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Autoimmune hypothesis
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== Evidence for autoimmunity in ME and CFS == [[File:MECFS comorbid autoimmune.jpg|alt=Shows fibromyalgia 30-77% overlap, Hashimoto's thyroiditis 17-20%, POTS 11-40% overlap and family history of autoimmune conditions 18-41% overlap.|thumb|Autoimmune conditions in people with ME/CFS. Source: Sotzny et al (2018), [[EUROMENE]] project.]] Many people with ME/CFS also have autoimmune conditions such as [[Hashimoto's thyroiditis]], or have a family history of autoimmune diseases.<ref name="Sotzny, 2018" /> [[Postural orthostatic tachycardia syndrome|POTS]], or postural orthostatic tachycardia syndrome, can be initiated or maintained by autoantibodies as well, and POTS is common in people with ME. A number of different immune system abnormalities have been found in some patients with ME/CFS.<ref name="Sotzny, 2018" /> One study found elevated cellular antigens in 83% of [[Chronic fatigue syndrome|CFS]] patients.<ref>{{Cite journal | last = von Mikecz | first = A. | last2 = Konstantinov | first2 = K. | last3 = Buchwald | first3 = D.S. | author-link3 = Dedra Buchwald | last4 = Gerace | first4 = L. | last5 = Tan | first5 = E.M. | date = Feb 1997 | title = High frequency of autoantibodies to insoluble cellular antigens in patients with chronic fatigue syndrome | url =https://www.ncbi.nlm.nih.gov/m/pubmed/9041942/ | journal = Arthritis and Rheumatism|volume=40 | issue = 2 | pages = 295β305|issn=0004-3591|pmid=9041942}}</ref> Autoimmune disease is one of several illnesses or conditions experienced alongside of [[ME/CFS]].<ref>{{Cite web | url = https://ammes.org/overlapping-conditions/ | title = Overlapping Conditions β American ME and CFS Society | website = ammes.org|language=en-US | access-date = 2018-08-12}}</ref> Samples from a large cohort (n=268) in Berlin, Germany and a smaller sample of patients treated with [[Rituximab]] (n=25) were measured against controls (n=168). Researchers found that antibodies against a [[neurotransmitter]] receptor were elevated in 29.5% of patients. Specifically, antibodies to Γ2 [[Adrenergic receptor|adrenergic]] and M3 and M4 muscarinic cholinergic receptors, which are both G protein-coupled receptors (GCPRs). In patients receiving Rituximab, those who were responders had significantly lower levels of Γ2 and M4 autoantibodies after treatment. The authors suggest that these autoantibodies could be [[biomarker]]s to those CFS patients most likely to respond to Rituximab treatment.<ref>{{Cite web | url = https://www.meaction.net/2015/09/26/antibodies-found-in-subset-of-cfs-patients/ | title = Autoantibodies found in subset of CFS patients {{!}} #MEAction|website = [[The MEAction Network]]|language=en-US | access-date = 2018-08-12}}</ref><ref>{{Cite journal | last = Loebel | first = Madlen | author-link = Madlen LΓΆbel | last2 = Grabowski | first2 = Patricia | author-link2 = Patricia Grabowski | last3 = Heidecke | first3 = Harald | last4 = Bauer | first4 = Sandra | author-link4 = Sandra Bauer | last5 = Hanitsch | first5 = Leif G. | last6 = Wittke | first6 = Kirsten | last7 = Meisel | first7 = Christian | last8 = Reinke | first8 = Petra | last9 = Volk | first9 = Hans-Dieter | date = Feb 2016 | title = Antibodies to Ξ² adrenergic and muscarinic cholinergic receptors in patients with Chronic Fatigue Syndrome | url =https://www.ncbi.nlm.nih.gov/pubmed/26399744 | journal = Brain, Behavior, and Immunity|volume=52 | pages = 32β39|doi=10.1016/j.bbi.2015.09.013|issn=1090-2139|pmid=26399744}}</ref>
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