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Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is a multisystem disease, the pathogenesis of which remains undetermined.

We set out to determine the precise abnormalities of gene expression in the blood of patients with CFS/ME. We analyzed gene expression in peripheral blood from 25 patients with CFS/ME diagnosed according to the Centers for Disease Control and Prevention diagnostic criteria and 50 healthy blood donors, using a microarray with a cutoff fold difference of expression of >/=2.5. Genes showing differential expression were further analyzed in 55 patients with CFS/ME and 75 healthy blood donors, using quantitative polymerase chain reaction.

Differential expression was confirmed for 88 genes; 85 were upregulated, and 3 were downregulated. Highly represented functions were hematological disease and function, immunological disease and function, cancer, cell death, immune response, and infection.

Clustering of quantitative polymerase chain reaction data from patients with CFS/ME revealed 7 subtypes with distinct differences in Medical Outcomes Survey Short Form-36 scores, clinical phenotypes, and severity.

[Note: See also an article and readers’ comments published in The Economist on May 8 - “The roots of chronic fatigue - ME is a puzzling illness, but it appears to have a biological basis and a test for it could be developed.”]

Source: Journal of Infectious Diseases. 2008 Apr 15;197(8):1171-1184. PMID: 18462164, by Kerr JR, Petty R, Burke B, Gough J, Fear D, Sinclair LI, Mattey DL, Richards SC, Montgomery J, Baldwin DA, Kellam P, Harrison TJ, Griffin GE, Main J, Enlander D, Nutt DJ, Holgate ST. Department of Cellular & Molecular Medicine, St. George's University of London; Department of Asthma, Allergy and Respiratory Sciences, King's College London; Departments of Infection and Medicine, Windeyer Institute of Medical Sciences, University College London; Department of Infectious Diseases and General Medicine, Imperial College London, St. Mary's Hospital, London; Psychopharmacology Unit, Department of Community Based Medicine, University of Bristol, Bristol; Staffordshire Rheumatology Centre, Stoke on Trent; 8Dorset CFS Service, Poole Hospital, Dorset; ;MRC Department of Immunopharmacology, University of Southampton, Southampton General Hospital, Southampton, UK; Penn Microarray Facility, University of Pennsylvania, Philadelphia; New York ME/CFS Service, New York, USA. [E-mail: jkerr@sgul.ac.uk]