Showing posts with label Ian Lipkin. Show all posts
Showing posts with label Ian Lipkin. Show all posts

Friday, 4 October 2013

Waiting patent-ly: Gc globulin, vitamin D and autism?

As summer inevitably turns to Autumn and the prospect of those colder, darker winter days and nights further encroaches, I find myself again talking about the growing body of research and speculation suggestive of a link between autism (or at least some of the autisms) and the sunshine vitamin - vitamin D - and its related biochemistry.
Autumn @ Wikipedia 

I was brought to this post by an interesting patent application by The Trustees Of Columbia University In The City Of New York regarding an invention by two very well known and renowned scientists: Ian Lipkin and Mady Hornig titled: "Autism-associated biomarkers and uses thereof" (see here*).

Filed earlier this year (2013) the application discusses quite a few things with a focus on vitamin D and autism and in particular: "detecting whether or not there is an alteration in the express of a Gc globulin protein in the subject as compared to a non-autistic subject".

OK, some background just in case you need it. Vitamin D is something of a rock star in health research circles of late. Traditionally thought to be just the stuff needed to help the absorption of calcium, a more varied role has been reported for the sunshine vitamin in recent years covering lots and lots of ailments and conditions. With autism in mind, vitamin D has been the source of quite a bit of speculation** and research (see my previous posts here and here and here). Although requiring further investigation, it would be a brave/foolish (delete as appropriate) person to say that it shows absolutely no link to autism or at least certain facets or cases of autism on the basis of the existing evidence.

Researchers, Ian Lipkin and Mady Hornig, are also highly respected on this blog. Regular readers might remember their names in relation to quite a few topics I've talked about including the old XMRV-CFS/ME de-discovery story (see here) and the fascinating work on autism and Sutterella (see here). Prof Lipkin was also credited in bringing 'science to Hollywood' in his role as an adviser for the film Contagion (see here) and they both share credit for the 'three strikes hypothesis'. Indeed, this is not the first time that their autism work has entered the patent arena (see here).

The recent patent application, I have to admit, was hard going for me in terms of all the details it contained. My trawl for some background information on Gc globulin protein - also I think called vitamin D binding protein (DBP) - revealed that this protein is principally involved in getting vitamin D and its relations around the body among other things***. Specifically the patent is built on: "the finding that increased levels in the Gc globulin GcFl (which is a vitamin D binding protein) can serve as a biomarker for human Autism Spectrum Disorders". This I interpret to mean that too much Gc globulin being present means that too much vitamin D gets bound up with the stuff and levels of free, available vitamin D (and metabolites) might therefore be lower than that required. The patent goes on: "elevated levels of Gc globulin in the umbilical cord plasma of ASD patients were observed relative to control cases".

These are potentially big words. At the time of writing (September 2013) I was unable to find anything in the peer-reviewed research literature looking at Gc globulin in relation to autism, let alone anything suggesting that increased levels of the protein might be the stuff of biomarkers. That's not to say that there may not be something waiting in the pre-publication arena about this, as per the patent talking about proteomic analysis of "umbilical cord blood plasma samples from children diagnosed with autism (n=l 1 cases) and children without evidence of developmental disorder (n=12 controls)". Proteomics you say?

Further down the patent I noted other points. So: "administering to the subject a therapeutic amount of GcMAF, thereby treating or preventing autism or an ASD". Without getting into any debates about treatment and prevention (which seems to be a common theme as per the MAR autism letter recently), Gc-MAF is another interesting part of this application. Regular readers might have seen my post on Gc-MAF and nagalase in relation to autism (see here) and the early-day connections being made there (see here also).

A quick non-expert look at the connection between Gc globulin and Gc-MAF reveals that Gc globulin is the precursor to Gc-MAF****. I think (and it is just that) the patent is suggesting that because greater than usual quantities of vitamin D might be bound up with Gc globulin, there are knock-on immune effects resulting from this vitamin D deficiency, ergo: "administering to the subject a therapeutic amount of GcMAF, thereby treating or preventing the vitamin D deficiency-related immune deficit." Onwards, the assumption is that this might have an effect on the presentation of autism too. Again, with my non-expert hat on, administration of Gc-MAF does seem to affect Gc globulin activity (at least in the lab and using cells from patients with systemic lupus erythematosus*****). Don't quote me on that by the way.

There is quite a bit more information included in this patent which I can't cover here in one post. As if you needed more evidence that vitamin D deficiency might be quite prevalent in autism (and across different geographies) I would also refer you to the recent papers by Duan and colleagues****** & Gong and colleagues******* based in China. That being said, if the Lipkin/Hornig patent turns out to be correct at least for some on the autism spectrum, simply adding more vitamin D into the diet or supplementing or increasing sunshine exposure when a deficiency is present alongside high levels of Gc globulin, might not necessarily be the most desirable course of action.

Finally, I should point out that this is a patent application and not peer-reviewed science so whilst being as enthused as I am about the potential for this line of inquiry, one has to take a step back. As with all patent applications, the aim is protection; protection for the your work, the intellectual property of your work and indeed, the commercialisation of your work from being copied by others presumably for profit. Autism has seen its fair share of patents down the years, over 98,000 at the time I looked, and whilst many would love to see these patents actually produce some real-life benefits for people with autism and their families, the question is: how many actually do?

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* Autism-associated biomarkers and uses thereof. The Trustees Of Columbia University In The City Of New York. WO2013130953 A2. Application number PCT/US2013/028589. Filed: March 1 2013. Published: September 6 2013.

** Cannell JJ. Autism, will vitamin D treat core symptoms? Med Hypotheses. 2013 Aug;81(2):195-8. doi: 10.1016/j.mehy.2013.05.004.

*** Haddad JG. Plasma vitamin D-binding protein (Gc-globulin): Multiple tasks. J Steroid Biochem Mol Biol. 1995; 53: 579-582.

**** Nagasawa H. et al. Gc Protein (Vitamin D-binding Protein): Gc Genotyping and GcMAF Precursor Activity. Anticancer Res. 2005; 25: 3689-3696.

***** Yamamoto N. et al. Deglycosylation of serum vitamin D3-binding protein by alpha-N-acetylgalactosaminidase detected in the plasma of patients with systemic lupus erythematosus. Clin Immunol Immunopathol. 1997 Mar;82(3):290-8.

****** Duan XY. et al. Relationship between vitamin D and autism spectrum disorder. Zhongguo Dang Dai Er Ke Za Zhi. 2013 Aug;15(8):698-702.

******* Gong ZL. et al. Serum 25-hydroxyvitamin D levels in Chinese children with autism spectrum disorders. Neuroreport. 2013 Oct 1. [Epub ahead of print]

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ResearchBlogging.org Cannell JJ (2013). Autism, will vitamin D treat core symptoms? Medical hypotheses, 81 (2), 195-8 PMID: 23725905

Tuesday, 18 September 2012

XMRV and chronic fatigue syndrome: the results are in...

Drummer boy @ Wikipedia
Drum roll please maestro.

It's been on the horizon for quite a while. The speculation about what will be found, the teaser announcements pinpointing Tuesday 18th September 2012 as the big day, the excitement was building.

And finally here it is.

The big multi-centre study initiated by the US National Institute of Allergy and Infectious Diseases headed by the Center for Infection and Immunity at Columbia University’s Mailman School of Public Health to once-and-for-all answer the question on many a person's lips:

Is XMRV linked to chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME)?

And the answer....

Very probably not.

The study by Harvey Alter and colleagues* is open-access and published in the the journal mBio.

OK, a quick recap first. XMRV (xenotropic murine leukemia virus-related virus) was initially suggested to be present in quite a number of cases of Chronic Fatigue Syndrome (CFS). It was followed by lots of media attention including some questions over the blood supply, a not altogether successful line of experimental replication, some pretty strong indications of contamination** affecting results, a backstory like something out of a soap opera, and now the final say-so study headed by Prof. Ian Lipkin, microbe and virus hunter extraordinaire (see this previous post on Sutterella and autism).

The study is open-access for all to see and has been covered by a number of sources so far (here) but a quick summary of the results, bearing in mind my considerable non-expertise in the very complicated world of virology:

  • Blood samples were taken from 147 participants diagnosed with CFS and compared with samples from 146  asymptomatic controls. CFS diagnoses were confirmed by several of the criteria available for describing CFS. Said cases had been ill with CFS for an average of 16 years.
  • Blinded analysis of peripheral blood samples was conducted for the genetic footprints of XMRV and pMLV (polytropic murine leukemia virus). 
  • Results: none of the samples (CFS or controls) showed evidence of XMRV or pMLV. The various labs involved in the trial as well as being pretty meticulous in avoiding any contamination, used both positive and negative controls as part of their analytical methods so knew what to look for.
  • There was a suggestion that nine of samples from each group showed a positive result to XMRV / pMRV reactive antibodies but this result is accompanied by some questions about accuracy and specificity to CFS cases.

What's more to say other than the headline by the NYTimes "Chronic Fatigue Syndrome Back to Square 1". Actually no, I wouldn't agree that we are back to square one. As per the comments from Prof. Lipkin, lessons have been learned and also now some very valuable biological samples from quite a well-defined group of people with CFS are available to science to test other theories as and when they come along (as they inevitably will).

I do have one remaining question for the whole XMRV story as per the results reported by Paolucci and colleagues discussed recently. They reported finding something that looked like XMRV/MLV in two of their patient group with CFS. Do the Lipkin findings then mean that they were wrong? Is yet another scientific retraction on the horizon?

Outside of the science bit, I imagine that quite a few people with CFS/ME will carry a sigh at the publication of these results as again, hopes and dreams of getting to the bottom of this mysterious, unexplained condition take another set-back. For their sake, one can only hope that the XMRV episode will at least stimulate more research interest into CFS/ME as per other US Government departments talking about CFS with drug development in mind. Not forgetting also that there are several areas of research into CFS which seem really quite interesting such as the recent mitochondrial findings and the whole immune functioning area.

OK, that's enough for now. 

I was pondering what song to finish this post with. Something related to the post? Nah, instead something completely unrelated... the Noisettes and That Girl.

Update (18/09/12): The association between XMRV and prostate cancer has also been questioned as per this study by Lee and colleagues (full-text).

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* Alter H et al. A Multicenter Blinded Analysis Indicates No Association between Chronic Fatigue Syndrome/Myalgic Encephalomyelitis and either Xenotropic Murine Leukemia Virus-Related Virus or Polytropic Murine Leukemia Virus. mBio. 2012; 3: e00266-12.

** Stieler K. et al. XMRV induces cell migration, cytokine expression and tumor angiogenesis: are 22Rv1 cells a suitable prostate cancer model? PLoS ONE. 2012; 7: e42321.

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ResearchBlogging.org Harvey J. Alter, Judy A. Mikovits, William M. Switzer, Francis W. Ruscetti, Shyh-Ching Lo, Nancy Klimas, Anthony L. Komaroff, Jose G. Montoya, Lucinda Bateman, Susan Levine, Daniel Peterson, Bruce Levin, Maureen R. Hanson, Afia Genfi, Meera Bhato, HaoQiang Zheng, Richard Wang, Bingjie Li, Guo-Chiuan Hung, Li Ling Lee, Stephen Sameroff, Walid Heneine, John Coffin, Mady Hornigo, & W. Ian Lipkino (2012). A Multicenter Blinded Analysis Indicates No Association between Chronic Fatigue Syndrome/Myalgic Encephalomyelitis and either Xenotropic Murine Leukemia Virus-Related Virus or Polytropic Murine Leukemia Virus mBio : 10.1128/​mBio.00266-12