter medications can cause serious harm if used incorrectly, even when applied to skin.

Heterogenous circulating miRNA changes in ME/CFS converge on a unified cluster of target genes: A computational analysis.

Kaczmarek, Mateusz Piotr·PloS one·2023

This study looked at tiny molecules called microRNAs in the blood of people with ME/CFS to understand what might be going wrong. While different patients had different patterns of these microRNAs, the researchers found that they all tend to affect the same core group of genes—suggesting ME/CFS may disrupt similar biological pathways across patients. These changes seem to affect muscle blood flow during exercise, the body's ability to handle low oxygen, antioxidant defenses, and mitochondrial function.

Energy Metabolism

Energy MetabolismImmune SystemPost-Exertional Malaise

Suppressed immune and metabolic responses to intestinal damage-associated microbial translocation in myalgic encephalomyelitis/chronic fatigue syndrome.

Uhde, Melanie, Indart, Alyssa C, Green, Peter H R et al.·Brain, behavior, & immunity - health·2023

This study found that people with ME/CFS have a weakened immune response to bacteria that leak through a damaged gut lining, along with unusual changes in how their bodies process glucose and other nutrients. The immune system appears to be suppressed in some ways while overactive in others, and these patterns were linked to metabolic changes. These findings suggest that gut health and metabolic dysfunction may play important roles in ME/CFS symptoms.

E3 PreliminaryReviewPEM unclearReview-Narrative

Cardiovascular and haematological pathology in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): A role for viruses.

Nunes, Jean M, Kell, Douglas B, Pretorius, Etheresia·Blood reviews·2023

This review examines how the heart, blood vessels, and blood clotting system may be affected in ME/CFS. Research shows that ME/CFS patients often have problems with blood flow to the brain, abnormal blood clotting, and damaged blood vessel linings—similar to what happens in Long COVID. These cardiovascular and blood abnormalities may contribute to ME/CFS symptoms and could potentially become targets for new treatments.

Autonomic Nervous System

E3 PreliminaryCohortPEM unclearCross-Sectional

Increased SARS-CoV-2 reactive low avidity T cells producing inflammatory cytokines in pediatric post-acute COVID-19 sequelae (PASC).

Paniskaki, Krystallenia, Goretzki, Sarah, Anft, Moritz et al.·Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology·2023

This study looked at children who had COVID-19 and developed long-lasting symptoms like breathing problems, fatigue, and brain fog—a condition called pediatric long COVID. Researchers found that these children had more immune cells fighting the virus that were less effective than usual, and these cells released inflammatory chemicals that may have been causing their symptoms. The findings suggest that ongoing immune system activation after COVID-19 might explain why some children develop persistent health problems similar to ME/CFS.

Broadband Electrical Spectroscopy to Distinguish Single-Cell Ca2+ Changes Due to Ionomycin Treatment in a Skeletal Muscle Cell Line.

Ferguson, Caroline A, Santangelo, Carmen, Marramiero, Lorenzo et al.·Sensors (Basel, Switzerland)·2023

Researchers used a specialized technology to measure electrical changes in muscle cells when calcium levels increased abnormally. They found that calcium buildup—a problem seen in ME/CFS and other muscle diseases—creates detectable electrical differences that can be measured. This new method may eventually help doctors identify calcium problems in patient cells more easily.

Energy Metabolism

In vitro B cell experiments explore the role of CD24, CD38, and energy metabolism in ME/CFS.

Armstrong, Christopher W, Mensah, Fane F K, Leandro, Maria J et al.·Frontiers in immunology·2023

This study examined immune cells called B cells from ME/CFS patients and healthy people to understand how they handle energy differently. Researchers found that B cells from ME/CFS patients struggle to produce enough energy and have to work harder, using more nutrients to keep functioning. These cells also showed signs of being under stress, which may help explain why ME/CFS patients feel exhausted.

E3 PreliminaryCohortPEM unclearCross-Sectional

Contesting misrecognition online: Experiences of epistemic in/justice by vloggers with contested illnesses.

Groenevelt, I P Irene, de Boer, M L Marjolein·Social science & medicine (1982)·2023

This study looked at how seven Dutch women with ME/CFS and other contested illnesses used video blogs (vlogs) to share their experiences online. The researchers found that these women felt their knowledge and experiences were often discredited because of prejudice against their illnesses—a problem called "epistemic injustice." While vlogging helped some women feel more empowered to share their true experiences, they still faced challenges from YouTube's design and social pressure to soften their messages.

E3 PreliminaryGuidelinePEM requiredGuideline

Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) in Adolescents: Practical Guidance and Management Challenges.

Rowe, Katherine·Adolescent health, medicine and therapeutics·2023

ME/CFS is a serious illness causing extreme tiredness that doesn't improve with rest, along with worsening after activity, brain fog, poor sleep, and sometimes dizziness and pain. This paper reviews what we know about treating ME/CFS in teenagers and young people, finding that currently there are no proven cure treatments, but symptom management and lifestyle adjustments help most. The study emphasizes that staying connected to school and having supportive doctors who listen made the biggest difference in how well young people managed their illness over time.

Post-Exertional Malaise

E3 PreliminaryMechanismPEM unclearCross-Sectional

Investigating Antibody Reactivity to the Intestinal Microbiome in Severe Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): A Feasibility Study.

Seton, Katharine A, Defernez, Marianne, Telatin, Andrea et al.·International journal of molecular sciences·2023

This study explored whether ME/CFS might be caused by a leaky gut that allows bacteria to escape into the bloodstream, triggering an abnormal immune response. Researchers compared antibody levels and immune reactions to gut bacteria in severely ill ME/CFS patients and healthy household members. They found that ME/CFS patients showed reduced immune responses to their gut bacteria, which was unexpected and suggests the immune system may not be working properly in ME/CFS.