Transient clinical improvement and immune modulation following recombinant Zoster vaccination in a patient with ME/CFS.
7 affiliations
- 1Mike Petryk School of Dentistry, Division of Foundational Sciences, University of Alberta, Edmonton, AB, T6G 2E1, Canada.
- 2Department of Medicine, Division of Rheumatology, University of Alberta, Edmonton, AB, T6G 2E1, Canada.
- 3Li Ka Shing Institute of Virology, University of Alberta, Edmonton, AB, T6G 2E1, Canada.
- 4Women and Children Health Research Institute, University of Alberta, Edmonton, AB, T6G 2E1, Canada.
- 5Cancer Research Institute of Northern Alberta, University of Alberta, Edmonton, AB, T6G 2E1, Canada.
- 6Glycomics Institute of Alberta, University of Alberta, Edmonton, AB, T6G 2E1, Canada.
- 7Alberta Transplant Institute, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, T6G 2E1, Canada.
Abstract
Introduction
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating multisystem disorder associated with immune dysregulation yet lacks definitive biomarkers or effective therapies. Acute immune perturbations may transiently modulate disease manifestations.Methods
We report the case of a female patient in her 60s with severe, long-standing ME/CFS who experienced changes in symptom following administration of recombinant zoster vaccine (RZV; Shingrix). Peripheral blood mononuclear cells were analyzed pre- and post-vaccination using flow cytometry, with comparison to a female healthy control. Plasma galectin-9 (Gal-9) levels were quantified by ELISA.Results
Both RZV doses were associated with rapid, transient remission of symptoms, including improved sleep, cognition, pain, mobility, and respiratory function, followed by relapse. Immunologically, pre-vaccination profiling revealed elevated monocytes, increased CD71⁺ erythroid cells, and features of T cell exhaustion marked by Gal-9/PD-1 co-expression and impaired cytokine responses. Post-vaccination, monocyte frequency decreased, Gal-9⁺/PD-1⁺ T cells were reduced, and NK cell degranulation improved, indicating partial restoration of immune function.Conclusion
This case demonstrates that immune stimulation via RZV may transiently reverse immune dysfunction and improve clinical symptoms in ME/CFS. These findings support a role for reversible immune exhaustion in disease pathogenesis and highlight potential avenues for biomarker development and therapeutic intervention.
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BibTeX
@article{bigleri2026transient,
title = {{Transient clinical improvement and immune modulation following recombinant Zoster vaccination in a patient with ME/CFS.}},
author = {AmirAli Bigleri and Emmanuel T Alimo and Amal Abouda and Mohammed Osman and Jan Willem Cohen Tervaert and Shokrollah Elahi},
journal = {Brain, behavior, \& immunity - health},
year = {2026},
month = oct,
doi = {10.1016/j.bbih.2026.101388},
url = {https://europepmc.org/article/MED/42927120},
note = {CC BY},
}
RIS
TY - JOUR
TI - Transient clinical improvement and immune modulation following recombinant Zoster vaccination in a patient with ME/CFS.
AU - AmirAli Bigleri
AU - Emmanuel T Alimo
AU - Amal Abouda
AU - Mohammed Osman
AU - Jan Willem Cohen Tervaert
AU - Shokrollah Elahi
PY - 2026
DA - 2026/10/13
JO - Brain, behavior, & immunity - health
DO - 10.1016/j.bbih.2026.101388
UR - https://europepmc.org/article/MED/42927120
AB - Introduction Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating multisystem disorder associated with immune dysregulation yet lacks definitive biomarkers or effective therapies. Acute immune perturbations may transiently modulate disease manifestations.Methods We report the case of a female patient in her 60s with severe, long-standing ME/CFS who experienced changes in symptom following administration of recombinant zoster vaccine (RZV; Shingrix). Peripheral blood mononuclear cells were analyzed pre- and post-vaccination using flow cytometry, with comparison to a female healthy control. Plasma galectin-9 (Gal-9) levels were quantified by ELISA.Results Both RZV doses were associated with rapid, transient remission of symptoms, including improved sleep, cognition, pain, mobility, and respiratory function, followed by relapse. Immunologically, pre-vaccination profiling revealed elevated monocytes, increased CD71⁺ erythroid cells, and features of T cell exhaustion marked by Gal-9/PD-1 co-expression and impaired cytokine responses. Post-vaccination, monocyte frequency decreased, Gal-9⁺/PD-1⁺ T cells were reduced, and NK cell degranulation improved, indicating partial restoration of immune function.Conclusion This case demonstrates that immune stimulation via RZV may transiently reverse immune dysfunction and improve clinical symptoms in ME/CFS. These findings support a role for reversible immune exhaustion in disease pathogenesis and highlight potential avenues for biomarker development and therapeutic intervention.
SN - 2666-3546
ER -