E2 ModerateModerate confidencePEM unclearCross-SectionalPeer-reviewedReviewed
Epigenetic modifications and glucocorticoid sensitivity in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS).
de Vega, Wilfred C, Herrera, Santiago, Vernon, Suzanne D et al. · BMC medical genomics · 2017 · DOI
Quick Summary
This study looked at chemical tags attached to DNA in immune cells from ME/CFS patients and compared them to healthy people. Researchers found that ME/CFS patients had different patterns of these chemical tags, especially in genes related to how cells produce energy. Some of these differences were linked to patients' reported quality of life, suggesting that changes in how genes are regulated may contribute to ME/CFS symptoms.
Why It Matters
Understanding epigenetic modifications in ME/CFS could help identify biological mechanisms underlying the disease and lead to objective biomarkers for diagnosis. The link between DNA methylation patterns and glucocorticoid sensitivity is particularly important because the HPA axis dysfunction is a consistently observed feature in ME/CFS, and biomarkers could improve clinical testing and patient stratification.
Observed Findings
- 12,608 differentially methylated sites identified between ME/CFS patients and healthy controls, predominantly in genes involved in cellular metabolism
- Some methylation differences were associated with patients' self-reported quality of life health scores
- Among ME/CFS patients, 13 epigenetic loci showed differential methylation correlated with glucocorticoid sensitivity differences
- Epigenetic modifications were found despite the heterogeneous clinical presentation of ME/CFS
Inferred Conclusions
- DNA methylation modifications in cellular metabolism genes may contribute to immune and HPA axis dysfunction in ME/CFS
- Epigenetic modifications at loci affecting glucocorticoid sensitivity could serve as potential biomarkers for clinical testing
- Impairment in cellular energy production processes is implicated in ME/CFS pathophysiology
Remaining Questions
- Do these epigenetic modifications precede ME/CFS onset or develop as a consequence of the illness, and are they reversible with treatment?
- How do methylation patterns differ in male versus female ME/CFS patients, and are results generalizable across demographic groups?
- What external factors (infections, stress, environmental exposures) might trigger or maintain these epigenetic changes in ME/CFS?
What This Study Does Not Prove
This study demonstrates correlation between DNA methylation patterns and ME/CFS but does not prove that these epigenetic changes cause the disease—they could be consequences of the illness rather than causes. The findings are limited to female patients and peripheral blood cells, so results may not apply to male ME/CFS patients or other tissue types. The study does not establish whether these methylation changes are reversible or how they develop over time.
Tags
Symptom:Fatigue
Biomarker:Gene ExpressionBlood Biomarker
Method Flag:Exploratory OnlySex-StratifiedWeak Case DefinitionSmall Sample
Metadata
- DOI
- 10.1186/s12920-017-0248-3
- PMID
- 28231836
- Review status
- Editor reviewed
- Evidence level
- Single-study or moderate support from human research
- Last updated
- 12 April 2026
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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