Is the immune dysregulation hypothesis proven?

A European team led by Dr Amolak Bansal review a number of areas of research into ME/CFS before concluding:

“After over 20 year of attempting to identify specific immune defects and infectious agents that cause ME/CFS, clear pathways are still not evident. However, a complex interaction between the immune system and viruses/retroviruses is now emerging and manifesting subtle changes in cytokines, NK
cells and T cells which directly or via autoimmunity may be responsible for the plethora of symptoms seen in ME/CFS.

Combined with immune and pathogen-induced mitochondrial dysfunction now being dissected by several research groups it
is quite possible that it will gain real insight into the cause of this enigmatic and highly disabling illness.”

What Causes ME/CFS: The Role of the Dysfunctional Immune System and Viral Infections, by Amolak S Bansal, Aletta D Kraneveld, Elisa Oltra and Simon Carding, in Journal of Immunology and Allergy 2022;3(2):1-15

Review abstract:

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) remains an enigmatic highly disabling and complex long-term condition with a wide range of aetiologies and symptoms.

A viral onset is commonly mentioned by patients and several bodily systems are ultimately disturbed. The parallel with long-covid is clear.

However, immune dysregulation with impaired NK cell dysfunction and tendency to novel autoimmunity have been frequently reported. These may contribute to reactivation of previous acquired viruses/retroviruses accompanied by impaired endocrine regulation and mitochondrial energy generation.

The unpredictable nature of seemingly unconnected and diverse symptoms that are poorly responsive to several allopathic and alternative therapies then contributes to an escalation of the illness with secondary dysfunction of multiple other systems.

Treatment of established ME/CFS is therefore difficult and requires multi-specialty input addressing each of the areas affected by the illness.