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There are no known biomarkers that can distinguish between patients with ME\/CFS, although mitochondrial abnormalities are often demonstrated. We sought to assess the prevalence of ME\/CFS in limited cutaneous SSc (lcSSc) patients early in their disease (&lt;5 years from the onset of non-Raynaud\u2019s symptoms) and to determine if alterations in mitochondrial electron transport chain (ETC) transcripts and mitochondrial DNA (mtDNA) integrity could be used to distinguish between fatigued and non-fatigued patients. All SSc patients met ACR\/EULAR classification criteria. ME\/CFS-related symptoms were assessed through validated questionnaires, and the expression of ETC transcripts and mtDNA integrity were quantified via qPCR. SSc patients with ME\/CFS could be distinguished from non-fatigued patients through ETC gene analysis; specifically, reduced expression of ND4 and CyB and increased expression of Cox7C. ND4 and CyB expression correlated with indicators of disease severity. Further prospective and functional studies are needed to determine if this altered signature can be further utilized to better identify ME\/CFS in SSc patients, and whether ME\/CFS in early SSc disease could predict more severe disease outcomes.<\/jats:p>","DOI":"10.3390\/ijms241512057","type":"journal-article","created":{"date-parts":[[2023,7,28]],"date-time":"2023-07-28T01:51:47Z","timestamp":1690509107000},"page":"12057","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Evidence of a Novel Mitochondrial Signature in Systemic Sclerosis Patients with Chronic Fatigue Syndrome"],"prefix":"10.3390","volume":"24","author":[{"given":"Charmaine","family":"van Eeden","sequence":"first","affiliation":[{"name":"Division of Rheumatology, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2G3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9379-051X","authenticated-orcid":false,"given":"Desiree","family":"Redmond","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2G3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naima","family":"Mohazab","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2G3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maggie J.","family":"Larch\u00e9","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Medicine, McMaster University, Hamilton, ON L8N 3Z5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew L.","family":"Mason","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2G3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7407-6364","authenticated-orcid":false,"given":"Jan Willem","family":"Cohen Tervaert","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2G3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed S.","family":"Osman","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2G3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2087","DOI":"10.1136\/annrheumdis-2013-203716","article-title":"Preliminary analysis of the Very Early Diagnosis of Systemic Sclerosis (VEDOSS) EUSTAR multicentre study: Evidence for puffy fingers as a pivotal sign for suspicion of systemic sclerosis","volume":"73","author":"Minier","year":"2014","journal-title":"Ann. 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