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Diagnostic biomarker
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=== Messenger RNA (mRNA) === In 2021, a Dutch study identified a signature of 23 genes capable of distinguishing between ME/CFS cases and healthy controls. They used publicly available mRNA expression data and and DNA methylation data from peripheral blood mononuclear cells (PBMCs) of 93 ME/CFS patients and 25 healthy controls. The authors believe that ten of the 23 genes could be interpreted in the context of the derailed immune system of ME/CFS. The ten proteins focused on in this study are MAPK4, ARRB1, GOLGA4, ABCE1, PHKA2, IL2RB, CCR4, HLA-DQA1, PRG4 and OGG1. The mRNA transcripts encoding these proteins were all downregulated in ME/CFS patients compared to healthy controls.<ref>{{Cite journal | last = Metselaar | first = Paula I. | authorlink = | last2 = Mendoza-Maldonado | first2 = Lucero | authorlink2 = | last3 = Li Yim | first3 = Andrew Yung Fong | authorlink3 = | last4 = Abarkan | first4 = Ilias | authorlink4 = | last5 = Henneman | first5 = Peter | author-link5 = | last6 = te Velde | first6 = Anje A. | author-link6 = | last7 = Schönhuth | first7 = Alexander | last8 = Bosch | first8 = Jos A. | last9 = Kraneveld | first9 = Aletta D. | date = Feb 2021 | title = Recursive ensemble feature selection provides a robust mRNA expression signature for myalgic encephalomyelitis/chronic fatigue syndrome | url =http://www.nature.com/articles/s41598-021-83660-9|journal=Scientific Reports|language=en|volume=11|issue=1 | page = 4541 |doi=10.1038/s41598-021-83660-9|issn=2045-2322|pmc = 7907358|pmid=33633136|access-date=|quote=|via=}}</ref>
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