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Diagnostic biomarker
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===Cytokine expression=== ''{{main article| page_name=Cytokine}}'' Several researchers are exploring if [[cytokine]] expression in ME/CFS is a unique enough signature to be used as a diagnostic marker.<ref name="Russell, 2016" /><ref name="Peterson, 2015" /><ref name="Hornig, 2016" /><ref name="Montoya, 2017" /> Cytokine expression changes in ME/CFS related to length of illness, with some cytokines levels increasing and some decreasing dependent on illness duration. [[Lindsey Russell|Russell]], et al, focused on a subset of three cytokines, [[IL-1α]], [[Interleukin 6|6]] and [[Interleukin 8|8]], in plasma samples and concluded that: "Setting these 3 markers as a triple screen and adjusting their contribution according to illness duration [the] sub-groups produced ME/CFS classification accuracies of 75–88%."<ref name="Russell, 2016" /> Obstacle for use: Since cytokine expression changes in ME/CFS related to progression of the illness, the validity of potentially useful markers may be obscured by such variation.<ref name="Russell, 2016" /> In 2016, Landi, et al, "observed highly significant reductions in the concentration of circulating [[interleukin]] [[Interleukin 16|(IL)-16]], [[Interleukin 7|IL-7]], and [[Vascular endothelial growth factor|Vascular Endothelial Growth Factor]] A (VEGF-A) in ME/CFS patients" but not in patients of other chronic illnesses with fatigue as a symptom. This three cytokine pattern is being studied further as a potential biomarker for ME/CFS.<ref name="Landi, 2016" /> In 2018, [[Kegan Moneghetti|Moneghetti]], et al, compared the results of cytokine profiles 18 hours post exercise for ME/CFS patients vs healthy patients matched for cardiac structure and exercise capacity. They found that the most discriminatory cytokines detected post exercise in ME/CFS patients were [[CD40L]], [[platelet activator inhibitor]], [[Interleukin 1 beta|interleukin 1-β]], [[Interferon alpha|interferon-α]] and [[CXCL1]]. They concluded that cytokine profiling following exercise may help differentiate patients with ME/CFS from sedentary controls.<ref name="Moneghetti, 2018" /> Obstacle for use: These studies need to be duplicated with other patient cohorts to assure the results are specific enough for an accurate diagnosis of ME/CFS.
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