Sharma, Sayan, Rodger, Euan J, Chatterjee, Aniruddha et al. · Trends in genetics : TIG · 2026 · DOI
This review examines how chemical tags on DNA (called DNA methylation) may help explain why ME/CFS, long COVID, fibromyalgia, and hypermobile Ehlers-Danlos syndrome share similar symptoms. The authors propose that studying these chemical changes across these related conditions could improve diagnosis and treatment. However, this is a framework paper synthesising existing evidence, not a new study proving how methylation causes these illnesses.
By analogy from this framework, methylation patterns associated with long COVID and fibromyalgia may yield mechanistic insights applicable to ME/CFS, particularly given symptom overlap. The proposed cross-condition approach may inform future diagnostic and biomarker research in ME/CFS. However, relevance to ME/CFS-specific pathophysiology depends on validation studies in well-characterised ME/CFS cohorts.
This review does not establish that DNA methylation causes any of these four conditions, nor does it demonstrate that methylation-based diagnostics are clinically ready. It does not prove that findings in fibromyalgia or long COVID will directly apply to ME/CFS populations. It does not recommend any methylation-based treatment.
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 →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Sharma, Sayan, Rodger, Euan J, Chatterjee, Aniruddha, & Tate, Warren P (2026). DNA methylation: unifying framework for complex chronic conditions.. Trends in genetics : TIG. https://doi.org/10.1016/j.tig.2026.09.001
BibTeX
@article{mecfsatlas-sharma-2026-dna-methylation,
author = {Sharma, Sayan and Rodger, Euan J and Chatterjee, Aniruddha and Tate, Warren P},
title = {DNA methylation: unifying framework for complex chronic conditions.},
journal = {Trends in genetics : TIG},
year = {2026},
doi = {10.1016/j.tig.2026.09.001},
note = {PubMed: 42786072},
url = {https://www.mecfsatlas.com/evidence/sharma-2026-dna-methylation},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-09-25. https://www.mecfsatlas.com/evidence/sharma-2026-dna-methylation
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