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

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.