Opinion Editorial: Unraveling the biological mechanisms of chronic fatigue: a multifaceted approach, 2026, Almulla et al

[Dolphin]

Frontiers | Editorial: Unraveling the biological mechanisms of chronic fatigue: a multifaceted approach

Chronic fatigue, and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) in particular, remain without a validated diagnostic marker or a treatment. ...

www.frontiersin.org

EDITORIAL article​

Front. Med., 29 July 2026

Sec. Translational Medicine

Volume 13 - 2026 | https://doi.org/10.3389/fmed.2026.1936679

Editorial: Unraveling the biological mechanisms of chronic fatigue: a multifaceted approach​

• 
  Abbas F. Almulla 1,2,3*
• 
  Benjamin H. Natelson 4
• 
  Leonard H. Calabrese 5
• 
  Fereshteh Jahanbani 6,7

• 1. Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
• 2. Key Laboratory of Psychosomatic Medicine, Chinese Academy of Medical Sciences, Chengdu, China
• 3. Medical Laboratory Technology Department, College of Medical Technology, The Islamic University, Najaf, Iraq
• 4. Icahn School of Medicine at Mount Sinai, New York, NY, United States
• 5. Cleveland Clinic, Cleveland, OH, United States
• 6. Center for Complex Chronic Multisystem Conditions (4C), Stanford University, Stanford, CA, United States
• 7. Division of Immunology and Rheumatology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States

Editorial on the Research Topic Unraveling the biological mechanisms of chronic fatigue: a multifaceted approach

 

[Chandelier]

Figure 1:

 

[duncan]

This appears to me to be not so much an expose of the biological mechanisms of chronic fatigue, as a loosely linked series of theories, loaded with "maybes" and "possiblys".

Some of it makes me want to hit my head against a wall:

"provide a complementary exercise physiology perspective. Using serial 2-day cardiopulmonary exercise testing, they found that dysfunctional breathing and hyperventilation were common in patients with ME/CFS. These abnormalities occurred despite peak oxygen consumption being comparable to sedentary controls. This finding suggests that exercise intolerance in some patients may reflect abnormal ventilatory regulation rather than reduced aerobic capacity alone. The study also raises the possibility that breathing-pattern assessment may identify a treatable component in a subset of patients (Mancini et al.)."

The idea that teaching pwME how to breath better might meaningfully reduce their symptom burden always struck me as hard-core silliness.

There is some interesting stuff here though (e.g., the TRPM3 channel signaling in NK cells), most if not all of which has been discussed on this forum.

 

[Jonathan Edwards]

Judging by figure 1 these people are completely out of touch with science.

 

[InitialConditions]

The first author is a long-time collaborator and colleague of Michael Maes.

I hope they are happy with their editorial, which was likely written by AI.