title: Epigenetic modifications and glucocorticoid sensitivity in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS).
abstract: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a debilitating idiopathic disease characterized by unexplained fatigue that fails to resolve with sufficient rest. Diagnosis is based on a list of symptoms and exclusion of other fatigue-related health conditions. Despite a heterogeneous patient population, immune and hypothalamic-pituitary-adrenal (HPA) axis function differences, such as enhanced negative feedback to glucocorticoids, are recurring findings in ME/CFS studies. Epigenetic modifications, such as CpG methylation, are known to regulate long-term phenotypic differences and previous work by our group found DNA methylome differences in ME/CFS, however the relationship between DNA methylome modifications, clinical and functional characteristics associated with ME/CFS has not been examined.
  
  
  
  We examined the DNA methylome in peripheral blood mononuclear cells (PBMCs) of a larger cohort of female ME/CFS patients using the Illumina HumanMethylation450 BeadChip Array. In parallel to the DNA methylome analysis, we investigated in vitro glucocorticoid sensitivity differences by stimulating PBMCs with phytohaemagglutinin and suppressed growth with dexamethasone. We explored DNA methylation differences using bisulfite pyrosequencing and statistical permutation. Linear regression was implemented to discover epigenomic regions associated with self-reported quality of life and network analysis of gene ontology terms to biologically contextualize results.
  
  
  
  We detected 12,608 differentially methylated sites between ME/CFS patients and healthy controls predominantly localized to cellular metabolism genes, some of which were also related to self-reported quality of life health scores. Among ME/CFS patients, glucocorticoid sensitivity was associated with differential methylation at 13 loci.
  
  
  
  Our results indicate DNA methylation modifications in cellular metabolism in ME/CFS despite a heterogeneous patient population, implicating these processes in immune and HPA axis dysfunction in ME/CFS. Modifications to epigenetic loci associated with differences in glucocorticoid sensitivity may be important as biomarkers for future clinical testing. Overall, these findings align with recent ME/CFS work that point towards impairment in cellular energy production in this patient population.
authors.affiliation: Department of Biological Sciences, University of Toronto, Scarborough, 1265 Military Trail, Toronto, ON, M1C 1A4, Canada.|Department of Cell and Systems Biology, University of Toronto, Toronto, ON, Canada.
authors.forename: Wilfred C
authors.initials: WC
authors.lastname: de Vega
authors.affiliation: Department of Biological Sciences, University of Toronto, Scarborough, 1265 Military Trail, Toronto, ON, M1C 1A4, Canada.|Present affiliation: Department of Biological Sciences, Lehigh University, Bethlehem, PA, USA.
authors.forename: Santiago
authors.initials: S
authors.lastname: Herrera
authors.affiliation: Solve ME/CFS Initiative, Los Angeles, CA, USA.|Present affiliation: The Bateman Horne Center of Excellence, Salt Lake City, UT, USA.
authors.forename: Suzanne D
authors.initials: SD
authors.lastname: Vernon
authors.affiliation: Department of Biological Sciences, University of Toronto, Scarborough, 1265 Military Trail, Toronto, ON, M1C 1A4, Canada. patrick.mcgowan@utoronto.ca.|Department of Cell and Systems Biology, University of Toronto, Toronto, ON, Canada. patrick.mcgowan@utoronto.ca.|Department of Psychology, University of Toronto, Toronto, ON, Canada. patrick.mcgowan@utoronto.ca.|Department of Physiology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada. patrick.mcgowan@utoronto.ca.
authors.forename: Patrick O
authors.initials: PO
authors.lastname: McGowan
mesh_terms: D016022:Case-Control Studies; D015331:Cohort Studies; D019175:DNA Methylation / Q000187:drug effects; D044127:Epigenesis, Genetic / Q000187:drug effects*; D015673:Fatigue Syndrome, Chronic / Q000097:blood / Q000235:genetics* / Q000473:pathology / Q000503:physiopathology; D005260:Female; D056426:Genetic Loci / Q000235:genetics; D005938:Glucocorticoids / Q000494:pharmacology*; D006801:Humans; D007031:Hypothalamus / Q000187:drug effects / Q000503:physiopathology; D007963:Leukocytes, Mononuclear / Q000187:drug effects / Q000378:metabolism; D008875:Middle Aged; D010913:Pituitary-Adrenal System / Q000187:drug effects / Q000503:physiopathology; D011788:Quality of Life; D015398:Signal Transduction / Q000187:drug effects
chemical_list: D005938:Glucocorticoids
keywords: Chronic fatigue syndrome; Dna methylation; Epigenetics; Glucocorticoid; Hpa axis; Immune cells; Myalgic encephalomyelitis