John Mac
Senior Member (Voting Rights)
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.
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.