Evidence map›Paper›PMID 42533331›Full record

ArticleJournal of translational medicine2026

Circulating extracellular vesicles-microRNAs as potential biomarkers for the identification of ME/CFS: differentiating fatigue-related conditions.

Akiko Eguchi, Hirohiko Kuratsune, Yasuhito Nakatomi, Takao Yasui, Ryo Nakagawa, Yasuyoshi Watanabe, Sanae Fukuda

Abstract read
In one paragraph

Article in Journal of translational medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Akiko EguchiBiobank Center, Mie University Hospital, 2-174 Edobashi, Tsu, Mie, 514- 8507, Japan. akieguchi@med.mie-u.ac.jp.ORCID http://orcid.org/0000-0002-0555-2707
Hirohiko KuratsuneDivision of Health Sciences, Osaka University Graduate School of Medicine, 1-7 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Yasuhito NakatomiFatigue & Sleep Clinic Yodoyabashi, Osaka, 541-0043, Japan.
Takao YasuiDepartment of Biomolecular Engineering, Graduate School of Engineering, Nagoya University, Furo, Chikusa, Nagoya, 464-8603, Japan.
Ryo NakagawaOmiya City Clinic, Saitama, 330-0854, Japan.
Yasuyoshi WatanabeRIKEN Compass to Healthy Life Research Complex Program, Kobe, 650- 0047, Japan.
Sanae FukudaDepartment of Health Welfare Sciences, Kansai University of Welfare Sciences, Kashiwara, 582-0026, Japan.

Funding

AMED JP25fk0108914AMED JP26fk0210209Japan Society for the Promotion of Science KAKEN 20K11521Japan Society for the Promotion of Science KAKEN 23K10929
6 · The paper itself

Abstract

backgroundMyalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating, multi-systemic condition that has gained renewed global attention due to its clinical overlap with the growing population of long COVID patients. Despite ongoing efforts to characterize the disease, definitive diagnostic molecular markers are yet to be fully established, posing challenges in clinically differentiating from idiopathic chronic fatigue (ICF) and depression (Dep). This study aimed to identify circulating extracellular vesicles (EVs)-associated microRNAs (miRNAs) that serve as both diagnostic signatures and windows into the disease's underlying pathophysiology.

methodsCirculating EVs from ME/CFS (n = 6), ICF (n = 6), and depression (n = 8) patients were analyzed using flow cytometry, nano-tracking analysis, and comprehensive miRNA analysis. Differentially expressed miRNAs were analyzed using KEGG pathway enrichment to identify ME/CFS-specific signatures. Key candidate biomarkers were further validated in an additional healthy control (HC) cohort (n = 4).

resultsME/CFS-EVs exhibited a unique subpopulation with high calcein intensity and larger diameters. Initial global miRNA profiling (Volcano plot) identified miR-21-5p, let-7f-5p, miR-26b-5p, and miR-20a-5p as significantly dysregulated EV-miRNAs in ME/CFS compared to ICF and Dep. To explore systemic pathophysiology, we identified a 114 EV-miRNA signature that achieved 87.0 ± 4.8% sensitivity and 93.7 ± 2.4% specificity within repeated cross-validation of the discovery cohort. After adjusting for covariates, 91 miRNAs remained significant; pathway analysis of the 62 up-regulated EV-miRNAs revealed significant enrichment in neuro-systemic axes, encompassing cellular structural integrity (focal adhesion), core signaling hubs (PI3K-Akt), and systemic homeostasis (such as insulin signaling and endocrine functions). Preliminary evaluation confirmed that these target EV-miRNAs remained at minimal or undetectable levels in the HC group.

conclusionsA 62 EV-miRNA signature provides insight into the interconnected neuro-systemic pathways disrupted in ME/CFS, particularly those governing neuronal connectivity and cellular scaffolding. Within this candidate EV-miRNA signature, the top-ranked miRNAs-miR-21-5p, let-7f-5p, miR-26b-5p, and miR-20a-5p-emerge as potential candidate biomarkers whose specific elevation was not shared by HC. These findings establish a valuable framework for targeted diagnosis and enhance our understanding of the molecular pathways involved in synaptic and structural alterations in ME/CFS.

Indexed as

Extracellular VesiclesFatigue Syndrome, ChronicMicroRNAsAdultBiomarkersCase-Control StudiesDiagnosis, DifferentialFemaleGene Expression ProfilingHumansMaleMiddle AgedBiomarkersMicroRNAsAbnormal neuronal pathwayCirculating EVME/CFSNon-invasive biomarkers

Identifiers

PMID42533331
PMCPMC13425937

What Socratic holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.