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Complement C4a
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==ME/CFS== Increased C4a levels have been found one to six hours after exercise challenge tests in [[ME/CFS]] patients but not in healthy controls.<ref name="Sorensen2003"/> {{Quote frame|quote=A significant correlation was found [in Chronic Fatigue Syndrome patients] between the increase in C4a and total symptom score (P < .05) and the following individual symptoms: headaches (P < .02), joint problems (P < .05), and thinking difficulty (P < .03), through the use of 1-sided tests.<ref name="Sorensen2003"/>|source=Sorensen et al, 2003}} Nijs et al. (2010) found a strong relation between the change in [[complement C4a]] level and an increase in post-exertional [[pain]] and [[fatigue]] in ME/CFS patients.<ref name="Nijs2010">{{Cite journal | last = Nijs | first = J. | authorlink = Jo Nijs | last2 = Van Oosterwijck | first2 = J. | authorlink2 = Jessica Van Oosterwijck | last3 = Meeus | first3 = M. | author-link3 = Mira Meeus | last4 = Lambrecht | first4 = L. | author-link4 = | last5 = Metzger | first5 = K. | author-link5 = | last6 = Frémont | first6 = M. | last7 = Paul | first7 = L. | date = 2010 | title=Unravelling the nature of postexertional malaise in myalgic encephalomyelitis/chronic fatigue syndrome: the role of elastase, complement C4a and interleukin-1β | url = https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2796.2009.02178.x|journal=Journal of Internal Medicine|language=en|volume=267 | issue = 4 | pages = 418–435|doi=10.1111/j.1365-2796.2009.02178.x|issn=1365-2796|quote=|via=}}</ref> Previously, complement C4a, in combination with other proteins, was being considered as a potential diagnostic [[biomarker]] of [[post-exertional malaise]] in [[ME/CFS]].<ref name="Sorensen2009" />
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