Microbial infections in eight genomic subtypes of Chronic Fatigue Syndrome

J Clin Pathol. 2009 Dec 2. [Epub ahead of print]

Microbial infections in eight genomic subtypes of Chronic Fatigue Syndrome / Myalgic Encephalomyelitis (CFS/ME).

Zhang L, Goudh J, Christmas D, Mattey D, Richards S, Main J, Enlander D, Honeybourne D, Ayres J, Nutt DJ, Kerr J. St George's University of London, United Kingdom;

We have previously reported genomic subtypes of CFS/ME based on expression of 88 human genes. In this study we attempted to reproduce these findings, determine specificity of this signature to CFS/ME, and test for associations between CFS/ME subtype and infection. We determined expression levels of 88 human genes in blood of 61 new patients with idiopathic CFS/ME (according to Fukuda criteria), 6 patients with Q-fever associated CFS/ME form the Birmingham Q-fever outbreak (according to Fukuda criteria), 14 patients with endogenous depression (according to DSM-IV criteria) and 18 normal blood donors. In patients with CFS/ME differential expression was confirmed for all 88 genes. Q-CFS/ME patients had similar patterns of gene expression to idiopathic CFS/ME. Gene expression in endogenous depression patients was similar to that in the normal controls, except for upregulation of five genes (APP, CREBBP, GNAS, PDCD2, PDCD6).

Clustering of combined gene data in CFS/ME patients for this and our previous study (n=117 CFS/ME patients) revealed genomic subtypes with distinct differences in SF-36 scores, clinical phenotypes, severity and geographical distribution. Antibody testing for Epstein-Barr virus (EBV), enterovirus, Coxiella burnetii and parvovirus B19 revealed subtype-specific relationships for EBV and enterovirus, the two most common infectious triggers of CFS/ME.

PMID: 19955554 [PubMed - as supplied by publisher]

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written by Maff, December 14, 2009

Dr. Jonathan Kerr and colleagues have been instrumental in defining specific subtypes among ME/CFS patients. Previous work has established subtypes based on symptom patterns. Patients will no doubt be aware that there are core symptoms of ME/CFS but they may not suffer all the symptoms that others do and shared symptoms are experienced at different severities. To read more about subtypes based on symptoms based on This team's research please see Genetic study finds seven different types of Chronic Fatigue Syndrome.

This latest study is exciting in that genetic subtypes have been linked to specific viral infections. Such information could potentially be used in diagnosis and to tailor treatments more effectively to individual ME/CFS patients.