Development and validation of blood-based diagnostic biomarkers for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) using EpiSwitch<sup>®</sup> 3-dimensional genomic regulatory immuno-genetic profiling. — ME/CFS Atlas
Development and validation of blood-based diagnostic biomarkers for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) using EpiSwitch® 3-dimensional genomic regulatory immuno-genetic profiling.
Hunter, Ewan, Alshaker, Heba, Bundock, Oliver et al. · Journal of translational medicine · 2025 · DOI
Quick Summary
Researchers developed a new blood test called EpiSwitch®CFS that may help diagnose ME/CFS by detecting specific patterns in how DNA is organized in blood cells. When tested on stored blood samples from 47 ME/CFS patients and 61 healthy people, the test correctly identified 92% of ME/CFS patients and correctly ruled out 98% of healthy controls. This could potentially help doctors diagnose ME/CFS more reliably, since there is currently no standard blood test for the condition.
Why It Matters
ME/CFS currently lacks objective diagnostic criteria, leading to delayed diagnosis and mismanagement. A validated blood biomarker could enable earlier detection, reduce diagnostic uncertainty, and potentially identify patient subgroups likely to respond to specific therapies like rituximab or glatiramer acetate. This work provides preliminary evidence that epigenetic profiling may bridge the diagnostic gap in ME/CFS.
Observed Findings
A 200-marker epigenetic signature distinguished ME/CFS patients from healthy controls with 92% sensitivity and 98% specificity in the validation cohort.
Pathway analysis identified dysregulation of interleukins, TNFα, neuroinflammatory pathways, toll-like receptor signaling, and JAK/STAT signaling in ME/CFS samples.
IL-2 was identified as a shared pathway between the ME/CFS epigenetic signature and mechanisms of action of rituximab and glatiramer acetate.
Disease-specific chromosome conformation patterns were detected in peripheral blood mononuclear cells of ME/CFS patients.
Inferred Conclusions
Epigenetic profiling via 3D chromosome conformation analysis may serve as an objective blood-based diagnostic test for ME/CFS.
Immune dysregulation, particularly involving IL-2 signaling pathways, appears central to ME/CFS pathophysiology and may identify treatment responder populations.
The EpiSwitch®CFS test could potentially stratify patients for targeted immunomodulatory therapies with higher likelihood of benefit.
Remaining Questions
Will the 200-marker signature maintain equivalent diagnostic accuracy in prospective, multicenter validation studies with diverse patient populations and disease severities?
Can IL-2 pathway profiling reliably predict individual treatment response to rituximab or glatiramer acetate in ME/CFS patients?
What This Study Does Not Prove
This retrospective study does not establish that chromosome conformations cause ME/CFS—they may be markers of disease rather than drivers. The findings require prospective validation in independent, diverse patient populations before clinical implementation. High sensitivity/specificity in a retrospective cohort does not guarantee equivalent performance in real-world clinical settings with varied disease presentations.
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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