Among the additional genes of interest identified during relapse in the ME/CFS patients were seven mitochondrial genes in P1 that included ACOT9, which is a member of the acyl-CoA family involved in the hydrolysis of Coenzyme A. HADHA, HADHB are both involved in mitochondrial beta-oxidation of long chain fatty acids into either 3-etoacyl-CoA if NAD is present, or acetyl CoA if both NAD and coenzyme A are present [34]. This evidence concerns the gene ACOT9 and myalgic encephalomeyelitis/chronic fatigue syndrome.