Dr. Konstance Knox
Presents STAT1 Data to
Researchers and Clinicians at AACFS Conference
by Alan Cocchetto, NCF Medical Director
(Copyright 2004)
The American Association for Chronic Fatigue
Syndrome (AACFS) held its latest conference
on October 8-10, 2004 in Madison, Wisconsin. The three-day
conference was co-sponsored
by the Centers for Disease Control (CDC), the National Center
for Infectious Diseases and
hosted locally by the Wisconsin CFS Association.
The National CFIDS Foundation (NCF) sponsored
this STAT1 study through its Research Grant Program with sole
funding provided by patient donations. STAT1 is known to be a
critically important protein necessary for mounting an
appropriate immune response to bacterial and viral pathogens.
Details of its importance in host immunity has been previously
reported upon in an investigative report in the Forum. Click
here to read our
articles about STAT1.
This research project was completed by Dr.
Konstance Knox and Dr. Donald Carrigan, scientists from the
Institute for Viral Pathogenesis (IVP). At the AACFS Conference,
Dr. Konstance Knox presented the following research data in the
microbiology/immunology portion of the conference:
"Deficiency in the
Expression of STAT1 Protein in a Subpopulation
of Patients with Chronic Fatigue Syndrome (CFS)"
by KK Knox, A Cocchetto, E Jordan, D Leech, DR Carrigan
Background:
CFS is a debilitating illness associated with persistent severe
fatigue, a variety of physical and
neuropsychological signs and symptoms, and frequently, an
unusual susceptibility to a variety
of infections. The study of intracellular signal transduction
pathways may have provided a key
insight into the immunological defect operative in CFS patients.
Signal transducers and activators of transcription (STAT) are a
family of proteins that play central roles in the responses of
cells to cytokines. Specifically, the protein STAT1 is
intimately involved in the response of cells to Type I (alpha
and beta) and Type II (gamma) interferons.
Objectives:
The aim of these studies was to evaluate samples of peripheral
blood mononuclear cells (PBMC) from CFS patients and healthy
control subjects for the expression of STAT1.
Methods:
PBMC were purified and lysed in a buffer containing
non-ionic detergent, a protease inhibitor cocktail and a
combination of two proteasomal protease inhibitors (MG-132 and
lactacystin). Samples corresponding to known numbers of PBMC
were then subjected to an immunoblotting procedure using a STAT1
specific antiserum (sc-592; Santa Cruz Biotechnology). A
quantitation method was developed using densitometric scanning
of the protein bands detected by the antiserum. Titration
experiments with PBMC from control subjects demonstrated that
STAT1 protein detection was quantitatively linear for samples of
between 20000 and 140000 cells per well in PAGE. Therefore, PBMC
samples were screened for STAT1 protein using 100000 cells per
well. Adequacy of protein in all samples was monitored by
staining the immunoblots for actin.
Results:
In both CFS patients and controls, five proteins reacting
with the sc592 antiserum were identified. Specificity of the
antiserum staining was demonstrated by complete blocking of the
detection of all five proteins by preincubation of the antiserum
with the peptide used for production of the antiserum. STAT1
proteins detected were (1) a minor, inconsistent band of
approximately 150 kiloDaltons (kD) (function unknown), (2) a
strong band at 91 kD (STAT1-alpha splice variant; STAT1-91), (3)
a strong band at 84 kD (STAT1-beta splice variant; STAT1-84),
(4) a strong band at 56 kD (function unknown; STAT1-56) and (5)
a strong band at 51 kD (function unknown; STAT1-51). STAT1-91
and STAT1-84 were not consistently resolved from one another and
were analysed together (STAT1-91/84). Results based on 27
controls and 25 CFS patient samples were presented at the
conference on several overheads as follows:
Two-Sided Fisher's Exact
Test Analysis of STAT1-91/84 Expression
in Healthy Control Subjects and CFS Patients:
|
Healthy
Controls |
CFS
Patients |
Total |
STAT1-91/84
Negative |
1
(4%) |
8
(32%) |
9 |
STAT1-91/84
Positive |
26
(96%) |
17
(68%) |
43 |
Total |
27
(100%) |
25
(100%) |
52 |
p = 0.0098; Very Significant
Comparison
of Positivity for STAT-91/84, STAT1-56 and STAT1-51 for
Healthy Control Subjects and CFS Patients:
Subjects |
Percent
STAT1-91/84
Positive |
Percent
STAT1-56
Positive |
Percent
STAT1-51
Positive |
CFS
Patients |
68%
(17/25) |
84%
(21/25) |
100%
(25/25) |
Healthy
Controls |
96%
(26/27) |
93%
(25/27) |
96%
(26/27) |
Discussion:
Dr. Knox's overheads included the following discussion
highlights that were presented to the
audience at her presentation:
* STAT is known as Signal Transducers and
Activators of Transcription
- Family of transcription factors
- Activated by a variety of cytokines including:
Interferons: alpha-interferon, beta-interferon and
gamma-interferon
Interleukins: IL-2,3,4,5,6,7,9,10,12,13,15
Growth hormones: erythropoietin/EPO, growth hormone/GH,
prolactinPRL
Growth factors: EDF, PDGF, CSF-1, G-CSF
* STAT: Involved in a wide spectrum of
physiological responses
- Cell proliferation
- Cell differentiation
- Apoptosis
- Immune responses
- Development
- Hematopoiesis
* STAT1:
- Centrally involved in the response of cells to:
Type 1 interferons (alpha and beta)
Type 2 interferons (gamma)
- In both animals and humans, defects in STAT1 are associated
with fatal infections
by both viruses and bacteria
* Importance of STAT1 in CFS stems from recent observations
suggesting that Type 1
interferon responses are abnormal in many patients with CFS
* An interesting observation in this area of
research is that of Englebienne and colleagues:
- As the RNase L ratio (37 kD/80 kD) increases, you see a
decrease in STAT1 protein
- Hypothesis: STAT1 is cleaved/degraded by the same enzyme that
is cleaving RNase L
* IVP study of STAT1 protein expression in CFS
patients:
- Blood samples from 25 CFS patients were studied from two
physician based practices
in Rochester, NY and Albuquerque, NM
- Blood samples from 27 healthy control subjects were obtained
from laboratory
personnel or purchased from Analytical Biological Sciences Inc,
Wilmington DE
* IVP study of STAT1 protein expression in CFS
patients:
- Upon receipt in the laboratory by overnight courier, PBMC were
purified by
centrifugation and known numbers of cells were frozen as cell
pellets at -70 degrees C.
- Immediately before use, several protease inhibitors were added
to the lysis buffer
- Two proteasomal protease inhibitors were also added
immediately before use of the
lysis buffer
- STAT1 proteins were detected on the membranes by means of an
antiserum specific for
an epitope in the carboxy terminus of STAT1 (sc-592)
* IVP study conclusions:
- STAT1 is comprised of at least five antigenically related
proteins with the two most
fully studied being the STAT1-91 (alpha splicing variant) and
STAT1-84 (beta splicing
variant).
- A subset (approximately 30%) of patients with CFS have a
quantitative deficiency in
the expression of STAT1-91/84 proteins.
- Another subset of patients with CFS were found to have
abnormally high levels of
STAT1-91/84 proteins.
- The STAT1 deficiency may predispose the patients to develop a
variety of infections
due to dysfunction of the Type 1 and Type 2 interferon systems.
The NCF
comments on the study:
Gail Kansky, President of the NCF, stated "This research study
formally establishes the extent of the immune dysfunction,
through our quantification of the STAT1 protein, in Chronic
Fatigue and Immune Dysfunction Syndrome - CFIDS. To find that
approximately 30% of our patients tested in this study had
little or no STAT1 protein is highly significant. We are most
appreciative to Dr. Konstance Knox and Dr. Donald Carrigan for
their scientific efforts in this study; to Dr. Edward Jordan and
Dr. David Leech who participated in this study; and to the
patients who were personally involved with the study themselves.
Furthermore, without the financial support from our patient
community that strongly believed in these research efforts, this
study never would have gotten off the ground" said Kansky.
"Let's face it, STAT1 deficiency isn't malingering nor is it
psychological! This immune problem is very real and it is
certainly very serious" stated Kansky.
During this interview, Kansky went on to say that
"The National CFIDS Foundation is most confident in our research
direction! We have several studies that are currently underway
and these reflect the NCF's absolute conviction to conquer this
disease. This additional research work should bring important
new knowledge to our understanding of this devastating disease
while offering true hope to those who suffer from it. In
addition, we are anticipating the publication of these research
studies in peer-reviewed medical journals. This is a vital step
in acknowledging the severity of this disease in the medical
community."
Additional importance of STAT1 cannot be
understated:
The latest research helps us to understand the underlying
importance and seriousness of STAT1 with regards to the immune
system response to infections. Researchers in the U.S. have now
shown that animals that lack the STAT1 protein lack the ability
to restrain or restrict infections in cells and tissues. Stated
another way, ordinary infections, such as influenza, that
normally only affect lung tissue cannot restrict the infection
to only lung tissue in STAT1 deficient hosts - other cells and
tissues subsequently become permissive to infection so that an
influenza or other common infections could now infiltrate other
organs systemically. As you can now understand and appreciate,
the lack of STAT1 is a severe host defect. This inherent lack of
restriction implies that secondary or tertiary infections could
potentially overtake the body's own defense system due to the
lack of STAT1 protein. Thus, these other infections would act to
throw scientific researchers "off the track" of the true
culprit/agent primarily responsible for damaging the immune
system in such an elusive and covert manner! Therefore, the
importance of this mechanism, that is operative in this disease,
cannot be understated nor underestimated and must be one that is
carefully studied scientifically. This is why the NCF is fully
committed to this research effort. We believe that true hope
lies within the medical truths of this disease and that our
blood is leading us to the truth....now, we just have to listen!