Evidence browser

Investigating the aetiology of adverse events following HPV vaccination with systems vaccinology.

Campbell-Tofte, Joan, Vrahatis, Aristidis, Josefsen, Knud et al.·Cellular and molecular life sciences : CMLS·2019

This paper proposes a research approach to investigate whether HPV vaccine can cause ME/CFS-like symptoms in some people. The authors suggest using detailed blood and immune system tests to compare vaccinated people who experienced problems with unvaccinated people who have similar symptoms, to see if the vaccine is actually responsible. This type of detailed comparison could help identify who might be at risk and provide objective evidence about vaccine safety.

Recent insights into innate and adaptive immune responses to Giardia.

Singer, Steven M, Fink, Marc Y, Angelova, Vanessa V·Advances in parasitology·2019

This review examines how the body's immune system responds to infection with Giardia, a parasite that causes diarrhea and other gastrointestinal symptoms. Researchers have discovered that Giardia infection can lead to long-term complications including chronic fatigue syndrome and irritable bowel syndrome in some people. Understanding how the immune system fights Giardia may help explain why some infections lead to these persistent conditions and could guide development of better treatments or vaccines.

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.

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.

E3 PreliminaryMechanismPEM unclearObservational

Modification of Immunological Parameters, Oxidative Stress Markers, Mood Symptoms, and Well-Being Status in CFS Patients after Probiotic Intake: Observations from a Pilot Study.

Venturini, Letizia, Bacchi, Sara, Capelli, Enrica et al.·Oxidative medicine and cellular longevity·2019

This study tested whether taking a specific combination of probiotic supplements (beneficial bacteria) could help people with ME/CFS. Researchers measured changes in immune function, inflammation markers, oxidative stress, and mood before and after patients took probiotics. The results showed improvements in well-being and reductions in inflammatory markers, though one patient experienced a temporary worsening of fatigue symptoms.

CD24 Expression and B Cell Maturation Shows a Novel Link With Energy Metabolism: Potential Implications for Patients With Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Mensah, Fane F K, Armstrong, Christopher W, Reddy, Venkat et al.·Frontiers in immunology·2018

This study looked at a specific type of immune cell marker called CD24 found on B cells (infection-fighting cells) in ME/CFS patients. Researchers found that ME/CFS patients have more CD24+ B cells than healthy people, and these cells behave differently when it comes to energy use and cell survival. The findings suggest that ME/CFS may involve problems with how B cells handle energy metabolism.

E3 PreliminaryReviewPEM not requiredReview-Narrative

The putative role of oxidative stress and inflammation in the pathophysiology of sleep dysfunction across neuropsychiatric disorders: Focus on chronic fatigue syndrome, bipolar disorder and multiple sclerosis.

Morris, Gerwyn, Stubbs, Brendon, Köhler, Cristiano A et al.·Sleep medicine reviews·2018

This review explores why people with ME/CFS, bipolar disorder, and multiple sclerosis often have severe sleep problems. The authors suggest that inflammation and stress in the body's cells may damage the brain's ability to control sleep and daily rhythms. They propose that when the immune system stays activated, it can trigger harmful processes that disrupt sleep, which then makes inflammation worse—creating a harmful cycle.

E3 PreliminaryReviewPEM requiredReview-Narrative

Infection Elicited Autoimmunity and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: An Explanatory Model.

Blomberg, Jonas, Gottfries, Carl-Gerhard, Elfaitouri, Amal et al.·Frontiers in immunology·2018

This study proposes that ME/CFS may develop when a person's immune system mistakenly attacks their own body after an infection, particularly affecting energy production in muscles and the brain. The researchers suggest that some people may have a genetic tendency to develop these harmful immune responses, especially when their gut bacteria are out of balance. When exposed to a triggering infection, the immune system can begin attacking proteins involved in energy metabolism and nerve function, leading to the exhaustion and post-exertion symptoms that characterize ME/CFS.

Immune SystemPost-Exertional Malaise

Loss of Transient Receptor Potential Melastatin 3 ion channel function in natural killer cells from Chronic Fatigue Syndrome/Myalgic Encephalomyelitis patients.

Cabanas, Hélène, Muraki, Katsuhiko, Eaton, Natalie et al.·Molecular medicine (Cambridge, Mass.)·2018

This study examined a specific ion channel called TRPM3 in immune cells called natural killer (NK) cells, which help fight infections and cancer. Researchers found that this channel doesn't work properly in ME/CFS patients compared to healthy people, which may affect how these immune cells function. This discovery could help explain why ME/CFS patients often have weakened immune responses.

E3 PreliminaryReviewPEM not requiredReview-Narrative

Hypothalamus-Pituitary-Adrenal Dysfunction in Cholestatic Liver Disease.

Petrescu, Anca D, Kain, Jessica, Liere, Victoria et al.·Frontiers in endocrinology·2018

This review examines how the stress hormone system (HPA axis) works and what happens when it breaks down in people with liver disease. The HPA axis is like your body's control center that manages stress responses and many other important functions. The authors explain how inflammation in the liver can disrupt this system, potentially leading to the fatigue and other symptoms seen in both liver disease and chronic fatigue syndrome.

E3 PreliminaryMechanismPEM not requiredMechanistic

Changes in fatigue, autonomic functions, and blood biomarkers due to sitting isometric yoga in patients with chronic fatigue syndrome.

Oka, Takakazu, Tanahashi, Tokusei, Sudo, Nobuyuki et al.·BioPsychoSocial medicine·2018

This study tested whether a gentle form of yoga practiced while sitting could help reduce fatigue in ME/CFS patients. Fifteen patients who had not improved with standard treatments did sitting isometric yoga twice a week with an instructor plus daily practice at home for eight weeks. After a single session, patients reported feeling less tired and more energetic, with their bodies showing signs of reduced stress and inflammation.

E3 PreliminaryMechanismPEM not requiredMechanistic

Females have stronger neurogenic response than males after non-specific nasal challenge in patients with seasonal allergic rhinitis.

Tomljenovic, Dejan, Baudoin, Tomislav, Megla, Zeljka Bukovec et al.·Medical hypotheses·2018

This study looked at how men and women with seasonal allergies respond differently to nasal irritants. Researchers found that women had stronger burning sensations and higher levels of a nerve-signaling chemical called substance P compared to men when exposed to salt water or allergen challenges. This suggests that women's bodies may process nasal irritation through a different biological pathway involving both immune cells and nerve signals.

Rituximab impedes natural killer cell function in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis patients: A pilot in vitro investigation.

Eaton, Natalie, Cabanas, Hélène, Balinas, Cassandra et al.·BMC pharmacology & toxicology·2018

This study examined how a drug called Rituximab affects natural killer (NK) cells—immune cells that help fight infections—in people with ME/CFS. Researchers tested blood samples from 8 ME/CFS patients and 9 healthy people in a lab dish. When exposed to Rituximab, NK cells from ME/CFS patients became less effective at killing infected cells and showed signs of stress, suggesting the drug might harm these already-weakened immune cells.

Immunoadsorption to remove ß2 adrenergic receptor antibodies in Chronic Fatigue Syndrome CFS/ME.

Scheibenbogen, Carmen, Loebel, Madlen, Freitag, Helma et al.·PloS one·2018

This small study tested whether a blood-cleaning procedure called immunoadsorption could help ME/CFS patients who have specific antibodies attacking their nervous system. Ten patients received this treatment over 5 days, and seven reported symptom improvement during the procedure. Three patients had improvements lasting 6-12+ months, suggesting the treatment may help some people, though more research is needed.

E3 PreliminaryCohortPEM unclearCross-Sectional

Integration of DNA methylation & health scores identifies subtypes in myalgic encephalomyelitis/chronic fatigue syndrome.

de Vega, Wilfred C, Erdman, Lauren, Vernon, Suzanne D et al.·Epigenomics·2018

Researchers studied 70 women with ME/CFS and found that their DNA showed different chemical patterns in immune cells. These chemical differences matched up with specific symptoms and health problems that patients reported. The study identified four distinct subtypes of ME/CFS, each with its own pattern of DNA changes and symptom profile, suggesting that ME/CFS may not be one uniform condition but rather several related conditions with different underlying biology.

Immune SystemPost-Exertional Malaise

Immune SystemPost-Exertional Malaise

Autonomic dysfunction and HPV immunization: an overview.

Blitshteyn, Svetlana, Brinth, Louise, Hendrickson, Jeanne E et al.·Immunologic research·2018

This review looked at case reports from multiple countries describing people who developed serious symptoms after HPV vaccination, including extreme fatigue, pain, dizziness, and cognitive problems. These symptoms are similar to those seen in ME/CFS, POTS, and other conditions. The authors suggest that in some genetically vulnerable people, the vaccine might trigger an immune system response that affects the nervous system, but they emphasize that timing alone doesn't prove the vaccine caused the illness.

Aluminum in vaccines: Does it create a safety problem?

Principi, Nicola, Esposito, Susanna·Vaccine·2018

This review examined whether aluminum in vaccines could cause serious health problems, particularly in children. The researchers looked at existing research on aluminum's effects on the nervous system and found no clear evidence that aluminum in vaccines causes brain damage. However, they noted that a possible link between certain aluminum-containing vaccines and two conditions—macrophagic myofascitis and ME/CFS—needs further investigation before firm conclusions can be made.

E3 PreliminaryMechanismPEM unclearObservational

The expression signature of very long non-coding RNA in myalgic encephalomyelitis/chronic fatigue syndrome.

Yang, Chin-An, Bauer, Sandra, Ho, Yu-Chen et al.·Journal of translational medicine·2018

Researchers looked at special molecules called very long non-coding RNAs in the blood of ME/CFS patients to see if they might be disease markers. They found that three of these RNA molecules (NTT, MIAT, and EmX2OS) were present at higher levels in ME/CFS patients compared to healthy people, and two of them (NTT and EmX2OS) increased with disease severity. When they tested these findings in lab cells exposed to oxidative stress and viral signals, the RNA levels increased, suggesting these molecules respond to the kinds of biological stresses that may occur in ME/CFS.

BiomarkersImmune System

NeuroinflammationImmune System

[Immunopathogenesis of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)].

Yamamura, Takashi, Ono, Hirohiko, Sato, Wakiro·Brain and nerve = Shinkei kenkyu no shinpo·2018

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.