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okay so i'm really confused about how acclydine works. i need some

help here.

i found two conflicting articles.

1) from the recent NCF article on low STAT levels in PWCs

http://www.ncf-net.org/forum/TotalExposure.htm

2) from the distrbutor of Acclydine.

http://216.239.41.104/search?

q=cache:Yfljcq6i6MUJ:www.geocities.com/cfsnova/accyldineProtOct.pdf+ac

clydine,+cost & hl=en & ie=UTF-8

you will need to either copy and paste this second link to get there

or do a google search for " acclydine, cost " to find the second

article.

so, the NCF one states that acclydine works by increasing IGFBP-3,

which increases the production on STAT-1.

number 2 says that Acclydine works by increasing IGF-1, which in turn

corrects the ratio of IGFBP-3/IGF-1.

this seems to be a direct contradiction. If acclydine increases

IGFBP-3 like the NCF says, that would worsen the ratio of IGFBP-3/IGF-

1.

but if the point is to increase STAT-1, then i don't see how

acclydine does that. how can acclydine simultaneously increase IGFBP-3

and decrease the ratio of IGFBP-3/IGF-1?

it just doesn't make sense.

any help here?

thanks

bill

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What I suggest you do is to take a look at the references that the

NCF used....

Quoting directly " Acclydine therapy, as suggested by Dr. DeMeirleir,

acts by increasing IGFBP-3 [19]. Thus, by increasing the levels of

IGFBP-3 in the cell, IGF-1 is blocked from binding to its receptor

thereby suppressing the growth of the cell, promoting apoptosis, and

counteracting the loss of functional p53 protein on the growth of the

cell. "

Reference 19: US Patent Application # 20030017492; published January

23, 2003; filed June 17, 2002; titled Methods for diagnosis and

treatment of chronic immune diseases; Inventors: Fremont M,

Englebienne P, Herst CVT

I suggest you read the patent if interested.....the NCF quoted directly

from the patent! Hope this helps.

- Beach

> okay so i'm really confused about how acclydine works. i need some

> help here.

>

> i found two conflicting articles.

>

> 1) from the recent NCF article on low STAT levels in PWCs

>

> http://www.ncf-net.org/forum/TotalExposure.htm

>

>

> 2) from the distrbutor of Acclydine.

>

> http://216.239.41.104/search?

> q=cache:Yfljcq6i6MUJ:www.geocities.com/cfsnova/accyldineProtOct.pdf+ac

> clydine,+cost & hl=en & ie=UTF-8

>

> you will need to either copy and paste this second link to get there

> or do a google search for " acclydine, cost " to find the second

> article.

>

>

> so, the NCF one states that acclydine works by increasing IGFBP-3,

> which increases the production on STAT-1.

>

> number 2 says that Acclydine works by increasing IGF-1, which in turn

> corrects the ratio of IGFBP-3/IGF-1.

>

> this seems to be a direct contradiction. If acclydine increases

> IGFBP-3 like the NCF says, that would worsen the ratio of IGFBP-3/IGF-

> 1.

>

> but if the point is to increase STAT-1, then i don't see how

> acclydine does that. how can acclydine simultaneously increase IGFBP-3

> and decrease the ratio of IGFBP-3/IGF-1?

>

> it just doesn't make sense.

>

> any help here?

>

> thanks

> bill

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Share on other sites

Here's the patent info for those who are interested:

United States Patent Application 20030017492

remont, Marc ; et al. January 23, 2003

Methods for diagnosis and treatment of chronic immune diseases

Abstract:

Methods are provided for diagnosing/characterizing chronic immune

disease activity in a subject. In the subject methods, a sample is

obtained from a subject suspected of having or known to have a chronic

immune disease. The sample is then assayed for the presence and amount

of intact (i.e., native) p53 protein and/or fragments thereof. The

assay results are used to diagnose the presence of chronic immune

disease and/or characterize chronic immune disease activity in a

subject, and/or to determine appropriate treatments protocols. Also

provided by the subject invention are methods of treating chronic

immune disease conditions by enhancing p53 activity. Also provided by

the subject invention are kits for practicing the methods.

Inventors: Fremont, Marc; (Vccle, BE) ; Englebienne, ; (Zingem,

BE) ; Herst, C.V. ; (Oakland, CA)

Filed: June 17, 2002

Claims:

What is claimed is:

1. A method for diagnosing whether a host suffers from a chronic

immune disease, said method comprising: assaying a sample from said

host for the presence of at least one low molecular weight p53

fragment to obtain assay results; and determining whether said host

suffers from a chronic immune disease using said assay results;

whereby said host is diagnosed for said chronic immune disease.

2. The method according to claim 1, wherein said chronic immune

disease is selected from the group consisting of CFS and MS.

3. The method according to claim 1, wherein said sample is a blood

cell derived sample.

4. The method according to claim 1, wherein said sample is a PBMC

derived sample.

5. The method according to claim 1, wherein said host is a human.

6. A method of characterizing chronic immune disease activity in a

human subject, said method comprising: (a) obtaining a sample from

said subject; (B) determining the relative amounts of native p53

protein to one or more low molecular weight p53 protein fragments in

said sample; and © using said relative amounts to characterize the

chronic immune disease activity in said subject.

7. The method according to claim 6, wherein said chronic immune

disease is selected from the group consisting of CFS and MS.

8. The method according to claim 6, wherein said low molecular weight

p53 fragment(s) has a molecular weight of approximately 53 kDa under

SDS-PAGE reducing conditions.

9. The method according to claim 6, wherein said sample is a blood

derived sample.

10. The method according to claim 6, wherein said blood derived sample

is derived from PBMCs.

11. The method according to claim 6, wherein said method is a method

of confirming whether said subject suffers from said chronic immune

disease.

12. A method of characterizing a chronic immune disease activity in a

human subject, said method comprising: (a) obtaining a sample from

said subject; (B) identifying a pattern of low molecular weight p53

fragments in said sample; and © using said pattern to characterize

said chronic immune disease activity in said subject.

13. The method according to claim 12, wherein said chronic immune

disease is selected from the group consisting of CFS and MS.

14. The method according to claim 12, wherein said sample is a blood

derived sample.

15. The method according to claim 12, wherein said blood derived

sample is derived from PBMCs.

16. A kit for use in characterizing a chronic immune disease activity

in a subject, said kit comprising: (a) the means for assaying a sample

for the presence of at least one low molecular weight p53 fragment to

obtain p53 fragment assay results; and (B) a medium comprising

reference information relating low molecular weight fragment amount

detected to chronic immune disease activity.

17. The kit according to claim 16, wherein said chronic immune disease

is selected from the group consisting of CFS and MS.

18. The kit according to claim 16, wherein said kit further comprises

means for obtaining a sample from said subject.

19. The kit according to claim 16, wherein said kit further comprises

instructions for practicing the method of claim 1.

20. The kit according to claim 16, wherein said kit further comprises

means for assaying said sample for the presence of low molecular

proteins having p53 activity.

21. A method for characterizing chronic immune disease activity in a

subject, said method comprising: (a) contacting a source of a least

one of native p53 protein and/or recombinant p53 protein with a sample

from said subject to produce a reaction mixture; (B) detecting the

presence of at least one p53 fragment in said reaction mixture; and

© relating the presence of said fragment(s) to said chronic immune

disease activity; whereby said chronic immune disease activity in said

subject is characterized.

22. The method according to claim 21, wherein said chronic immune

disease is CFS or MS.

23. The method according to claim 21, wherein said sample is a blood

derived sample.

24. The method according to claim 21, wherein said blood derived

sample is derived from PBMCs.

25. The method according to claim 21, wherein said source of p53 is a

recombinant source.

26. The method according to claim 21, wherein said source of p53 is

stably attached to a solid support.

27. The method according to claim 21, wherein said source of p53 is

labeled.

28. A method of treating a host suffering from a chronic immune

disease, said method comprising: (a) administering to said host an

effective amount of an agent that enhances p53 activity in said host

to treat said host for said chronic immune disease.

29. The method according to claim 28, wherein said chronic immune

disease is selected from the group consisting of CFS and MS.

30. The method according to claim 28, wherein said agent is a p53

cleavage-antagonist.

31. The method according to claim 28, wherein said agent enhances p53

expression.

32. The method according to claim 28, wherein said host is a mammal.

33. The method according to claim 28, wherein said mammal is a human.

34. A method for determining the ability of a test compound to inhibit

p53 cleavage activity, said method comprising: (a) contacting said

test compound with: (i) a source of p53; and (ii) a source of protease

specific for p53; (B) determining the effect of said test compound on

the production of p53 fragments.

35. The method according to claim 34, wherein said source of p53 is

recombinant.

36. The method according to claim 34, wherein said source of protease

specific for p53 is a PBMC extract.

37. The method according to claim 34, wherein said p53 is labeled.

38. The method according to claim 34, wherein said determining step

comprises identifying the presence of p53 fragments.

Description

CROSS REFERENCE TO RELATED APPLICATIONS

[0001] Pursuant to 35 U.S.C. .sctn.119 (e), this application claims

priority to the filing date of the U.S. Provisional Patent Application

Serial No. 60/299,792 filed Jun. 20, 2001; the disclosure of which are

herein incorporated by reference.

INTRODUCTION

[0002] 1. Technical Field

[0003] The field of invention is chronic immune disease, particularly

multiple sclerosis and chronic fatigue syndrome.

[0004] 2. Background of the Invention

[0005] Chronic immune diseases can be highly debilitating, often

requiring treatment. Two such chronic immune diseases are multiple

sclerosis and chronic fatigue syndrome.

[0006] Multiple sclerosis (MS) is a neurological illness of unknown

etiology associated with attacks of focal or multifocal neurological

dysfunction indicating lesions within the central nervous system

(CNS). In America and Northern Europe, MS is the most common

neurological disease, with prevalence rates estimated between 50-100

per 100,000 population. The onset of disease is most common in early

adulthood. Recurrent attacks can occur over many years, with

approximately 30 percent of the patients progressing to a severe form

of the disease which can be fatal.

[0007] MS is pleomorphic in its presentation. The clinical

manifestations are determined in part by the location of the foci of

demyelination within the CNS. Classical features of the disease

include impaired vision, nystagmus, dysarthria, ataxia and intention

tremor, and weakness/paralysis of one or more limbs. The demyelination

is likely due to an autoimmune, inflammatory response that results in

the destruction of the myelin sheath covering the axon of the

peripheral nerves in the CFS.

[0008] The most common form of the disease is episodic. Symptoms

develop with subsequent recovery, followed by another attack. In

approximately 50 percent of all patients with MS, attacks become more

frequent, usually with a worsening of symptomatology. In 30 percent,

the disease develops into what is referred to as

" progressive/relapsing, " the most severe form of the disease. In this

state remissions are rare and patients frequently become wheelchair bound.

[0009] The diagnosis of MS remains problematic, and frequently the

disease is not diagnosed until the patient has experiences two or more

" attacks. " To aid the clinician, the only laboratory test available is

testing the cerebrospinal fluid for oligoclonal bands, present in

approximately 90 percent of all patients. Examination of the brain for

demyelinating plaques, using magnetic resonance imaging (MRI) is

useful but expensive and is not warranted except in a small group of

patients in which all other clinical and laboratory tests are negative.

[0010] There is no diagnostic laboratory test to determine if a

patient is having an " attack, " to monitor the progress of the

" attack, " to determine if the patient is progressing to a more active

form of the disease (i.e., progressive/relapsing), nor is any

laboratory test available as a prognostic indicator and/or to monitor

therapy if administered.

[0011] Chronic Fatigue Syndrome (CFS) is an illness of unknown

etiology. CFS is often associated with sudden onset, flu-like

symptoms, debilitating fatigue, low-grade fever, myalgia and

neurocognitive dysfuntion. CFS patients typically display reduced

Karnofsky Performance (KPS) scores. The KPS measures an individual's

ability to function and carry on normal activities. KPS scores range

from zero (0) for a completely non-funtional or dead patient to one

hundred (100) for a completely normal function.

[0012] Diagnosis of CFS remains one of exclusion. An accumulating body

of evidence suggests that CFS is associated with dysregulation of both

humoral and cellular immunity, including mitogen response,

reactivation of viruses, abnormal cytokine production, diminished

natural killer cell function and changes in intermediary metabolites.

[0013] It has been suggested that the clinical and immunological

abnormalities observed in MS and CFS might be caused by defects in the

interferon-inducible pathways i.e., the 2'-5'-oligoadenylate (2-5A)

synthetase/RNase L and p68 kinase (PKR) antiviral defense pathways

(Suhadolnik et al., Clin. Infect. Dis. 18:S96-S104, 1994; Suhadolnik

et al., In Vivo 8:599-604, 1994). The 2-5A synthetase/RNase L pathway

is part of the antiviral defense mechanism in mammalian cells

(Lengyel, Ann. Rev. Biochem. 51:251-282, 1982; Sen et al., Adv. Virus

Res. 42:57-102, 1993).

[0014] When activated by dsRNA, 2-5A synthetase converts ATP to

2'-5'-linked oligoadenylates with 5' terminal phosphates. Biologically

active 2-5A binds to and activates a latent endoribonuclease, RNase L,

which in turn hydrolyzes single-stranded cellular and viral RNA,

primarily after UpNp sequences, thereby inhibiting protein synthesis.

In addition, circulating white blood cells from patients with CFS have

been demonstrated to contain abnormal, low molecular weight forms of

RNase L (Suhadolnik et al., J. Interferon & Cytokine Res. 17:377-385,

1997; De Meirleir et al., Am. J. Med. 108:99-105, 2000).

[0015] The 2-5A synthetase/RNase L antiviral pathway has also been

demonstrated to play an important role in the regulation of cell

growth and differentiation, specifically in the regulation of

apoptosis as an additional host defense mechanism against viral

infection and replication (Castelli et al., J.Exp. Med. 186:967-972,

1997; -Guerra et al., Virology 236:354-363, 1997). Apoptosis,

defined as programmed cell death, plays an important role in many

physiological and pathological conditions including embryo and organ

development, immune responses, and tumor development and growth.

Apoptosis is characterized by many biological and morphological

changes at the cellular level including activation of calpain,

caspases, DNA fragmentation, membrane blebbing and the formation of

apoptotic bodies.

[0016] Another important protein that regulates the induction of

apoptosis is p53 (Atencio et al., Cell Growth & Differentiation

11:247-253, 2000). The p53 protein is normally activated in response

to genetic damage within the cell and its activation is accompanied by

self-stabilization, allowing it to accumulate to high levels and cause

cell cycle arrest and induce apoptosis (Kubbutat, M. et al., Mol.

Cell. Biol. 17:460-468, 1997).

[0017] In addition, the p53 protein has a critical role in protecting

the cell from malignant development; mutations in the p53 gene (and

protein) are the most frequently detected genetic event in cancer

(Hollstein et al., Nucleic Acids Res. 22:3551-3555, 1994). Mutations

in p53 may occur at the genetic level (i.e. DNA sequence alterations

that change the amino acid structure of the protein), or its function

may be altered by alterations in the numerous proteins with which p53

interacts. p53 may also be altered by the action of certain proteases,

resulting in cleavage, preventing the formation of active tetramers of

the protein (Vogelstein et al., Nature 408:307-310, 2000).

[0018] If p53 is cleaved and/or otherwise disabled in the cells of the

immune system, these cells would be being blocked from entering the

apoptotic pathway if infected with a virus or other microorganism. In

addition, persistent inactivation of the p53 protein may lead to

increased incidence of cancer (Levine et al., J. Chronic Fatigue

Syndrome 7:29-38, 2000). Activation of the 2-5A synthetase/RNase L

antiviral pathway has been demonstrated to induce apoptosis, while

induction of the same pathway in cells expressing mutant forms of p53

was demonstrated to suppress the apoptotic pathway.

[0019] The inactivation of p53, RNase L, and other proteins within the

cells of the immune system most certainly leads to a dysfunctional

immune system, unable to respond to challenge by microorganisms and/or

the presence of pre-malignant cells. Indeed the immune system itself

may be in a pre-malignant state.

[0020] To accurately diagnose and quantify the extent of chronic

immune disease present in a patient, new markers of disease are

required. In addition, methods are needed to treat chronic immune

disease conditions. The present invention satisfies these and other

needs in the art.

[0021] Relevant Literature

[0022] U.S. Patents of interest include: 5,766,859; 5,776,690;

5,830,668; 5,853,996, 5,955,263, 5,985,565, 6,017,524, 6,090,566,

6,110,671, 6,140,058, 6,153,391, 6,153,591, 6,169,073, and 6,184,210.

Also of interest is WO 91/00097. Other references of interest include:

Kastan et al., Cancer Res. 51:6304-6311, 1991; Kuerbitz et al., Proc.

Natl. Acad. Sci. 89:7491-7495, 1992; Lowe et al., Nature 362:847-849,

1993; et al., Nature 362: 849-852, 1993; Lowe et al., Cell

74:957-967, 1994; Pariat, et al. Mol. Cell. Biol. 17:2806-2815, 1997;

Komaroff, Am. J. Med. 108:69-71, 2000.

SUMMARY OF THE INVENTION

[0023] Methods are provided for diagnosing/characterizing chronic

immune disease activity in a subject. In the subject methods, a sample

is obtained from a subject suspected of having or known to have a

chronic immune disease. The sample is then assayed for the presence

and amount of intact (i.e., native) p53 protein and/or fragments

thereof. The assay results are used to diagnose the presence of

chronic immune disease and/or characterize chronic immune disease

activity in a subject, and/or to determine appropriate treatments

protocols. Also provided by the subject invention are methods of

treating chronic immune disease conditions by enhancing p53 activity.

Also provided by the subject invention are kits for practicing the

methods.

BRIEF DESCRIPTION OF THE FIGURES

[0024] FIG. 1 represents a densitometric scan of a Western blot

detecting p53 protein fragments from PBMC extracts from CFS patients.

The value indicated at the top of each lane is the ratio of RNase L

fragments as calculated by [Log10((LMW/HMW)*10)] as assayed in PBMC

extracts from CFS patients.

DESCRIPTION OF THE SPECIFIC EMBODIMENTS

[0025] Methods are provided for diagnosing and/or characterizing

chronic immune disease activity in a subject. In the subject methods,

a sample is obtained from a subject suspected of having or known to

have a chronic immune disease. The sample is then assayed for the

presence of low molecular weight p53 fragments. The assay results are

used to diagnose the presence of chronic immune disease activity

and/or characterize chronic immune disease activity in the subject,

e.g. to confirm an initial chronic immune disease diagnosis, to

determine the stage of the disease, to monitor disease progression, to

predict disease attacks, and the like. In addition, methods of

treating a host suffering from a chronic immune disease are provided,

where an effective amount of a p53 activity enhancing agent is

administered to the host. Also provided by the subject invention are

kits for practicing the methods.

[0026] Before the invention is described further, it is to be

understood that the invention is not limited to the particular

embodiments of the invention described below, as variations of the

particular embodiments may be made and still fall within the scope of

the appended claims. It is also to be understood that the terminology

employed is for the purpose of describing particular embodiments, and

is not intended to be limiting. Instead, the scope of the present

invention will be established by the appended claims.

[0027] In this specification and the appended claims, the singular

forms " a, " " an " and " the " include plural reference unless the context

clearly dictates otherwise. Unless defined otherwise, all technical

and scientific terms used herein have the same meaning as commonly

understood to one of ordinary skill in the art to which this invention

belongs.

[0028] Where a range of values is provided, it is understood that each

intervening value, to the tenth of the unit of the lower limit unless

the context clearly dictates otherwise, between the upper and lower

limit of that range, and any other stated or intervening value in that

stated range, is encompassed within the invention. The upper and lower

limits of these smaller ranges may independently be included in the

smaller ranges, and are also encompassed within the invention, to any

specifically excluded limit in the stated range. Where the stated

range includes one or both of the limits, ranges excluding either or

both of those included limits are also included in the invention.

[0029] Unless defined otherwise, all technical and scientific terms

used herein have the same meaning as commonly understood to one of

ordinary skill in the art to which this invention belongs. Although

any methods, devices and materials similar or equivalent to those

described herein can be used in the practice or testing of the

invention, the preferred methods, devices and materials are now described.

[0030] All publications mentioned herein are incorporated herein by

reference for the purpose of describing and disclosing the invention

components which are described in the publications which might be used

in connection with the presently described invention.

[0031] As summarized above, the subject invention provides a method of

diagnosing the presence of a chronic immune disease in a host. In

other words, the subject invention provides a means for determining

whether a host is suffering from a chronic immune disease.

Specifically, the subject invention provides a method of determining

whether a host is suffering from MS or CFS. MS and CFS are disease

conditions as defined in the background section above, and further

defined below.

[0032] In determining whether a host suffers from a chronic immune

disease, a sample from the host is assayed for the presence of one or

more low molecular weight fragments of p53 protein (or p53). By low

molecular weight p53 fragment is meant a polypeptide that has a

sequence of amino acid residues found in full length p53, where this

sequence is at least about 10, usually at least about 20 and more

usually at least about 50 residues long and is often longer, where the

polypeptide has a molecular weight that is less than that molecular

weight of full length p53, i.e. where the polypeptide has a molecular

weight that is less than about 50 kDa, as measured by SDS-PAGE (see

the Experimental Section, infra.) Specifically, the sample is assayed

for low molecular weight p53 fragments ranging in weight from about 15

to 45 kDa, usually from about 20 to 40 kDa and more usually from about

25 to 35 kDa. Of particular interest is the identification of a p53

fragment having a molecular weight of about 30 kDa, as determined by

SDS-PAGE. Representative samples and assay methods for identifying the

presence of, and amounts of, low molecular weight p53 fragments in a

sample are described in greater detail infra.

[0033] The presence or absence of the low molecular weight p53

fragments is then used to diagnose whether or not the host suffers

from the chronic immune disease. In other words, the presence or

absence of low molecular weight p53 fragments in the sample is used to

determine whether or not the host suffers from a chronic immune

disease, such as CFS or MS. For example, in one embodiment, the

presence of one or more low molecular weight p53 fragments is used to

determine whether the host suffers from CFS. Likewise, in another

embodiment, the presence of one or more low molecular weight p53

fragments is used to determine whether a host suffers from MS. As part

of the diagnosis, one may also evaluate the subject for other symptoms

of the disease of interest that is to be diagnosed, e.g. the MS or CFS

symptoms described in the background section, supra, as well as in

other parts of this application.

[0034] Also provided by the subject invention are methods of

characterizing the chronic immune disease activity, e.g. CFS or MS

disease activity, in a subject suspected of having, or known to have,

a chronic immune disease, e.g. CFS or MS. Subjects suspected of

having, or known to have, a chronic immune disease and thus amenable

to the subject methods can be identified using any convenient

protocol. One convenient protocol is diagnosis based on clinical

symptoms. A number of different clinical symptoms may be used to

identify subjects that may have or have the chronic immune disease of

interest, where the specific symptoms employed will necessarily depend

on the specific chronic immune disease. For example, where the chronic

immune disease of interest is CFS, clinical symptoms of interest

include: fatigue of six months or longer that causes a reduction in

effort of greater than 50 percent of normal output, athralgia,

myalgia, sore throat accompanied by swollen glands, cognitive

dysfunction (e.g. memory loss); and the like. For MS, clinical

symptoms include: weakness of the limbs; sensory symptoms, e.g.

paresthesia or hypesthesia; ataxia; optic neuritis; diplopia;

trigeminal neuralgia; facial paralysis; vertigo; urinary or bowel

movement abnormalities; and cognitive dysfunction, e.g. memory loss,

impaired attention, problem-solving difficulties, slowed information

processing, and difficulty in shifting between cognitive tasks. The

presence of one or more of the above symptoms may be used to identify

subjects suspected of suffering from CFS or MS, respectively. Other

assays may also be employed, including MRI imaging, the oligoclonal

band assay described in greater detail infra, etc.

[0035] The first step of the subject methods is to obtain a suitable

sample from the subject or patient of interest, i.e. a patient

suspected of having or known to have the chronic immune disease of

interest, e.g. CFS or MS. The sample is derived from any initial

source that contains native p53 and the low molecular weight p53

fragments (if present). Sample sources of interest include, but are

not limited to, many different physiological sources, e.g. CSF, urine,

saliva, tears, tissue derived samples, e.g. homogenates, and blood or

derivatives thereof.

[0036] In many embodiments, the sample is derived from cells that

comprise the p53 fragments of interest, if present--i.e. if the

patient from which the cells are derived has chronic immune disease.

In other embodiments, the sample may be derived from fluids into which

the proteins of interest have been released, e.g. are present. In many

embodiments, a suitable initial source for the patient sample is

blood. As such, the sample employed in the subject assays of these

embodiments is generally a blood derived sample. The blood derived

sample may be derived from whole blood or a fraction thereof, e.g.

serum, plasma, etc., where in many embodiments the sample is derived

from blood cells harvested from whole blood. Of particular interest as

a sample source are mononuclear cells. As such, a preferred sample is

one that is derived from peripheral blood mononuclear cells (PBMCs).

In certain situations, the sample may be treated to displace p53

fragments from p53 binding proteins, where any convenient treatment

protocol may be employed, e.g. acidification, etc.

[0037] In these preferred embodiments in which the sample is a PBMC

derived sample, the sample is generally a fluid PBMC derived sample.

Any convenient methodology for producing a fluid PBMC sample may be

employed. In many embodiments, the fluid PBMC derived sample is

prepared by: (a) separating PBMCs from whole blood, i.e. collecting

PBMCs, e.g. by centrifugation (such as by Ficoll-Hypaque density

gradient centrifugation); (B) disrupting the collected cells, e.g. by

contacting with a lysing buffer; © and removing the resultant

cellular debris to obtain a cell-free extract, e.g. by centrifugation.

A representative means for producing a suitable fluid PBMC derived

sample, i.e. a fluid PBMC extract, is disclosed in WO 98/15646 and

U.S. Pat. No. 5,985,565; the disclosures of which is herein

incorporated by reference.

[0038] Once the patient derived sample is obtained, it is assayed for

the presence or absence of one or more low molecular weight p53

fragments, either directly or indirectly. The low molecular weight p53

fragments of interest are those having a molecular weight ranging from

about 15 to 45 kDa, usually from about 20 to 40 kDa and specifically

of about 25 to 35 kDa, as determined under SDS-PAGE reducing

conditions, as described above, with the specific fragment of interest

being that having the following molecular weight: 30 kDa.

[0039] The sample may be assayed for the presence or absence of the

low molecular weight p53 fragments using any convenient methodology.

In many embodiments, such methodology involves the following two

steps: (a) fractionation of the sample in a manner sufficient such

that the one or more p53 fragments and the native p53 (if present) are

present in different fractions, i.e. separating the low molecular

weight fragments from each other and from the native p53; and (B)

detection of the low molecular weight fragments in the specific

fractions, i.e. assaying each fraction for the presence or absence of

a p53 fragment, where the detection may be qualitative,

semi-quantitative or quantitative, and is usually at least

semi-quantitative (i.e. not just qualitative).

[0040] In these embodiments, fractionation may be accomplished using

any convenient methodology. The fractionation technique employed may

or may not employ native or non-denaturing conditions. Whether

fractionation is carried out under denaturing or non-denaturing

conditions depends on the particular manner in which the low molecular

weight fragments are detected, e.g. whether or not a non-denatured

form is required for detection, where representative detection methods

are described in greater detail below. Typically, the non-denaturing

conditions are `native` conditions. By `native` conditions is meant

fractionation by a process that substantially preserves the

conformation and folding of the low molecular fragment species in the

sample. Native conditions are those conditions that do not denature

proteins. A variety of non-denaturing fractionation means are known to

those of skill in the art, where one means of interest is gel

filtration high performance liquid chromatography. Alternatively,

fractionation may be carried out under non-native, e.g. denaturing

conditions, such as SDS-PAGE (sodium dodecylsulfate-polyacrylamide gel

electrophoresis). As the fractionating step involves separating the

various low molecular weight p53 fragments, fractionation results in

the production of one or more fractions that putatively contain the

low molecular p53 fragment (i.e. is suspected of containing a low

molecular weight fragment).

[0041] As discussed above, the sample or fraction(s) thereof are

assayed for the presence or absence of low molecular weight p53

fragments, where the assay may be a direct assay or an indirect assay.

By direct assay is meant an assay that provides for a direct detection

of low molecular weight p53 fragments, e.g., an assay that yields

direct information regarding the presence and often amount of low

molecular weight p53 fragments in sample, e.g. an assay where an p53

specific antibody is employed to detect low molecular weight p53

fragments in an appropriately fractionated sample. By indirect assay

is meant an assay that detects the presence or absence of low

molecular weight p53 fragments through detection, usually

quantitation, of another species, e.g. native p53 and total p53

species (e.g., where a relative amount of native p53 to total p53

species in a sample is determined, from which the presence of low

molecular weight p53 fragments is indirectly determined). As such, the

assay employed may or may not also include a determination of the

amount of native or full length p53, i.e. p53 having a molecular

weight of approximately 53 kDa in the sample.

[0042] Any convenient assay protocol may be employed. Suitable assays

that may be employed include antibody-based assays, e.g. Western blot

assays, such as those described in the experimental section infra.

Antibody based assays require the use of antibodies specific for the

p53 fragments and native p53. The assays may be direct assays, i.e.,

those which employ antibodies specific for low molecular weight p53

fragments. Alternatively, the assays may be indirect assays, i.e.,

those which detect native p53 and total amounts of p53 species in a

sample, e.g., an assay in which an antibodies specific for the C- and

N-termini of the native p53 are employed.

[0043] Antibodies that specifically bind to the subject p53 protein

and low molecular weight fragments thereof can be prepared using a

variety of convenient methods known to those of skill in the art. See

Guide to Protein Purification, supra, as well as Antibodies, A

Laboratory Manual (Harlow & Lane eds., Cold Spring Harbor Press,

1988). The antibodies may be polyclonal or monoclonal antibodies

depending on the nature of the intended use, as long as they are

specific for one or more forms of p53 or fragments thereof of interest.

[0044] For preparation of polyclonal antibodies, the first step is

immunization of the host animal with p53 or an immunogenic fragment,

including fragment derivative thereof, where the p53 immunogen will

preferably be in substantially pure form, comprising less than about

1% contaminant. The immunogen may comprise complete p53, fragments or

derivatives thereof. To increase the immune response of the host

animal, the immunogen may be combined with an adjuvant, where suitable

adjuvants include alum, dextran, sulfate, large polymeric anions, oil

& water emulsions, e.g. Freund's adjuvant, Freund's complete adjuvant,

and the like. The immunogen may also be conjugated to synthetic

carrier proteins or synthetic antigens. A variety of hosts may be

immunized to produce the polyclonal antibodies. Such hosts include

rabbits, guinea pigs, rodents, e.g. mice, rats, sheep, goats, and the

like. The immunogen is administered to the host, usually

intradermally, with an initial dosage followed by one or more, usually

at least two, additional booster dosages. Following immunization, the

blood from the host is collected, followed by separation of the serum

from the blood cells. The Ig present in the resultant antiserum may be

further fractionated using known methods, such as ammonium salt

fractionation, DEAE chromatography, and the like.

[0045] As with the preparation of polyclonal antibodies, the first

step in preparing monoclonal antibodies specific for p53 and fragments

thereof is to immunize a suitable host, where suitable hosts include

rats, hamsters, mice and the like, and are preferably mice. The p53

immunogen, which as above, may be the entire p53 protein or a fragment

or derivative thereof, is administered to the host in any convenient

manner, where such methods include: subcutaneous injection with

adjuvants, nitrocellulose implants comprising the immunogen,

intrasplenic injections, and the like, where the immunization protocol

may be modulated to obtain a desired type of antibody, e.g. IgG or

IgM, where such methods are known in the art. Following immunization,

plasma cells are harvested from the immunized host, where sources of

plasma cells include the spleen, lymph nodes and the like, with the

spleen being preferred. The plasma cells are then immortalized with

myeloma cells to produce hybridoma cells. A variety of myeloma cell

lines are available and known to those of skill in the art. The plasma

and myeloma cells are fused by combining the cells in a fusion medium

usually in a ratio of about 10 plasma cells to 1 myeloma cell, where

suitable fusion mediums include a fusion agent, e.g. PEG 1000, and the

like. Following fusion, the fused cells are selected, e.g. by growing

on HAT medium. Following hybridoma cell production, culture

supernatant from individual hybridomas is screened for reactivity with

p53 using standard techniques, where such screening techniques include

ELISA, dot blot immunoassays and the like. The antibody may be

purified from the supernatants or ascites fluid by conventional

techniques, e.g. affinity chromatography p53 bound to an insoluble

support, protein A sepharose and the like.

[0046] Antibodies specific for p53 are known in the art, and include

those described in U.S. Pat. Nos. 5,382,510; 5,688,918; and 5,798,266;

the disclosures of which are herein incorporated by reference.

[0047] The above prepared or obtained antibodies may be modified in a

number of different ways to optimize their utility for use in a

particular immunoassay. For example, antibody fragments, such as Fv,

F(ab).sub.2 and Fab may be prepared by cleavage of the intact protein,

e.g. by protease or chemical cleavage.

[0048] The antibodies, fragments or derivatives thereof may also be

labeled in order to facilitate detection. A variety of protein

labeling schemes are known in the art and may be employed, the

particular scheme and label chosen being the one most convenient for

the intended use of the antibody, e.g. immunoassay. Examples of labels

include labels that permit both the direct and indirect measurement of

the presence of the antibody. Examples of labels that permit direct

measurement of the antibody include radiolabels, such as .sup.3H or

..sup.125I, fluorescers, dyes, beads, chemilumninescers, colloidal

particles, and the like. Examples of labels which permit indirect

measurement of the presence of the antibody include enzymes where a

substrate may provide for a colored or fluorescent product. For

example, the antibodies may be labeled with a covalently bound enzyme

capable of providing a detectable product signal after addition of

suitable substrate. Instead of covalently binding the enzyme to the

antibody, the antibody may be modified to comprise a first member of

specific binding pair which specifically binds with a second member of

the specific binding pair that is conjugated to the enzyme, e.g. the

antibody may be covalently bound to biotin and the enzyme conjugate to

streptavidin. Examples of suitable enzymes for use in conjugates

include horseradish peroxidase, alkaline phosphatase, malate

dehydrogenase and the like. Where not commercially available, such

antibody-enzyme conjugates are readily produced by techniques known to

those skilled in the art.

[0049] In immunoassays of the subject invention, a number of different

immunoassay formats are known in the art and may be employed.

Representative assay formats include Western blots on protein gels or

protein spots on filters, where the antibody is labeled as described

above, as is known in the art. For a representative example of a

Western blot assay for the presence of p53 and fragments thereof in a

sample, see the experimental section infra.

[0050] Other immunoassays include those based on competitive formats,

as are known in the art. One such format would be where a solid

support is coated with p53. Labeled antibody is then combined with the

patient derived sample suspected to produce a reaction mixture which,

following sufficient incubation time for binding complexes to form, is

contacted with the solid phase bound p53. The amount of labeled

antibody which binds to the solid phase will be proportional to the

amount of p53 or fragments thereof in the sample, and the presence of

p53 and fragments thereof may therefore be detected. Other competitive

formats that may be employed include those where the sample suspected

of comprising p53 fragments is combined with a known amount of labeled

p53 fragments and then contacted with a solid support coated with

antibody specific for p53 fragments. Such assay formats are known in

the art and further described in both Guide to Protein Purification,

supra, and Antibodies, A Laboratory Manual, supra. Sandwich-format

assays may also be employed. A sandwich assay is performed by

initially attaching a first of the two types of antibodies to an

insoluble surface or support. This first antibody may be bound to the

surface by any convenient means, depending upon the nature of the

surface, either directly or through specific antibodies. The

particular manner of binding is not crucial so long as it is

compatible with the reagents and overall methods of the invention.

They may be bound to the plates covalently or non-covalently,

preferably non-covalently. The insoluble supports may be any

compositions to which antibodies or fragments thereof can be bound,

which is readily separated from soluble material, and which is

otherwise compatible with the overall method of measuring p53 in the

sample. The surface of such supports may be solid or porous and of any

convenient shape. Examples of suitable insoluble supports to which the

receptor is bound include beads, e.g. magnetic beads, membranes and

microtiter plates. These are typically made of glass, plastic (e.g.

polystyrene), polysaccharides, nylon or nitrocellulose. Microtiter

plates are especially convenient because a large number of assays can

be carried out simultaneously, using small amounts of reagents and

samples. Before adding patient samples or fractions thereof, the

non-specific binding sites on the insoluble support i.e. those not

occupied by the first antibody, are generally blocked. Preferred

blocking agents include non-interfering proteins such as bovine serum

albumin, casein, gelatin, and the like. Alternatively, several

detergents at non-interfering concentrations, such as Tween, NP40,

TX100, and the like may be used. Samples, fractions or aliquots

thereof are then added to separately assayable supports (for example,

separate wells of a microtiter plate) containing support-bound

allergen. Preferably, a series of standards, containing known

concentrations of p53 is assayed in parallel with the samples or

aliquots thereof to serve as controls. Generally from about 0.001 to 1

ml of sample, diluted or otherwise, is sufficient, usually about 0.01

ml sufficing. Preferably, each sample and standard will be added to

multiple wells so that mean values can be obtained for each. The

incubation time should be sufficient for p53 molecules to bind the

insoluble first antibody. Generally, from about 0.1 to 3 hr is

sufficient, usually 1 hr sufficing. After incubation, the insoluble

support is generally washed of non-bound components. Generally, a

dilute non-ionic detergent medium at an appropriate pH, generally 7-8,

is used as a wash medium. From one to six washes may be employed, with

sufficient volume to thoroughly wash nonspecifically bound proteins

present in the sample. After washing, a solution containing the second

p53 or p53 fragment specific antibody is applied. The second antibody

may be labeled, as described above, to facilitate direct, or indirect

detection and/or quantification of binding. Examples of labels which

permit direct measurement of immunocomplexes include radiolabels, such

as .sup.3H or .sup.125I, fluorescers, dyes, beads, chemilumninescers,

colloidal particles, and the like. Examples of labels which permit

indirect measurement of binding include enzymes where the substrate

may provide for a colored or fluorescent product. In a preferred

embodiment, the second antibody is labeled with a covalently bound

enzyme capable of providing a detectable product signal after addition

of suitable substrate. Examples of suitable enzymes for use in

conjugates include horseradish peroxidase, alkaline phosphatase,

malate dehydrogenase and the like. Where not commercially available,

such antibody-enzyme conjugates are readily produced by techniques

known to those skilled in the art. Alternatively, the antibody may be

unlabeled. In this case, a labeled second receptor-specific compound

is employed which binds to the second antibody. Such a second

receptor-specific compound can be labeled in any of the above manners.

It is possible to select such compounds such that multiple compounds

bind each molecule of bound second receptor. Examples of second

antibody/second receptor-specific molecule pairs include

antibody/anti-antibody and avidin (or streptavidin)/biotin. Since the

resultant signal is thus amplified, this technique may be advantageous

where only a small amount of p53 or fragment thereof is present. An

example is the use of a labeled antibody specific to the second

antibody. The volume, composition and concentration of second antibody

solution provides for measurable binding to the p53 already bound to

the first antibody. Generally, the same volume as that of the sample

is used: from about 0.001 to 1 ml is sufficient, usually about 0.1 ml

sufficing. The concentration will generally be sufficient to saturate

all p53 potentially bound to first antibody. The concentration

generally will be about 0.1 to 50 .mu.g/ml, preferably about 1

..mu.g/ml. The solution containing the second antibody is generally

buffered in the range of about pH 6.5-9.5. The solution may also

contain an innocuous protein as previously described. The incubation

time should be sufficient for the labeled ligand to bind available

molecules. Generally, from about 0.1 to 3 hr is sufficient, usually 1

hr sufficing. After the second antibody has bound, the insoluble

support is generally again washed free of non-specifically bound

second receptor, essentially as described for prior washes. After

non-specifically bound material has been cleared, the signal produced

by the bound conjugate is detected by conventional means. Where an

enzyme conjugate is used, an appropriate enzyme substrate is provided

so a detectable product is formed. More specifically, where a

peroxidase is the selected enzyme conjugate, a preferred substrate

combination is H.sub.2O.sub.2 and O-phenylenediamine which yields a

colored product under appropriate reaction conditions. Appropriate

substrates for other enzyme conjugates such as those disclosed above

are known to those skilled in the art. Suitable reaction conditions as

well as means for detecting the various useful conjugates or their

products are also known to those skilled in the art. For the product

of the substrate O-phenylenediamine for example, light absorbance at

490-495 nm is conveniently measured with a spectrophotometer.

[0051] Depending on the particular nature of the antibody based assay

employed, it may be desirable to employ antibodies that are capable of

distinguishing between the various p53 forms and fragments thereof.

For example, in a Western blot assay a single type of antibody that

recognizes all of the various p53 fragments and the native p53 itself

may be employed, since the various fragments and native protein are

pre-separated, e.g. by gel electrophoresis. However, where the various

fragments and native protein are not separated prior to detection,

e.g. in the competitive and sandwich assays described above, it is

desirable to use a plurality of antibodies which are capable of

specifically recognizing only a single p53 species of interest, with

substantially no cross-reactivity with other p53 species or fragments

that may be present in the sample.

[0052] In the subject methods, the sample or fractions thereof are at

least assayed for the presence or absence of the low molecular p53

fragments or species, and often times the native species as well,

where the assay may be a direct assay for low molecular weight

fragments or an indirect assay for low molecular weight fragments, as

indicated above. In some embodiments, qualitative results are

sufficient. Thus, one may be interested in identifying the presence or

absence of the low molecular weight p53 fragments as a marker for the

chronic immune disease, e.g. in the diagnostic methods described

above. Alternatively, one may be interested in making a qualitative

determination of the ratio of the low molecular weight species to the

native species. In many embodiments, the assays employed at least

provide semi-quantitative detection of the various molecular weight

p53 species, and not just qualitative detection.

[0053] In assaying for low molecular weight p53 fragments or species

in the subject methods, one may look for: (a) the presence or absence

of the low molecular weight fragments; (B) the pattern of the low

molecular weight fragments and, optionally full length p53 (where by

pattern is meant the presence of each fragment and, optionally

relative amount of each fragment); © the ratio of the amounts of the

various low molecular weight species to each other and/or to the full

length p53; and the like; (d) the relative amount of high molecular

weight or native p53 to all p53 species in the sample; etc.

[0054] In many embodiments, based on the presence or absence of the

various molecular weight p53 species, and usually the

semi-quantitative values obtained for each of the species of interest,

the chronic immune disease activity in the subject from which the

sample was derived is characterized. This broad category of

embodiments includes those in which the low molecular weight p53

species are directly assayed, e.g., those methods where: (a) the

simple presence or absence of low molecular weight species is used to

characterize the disease; (B) the ratio of low molecular weight

species to high molecular weight species is used to characterize the

disease; and © the pattern or amounts of two or more different low

molecular weight species is used to characterize the disease; etc. In

yet other embodiments, e.g. those based on assays which indirectly

determine the presence or absence of low molecular weight p53 species,

the relative amounts of the various p53 species in the sample to each

other, e.g., the relative amount of native or high molecular weight

p53 to the total amount of p53, i.e., native p53 and fragment species

thereof, in the sample is used to characterize the chronic immune

disease activity in the subject.

[0055] Characterization of chronic immune disease activity according

to the subject methods typically involves comparing the results

obtained to a table or other source of predetermined values or

reference values which provide information about the disease activity

in the host, e.g. that positively or negatively correlate to the

presence of the chronic immune disease, a particular stage of the

chronic immune disease, and the like. For example, a table of values

may be consulted in this step, where the table comprises

representative values for the high and low molecular weight proteins

as found in patients suffering from the chronic immune disease of

interest. The values may be presented in numerical form, in picture

form (e.g. as bands on a gel), and the like. By comparing the observed

values with these reference values, e.g. by comparing a pattern of the

p53 species in the sample to a reference pattern or picture,

characterization of the disease activity, e.g. confirmation of

diagnosis, determination of disease state, etc., is readily made. In

other embodiments, the ratio of two or more of the different species

and/or full length p53 is then compared to reference list of ratios to

characterize the chronic immune disease activity.

[0056] As summarized above, the subject methods are methods of

characterizing chronic immune disease activity in a host. The term

characterizing is used broadly to refer to derivation of any type of

information about the state of the chronic immune disease in the host.

As such, the subject methods may be used to confirm an initial

diagnosis of chronic immune disease, to determine the state of the

disease in a patient known to have the chronic immune disease, to

monitor the progression of the disease, to predict the occurrence of

an attack, and the like. Where the subject invention is employed to

confirm an initial diagnosis, a sample is obtained from subject

suspected of having the chronic immune disease (where the subject may

be identified as described supra). For example, the sample is assayed

for the presence of the high and low molecular weight p53 species, a

ratio of the two species is derived and then compared to reference

values, where the reference values correlate given ratios to the

presence or absence of the chronic immune disease.

[0057] The subject methods are also employed to determine the stage of

the chronic immune disease in the subject. In other words, the subject

chronic immune disease activity characterization methods may be

employed to determine whether the patient is in a remission stage, a

chronic stage etc. For example, the subject methods may be employed to

determine whether an MS patient is in the relapsing-remitting stage or

in the chronic progressive stage of the disease. To determine the

stage of the disease, the observed values for the one or more p53

species, and ratios where desired, in the assayed sample are compared

to reference values that are correlated to a particular stage of

chronic immune disease, e.g. remitting relapsing or chronic

progressive stage of MS.

[0058] In yet other embodiments, characterization of disease activity

yields information concerning the disease progression in the patient,

e.g. whether disease progression has accelerated or slowed. For

example, the initial characterization date, i.e. the amount of high

(i.e., native) and low molecular weight forms of p53 in the patient

derived sample could be employed as a baseline value to evaluate

subsequent samplings, e.g. at some time following the initial testing,

e.g. 3 months. If the amount of low molecular weight form decreases in

subsequent testing, this indicates that the disease is not

progressing. Alternatively, if the amount of low molecular weight form

increases, this indicates that the disease is progressing in severity.

[0059] The characterization data obtained from the subject methods may

also be used to determine whether a particular therapeutic regimen is

having positive affects with respect to the progression of the

disease. For example, at various time periods during the course of

treatment, the subject methods may be performed to obtain a reading of

the amount of high and low molecular weight forms of the p53 species

of interest. If the amount of the low molecular weight marker is

increasing, this indicates that the treatment regimen is not having

the desired effect. Alternatively, if the amount of the low molecular

weight marker is decreasing, this indicates that the treatment regimen

is working.

[0060] In yet other embodiments, the characterization data obtained

from the subject methods is used to predict when a chronic immune

disease attack, e.g. MS attack, may occur. In this embodiment, the

characterization data is compared to reference values, where some of

the reference values correlate to the occurrence of an attack.

[0061] Depending on the particular test protocol, the subject methods

may further include one or more additional assays associated with the

chronic immune disease of interest. For example, one may couple the

subject methods with assays that look for the presence of low

molecular weight proteins that exhibit RNase L activity, the ratio of

high to low molecular weight proteins that exhibit RNase L activity,

etc., as described in U.S. Pat. Nos. 5,985,565; 6,080,554; 6,207,366;

and 6,214,544 the disclosures of which are herein incorporated by

reference. Other representative assays of interest include biochemical

assays capable of identifying MS activity in the subject, e.g. assays

which detect the presence of oligoclonal bands in cerebral spinal

fluid (CSF). A variety of such assays are known to those of skill in

the art and may be employed in the subject methods. See e.g. Mehta et

al., Electrophoresis 9:126-8, 1998; Mehta et al., J Clin Lab Immunol.

6:17-22, 1981; Trbojevic-Cepe et al., Neurologija. 38:11-21, 1989;

Lasne et al., J Neurochem. 36:1872-4, 1981; Mehta et al., J Neurosci

Methods 16:277-82, 1986.

[0062] Also provided by the subject invention are kits for use in

carrying out the subject methods. The kits at least comprise reagents

necessary for carrying out the p53 species detection assays, where

such kits may include: p53 specific antibodies and/or immunoassay

devices comprising the same; members of a signal producing system,

such as antibodies, enzyme substrates, and the like; various buffers

for use in carrying out the subject detection assays; and the like.

The kits may further include one or more reagents necessary for

preparation of the patient derived sample, such as heparin,

Ficoll-Hypaque, lysing buffer, protease inhibitor, and the like, e.g.

where the patient sample is PBMC derived, etc. In addition, the

subject kits may further include one or more components employed in

fractionation of the sample, such as an electrophoretic medium or

precursors thereof, e.g. dried precursors of polyacrylamide gels, one

or more buffer mediums or components thereof, and the like. In most

embodiments, the kits further include at least an information storage

and presentation medium that contains reference data with which assay

results may be compared in order to diagnose and/or characterize the

chronic immune disease activity in the subject being assayed, i.e.

reference data that includes various values of the high and low

molecular weight p53 species and relates these values to the presence

or absence of chronic immune disease and/or the activity of the

disease in the host. The information storage and presentation medium

may be in any convenient form, such as a printed information on a

package insert, an electronic file present on an electronic storage

medium, e.g. a magnetic disk, CD-ROM, and the like. In yet other

embodiments, the kits may include alternative means for obtaining

reference data, e.g. a website for obtaining the reference data

" on-line. " The kits may further include means for obtaining the

patient sample, e.g. a syringe. The subject kits further typically

include instructions for carrying out the subject methods, where these

instructions may be present on a package insert and/or the packaging

of the kit. Finally, the kit may further include one or more reagents

from an additional biochemical assay which is used to detect the

presence of and/or characterize the chronic immune disease of

interest. For example, where MS is the chronic immune disease of

interest, the kits may further include one or more reagents from an

assay designed to detect the presence of oligoclonal bands in CSF,

e.g. immunoxification reagents (e.g. anti-IgG); labeling reagents,

such as silver salts, and the like.

[0063] Also provided by the subject invention are assay methods for

use in detecting the proteolytic activity of a sample with respect to

direct cleavage of native p53 protein and/or recombinant p53 protein.

In these assay methods of the subject invention, a subject sample, as

described above, is contacted with a source of native and/or

recombinant p53 protein under conditions sufficient for p53 protein

cleavage products to be generated if the sample comprises the

proteolytic activity of interest. Generally, contact is maintained for

a period of time sufficient for a representative amount of cleavage

products to be produced, where this incubation time typically ranges

from about 5 to 120 minutes, usually from about 30 to 60 minutes. The

source of native p53 protein and/or recombinant p53 protein that may

be used in these assays may be any convenient source. As such, the

source may be a naturally occurring source, a recombinant source and

the like.

[0064] Any convenient cleavage product detection format may be

employed. Depending on the detection format employed, the source of

native and/or recombinant p53 protein may or may not be labeled. For

example, one convenient assay employs the use of substrate bound

native and/or recombinant p53, where the proteins are labeled,

generally proximal to or at the end of the protein that is not

attached, either directly or indirectly, to the substrate. The

substrate bound protein is then contacted with the sample, as

described above, and, following incubation, any cleavage products,

e.g. low molecular weight p53 cleavage products, are detected.

Non-labeled protocols may also be employed, e.g. antibody based (such

as Western blot formats) as described supra.

[0065] Following detection of the cleavage products, the presence of,

and generally amount of cleavage products is related to the

proteolytic activity of the sample, specifically the mp53 proteolytic

activity of the sample. In other words, the pattern of native and/or

recombinant p53 cleavage products or proteins in the sample is related

to the proteolytic characteristics or ability of the sample. For

example, the presence of cleavage products indicates that the sample

comprises the target proteolytic activity, while the amount of the

cleavage products indicates the level of proteolytic activity.

[0066] The above assay for proteolytic activity in the sample may be

employed in many applications. For example, the above proteolytic

activity assay may be employed in addition to, or as a substitute for,

the p53 species detection assays in the above described methods of

diagnosing and/or characterizing chronic immune disease activity.

[0067] Also provided are kits for use in practicing the subject

proteolytic activity assays. The subject kits include, among other

components, a source of native and/or recombinant p53 (e.g. source of

full length recombinant p53 protein), where the source may be stably

associated with the surface of a substrate and/or labeled, depending

on the nature of the assay to be performed. Generally, the kits will

also comprise a medium having reference values recorded thereon for

use in interpreting the assay data and relating the data to the

proteolytic activity in the sample.

[0068] As summarized above, the subject invention also provides

methods for treating a host suffering from a chronic immune disease.

Specifically, the subject invention provides methods of treating a

host suffering from MS or CFS.

[0069] In practicing the subject methods, an effective amount of an

agent that enhances p53 protein activity, specifically in PBMC, is

administered to the host suffering from the chronic immune disease. By

enhance is meant that the p53 activity in the host, particularly in

PBMC of the host, is increased by at least about 2 fold, usually by at

least about 3 fold and more usually by at least about 5 fold, as

compared to that observed in a control, i.e., a PBMC from the host

that has not been contacted by the active agent(s).

[0070] Enhancement of p53 activity can be accomplished in any

convenient manner. Particular active agents of interest include, but

are not limited to p53 cleavage-inhibitory agents and p53 expression

enhancing agents. Each of these types of agents is now described

separately in greater detail.

[0071] p53 Cleavage-Inhibitory Agents

[0072] p53 cleavage-inhibitory agents of interest for use in the

subject methods are agents that inhibit cleavage or fragmentation of

p53 protein. The target molecule is a protein or activity, e.g.,

enzyme, that cleaves native p53 protein into fragments. An example of

such a protein with p53 cleavage ability is calpain (see Kubbutat,

supra, the contents of which is incorporated herein by reference). By

inhibit is meant that these agents at least reduce, if not

substantially or complete stop, the cleavage of p53. p53

cleavage-inhibitory agents typically reduce the cleavage or p53 by at

least about 2 fold, usually at least about 3 fold and more usually at

least about 5 fold. Inhibitors of interest include agents that bind to

the target molecule (e.g., protease) and concomitantly reduce its

activity, as well as agents that reduce the expression of the target

molecule so that the overall cleavage activity of the target molecule

is reduced. As such, agents of interest include small molecule agents,

as may be identified in the assays described below and antibodies

specific to inhibiting the action of the p53 cleaving target

molecules. Small molecule agents of interest include small organic

compounds having a molecular weight of more than 50 and less than

about 2,500 daltons (see for example U.S. Pat. Nos. 6,083,944,

6,100,267, and 6,214, 856 the disclosures of which are herein

incorporated by reference). The small molecule agents comprise

functional groups necessary for structural interaction with proteins,

particularly hydrogen bonding, and typically include at least an

amine, carbonyl, hydroxyl or carboxyl group, preferably at least two

of the functional chemical groups. The small molecule agents often

comprise cyclical carbon or heterocyclic structures and/or aromatic or

polyaromatic structures substituted with one or more of the above

functional groups. Small molecule agents of interest are also found

among biomolecules including, but not limited to: peptides,

saccharides, fatty acids, steroids, purines, pyrimidines, derivatives,

structural analogs or combinations thereof. Candidate agents are

obtained from a wide variety of sources including libraries of

synthetic or natural compounds. For example, numerous means are

available for random and directed synthesis of a wide variety of

organic compounds and biomolecules, including expression of randomized

oligonucleotides and oligopeptides. Alternatively, libraries of

natural compounds in the form of bacterial, fungal, plant and animal

extracts are available or readily produced. Additionally, natural or

synthetically produced libraries and compounds are readily modified

through conventional chemical, physical and biochemical means, and may

be used to produce combinatorial libraries. Known pharmacological

agents may be subjected to directed or random chemical modifications,

such as acylation, alkylation, esterification, amidification, etc. to

produce structural analogs. New potential therapeutic agents may also

be created using methods such as rational drug design or computer

modeling. Protease specific antibodies may be readily produced using

the procedures described above.

[0073] In yet other embodiments of the invention, the active agent is

an agent that modulates, and generally decreases or down regulates,

the expression of the p53-specific protease gene (e.g., m- or

u-calpain) in the host. Antisense molecules can be used to

down-regulate expression of genes in cells. The antisense reagent may

be antisense oligonucleotides (ODN), particularly synthetic ODN having

chemical modifications from native nucleic acids, or nucleic acid

constructs that express such anti-sense molecules as RNA. The

antisense sequence is complementary to the mRNA of the targeted gene,

and inhibits expression of the targeted gene products. Antisense

molecules inhibit gene expression through various mechanisms, e.g. by

reducing the amount of mRNA available for translation, through

activation of RNAse H, or steric hindrance. One or a combination of

antisense molecules may be administered, where a combination may

comprise multiple different sequences.

[0074] Antisense molecules may be produced by expression of all or a

part of the target gene sequence in an appropriate vector, where the

transcriptional initiation is oriented such that an antisense strand

is produced as an RNA molecule. Alternatively, the antisense molecule

is a synthetic oligonucleotide. Antisense oligonucleotides will

generally be at least about 7, usually at least about 12, more usually

at least about 20 nucleotides in length, and not more than about 500,

usually not more than about 50, more usually not more than about 35

nucleotides in length, where the length is governed by efficiency of

inhibition, specificity, including absence of cross-reactivity, and

the like. It has been found that short oligonucleotides, of from 7 to

8 bases in length, can be strong and selective inhibitors of gene

expression (see Wagner et al., Nature Biotechnol. 14:840-844, 1996).

[0075] A specific region or regions of the endogenous sense strand

mRNA sequence is chosen to be complemented by the antisense sequence.

Selection of a specific sequence for the oligonucleotide may use an

empirical method, where several candidate sequences are assayed for

inhibition of expression of the target gene in an in vitro or animal

model. A combination of sequences may also be used, where several

regions of the mRNA sequence are selected for antisense complementation.

[0076] Antisense oligonucleotides may be chemically synthesized by

methods known in the art (see Wagner et al., supra, and Milligan et

al., supra.) Preferred oligonucleotides are chemically modified from

the native phosphodiester structure, in order to increase their

intracellular stability and binding affinity. A number of such

modifications have been described in the literature to alter the

chemistry of the backbone, sugars or heterocyclic bases.

[0077] Among useful changes in the backbone chemistry are

phosphorothioates; phosphorodithioates, where both of the non-bridging

oxygens are substituted with sulfur; phosphoroamidites; alkyl

phosphotriesters and boranophosphates. Achiral phosphate derivatives

include 3'-O'-5'-S-phosphorothioate, 3'-S-5'-O-phosphorothioate,

3'-CH.sub.2-5'-phosphonate and 3'-NH-5'-O-phosphoroamidate. Peptide

nucleic acids replace the entire ribose phosphodiester backbone with a

peptide linkage. Sugar modifications are also used to enhance

stability and affinity. The .alpha.-anomer of deoxyribose may be used,

where the base is inverted with respect to the natural .beta.-anomer.

The 2'-OH of the ribose sugar may be altered to form 2'-O-methyl or

2'-O-allyl sugars, which provides resistance to degradation without

comprising affinity. Modification of the heterocyclic bases must

maintain proper base pairing. Some useful substitutions include

deoxyuridine for deoxythymidine; 5-methyl-2'-deoxycytidine and

5-bromo-2'-deoxycytidine for deoxycytidine. 5-propynyl-2'-deoxyuridine

and 5-propynyl-2'-deoxycytidine have been shown to increase affinity

and biological activity when substituted for deoxythymidine and

deoxycytidine, respectively.

[0078] As an alternative to anti-sense inhibitors, catalytic nucleic

acid compounds, e.g. ribozymes, anti-sense conjugates, etc. may be

used to inhibit gene expression. Ribozymes may be synthesized in vitro

and administered to the patient, or may be encoded on an expression

vector, from which the ribozyme is synthesized in the targeted cell

(for example, see International patent application WO 9523225, and

Beigelman et al., Nucl. Acids Res. 23:4434-42, 1995). Examples of

oligonucleotides with catalytic activity are described in WO 9506764.

Conjugates of anti-sense ODN with a metal complex, e.g.

terpyridylCu(II), capable of mediating mRNA hydrolysis are described

in Bashkin et al., Appl. Biochem. Biotechnol. 54:43-56, 1995.

[0079] A further alternative to the above is the use of

double-stranded RNA sequences, or the production thereof by

introducing vectors for such in the host, the nucleic acid sequences

of which are identical to all or part of the p53-specific protease

gene. Such a double-stranded RNA is capable of binding to and causing

the degradation of the homologous mRNA species. Thus, the mRNA coding

for the production of p53-specific protease is targeted for removal by

this method. This technique is referred to as RNA interference,

examples of which are described in Tuschl et al., Genes and

Development 13:3191-3197, 1999, and Zamore, Cell 101:25-33, 2000.

[0080] p53 Expression Enhancing Agents

[0081] In yet other embodiments of the subject invention, the active

agent is a p53 expression-enhancing agent. By p53 expression enhancing

agent is meant an agent that enhances expression of native p53 mRNA

and/or the production of native p53 protein in the host, particularly

in PBMC of the host. Agents of interest include, but are not limited

to: p53 nucleic acid and protein therapeutic compositions. In this

embodiment, the genes or gene fragments are useful in gene therapy to

enhance p53 gene activity. Expression vectors may be used to introduce

the p53 gene into a cell. Such vectors generally have convenient

restriction sites located near the promoter sequence to provide for

the insertion of nucleic acid sequences. Transcription cassettes may

be prepared comprising a transcription initiation region, the target

gene or fragment thereof, and a transcriptional termination region.

The transcription cassettes may be introduced into a variety of

vectors, e.g., plasmid; retrovirus, e.g. lentivirus; adenovirus; and

the like, where the vectors are able to transiently or stably be

maintained in the cells, usually for a period of at least about one

day, more usually for a period of at least about several days to

several weeks.

[0082] The gene or protein may be introduced into tissues or host

cells by any number of routes, including viral infection,

microinjection, or fusion of vesicles. Jet injection may also be used

for intramuscular administration, as described by Furth et al., Anal.

Biochem. 205:365-368, 1992. The DNA may be coated onto gold

microparticles, and delivered intradermally by a particle bombardment

device, or " gene gun " as described by Tang et al., Nature 356:152-154,

1992, where gold microprojectiles are coated with the DNA and then

bombarded into skin cells. The nucleic acid and protein sequence of

p53 is known, where the human cDNA and amino acid sequence are

deposited in GenBank under Accession no. CAC22427 and AXO57140.

[0083] Also of interest is the use of agents that modulate the

endogenous p53 gene of the host to enhance its expression. For

example, the endogenous p53 gene of a cell can be regulated by an

exogenous regulatory sequence inserted into the genome of the cell at

location sufficient to at least enhance expressed of the gene in the

cell. The regulatory sequence may be designed to integrate into the

genome via homologous recombination, as disclosed in U.S. Pat. Nos.

5,641,670 and 5,733,761, the disclosures of which are herein

incorporated by reference, or may be designed to integrate into the

genome via non-homologous recombination, as described in WO 99/15650,

the disclosure of which is herein incorporated by reference. As such,

also encompassed in the subject invention is the enhancement of p53

expression without manipulation of the encoding nucleic acid itself,

but instead through integration of a regulatory sequence into the

genome of cell of the host that already includes a gene encoding the

desired protein, as described in the above incorporated patent documents.

[0084] Also of interest is the use of agents that modulate the levels

of native p53 protein in the host, particularly in PBMC of the host.

Such an agent may act directly on the PBMCs of the host, such as one

of the interferon class of proteins, or indirectly on the PBMCs

through the induction of related cytokines whose effects modulate the

levels of native p53 protein.

[0085] Also of interest is the use of agents that directly suppress

the tumorigenic effects that arise from the loss of functional p53

protein by proteolytic damage (see U.S. Pat. No. 5,840,673 the

contents of which are incorporated herein by reference). An example of

such an agent is Insulin-like growth factor binding protein type 3

(IGF-BP3). This protein may be modulated by the administration of (1)

a modulator of IGF-BP3 (e.g., plant extracts such as those contained

in Acclydine.RTM.), (2) IGF-BP3 itself, or (3) and expression vector

comprising a nucleotide sequence encoding IGF-BP3 by any of the means,

methodologies or techniques as described supra. In such instance where

the agent acts to increase the levels of IGF-BP3 in the cell,

insulin-like growth factor (IGF) is blocked from binding to its

receptor, suppressing the growth of the cell, promoting apoptosis, and

counteracting the loss of functional p53 protein on the growth of the

cell.

[0086] As mentioned above, in the subject methods an effective amount

of one or more of the above described active agents is administered to

the host, where " effective amount " means a dosage sufficient to

produce a desired result, where the desired result is at least an

amelioration, if not complete cessation of the chronic immune disease

symptoms.

[0087] In the subject methods, the active agent(s) may be administered

to the host using any convenient means capable of resulting in the

desired treatment. Thus, the agent can be incorporated into a variety

of formulations for therapeutic administration. More particularly, the

agents of the present invention can be formulated into pharmaceutical

compositions by combination with appropriate, pharmaceutically

acceptable carriers or diluents, and may be formulated into

preparations in solid, semi-solid, liquid or gaseous forms, such as

tablets, capsules, powders, granules, ointments, solutions,

suppositories, injections, inhalants and aerosols.

[0088] As such, administration of the agents can be achieved in

various ways, including oral, buccal, rectal, parenteral,

intraperitoneal, intradermal, transdermal, intracheal, etc.,

administration.

[0089] In pharmaceutical dosage forms, the agents may be administered

in the form of their pharmaceutically acceptable salts, or they may

also be used alone or in appropriate association, as well as in

combination, with other pharmaceutically active compounds. The

following methods and excipients are merely exemplary and are in no

way limiting.

[0090] For oral preparations, the agents can be used alone or in

combination with appropriate additives to make tablets, powders,

granules or capsules, for example, with conventional additives, such

as lactose, mannitol, corn starch or potato starch; with binders, such

as crystalline cellulose, cellulose derivatives, acacia, corn starch

or gelatins; with disintegrators, such as corn starch, potato starch

or sodium carboxymethylcellulose; with lubricants, such as talc or

magnesium stearate; and if desired, with diluents, buffering agents,

moistening agents, preservatives and flavoring agents.

[0091] The agents can be formulated into preparations for injection by

dissolving, suspending or emulsifying them in an aqueous or nonaqueous

solvent, such as vegetable or other similar oils, synthetic aliphatic

acid glycerides, esters of higher aliphatic acids or propylene glycol;

and if desired, with conventional additives such as solubilizers,

isotonic agents, suspending agents, emulsifying agents, stabilizers

and preservatives.

[0092] The agents can be utilized in aerosol formulation to be

administered via inhalation. The compounds of the present invention

can be formulated into pressurized acceptable propellants such as

dichlorodifluoromethane, propane, nitrogen and the like.

[0093] Furthermore, the agents can be made into suppositories by

mixing with a variety of bases such as emulsifying bases or

water-soluble bases. The compounds of the present invention can be

administered rectally via a suppository. The suppository can include

vehicles such as cocoa butter, carbowaxes and polyethylene glycols,

which melt at body temperature, yet are solidified at room temperature.

[0094] Unit dosage forms for oral or rectal administration such as

syrups, elixirs, and suspensions may be provided wherein each dosage

unit, for example, teaspoonful, tablespoonful, tablet or suppository,

contains a predetermined amount of the composition containing one or

more inhibitors. Similarly, unit dosage forms for injection or

intravenous administration may comprise the inhibitor(s) in a

composition as a solution in sterile water, normal saline or another

pharmaceutically acceptable carrier.

[0095] The term " unit dosage form, " as used herein, refers to

physically discrete units suitable as unitary dosages for human and

animal subjects, each unit containing a predetermined quantity of

compounds of the present invention calculated in an amount sufficient

to produce the desired effect in association with a pharmaceutically

acceptable diluent, carrier or vehicle. The specifications for the

novel unit dosage forms of the present invention depend on the

particular compound employed and the effect to be achieved, and the

pharmacodynamics associated with each compound in the host.

[0096] The pharmaceutically acceptable excipients, such as vehicles,

adjuvants, carriers or diluents, are readily available to the public.

Moreover, pharmaceutically acceptable auxiliary substances, such as pH

adjusting and buffering agents, tonicity adjusting agents,

stabilizers, wetting agents and the like, are readily available to the

public.

[0097] Where the agent is a polypeptide, polynucleotide, analog or

mimetic thereof, e.g. antisense composition, it may be introduced into

tissues or host cells by any number of routes, including viral

infection, microinjection, or fusion of vesicles. Jet injection may

also be used for intramuscular administration, as described by Furth

et al., supra. The agent may be coated onto gold microparticles, and

delivered intradermally by a particle bombardment device, or " gene

gun " as described in the literature as described by Tang et al., supra.

[0098] Those of skill in the art will readily appreciate that dose

levels can vary as a function of the specific compound, the severity

of the symptoms and the susceptibility of the subject to side effects.

Preferred dosages for a given compound are readily determinable by

those of skill in the art by a variety of means.

[0099] As mentioned above, by treatment is meant that at least an

amelioration of the symptoms associated with the chronic immune

disease, where amelioration is used in a broad sense to refer to at

least a reduction in the magnitude of a parameter, e.g. symptom,

associated with the condition being treated. As such, treatment also

includes situations where the pathological condition, or at least

symptoms associated therewith, are completely inhibited, e.g.

prevented from happening, or stopped, e.g. terminated, such that the

host no longer suffers from the condition, or at least the symptoms

that characterize the chronic immune disease condition.

[0100] A variety of hosts are treatable according to the subject

methods. Generally such hosts are " mammals " or " mammalian, " where

these terms are used broadly to describe organisms which are within

the class mammalia, including the orders carnivore (e.g., dogs and

cats), rodentia (e.g., mice, guinea pigs, and rats), and primates

(e.g. humans, chimpanzees, and monkeys). In many embodiments, the

hosts will be humans.

[0101] Kits with unit doses of the active agent, usually in oral or

injectable doses, are provided. In such kits, in addition to the

containers containing the unit doses will be an informational package

insert describing the use and attendant benefits of the drugs in

treating pathological condition of interest. Preferred compounds and

unit doses are those described herein above.

[0102] The following examples are offered by way of illustration and

not by way of limitation.

Experimental Section

[0103] I. Procedures

[0104] A. Cell Isolation and Protein Extraction

[0105] Peripheral blood mononuclear cells (PBMCs) were separated from

heparinized blood (30 mLs) by Ficoll-Hypaque density gradient

centrifugation. The blood was layered onto 20 mLs of Ficoll-Hypaque

(Boyum, Scandinavian Journal of Clinical Laboratory Investigation,

97:101-109, 1968) at a density of 1.077 g/mL at 20C and centrifuged

for 30 minutes at 500.times. g. The PBMC layer was removed and washed

once with 5 volumes of phosphate buffered saline (PBS). The cells were

then resuspended in 5 mLs of red blood cell lysing buffer (155 mM

NH.sub.4Cl, 10 mM NaHCO.sub.3, 0.1 mM EDTA, pH 7.4), kept on ice for 5

minutes, then centrifuged for 5 minutes at 500.times. g. The resultant

cell pellet was washed once with 15 mLs of PBS and centrifuged for 5

minutes at 500.times. g. The resultant pellet was then stored at -70C

until the protein extraction procedure could be performed.

[0106] To extract the proteins from the cell pellet, PBMCs were

resuspended in a volume approximately 5-10 times the packed cell

volume in the extract buffer (10 mM HEPES, pH 7.6, 90 mM KCl, 1.5 mM

Mg(OAc).sub.2, 0.5% non-ionic detergent (such as Nonidet P-40 or

Igepal CA-630, Sigma Chemical Corporation)). The extract buffer also

contained a mixture of protease inhibitors to help stabilize the

extract and impeded the action of proteases. Once such commercially

available mixture is the MiniComplete protease inhibitor cocktail

(Boehringer-Mannheim). This contains aprotinin, leupeptin, pefabloc-SC

and EDTA.

[0107] The extraction procedure was performed at 2-4 degrees C.,

holding the cell pellet-extraction buffer in ice water or on wet ice

for 5 minutes. The cell pellet-buffer mix was then vortexed at medium

speed for 2 minutes at room temperature to ensure complete

solubilization of the cell membranes. The cell pellet-buffer mix was

then placed at 2-4C for an additional 5 minutes. The final step was to

centrifuge the cell pellet-buffer mix at high speed in a

microcentrifuge (16,000.times. g) for 2 minutes. The supernatant

containing the proteins of interest was collected and the cell pellet

is discarded. All cell extracts were stored at -70C until further

analysis could be performed.

[0108] Quantification of protein in the patient cell extracts was

performed using a standard commercially available procedure of a

modified Bradford method (Bio-Rad Laboratories) following the

manufacturer's recommended procedure.

[0109] B. Quantification of 2'-5' A Binding Proteins

[0110] Analysis of LMW and HMW 2'-5' A binding proteins was performed

using a radiolabeled 2'-5' A trimer and SDS-PAGE as described by the

method of Charachon et al. (Biochemistry 29:2550-2556, 1990). Briefly,

2'-5' A trimer was radiolabeled by the ligation of .sup.32P-pCp to the

3' end (method of Charachon). After removal of the 3' terminal

phosphate by treatment with bacterial alkaline phosphatase, the 3'

ribose residue of pC was oxidized with sodium metaperiodate (10 mM

final concentration, pH 4.75) for one hour at 4C to form 2'5'

A-.sup.32pC-OX. This reaction mixture was subsequently equilibrated to

pH 8.0 by the addition of NaOH. This oxidized molecule was used as the

radiolabel in all subsequent reactions for RNase L protein analysis

(referred to below as radiolabeled 2'5' A).

[0111] The radiolabeled 2'5' A was incubated with 200 micrograms of

cell extract at 2-4C for 15 minutes to allow the radiolabeled 2'5' A

to interact with any 2'5' A-binding proteins present, such as RNase L

(all molecular weight species). The 2'-5' A radiolabel was then

covalently attached to all RNase L species by the addition of

cyanoborohydride (20 mM in 100 mM phosphate buffer, pH 8.0). The

reduction reaction was allowed to occur for 20 minutes at room

temperature. SDS-PAGE sample buffer, including a tracking dye, was

added to the samples and all samples were incubated at 95C for 5

minutes to reduce any disulfide bonds present.

[0112] The samples were then subjected to standard SDS-polyacrylamide

gel electrophoresis using a 4 percent stacking gel and a 10 percent

separating gel (Bisbal et al, European Journal of Biochemistry

179:595-602, 1989). Also included in the first lane of each gel was a

molecular weight marker, pre-stained to be visible as it migrated

during the course of electrophoresis (Bio-Rad Laboratories). The gel

was electrophoresed until the tracking dye had migrated to the bottom

of the gel (approximately 5 hours at a constant current of 30 mAmps).

The gel was then dried and subjected to autoiradiography (Bio-Rad

Laboratories FX Imager).

[0113] The autoradiographs were then analyzed by densitometry, and

quantification of any and all RNase L species present was performed

using specialized software (Quantity One from Bio-Rad Laboratories).

The results are expressed as the density (or relative amount) of 37

kDa LMW RNase L present divided by the density (or relative amount) of

80 kDa HMW RNase L present, multiplied by a constant factor of 10.

[0114] C. Quantification of p53 Protein and Related Fragments by

Western Blot

[0115] Briefly, the procedure used is as follows: 200 micrograms of

protein extracted from the cytoplasm of PBMCs was mixed with 2.times.

SDS-PAGE gel sample dye that included a tracking dye, and heated to

95C for five minutes to denature the proteins. The denatured samples

were then subjected to standard SDS-PAGE using a 4 percent stacking

gel and 10 percent separating gel. Also included in the first lane of

each gel was a molecular weight marker, pre-stained to be visible as

it migrated during the course of electrophoresis (Bio-Rad

Laboratories). The gel was electrophoresed until the tracking dye had

migrated to the bottom of the gel.

[0116] The gel was then transferred to a PVDF membrane (Bio-Rad

Laboratories) using a semi-dry transfer system (Amersham-Pharmacia

Biotech). Transfer was performed at an average current of 0.8 milliamp

per cm2 of gel (or 100 mA for a standard 15 cm.times.8 cm gel) for two

hours. After transfer was complete (as determined by the visual

agreement of the transfer of the color from the pre-stained molecular

weight markers to the membrane), the membrane was allowed to dry

thoroughly at room temperature for at least one hour.

[0117] Western blotting was performed using the following format: The

membrane was first wet with a minimum volume of 100 percent methanol

(according to the manufacturer's instruction). Then a solution of five

percent non-fat dry milk (5% NFDM) was used to `block` the membrane

(`blocking buffer`) to eliminate non-specific background binding of

antibody. The membrane was `blocked` for one hour with gentle shaking

on an orbital shaker.

[0118] The blocking buffer was discarded and fresh blocking buffer was

added in the amount of approximately 0.1 mL per cm2 of membrane, to

which was added the primary antibody (rabbit polyclonal anti-p53

antibody; Santa Cruz Biotechnologies, sc-6243) at a 1:100 dilution.

The membrane was allowed to react with the primary antibody for one

hour with gentle shaking on an orbital shaker. The primary antibody

solution was then discarded and the membrane was washed three times

with 25 mLs per wash of phosphate buffered saline (PBS, pH=7.4) plus

0.1% Tween 20 (polyoxyethylene sorbitan monolaurate; Sigma

Corporation). Each wash was five minutes in length, with shaking, and

the each time the solution was discarded.

[0119] Fresh blocking buffer was added in the amount of approximately

0.1 mL per cm2 of membrane, to which was added the secondary antibody

(goat anti-rabbit antibody, conjugated to horseradish peroxidase

(GAR-HRP); Bio-Rad Laboratories) at a 1:2000 dilution according to the

manufacturer's recommendations. The membrane was allowed to react with

the secondary antibody for thirty minutes with gentle shaking on an

orbital shaker. The secondary antibody solution was discarded and the

membrane was washed three times with 25 mLs per wash of phosphate

buffered saline (PBS, pH=7.4) plus 0.1% Tween 20. Each wash was five

minutes in length, with shaking, and the each time the solution was

discarded.

[0120] Color development was performed using the Opti4-CN kit (Bio-Rad

Laboratories) according to the manufacturer's recommendations. Color

development was allowed to proceed for 15 minutes and the membrane was

then rinsed in copious changes of water and allowed to dry at room

temperature. The membrane was then analyzed by densitometry and

quantification of p53 and p53 fragment proteins present was performed

using specialized software (Quantity One from Bio-Rad Laboratories).

[0121] II. Analysis of Results

[0122] FIG. 1 represents a densitometric scan of a Western blot

detecting p53 protein and p53 protein fragments from PBMC extracts

from CFS patients. The value indicated at the top of each lane is the

ratio of RNase L fragments as calculated by [Log10((LMW/HMW)*10)] as

assayed in PBMC extracts from CFS patients. The above results

demonstrate that the presence and amount of p53 protein fragmentation

directly correlates with the presence and amount of low molecular

weight RNase L fragments in PBMC samples.

[0123] These data indicate that native p53 protein is fragmented at a

later point in the disease cycle than RNase L protein. The loss of

functional p53 protein in PBMCs render these cells unable to respond

to normal growth inhibitory stimuli and provide the means whereby

unregulated cell growth occurs, ultimately giving rise to

hematopoieitic tumors.

[0124] It is evident from the above results and discussion that

relatively simple and rapid methods for diagnosing and/or

characterizing chronic immune disease (e.g. MS or CFS) activity in a

subject are provided by the subject invention. With the subject

methods, accurate diagnosis of the chronic immune disease condition,

as well the identification of the stage and/or progression of the

chronic immune disease condition, may be obtained. As such, the

subject methods provide for more accurate diagnostic and/or treatment

regimens. In addition, methods of treating hosts for chronic immune

disease are provided. Accordingly, the subject invention represents a

significant contribution to the art.

[0125] All publications and patent applications cited in this

specification are herein incorporated by reference as if each

individual publication or patent application were specifically and

individually indicated to be incorporated by reference. The citation

of any publication is for its disclosure prior to the filing date and

should not be construed as an admission that the present invention is

not entitled to antedate such publication by virtue of prior invention.

[0126] Although the foregoing invention has been described in some

detail by way of illustration and example for purposes of clarity of

understanding, it is readily apparent to those of ordinary skill in

the art in light of the teachings of this invention that certain

changes and modifications may be made thereto without departing from

the spirit or scope of the appended claims.

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does anybody know what Dr DeMeirleir said in that recent talk about

Acclydine at the NJ CFS conference that is now available on video

tape?

thanks

bill

> okay so i'm really confused about how acclydine works. i need some

> help here.

>

> i found two conflicting articles.

>

> 1) from the recent NCF article on low STAT levels in PWCs

>

> http://www.ncf-net.org/forum/TotalExposure.htm

>

>

> 2) from the distrbutor of Acclydine.

>

> http://216.239.41.104/search?

>

q=cache:Yfljcq6i6MUJ:www.geocities.com/cfsnova/accyldineProtOct.pdf+ac

> clydine,+cost & hl=en & ie=UTF-8

>

> you will need to either copy and paste this second link to get

there

> or do a google search for " acclydine, cost " to find the second

> article.

>

>

> so, the NCF one states that acclydine works by increasing IGFBP-3,

> which increases the production on STAT-1.

>

> number 2 says that Acclydine works by increasing IGF-1, which in

turn

> corrects the ratio of IGFBP-3/IGF-1.

>

> this seems to be a direct contradiction. If acclydine increases

> IGFBP-3 like the NCF says, that would worsen the ratio of IGFBP-

3/IGF-

> 1.

>

> but if the point is to increase STAT-1, then i don't see how

> acclydine does that. how can acclydine simultaneously increase

IGFBP-3

> and decrease the ratio of IGFBP-3/IGF-1?

>

> it just doesn't make sense.

>

> any help here?

>

> thanks

> bill

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