This data also demonstrates a molecular basis for the reduction in NK cytotoxicity seen in CFS/ME patients mediated by miRNA, via direct down regulation of enzymes required for processing cytotoxic vesicle components and down regulation of genes within Autophagy, WNT and AKT pathways (ULK1, ATG2A, PMEPA1, DKK3, PDCD4) required for normal proliferation and maturation of activated NK cells. The gene discussed is PMEPA1; the disease is myalgic encephalomeyelitis/chronic fatigue syndrome.