In contrast, mixed lineage kinase domain-like protein (MLKL) (FC = 0.89), which plays a critical role in tumour necrosis factor (TNF)-induced necroptosis, was significantly lower in ME/CFS patients than controls, verall, indicating an alteration of the immune response in ME/CFS patients. This evidence concerns the gene TNF and myalgic encephalomeyelitis/chronic fatigue syndrome.