Myalgic Encephalomyelitis/Chronic Fatigue Syndrome - Evidence for an autoimmune disease

Autoimmun Rev. 2018 Jun;17(6):601-609. doi: 10.1016/j.autrev.2018.01.009. Epub 2018 Apr 7.

Abstract

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a frequent and severe chronic disease drastically impairing life quality. The underlying pathomechanism is incompletely understood yet but there is convincing evidence that in at least a subset of patients ME/CFS has an autoimmune etiology. In this review, we will discuss current autoimmune aspects for ME/CFS. Immune dysregulation in ME/CFS has been frequently described including changes in cytokine profiles and immunoglobulin levels, T- and B-cell phenotype and a decrease of natural killer cell cytotoxicity. Moreover, autoantibodies against various antigens including neurotransmitter receptors have been recently identified in ME/CFS individuals by several groups. Consistently, clinical trials from Norway have shown that B-cell depletion with rituximab results in clinical benefits in about half of ME/CFS patients. Furthermore, recent studies have provided evidence for severe metabolic disturbances presumably mediated by serum autoantibodies in ME/CFS. Therefore, further efforts are required to delineate the role of autoantibodies in the onset and pathomechanisms of ME/CFS in order to better understand and properly treat this disease.

Keywords: Autoantibodies; Autoimmune; Biomarker; Chronic Fatigue Syndrome; Myalgic Encephalomyelitis.

Publication types

  • Review

MeSH terms

  • Autoantibodies / physiology
  • Autoimmune Diseases / complications*
  • Autoimmune Diseases / drug therapy
  • Autoimmune Diseases / immunology
  • B-Lymphocytes / physiology
  • Fatigue Syndrome, Chronic / drug therapy
  • Fatigue Syndrome, Chronic / etiology*
  • Fatigue Syndrome, Chronic / immunology
  • Humans
  • Phenotype
  • Rituximab / therapeutic use

Substances

  • Autoantibodies
  • Rituximab