title: Microbial infections in eight genomic subtypes of chronic fatigue syndrome/myalgic encephalomyelitis.
abstract: BACKGROUND
  The authors have previously reported genomic subtypes of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) based on expression of 88 human genes.
  
  
  OBJECTIVE
  To attempt to reproduce these findings, determine the specificity of this signature to CFS/ME, and test for associations between CFS/ME subtype and infection.
  
  
  METHODS
  Expression levels of 88 human genes were determined in blood of 62 new patients with idiopathic CFS/ME (according to Fukuda criteria), six patients with Q-fever-associated CFS/ME from the Birmingham Q-fever outbreak (according to Fukuda criteria), 14 patients with endogenous depression (according to DSM-IV criteria) and 29 normal blood donors.
  
  
  RESULTS
  In patients with CFS/ME, differential expression was confirmed for all 88 genes. Q-CFS/ME had similar patterns of gene expression to idiopathic CFS/ME. Gene expression in patients with endogenous depression was similar to that in the normal controls, except for upregulation of five genes (APP, CREBBP, GNAS, PDCD2 and PDCD6). Clustering of combined gene data in CFS/ME patients for this and the authors' previous study (117 CFS/ME patients) revealed genomic subtypes with distinct differences in SF36 scores, clinical phenotypes, severity and geographical distribution. Antibody testing for Epstein-Barr virus, enterovirus, Coxiella burnetii and parvovirus B19 revealed evidence of subtype-specific relationships for Epstein-Barr virus and enterovirus, the two most common infectious triggers of CFS/ME.
  
  
  CONCLUSIONS
  This study confirms the involvement of these genes in CFS/ME.
authors: Department of Cellular & Molecular Medicine, St George's University of London, London, UK.
authors: Lihan
authors: L
authors: Zhang
authors: John
authors: J
authors: Gough
authors: David
authors: D
authors: Christmas
authors: Derek L
authors: DL
authors: Mattey
authors: Selwyn C M
authors: SC
authors: Richards
authors: Janice
authors: J
authors: Main
authors: Derek
authors: D
authors: Enlander
authors: David
authors: D
authors: Honeybourne
authors: Jon G
authors: JG
authors: Ayres
authors: David J
authors: DJ
authors: Nutt
authors: Jonathan R
authors: JR
authors: Kerr
mesh_terms: D000328:Adult; D003863:Depression / Q000235:genetics; D004769:Enterovirus Infections / Q000150:complications / Q000235:genetics; D020031:Epstein-Barr Virus Infections / Q000150:complications / Q000235:genetics; D015673:Fatigue Syndrome, Chronic / Q000235:genetics / Q000821:virology*; D005260:Female; D015870:Gene Expression; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D016133:Polymerase Chain Reaction / Q000379:methods; D011778:Q Fever / Q000150:complications / Q000235:genetics; D015854:Up-Regulation; D014777:Virus Diseases / Q000150:complications* / Q000235:genetics