A 37-kDa binding polypeptide accumulates in peripheral blood mononuclear cell (PBMC) extracts from chronic fatigue syndrome (CFS) patients and is being considered as a potential diagnostic marker (De Meirleir, K., Bisbal, C., Campine, I., De Becker, P., Salehzada, T., Demettre, E., and Lebleu, B. (2000) Am. J. Med. 108, 99 -105). We establish here that this low molecular weight 2-5A-binding polypeptide is a truncated form of the native 2-5A-dependent ribonuclease L (RNase L), generated by an increased proteolytic activity in CFS PBMC extracts. RNase L proteolysis in CFS PBMC extracts can be mimicked in a model system in which recombinant RNase L is treated with human leukocyte elastase. RNase L proteolysis leads to the accumulation of two major fragments with molecular masses of 37 and 30 kDa. The 37-kDa fragment includes the 2-5A binding site and the N-terminal end of native RNase L. The 30-kDa fragment includes the catalytic site in the C-terminal part of RNase L. Interestingly, RNase L remains active and 2-5A-dependent when degraded into its 30-and 37-kDa fragments by proteases of CFS PBMC extract or by purified human leukocyte elastase. The 2-5A-dependent nuclease activity of the truncated RNase L could result from the association of these digestion products, as suggested in pull down experiments.Chronic fatigue syndrome is characterized by long-lasting and debilitating fatigue, myalgia, impairment of neurocognitive functions, and flu-like symptoms, which are often severely worsened after physical exercise. A case definition has been proposed by the Center for Disease Control in Atlanta under the name of Holmes (2) and Fukuda (3) criteria. Most of these symptoms are unfortunately common to other diseases, thus complicating a diagnosis that still relies on extensive clinical testing to exclude other pathologies (4). A large proportion of the patients report an infectious episode at the onset of their chronic fatigue. No single agent has been conclusively associated with the disease, although several candidates including human T-cell lymphotrophic virus-1, human herpesvirus-6, Enterovirus, or mycoplasma have been proposed (5-8). Dysregulation of immune functions has also been suggested and natural killer cell cytotoxicity was significantly diminished in patients (when compared with normal controls) (9).These observations have prompted studies of possible dysfunctioning of interferon-induced responses. An up-regulation of the 2-5A/RNase L antiviral pathway in peripheral blood mononuclear cells (PBMC) 1 of CFS patients has been described (10). RNase L is the terminal enzyme in the 2-5A synthetase/ RNase L antiviral pathway and plays an essential role in the elimination of viral mRNAs (for review, see Ref. 11). Activation of RNase L requires the binding of a small 2Ј,5Ј-linked oligoadenylate (2-5A). Intriguingly, a low molecular weight 2-5A-binding polypeptide has been observed in a subset of patients diagnosed for CFS (12). Similar observations have been made in a larger study including CFS patients and control ...