Xu et al. (2026)
- Authors: Qing Xu, Mengyu Zhao, Qin Wang, Yanwen He, Guanting Ye, Junyi Yang, Wenhai Huang, Jianping Ren
- Institutes: Department of Psychiatry, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Publisher: Elsevier / Journal of Psychiatric Research
- Link: DOI
Summary
This comprehensive review updates the clinical understanding of ME/CFS by integrating recent findings on the gut-brain axis and post-viral immune exhaustion. It clarifies the commonalities between ME/CFS and Long COVID, providing clinicians with a more structured approach to diagnosis and a biological rationale for emerging therapies targeting the microbiome and neuroinflammation.
What was researched?
The researchers conducted an extensive review of the current scientific landscape regarding ME/CFS, focusing on its biological origins, underlying disease mechanisms, and evolving diagnostic and therapeutic approaches.
Why was it researched?
The study aimed to consolidate recent evidence on ME/CFS pathophysiology, particularly following the global increase in post-viral conditions, to help solve the diagnostic challenges and lack of standardized treatment protocols.
How was it researched?
The authors synthesized data from high-impact clinical trials and mechanistic studies published through May 2025, evaluating evidence across immunology, neurology, and gastroenterology.
What has been found?
The review highlights mitochondrial dysfunction and chronic neuroinflammation as central drivers of the disease. It identifies specific biomarkers of intestinal damage, such as FABP2, and notes that the use of probiotics 💊 and other microbial preparations may help restore homeostasis in the brain-immune-gut axis.
Discussion
A significant focus is placed on the role of mucosal-associated invariant T (MAIT) cells and their response to microbial antigens. The authors argue that while ME/CFS and Long COVID share core symptoms like post-exertional malaise, distinct biological markers are beginning to emerge.
Conclusion & Future Work
ME/CFS is a complex multisystemic disorder that requires a multidisciplinary management strategy. Future research should prioritize large-scale trials of immune modulators 💊 and gut-targeted interventions to improve patient outcomes.