LDN Social Media
Get connected with us on social networks
Research Into ME/CFS Pathology Points to Possible Treatments
Miriam E. Tucker
November 07, 2025
New possibilities for the treatment of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and long COVID are emerging as research continues to untangle the complex, multisystem pathophysiology of the two overlapping diseases.
At International Association for Chronic Fatigue Syndrome/ Myalgic Encephalomyelitis (IACFS/ME) 2025, speakers summarized their research into the underlying pathomechanisms of ME/CFS and long COVID and the potential for treatment approaches specifically targeting those identified abnormalities.
“We understand pathophysiology of ME much better than we used to, including the central role of neuroinflammation and the interaction of abnormalities in various systems such as the autonomic nervous system, circulatory, immune system, endocrine, and energy metabolism. Those abnormalities in all those systems continuously feed each other in a vicious cycle that helps to perpetuate the symptoms,” IACFS/ME board member and conference co-organizer Luis Nacul, MD, PhD, told Medscape Medical News.
Abnormalities of the immune system and the nervous system precede the others and therefore are important focuses of both basic and translational research, said Nacul, clinical associate professor at both the London School of Hygiene and Tropical Medicine in London, England, and at the University of British Columbia, Vancouver, British Columbia, Canada.
Any treatment for ME/CFS, including for those diagnosed with long COVID who meet ME/CFS criteria, will likely not work for all patients, nor as monotherapies, noted Nacul, who is currently studying low-dose naltrexone to target neuroinflammation in “post-COVID fatigue syndrome.”
“I think we will need many treatments because a combination may be more appropriate for most patients, and some treatments will be good for some, and other treatments for others. I don’t think there is a magic pill that will be the monotherapy, at least not soon,” Nacul said.
Autoimmunity Is a Major Research Focus and Potential Treatment Target
Carmen Scheibenbogen, MD, director of the Institute for Medical Immunology at Charité Hospital, Berlin, Germany, and Øystein Fluge, MD, PhD, Senior Consultant supervising the ME/CFS research group at the Department of Oncology and Medical Physics, University of Bergen, Haukeland University Hospital, Bergen, Norway, each spoke about their respective work examining the role of autoimmunity in ME/CFS and long COVID and their ongoing research into treatments aimed at quelling those processes. “I believe that autoimmunity is a key pathomechanism in a subgroup of ME/CFS patients, and that we have really made breakthroughs in recent years in understanding of this,” Scheibenbogen said in her introduction.
In a 2018 paper, Scheibenbogen and colleagues reviewed the literature up to that point, finding that autoimmune mechanisms can be linked with ME/CFS at least in a subset of patients, with most of the identified autoantibodies targeting nuclear and neurotransmitter receptors. They also identified multiple complex interactions with evidence of inflammation, associations with Epstein-Barr virus reactivation, autonomic dysfunction including sympathetic overactivity and vascular dysregulation with hypoperfusion, and impaired energy metabolism.
“We think the immune dysregulation is probably at the beginning of this…and we now have clear evidence that several of these dysfunctions are also associated with symptom severity, and altogether these mechanisms can explain the complex clinical symptoms of ME/CFS including post-exertional malaise,” she said.
For full article please go to https://www.medscape.com/viewarticle/research-me-cfs-pathology-points-possible-treatments-2025a1000uuu