JOURNAL OF IIMER May 2026 Session 2: A Post-Genomics Approach to ME The sequencing of the human genome was a beginning, not an end. Post-genomics research takes what that sequencing revealed and asks the harder questions - how are genes expressed, how is expression regulated, and how do molecular processes go wrong in disease? For ME, a condition whose biological mechanisms remain incompletely understood, these tools are proving increasingly powerful. The session is moderated by Dr Elisa Oltra, professor of Cell and Molecular Biology at the Universidad Católica de Valencia and a member of the EMERG. Dr Oltra has investigated the molecular basis of ME, identifying irregularities in RNAseL expression and miRNA profile changes in patients - work that places her at the intersection of molecular biology and ME research. Andrew Grimson, Professor of Molecular Biology and Genetics at Cornell University and Associate Director of the Cornell NIH ME Research Center, will present on T cell dysregulation in ME. His laboratory has used single-cell RNA sequencing to examine circulating immune cells in ME patients, finding evidence of T cell exhaustion - a state in which immune cells become progressively less effective, associated with chronic immune stimulation or long-term pathogen exposure. Published in the Proceedings of the National Academy of Sciences, the findings also identified changes in platelet gene expression during post-exertional malaise. The same pattern of T cell exhaustion has been observed in long COVID. Dr Vilma Lammi of the Institute for Molecular Medicine Finland (FIMM), University of Helsinki, coordinates the international Long COVID Host Genetics Initiative. Her work spans the genetics of both long COVID and ME, including a genome-wide association study of long COVID published in Nature Genetics in 2025. At BRMEC15 she will present findings on common genetic variants across long COVID and ME from large-scale international cohorts - evidence that the two conditions may share underlying biological architecture. Dr Elizabeth Worthey, Director of the Center for Computational Genomics and Data Science at the University of Alabama at Birmingham, brings a precision medicine perspective. A pioneer in clinical genomics, she was part of the team that in 2009 performed the first successful use of genomic sequencing to change a patient's treatment. At BRMEC15 she will present on actionable molecular stratification of ME using an N-of1 precision medicine approach - work with direct implications for how patients might one day be diagnosed and treated according to their individual molecular profiles. The three presentations reflect a field moving from description towards mechanism - and from mechanism towards the prospect of targeted intervention. Session 3: Chronic Infection Aetiology The role of chronic or persistent infection in ME has been debated for decades, but the tools to investigate it rigorously are now available. Viral persistence in tissue reservoirs, myeloid reprogramming, intracellular pathogens and the long-term consequences of immune activation following infection are all areas where ME research is now making meaningful progress. The parallels with long COVID - where spike Invest in ME Research Page 24 of 35
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