JOURNAL OF IIMER May 2026 The authors’ explicit goal is to transform ME from a symptom-based syndrome into a mechanism-driven, treatable condition. This review is a substantive step in that direction. Original Paper Perera KD, Oltra E, Carding SR. Human Endogenous Retroviruses in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Emerging Roles in Pathogenesis, Immunity, Biomarkers and Therapeutics. Int. J. Mol. Sci. 2026, 27(10), 4309. DOI: 10.3390/ijms27104309 - Published: 12 May 2026 - Open Access (CC BY) COMPASS-ME The COMPASS-ME Study - Investigating the Microbial Landscape of ME One of the questions that has persistently complicated ME research is deceptively simple: what role, if any, do microbes play in triggering or sustaining the disease? Many patients report a viral infection preceding the onset of their symptoms, and the overlap with long COVID has reinforced the view that post-infectious mechanisms are central to understanding ME. Yet despite decades of investigation, no single pathogen has been definitively linked to the condition, and the broader microbial picture - encompassing not only viruses but bacteria and fungi - has remained poorly characterised. The COMPASS-ME study, funded by Invest in ME Research and based at the Quadram Institute Bioscience on Norwich Research Park, is designed to address precisely this gap. Led by LunaNova fellow Dr Krishani Perera, working within Professor Simon Carding's research group, the study will analyse the mucosal microbial communities - including viruses, bacteria, and fungi - of individuals with and without ME, using mucosal swab samples taken from sites where microbial infections commonly begin. The approach is both scientifically rigorous and practically considered: given the significant mobility difficulties experienced by many people with ME, sampling methods have been chosen specifically to minimise the burden on participants and ensure the study is as inclusive as possible. Dr Perera brings to this work a background in molecular virology developed across Kansas State University and postdoctoral research in France, where she studied viruses that persist in immune-privileged sites in the body and contribute to long-term health consequences. That expertise in viral persistence and immune evasion is directly relevant to ME, where the mechanism by which an initial infection might give rise to chronic, systemic illness remains one of the field's central unanswered questions. The longer-term ambition of the COMPASS-ME study is to contribute to the development of reliable diagnostic tools for a disease that currently has none, and to identify the biological mechanisms that might, in time, be amenable to targeted treatment. It is work that is painstaking, methodologically careful, and - given the complexity of ME and the number of intersecting biological systems involved - necessarily cautious in its conclusions. That caution is a strength, not a limitation. The field has suffered from premature certainty in the past. What is needed now is precisely the kind of systematic, well-grounded investigation that this study represents. Further information: quadram.ac.uk Invest in ME Research Page 10 of 35
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