Figure 1From: Myalgic encephalomyelitis/chronic fatigue syndrome and encephalomyelitis disseminata/multiple sclerosis show remarkable levels of similarity in phenomenology and neuroimmune characteristics Diagram integrating immune signaling and metabolic pathways, which together explain the symptomatic similarities between both multiple sclerosis (MS) and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Shared pathways are dysfunctions in intracellular signaling pathways, for example, nuclear factor κB (NFκB); immunoinflammatory pathways, for example, T helper (Th) and T regulatory (Treg) cells, cyclo-oxygenase 2 (COX2), and proinflammatory cytokines (PICs); and oxidative and nitrosative stress (O+NS) pathways. These in turn may induce increased damage by O+NS to proteins and lipids, secondary autoimmune responses and mitochondrial defects. There is evidence that these dysfunctions together with brain disorders are associated with the onset of ME/CFS symptoms, which appear in ME/CFS and MS. PEM = post-exertional malaise.Back to article page