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Microbial infections in Eight Genomic Subtypes of Chronic Fatigue Syndrome / Myalgic Encephalomyelitis (CFS/ME)

Expression of 88 human genes was confirmed as being significantly different between CFS/ME patients and normal controls. Gene expression in endogenous depression patients was similar to that in the normal controls. CFS/ME patients can be grouped into Genomic subtypes which have different clinical phenotypes. There was evidence of subtype-specific relationships for Epstein-Barr virus (EBV) and enterovirus, the two most common triggers for CFS/ME.

 

J Clin Pathol. Published Online First: 2 December 2009. doi:10.1136/jcp.2009.072561

Copyright © 2009 by the BMJ Publishing Group Ltd & Association of Clinical Pathologists.
research-article
Microbial infections in eight genomic subtypes of Chronic Fatigue Syndrome / Myalgic Encephalomyelitis (CFS/ME)

Lihan Zhang1, John Goudh1, David Christmas2, Derek Mattey3, Selwyn Richards4, Janice Main5, Derek Enlander6, David Honeybourne7, Jon Ayres8, David J Nutt2, Jonathan Kerr1,*

1 St George's University of London, United Kingdom;
2 University of Bristol, United Kingdom;
3 Staffordshire Rheumatology Centre, United Kingdom;
4 Poole Hospital NHS Trust, United Kingdom;
5 Imperial College London, United Kingdom;
6 New York ME / CFS Service, United Kingdom;
7 Birmingham Heartlands Hospital, United Kingdom;
8 University of Birmingham, United Kingdom

Correspondence to: Jonathan R Kerr, Dept of Cellular & Molecular Medicine, St George's University of London, Cranmer Terrace, London, SW17 0RE, United Kingdom; jkerr@sgul.ac.uk

Accepted November 3, 2009

Abstract

We have previously reported genomic subtypes of CFS/ME basedon expression of 88 human genes. In this study we attemptedto reproduce these findings, determine specificity of this signatureto CFS/ME, and test for associations between CFS/ME subtypeand infection.

We determined expression levels of 88 human genes in blood of61 new patients with idiopathic CFS/ME (according to Fukudacriteria), 6 patients with Q-fever associated CFS/ME form theBirmingham Q-fever outbreak (according to Fukuda criteria),14 patients with endogenous depression (according to DSM-IVcriteria) and 18 normal blood donors. In patients with CFS/MEdifferential expression was confirmed for all 88 genes. Q-CFS/MEpatients had similar patterns of gene expression to idiopathicCFS/ME. Gene expression in endogenous depression patients wassimilar to that in the normal controls, except for upregulationof five genes (APP, CREBBP, GNAS, PDCD2, PDCD6).

Clustering of combined gene data in CFS/ME patients for thisand our previous study (n=117 CFS/ME patients) revealed genomicsubtypes with distinct differences in SF-36 scores, clinicalphenotypes, severity and geographical distribution. Antibodytesting for Epstein-Barr virus (EBV), enterovirus, Coxiellaburnetii and parvovirus B19 revealed subtype-specific relationshipsfor EBV and enterovirus, the two most common infectious triggersof CFS/ME.

Full text on: http://jcp.bmj.com/cgi/rapidpdf/jcp.2009.072561v1