As it has also been shown that dexamethasone, as a synthetic steroid similar to the stress hormone cortisol, upregulates the expression of mucin-16, this provides an additional link between mucin-16 expression, stress, and immune dysregulation in ME/CFS (Seo et al. 2007; Karlan et al. 1988). This evidence concerns the gene MUC16 and myalgic encephalomeyelitis/chronic fatigue syndrome.