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Diagnostic biomarker
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== Combination of methods == ===Blood and muscle nerves (electrical)=== A combination of M-wave, TBars, and CD26 values has been proposed as a possible diagnostic marker. A 2016 study in [[France]] by [[Fenouillet]], et al, examined 36 ME/CFS cases and 11 healthy controls with regard to three biological variables: a) post-exercise [[M-wave]] - a measurement after electrical stimulation of muscle nerves which coordinates with [[Muscle fatigability|muscle fatigue]] b) [[TBARS]] variations - a plasma marker which represents excessive oxidative stress response to exercise, and c) [[CD26]]-expression at rest - a protein potentially related to [[inflammation]], which was found to decrease in CFS patients. Although the researchers set out to explore physiological and biological abnormalities that could be indicative of the etiology, "striking differences" in the results between patients and controls lead them to believe that this combination could be used to identify patients with ME/CFS and help to distinguish ME/CFS patients from [[fibromyalgia]] patients.<ref name="Fenouillet, 2016" /> Obstacle for use: The findings in this published study need to be validated through replication by other studies. ===Blood and fecal matter=== In 2016 gut [[microbiome]] study done by [[Ludovic Giloteaux|Giloteaux]], [[Maureen Hanson | Hanson]], et. al., the gut bacterial [[microbiome]] of 48 [[ME/CFS]] patients and 39 healthy controls was examined by sequencing regions of 16S [[ribosomal ribonucleic acid]] (rRNA) genes that allow identification of the different types of bacteria present in the stool as well as [[inflammatory markers]] from serum. "Bacterial diversity was decreased in the ME/CFS specimens compared to controls, in particular, a reduction in the relative abundance and diversity of members belonging to the [[Firmicutes phylum]]...Using a machine learning approach trained on the data obtained from [[16S rRNA]] and inflammatory markers, individuals were classified correctly as ME/CFS with a cross-validation accuracy of 82.93%."<ref name="Giloteaux, 2016" />
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