title: Elevated apoptotic cell population in patients with chronic fatigue syndrome: the pivotal role of protein kinase RNA.
abstract: OBJECTIVE
  A prominent feature of chronic fatigue syndrome (CFS) is a disordered immune system. Recent evidence indicates that induction of apoptosis might be mediated in a dysregulated immune system by the upregulation of growth inhibitory cytokines. Therefore, the purpose of this study was to evaluate the apoptotic cell population, interferon-alpha (IFN-alpha) and the IFN-induced protein kinase RNA (PKR) gene transcripts in peripheral blood lymphocytes (PBL) of CFS individuals, as compared to healthy controls.
  
  
  METHODS
  PBL were isolated from CFS (n = 29) and healthy control individuals (n = 15) and subjected to quantitative analysis of apoptotic cell population and cell cycle progression by flow cytometry. Quantitative competitive polymerase chain reaction (Q/C PCR) and Western blot analysis were used to assess the levels of PKR mRNA and protein in control and CFS individuals. In addition, circulating IFN-alpha was measured by ELISA assay.
  
  
  RESULTS
  Increased apoptotic cell population was observed in CFS individuals, as compared to healthy controls (26.6 +/- 12.9% and 9.9 +/- 4.2%, respectively). The increased apoptotic subpopulation in CFS individuals was accompanied by an abnormal cell arrest in the S phase and the G2/M boundary of the cell cycle as compared to the control group (8.6 +/- 1.2 to 22.8 +/- 2.4 and 3.6 +/- 0.82 to 24.3 +/- 3.4, respectively). In addition, CFS individuals exhibited enhanced PKR mRNA and protein levels (mean basal level 3538 +/- 1050 and 2.7 +/- 0.26, respectively) as compared to healthy controls (mean basal level 562 +/- 162 and 0.89 +/- 0.18, respectively). In 50% of the CFS samples (n = 29) treated with 2-aminopurine (2-AP) (a potent inhibitor of PKR) the apoptotic population was reduced by more then 50%.
  
  
  CONCLUSIONS
  PKR-mediated apoptosis in CFS individuals may contribute to the pathogenesis and the fatigue symptomatology associated with CFS.
authors.affiliation: Immunosciences Laboratory Inc., Beverly Hills, California, USA.
authors.forename: A
authors.initials: A
authors.lastname: Vojdani
authors.forename: M
authors.initials: M
authors.lastname: Ghoneum
authors.forename: P C
authors.initials: PC
authors.lastname: Choppa
authors.forename: L
authors.initials: L
authors.lastname: Magtoto
authors.forename: C W
authors.initials: CW
authors.lastname: Lapp
mesh_terms: D015075:2-Aminopurine / Q000494:pharmacology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000963:Antimetabolites / Q000494:pharmacology; D017209:Apoptosis / Q000187:drug effects; D015153:Blotting, Western; D004305:Dose-Response Relationship, Drug; D004797:Enzyme-Linked Immunosorbent Assay; D015673:Fatigue Syndrome, Chronic / Q000097:blood*; D005260:Female; D006801:Humans; D016898:Interferon-alpha / Q000494:pharmacology*; D008214:Lymphocytes / Q000187:drug effects / Q000201:enzymology*; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods; D011494:Protein Kinases / Q000187:drug effects / Q000235:genetics*; D012313:RNA / Q000187:drug effects / Q000235:genetics*; D014158:Transcription, Genetic / Q000187:drug effects
chemical_list: D000963:Antimetabolites; D016898:Interferon-alpha; D015075:2-Aminopurine; D012313:RNA; D011494:Protein Kinases