Skip to content

Start Here
Atlas
Evidence
Research
Ask
Updates
About
Support

Evidence Atlas

ME/CFS Atlas — A public knowledge atlas for ME/CFS

Start Here
Atlas
Evidence
Research
Ask
FAQ
Glossary
Updates
Methodology
Press
Retractions
Contribute
About
Support
Contact

Weekly research digest — no spam

ME/CFS Atlas is an evidence reference platform, not a medical provider. Content is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.

Generator v1·Scanner v1.4·Lint gate: enforce·See methodology

© 2026 ME/CFS Atlas

ME/CFS Evidence Browser — Classified Studies on Myalgic Encephalomyelitis

Evidence browser

Search and filter 6,206 studies by evidence level, diagnostic criteria, PEM status, and research domain. Each entry links to the original source.

Studies sorted by evidence level, then year. Browse by topic instead →

Evidence level (E0–E3) reflects study type and replication, not methodological quality. A weak systematic review still sits at E0. How evidence levels work →

Sort

1205 studies

E0 — Consensus655E1 — Replicated321E2 — Moderate2,807E3 — Preliminary2,423

ME/CFS4,041Long COVID224Post-infectious190Overlapping1,064

Required for diagnosis417Not specified / unclear2,252Not required3,537

Post-Exertional Malaise1,082Cognitive Dysfunction1,750Pain1,629Unrefreshing Sleep805Orthostatic Intolerance484

Cytokines821Gene Expression573Metabolomics478Neuroimaging472Autoantibodies460

Infection-Triggered1,182Long COVID Overlap604Pediatric496Severe232

Strong Phenotyping445Sex-Stratified330Severe ME Included119

Systematic Review272Meta-Analysis61RCT301

Peer-reviewed6,149Preprint3Unclear54

941–960 of 1,205 studies

E3 PreliminaryMechanismPEM not requiredMechanistic

Severe restriction of xenotropic murine leukemia virus-related virus replication and spread in cultured human peripheral blood mononuclear cells.

Chaipan, Chawaree, Dilley, Kari A, Paprotka, Tobias et al.·Journal of virology·2011

This study investigated how XMRV, a virus found in some CFS patients, behaves when it infects human immune cells called PBMCs. Researchers discovered that human immune cells have natural defenses (proteins called APOBEC3G and APOBEC3F) that can damage the virus's genetic material and prevent it from spreading effectively. Although the virus could technically survive in these cells, it could not replicate well—suggesting the body has built-in brakes that limit XMRV's ability to cause ongoing infection.

E3 PreliminaryDiagnosticPEM not requiredMethods-Paper

Detection of an infectious retrovirus, XMRV, in blood cells of patients with chronic fatigue syndrome.

Mikovits, Judy A, Lombardi, Vincent C, Pfost, Max A et al.·Virulence·2010

This 2010 study reported finding a virus called XMRV in blood samples from over 75% of people with ME/CFS using multiple detection methods. The researchers emphasized that different laboratory techniques found the virus at different rates, with some methods being much more sensitive than others. The findings were controversial because other research groups had difficulty reproducing these results.

E3 PreliminaryCohortPEM not requiredCross-Sectional

Immune and hemorheological changes in chronic fatigue syndrome.

Brenu, Ekua W, Staines, Donald R, Baskurt, Oguz K et al.·Journal of translational medicine·2010

This study looked at immune system cells and blood cell properties in people with ME/CFS compared to healthy people. Researchers found that ME/CFS patients had weaker immune responses in certain white blood cells (neutrophils and NK cells) but normal blood cell flexibility and clumping. These immune differences might help explain why people with ME/CFS feel so tired and unwell.

E3 PreliminaryCohortPEM unclearCross-Sectional

A Comparison of Immune Functionality in Viral versus Non-Viral CFS Subtypes.

Porter, Nicole, Lerch, Athena, Jason, Leonard A et al.·Journal of behavioral and neuroscience research·2010

This study compared immune system function between ME/CFS patients whose illness started after a viral infection versus those without a clear viral trigger. Researchers tested blood samples to measure different types of immune cells. They found that the two groups had different patterns of immune cell activity, suggesting that how the immune system becomes unbalanced may differ depending on what caused the illness to start.

E3 PreliminaryCommentaryPEM unclearEditorial

Chronic fatigue syndrome/myalgic encephalomyelitis: an update.

Capelli, E, Zola, R, Lorusso, L et al.·International journal of immunopathology and pharmacology·2010

ME/CFS is a serious illness of unknown cause that affects about 1 in every 100 people worldwide, with women affected six times more often than men. Most people develop it between ages 20-40, and symptoms typically last several years. While doctors don't yet have a cure, treatment focuses on managing individual symptoms to help patients improve their quality of life.

E3 PreliminaryMechanismPEM not requiredObservational

Cytokines across the night in chronic fatigue syndrome with and without fibromyalgia.

Nakamura, Toru, Schwander, Stephan K, Donnelly, Robert et al.·Clinical and vaccine immunology : CVI·2010

Researchers studied immune signaling molecules called cytokines in people with ME/CFS and fibromyalgia while they slept in a lab, comparing them to healthy people. Instead of finding signs of excessive inflammation (which some theories predicted), they found slightly elevated levels of a calming immune molecule called interleukin-10. These small changes might help explain why many ME/CFS patients struggle with disrupted sleep.

E3 PreliminaryMechanismPEM unclearMechanistic

Susceptibility of xenotropic murine leukemia virus-related virus (XMRV) to retroviral restriction factors.

Groom, Harriet C T, Yap, Melvyn W, Galão, Rui Pedro et al.·Proceedings of the National Academy of Sciences of the United States of America·2010

Scientists studied a virus called XMRV that had been linked to ME/CFS to understand how it survives in human cells. They discovered that the body's natural antiviral defense proteins can block this virus, but XMRV does not appear to have developed ways to escape these defenses like some other viruses do. This finding helps researchers understand which cells XMRV can infect and how to design better laboratory studies of this virus.

E3 PreliminaryDiagnosticPEM unclearMethods-Paper

Characterization of antibodies elicited by XMRV infection and development of immunoassays useful for epidemiologic studies.

Qiu, Xiaoxing, Swanson, Priscilla, Luk, Ka-Cheung et al.·Retrovirology·2010

Researchers studied how the body's immune system responds to XMRV infection by infecting three monkeys and tracking antibodies (immune markers) over time. They found that infected animals developed detectable antibodies within two weeks and created three new blood tests to reliably detect XMRV infection, which could help researchers study whether XMRV is connected to ME/CFS.

E3 PreliminaryMechanismPEM not requiredMechanistic

Apobec 3G efficiently reduces infectivity of the human exogenous gammaretrovirus XMRV.

Stieler, Kristin, Fischer, Nicole·PloS one·2010

This study examined how a virus called XMRV (which has been suspected in ME/CFS) interacts with human immune defense proteins called Apobec3 proteins. Researchers found that one specific immune protein, called A3G, is very effective at stopping XMRV from infecting cells and spreading. Interestingly, cancer cells that are easily infected by XMRV don't produce much of this protective A3G protein.

E3 PreliminaryReviewPEM not requiredReview-Narrative

Neuroendocrine and immune contributors to fatigue.

Silverman, Marni N, Heim, Christine M, Nater, Urs M et al.·PM & R : the journal of injury, function, and rehabilitation·2010

This review explores how three body systems—the stress response system, the nervous system, and the immune system—may work together to cause the overwhelming tiredness experienced in ME/CFS. The researchers found that people with chronic fatigue often have an underactive stress-response system, an overactive fight-or-flight response, and immune system imbalances. Understanding how these systems interact may help explain why rest alone doesn't always resolve the fatigue.

Autonomic Nervous SystemImmune System

E3 PreliminaryReviewPEM unclearReview-Narrative

Gut inflammation in chronic fatigue syndrome.

Lakhan, Shaheen E, Kirchgessner, Annette·Nutrition & metabolism·2010

Many ME/CFS patients experience gut problems similar to irritable bowel syndrome. This review discusses how three interconnected gut issues—changes in the bacteria that live in your intestines, a weakened intestinal lining, and an altered immune response in the gut—may contribute to ME/CFS. The authors suggest that treatments like probiotics (beneficial bacteria) might help by restoring healthy gut bacteria and reducing inflammation.

E3 PreliminaryReviewPEM requiredReview-Narrative

Chronic fatigue syndrome: Harvey and Wessely's (bio)psychosocial model versus a bio(psychosocial) model based on inflammatory and oxidative and nitrosative stress pathways.

Maes, Michael, Twisk, Frank N M·BMC medicine·2010

This study compares two different ways of understanding ME/CFS. One model suggests the illness is mainly caused by how the mind and behavior interact with the body, and proposes treatments like cognitive behavioral therapy and graded exercise. The other model focuses on biological problems like inflammation and oxidative stress in the body. The authors argue that the biological model better explains ME/CFS and that exercise-based treatments could actually make some patients worse.

Immune SystemPost-Exertional Malaise

E3 PreliminaryReviewPEM unclearReview-Narrative

The human retrovirus XMRV in prostate cancer and chronic fatigue syndrome.

Silverman, Robert H, Nguyen, Carvell, Weight, Christopher J et al.·Nature reviews. Urology·2010

This review examines XMRV, a newly discovered virus that has been found in some people with prostate cancer and some with ME/CFS. Researchers have found the virus at very different rates in different studies (0-27% in prostate cancer, 0-67% in ME/CFS patients). While some antiviral drugs appear to block this virus, scientists still do not know whether XMRV actually causes either disease.

E3 PreliminaryMechanismPEM not requiredMechanistic

Effects of exercise on behavior and peripheral blood lymphocyte apoptosis in a rat model of chronic fatigue syndrome.

Zou, Jun, Yuan, Jianqi, Lv, Shuang et al.·Journal of Huazhong University of Science and Technology. Medical sciences = Hua zhong ke ji da xue xue bao. Yi xue Ying De wen ban = Huazhong keji daxue xuebao. Yixue Yingdewen ban·2010

Researchers created a rat model of ME/CFS using stress and shock, then tested whether exercise could help. Rats with the CFS-like condition showed decreased activity, memory problems, and abnormal immune cell death. When stressed rats were given access to a running wheel, their activity improved and their immune cell death decreased, suggesting exercise may help counteract some effects of the condition.

E3 PreliminaryReviewPEM unclearReview-Narrative

[Human herpesvirus 6].

Ongrádi, József, Kövesdi, Valéria, Medveczky, G Péter·Orvosi hetilap·2010

Human herpesvirus 6 (HHV-6) is a common virus that most people catch in early childhood, usually causing mild symptoms or no symptoms at all. The virus stays dormant in your body for life but can reactivate, especially if your immune system is weakened. Research suggests HHV-6 may play a role in ME/CFS and other serious conditions, possibly by changing how your immune system produces certain signaling molecules.

E3 PreliminaryReviewPEM not requiredReview-Narrative

EBV Chronic Infections.

Eligio, Pizzigallo, Delia, Racciatti, Valeria, Gorgoretti·Mediterranean journal of hematology and infectious diseases·2010

This review explores the connection between Epstein-Barr virus (EBV)—the virus that causes mononucleosis—and ME/CFS. While EBV can persist in the body and reactivate at times, it is not clear whether it directly causes chronic fatigue syndrome in most patients. The authors suggest that ME/CFS likely has multiple causes, including EBV in some people, other viruses in others, and non-infectious factors, but the underlying mechanism may involve inflammation and oxidative damage.

E3 PreliminaryReviewPEM unclearReview-Narrative

Biology and pathophysiology of the new human retrovirus XMRV and its association with human disease.

Rusmevichientong, Alice, Chow, Samson A·Immunologic research·2010

Scientists discovered a new virus called XMRV and found it in some people with prostate cancer and chronic fatigue syndrome (CFS). This review article summarizes what was known about this virus at the time, how it might work in the body, and what still needs to be studied to understand whether XMRV actually causes disease in humans.

E3 PreliminaryMechanismPEM unclearObservational

Severity of symptom flare after moderate exercise is linked to cytokine activity in chronic fatigue syndrome.

White, Andrea T, Light, Alan R, Hughen, Ronald W et al.·Psychophysiology·2010

This study looked at why some people with ME/CFS feel much worse after exercise. Researchers measured immune chemicals in the blood before and after moderate exercise in people with ME/CFS and healthy controls. They found that patients who experienced severe symptom flare had increased levels of certain immune chemicals 8 hours after exercise, while those with mild flare or healthy people did not show this pattern.

Immune SystemPost-Exertional Malaise

E3 PreliminaryCommentaryPEM not requiredEditorial

Xenotropic murine leukemia virus-related virus in chronic fatigue syndrome and prostate cancer.

Baraniuk, James N·Current allergy and asthma reports·2010

This study examined whether a virus called XMRV might be connected to ME/CFS. Researchers found this virus in about half to two-thirds of ME/CFS patients tested, compared to only about 4% of healthy people. The virus was able to spread from patient blood to laboratory cells, raising questions about whether it could be transmitted between people.

E3 PreliminaryReviewPEM not requiredReview-Narrative

Traditional chinese medicine for chronic fatigue syndrome.

Chen, Rui, Moriya, Junji, Yamakawa, Jun-Ichi et al.·Evidence-based complementary and alternative medicine : eCAM·2010

This review examines how traditional Chinese medicine (TCM) might help people with ME/CFS. The authors suggest that TCM treatments may reduce symptoms like fatigue, sleep problems, and brain fog, and may work by improving immune function and reducing oxidative stress. However, they note that current TCM research on ME/CFS has significant quality and consistency issues that need to be addressed.

← Previous Next 20 studies →

Or browse by topic

PEM Immune Neuro Metabolic Biomarkers Severe ME Long COVID Cognitive

Curated Collections

Thematic groupings by clinical question or research area.

Neuroinflammation Evidence

PET imaging and other studies providing evidence for brain inflammation in ME/CFS.

Metabolism & Mitochondria

Metabolomics and mitochondrial function studies revealing energy metabolism disruption.

Biomarkers

Studies identifying potential biological markers for ME/CFS diagnosis and stratification.

PEM-Specific Research

Studies specifically examining post-exertional malaise, the hallmark symptom of ME/CFS.