Embryonal Fyn-associated Substrate
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Embryonal fyn-associated substrate is a
protein Proteins are large biomolecules and macromolecules that comprise one or more long chains of amino acid residues. Proteins perform a vast array of functions within organisms, including catalysing metabolic reactions, DNA replication, respo ...
that in humans is encoded by the EFS
gene In biology, the word gene (from , ; "...Wilhelm Johannsen coined the word gene to describe the Mendelian units of heredity..." meaning ''generation'' or ''birth'' or ''gender'') can have several different meanings. The Mendelian gene is a ba ...
. It is also known as CASS3.


History and discovery

EFS (Embryonal Fyn-associated Substrate), also known as SIN (Src INteracting or Signal Integrating protein) was originally identified using cDNA library screening of mouse embryonal libraries for proteins containing SH3-interacting domains, or interacting with the SRC SH3 domain, in two independent studies by Ishino et al. in 1995 and Alexandropoulos et al. in 1996. In humans, the 561 amino acid EFS protein acts as a scaffolding protein for cell signaling based on interactions with SRC, FAK, and other proteins, and has been linked to roles in the function of the
immune system The immune system is a network of biological processes that protects an organism from diseases. It detects and responds to a wide variety of pathogens, from viruses to parasitic worms, as well as cancer cells and objects such as wood splinte ...
, and the development of
cancer Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal b ...
.


Gene

The chromosomal location of the EFS gene is 14q11.2 and its genomic coordinates are 14:23356400-23365633 on the reverse strand in GRChB38p2 (Genome Reference Consortium Human Build 38 patch release 2). According to the Human Genome Organization (
HUGO Hugo or HUGO may refer to: Arts and entertainment * ''Hugo'' (film), a 2011 film directed by Martin Scorsese * Hugo Award, a science fiction and fantasy award named after Hugo Gernsback * Hugo (franchise), a children's media franchise based on ...
) Gene Nomenclature Committee (
HGNC The HUGO Gene Nomenclature Committee (HGNC) is a committee of the Human Genome Organisation (HUGO) that sets the standards for human gene nomenclature. The HGNC approves a ''unique'' and ''meaningful'' name for every known human gene, based on a q ...
) its approved symbol is EFS and its synonyms are "Cas scaffolding protein family member 3", CASS3, EFS1, EFS2, HEFS and SIN. The official Gene IDs assigned to EFS are 16898 (
HGNC The HUGO Gene Nomenclature Committee (HGNC) is a committee of the Human Genome Organisation (HUGO) that sets the standards for human gene nomenclature. The HGNC approves a ''unique'' and ''meaningful'' name for every known human gene, based on a q ...
), 10278 (
Entrez Gene The Entrez (pronounced ''ɒnˈtreɪ'') Global Query Cross-Database Search System is a federated search engine, or web portal that allows users to search many discrete health sciences databases at the National Center for Biotechnology Information ...
) and ENSG00000100842 (
Ensembl Ensembl genome database project is a scientific project at the European Bioinformatics Institute, which provides a centralized resource for geneticists, molecular biologists and other researchers studying the genomes of our own species and other v ...
). In humans, at least three transcript variants are known for EFS: isoform 1, containing 6 exons end encoding the full-length protein with 561 amino acids; isoform 2, containing 5 exons and encoding a shorter protein (468 amino acids in length); and isoform 3, containing 6 exons and encoding the shortest protein (392 amino acids). Little is known about the
transcriptional regulation In molecular biology and genetics, transcriptional regulation is the means by which a cell regulates the conversion of DNA to RNA (transcription), thereby orchestrating gene activity. A single gene can be regulated in a range of ways, from alt ...
of EFS, but several transcriptional regulators for EFS have been proposed based on consensus binding sites in its promoter region for ATF (Activating transcription factor), NF-κβ, NF-κβ1, GATA-3,
C/EBPα CCAAT-enhancer-binding proteins (or C/EBPs) is a family of transcription factors composed of six members, named from C/EBPα to C/EBPζ. They promote the expression of certain genes through interaction with their promoters. Once bound to DNA, C ...
(CCAAT/enhancer-binding protein alpha),
glucocorticoid receptors Steroid hormone receptors are found in the nucleus, cytosol, and also on the plasma membrane of target cells. They are generally intracellular receptors (typically cytoplasmic or nuclear) and initiate signal transduction for steroid hormones which ...
α and β, and
p53 p53, also known as Tumor protein P53, cellular tumor antigen p53 (UniProt name), or transformation-related protein 53 (TRP53) is a regulatory protein that is often mutated in human cancers. The p53 proteins (originally thought to be, and often s ...
. Expression of isoforms 1 and 2 has been detected in multiple tissues, with maximal expression in the
placenta The placenta is a temporary embryonic and later fetal organ that begins developing from the blastocyst shortly after implantation. It plays critical roles in facilitating nutrient, gas and waste exchange between the physically separate mater ...
, and the embryonal
central nervous system The central nervous system (CNS) is the part of the nervous system consisting primarily of the brain and spinal cord. The CNS is so named because the brain integrates the received information and coordinates and influences the activity of all par ...
,
heart The heart is a muscular organ in most animals. This organ pumps blood through the blood vessels of the circulatory system. The pumped blood carries oxygen and nutrients to the body, while carrying metabolic waste such as carbon dioxide t ...
,
testes A testicle or testis (plural testes) is the male reproductive gland or gonad in all bilaterians, including humans. It is homologous to the female ovary. The functions of the testes are to produce both sperm and androgens, primarily testoster ...
and
lungs The lungs are the primary organs of the respiratory system in humans and most other animals, including some snails and a small number of fish. In mammals and most other vertebrates, two lungs are located near the backbone on either side of th ...
. Although its expression has been reported as lower in
thymus The thymus is a specialized primary lymphoid organ of the immune system. Within the thymus, thymus cell lymphocytes or ''T cells'' mature. T cells are critical to the adaptive immune system, where the body adapts to specific foreign invaders. ...
and
lymphocytes A lymphocyte is a type of white blood cell (leukocyte) in the immune system of most vertebrates. Lymphocytes include natural killer cells (which function in cell-mediated, cytotoxic innate immunity), T cells (for cell-mediated, cytotoxic adap ...
, functional studies of EFS to date have best defined it as important for immune system function. One screen for implantation-related genes regulated by
progesterone Progesterone (P4) is an endogenous steroid and progestogen sex hormone involved in the menstrual cycle, pregnancy, and embryogenesis of humans and other species. It belongs to a group of steroid hormones called the progestogens and is the m ...
found that EFS was downregulated by
17β-estradiol Estradiol (E2), also spelled oestradiol, is an estrogen steroid hormone and the major female sex hormone. It is involved in the regulation of the estrous and menstrual female reproductive cycles. Estradiol is responsible for the development of f ...
and
progesterone Progesterone (P4) is an endogenous steroid and progestogen sex hormone involved in the menstrual cycle, pregnancy, and embryogenesis of humans and other species. It belongs to a group of steroid hormones called the progestogens and is the m ...
in explants of late proliferative phase
endometrium The endometrium is the inner epithelial layer, along with its mucous membrane, of the mammalian uterus. It has a basal layer and a functional layer: the basal layer contains stem cells which regenerate the functional layer. The functional laye ...
.


Protein family

EFS is a member of the CAS (
Crk Adapter molecule crk also known as proto-oncogene c-Crk is a protein that in humans is encoded by the ''CRK'' gene. The CRK protein participates in the Reelin signaling cascade downstream of DAB1. Function Adapter molecule crk is a member of ...
-Associated Substrate) family of proteins. In humans and mammals, this group consists of four members: p130Cas/BCAR1, NEDD9/HEF1,
CASS4 Cas scaffolding protein family member 4 is a protein that in humans is encoded by the CASS4 gene. History and discovery CASS4 (Crk associated substrate 4) is the fourth and last described member of the CAS/CSE protein family, CAS protein family. ...
and EFS. There are no paraloguous genes for this family in
yeasts Yeasts are eukaryotic, single-celled microorganisms classified as members of the fungus kingdom. The first yeast originated hundreds of millions of years ago, and at least 1,500 species are currently recognized. They are estimated to constitut ...
and
fungi A fungus ( : fungi or funguses) is any member of the group of eukaryotic organisms that includes microorganisms such as yeasts and molds, as well as the more familiar mushrooms. These organisms are classified as a kingdom, separately from ...
, diploblasts and
nematode The nematodes ( or grc-gre, Νηματώδη; la, Nematoda) or roundworms constitute the phylum Nematoda (also called Nemathelminthes), with plant-Parasitism, parasitic nematodes also known as eelworms. They are a diverse animal phylum inhab ...
s such as ''
C. elegans ''Caenorhabditis elegans'' () is a free-living transparent nematode about 1 mm in length that lives in temperate soil environments. It is the type species of its genus. The name is a blend of the Greek ''caeno-'' (recent), ''rhabditis'' (r ...
''. A single ancestral member is found in
Drosophila ''Drosophila'' () is a genus of flies, belonging to the family Drosophilidae, whose members are often called "small fruit flies" or (less frequently) pomace flies, vinegar flies, or wine flies, a reference to the characteristic of many species ...
.


Structure

As the member of CAS protein family, EFS shares common structural characteristics with other members of the family. This includes 4 defined domains (summarized in Table 1): * An N-terminal SH3 domain that is highly conserved among the 4 CAS family members, and highly conserved throughout evolution (amino acids 5-68 for human EFS). SH3 domains bind to proline-rich motif containing proteins. The amino acid sequences of the SH3 domains are 70% identical among human EFS,
BCAR1 Breast cancer anti-estrogen resistance protein 1 is a protein that in humans is encoded by the ''BCAR1'' gene. Gene BCAR1 is localized on chromosome 16 on region q, on the negative strand and it consists of seven exons. Eight different gene is ...
, and
NEDD9 Neural precursor cell expressed developmentally down-regulated protein 9 (NEDD-9) is a protein that in humans is encoded by the ''NEDD9'' gene. NEDD-9 is also known as enhancer of filamentation 1 (EF1), CRK-associated substrate-related protein (CA ...
, making this the most highly conserved domain for the whole protein family. Notably, the murine and human EFS SH3 domains are 100% identical, while the rest of the amino acid sequences of mouse and human EFS are only 78% identical. Important binding partners for this region include FAK,
PTK2B Protein tyrosine kinase 2 beta is an enzyme that in humans is encoded by the ''PTK2B'' gene. Function This gene encodes a cytoplasmic protein tyrosine kinase that is involved in calcium-induced regulation of ion channels and activation of the ...
, C3G, PTP-PEST,
PTP1B Tyrosine-protein phosphatase non-receptor type 1 also known as protein-tyrosine phosphatase 1B (PTP1B) is an enzyme that is the founding member of the protein tyrosine phosphatase (PTP) family. In humans it is encoded by the ''PTPN1'' gene. PTP1B i ...
, CIZ, and FRNK. * Central “substrate domain” containing multiple repeats of tyrosine residues embedded within specific conserved sequences (YxxP) (amino acids 69-350 for human EFS). This region contains 9 such binding sites, in contrast to family members
BCAR1 Breast cancer anti-estrogen resistance protein 1 is a protein that in humans is encoded by the ''BCAR1'' gene. Gene BCAR1 is localized on chromosome 16 on region q, on the negative strand and it consists of seven exons. Eight different gene is ...
and
NEDD9 Neural precursor cell expressed developmentally down-regulated protein 9 (NEDD-9) is a protein that in humans is encoded by the ''NEDD9'' gene. NEDD-9 is also known as enhancer of filamentation 1 (EF1), CRK-associated substrate-related protein (CA ...
(20 and 18 motifs, respectively) and similar to
CASS4 Cas scaffolding protein family member 4 is a protein that in humans is encoded by the CASS4 gene. History and discovery CASS4 (Crk associated substrate 4) is the fourth and last described member of the CAS/CSE protein family, CAS protein family. ...
(estimated at 10 such motifs). Once phosphorylated by SRC or other kinases, these tyrosine motifs are bound by the SH2 domains of signaling proteins. Important binding partners for this region include Crk1/2 and Crk-L, a Crk1 paralogue. * A serine-rich domain encompassing a 4
α-helix The alpha helix (α-helix) is a common motif in the secondary structure of proteins and is a right hand-helix conformation in which every backbone N−H group hydrogen bonds to the backbone C=O group of the amino acid located four residues e ...
bundle (amino acids 351-488 for human EFS). Although primary amino acid sequence shows considerable divergence versus other CAS family members in this region, structural analysis predicts that this bundle has a highly conserved fold and provides a docking site for family members. * A C-terminal domain (489-561 amino acids in human EFS) is highly conserved between family members at both primary amino acid sequence and predicted fold. All CAS proteins except
CASS4 Cas scaffolding protein family member 4 is a protein that in humans is encoded by the CASS4 gene. History and discovery CASS4 (Crk associated substrate 4) is the fourth and last described member of the CAS/CSE protein family, CAS protein family. ...
contain a YDYVHL motif within this domain, which is an important binding site for the Src
SH2 domain The SH2 (Src Homology 2) domain is a structurally conserved protein domain contained within the Src oncoprotein and in many other intracellular signal-transducing proteins. SH2 domains allow proteins containing those domains to dock to phosphory ...
. This region is considered to possess a homo- or heterodimerization ability. There are three protein isoforms of human Efs. hEfs1 and hEfs2 were identified by Ishino et al. hEFS1 (561 aa) represents the human counterpart of mouse embryonal Efs (mEfs1) originally identified. hEFS1 and mEfs1 are 80% identical in their amino acid sequences and 100% identical within the
SH3 domain The SRC Homology 3 Domain (or SH3 domain) is a small protein domain of about 60 amino acid residues. Initially, SH3 was described as a conserved sequence in the viral adaptor protein v-Crk. This domain is also present in the molecules of phos ...
. hEFS2 (468 aa) is identical to hEFS1, except for its lack of the
SH3 domain The SRC Homology 3 Domain (or SH3 domain) is a small protein domain of about 60 amino acid residues. Initially, SH3 was described as a conserved sequence in the viral adaptor protein v-Crk. This domain is also present in the molecules of phos ...
. hEFS3 (392 aa) also lacks a functional
SH3 domain The SRC Homology 3 Domain (or SH3 domain) is a small protein domain of about 60 amino acid residues. Initially, SH3 was described as a conserved sequence in the viral adaptor protein v-Crk. This domain is also present in the molecules of phos ...
and has the same C-terminus and short N-terminal amino acid tail as the full-length protein. Although little functional analysis of hEFS2 has been performed, speculatively, given lack of an
SH3 domain The SRC Homology 3 Domain (or SH3 domain) is a small protein domain of about 60 amino acid residues. Initially, SH3 was described as a conserved sequence in the viral adaptor protein v-Crk. This domain is also present in the molecules of phos ...
, abundant hEFS2 may inhibit hEFS1 signaling by titrating partner proteins. As of 2015, there has been no functional analysis of hEFS3.


Function

As a member of the CAS protein family, EFS is a multi-domain docking molecule that lacks any known enzymatic activity, but instead mediates signaling by promoting protein–protein interactions through conserved sequence motifs (Figure 1). An important role of EFS as a CAS-family member function is transmission of
integrin Integrins are transmembrane receptors that facilitate cell-cell and cell-extracellular matrix (ECM) adhesion. Upon ligand binding, integrins activate signal transduction pathways that mediate cellular signals such as regulation of the cell cycle, ...
-initiated signals from the extracellular matrix to downstream effectors, leading to reorganization of the
actin Actin is a family of globular multi-functional proteins that form microfilaments in the cytoskeleton, and the thin filaments in muscle fibrils. It is found in essentially all eukaryotic cells, where it may be present at a concentration of over ...
cytoskeleton and changes in motility and invasion. The
SH3 domain The SRC Homology 3 Domain (or SH3 domain) is a small protein domain of about 60 amino acid residues. Initially, SH3 was described as a conserved sequence in the viral adaptor protein v-Crk. This domain is also present in the molecules of phos ...
is a point of contact with polyproline sequences on focal adhesion kinase ( FAK). or the related kinase
PTK2B Protein tyrosine kinase 2 beta is an enzyme that in humans is encoded by the ''PTK2B'' gene. Function This gene encodes a cytoplasmic protein tyrosine kinase that is involved in calcium-induced regulation of ion channels and activation of the ...
, also known as RAFTK/Pyk2/CAKβ. Typically, phosphorylation of the C-terminal region of CAS proteins by FAK or
PTK2B Protein tyrosine kinase 2 beta is an enzyme that in humans is encoded by the ''PTK2B'' gene. Function This gene encodes a cytoplasmic protein tyrosine kinase that is involved in calcium-induced regulation of ion channels and activation of the ...
creates a binding site for the
SH2 domain The SH2 (Src Homology 2) domain is a structurally conserved protein domain contained within the Src oncoprotein and in many other intracellular signal-transducing proteins. SH2 domains allow proteins containing those domains to dock to phosphory ...
of a SRC-family protein, which then hyper-phosphorylates the substrate domain, allowing the CAS protein to function as a scaffold for other proteins including
CRK Adapter molecule crk also known as proto-oncogene c-Crk is a protein that in humans is encoded by the ''CRK'' gene. The CRK protein participates in the Reelin signaling cascade downstream of DAB1. Function Adapter molecule crk is a member of ...
proteins and C3G, a guanine nucleotide exchange factor (GEF) for
RAP1 Rap1 (Ras-proximate-1 or Ras-related protein 1) is a small GTPase, which are small cytosolic proteins that act like cellular switches and are vital for effective signal transduction. There are two isoforms of the Rap1 protein, each encoded by ...
. PTP-PEST, a soluble protein tyrosine phosphatase that is ubiquitously expressed in mice both during embryonic development and in adult tissues, opposes FAK and
PTK2B Protein tyrosine kinase 2 beta is an enzyme that in humans is encoded by the ''PTK2B'' gene. Function This gene encodes a cytoplasmic protein tyrosine kinase that is involved in calcium-induced regulation of ion channels and activation of the ...
activity, as it dephosphorylates
PTK2B Protein tyrosine kinase 2 beta is an enzyme that in humans is encoded by the ''PTK2B'' gene. Function This gene encodes a cytoplasmic protein tyrosine kinase that is involved in calcium-induced regulation of ion channels and activation of the ...
, FAK and CAS family members, among other proteins. The PTP-PEST proline-rich sequence 332PPKPPR337 has been shown to interact directly with the
SH3 domain The SRC Homology 3 Domain (or SH3 domain) is a small protein domain of about 60 amino acid residues. Initially, SH3 was described as a conserved sequence in the viral adaptor protein v-Crk. This domain is also present in the molecules of phos ...
of members of EFS and another CAS protein,
NEDD9 Neural precursor cell expressed developmentally down-regulated protein 9 (NEDD-9) is a protein that in humans is encoded by the ''NEDD9'' gene. NEDD-9 is also known as enhancer of filamentation 1 (EF1), CRK-associated substrate-related protein (CA ...
. In normal untransformed cells, EFS acts as a SRC family kinase substrate in neurite outgrowth, a process that is dependent on activity of SRC kinases. Reciprocally, EFS activates SRC signaling through c-CRK and
RAP1 Rap1 (Ras-proximate-1 or Ras-related protein 1) is a small GTPase, which are small cytosolic proteins that act like cellular switches and are vital for effective signal transduction. There are two isoforms of the Rap1 protein, each encoded by ...
. Further, SRC directly phosphorylates residues Y576 and Y577 tyrosine sites on the EFS, enhancing targeting FAK, and eventually the solubility and/or stability of the complex. Through SRC, EFS may also negatively regulate expression of
E-cadherin Cadherin-1 or Epithelial cadherin (E-cadherin), (not to be confused with the APC/C activator protein CDH1) is a protein that in humans is encoded by the ''CDH1'' gene. Mutations are correlated with gastric, breast, colorectal, thyroid, and ovarian ...
at adherens junctions, a function that has been reported for other CAS proteins (
NEDD9 Neural precursor cell expressed developmentally down-regulated protein 9 (NEDD-9) is a protein that in humans is encoded by the ''NEDD9'' gene. NEDD-9 is also known as enhancer of filamentation 1 (EF1), CRK-associated substrate-related protein (CA ...
and
BCAR1 Breast cancer anti-estrogen resistance protein 1 is a protein that in humans is encoded by the ''BCAR1'' gene. Gene BCAR1 is localized on chromosome 16 on region q, on the negative strand and it consists of seven exons. Eight different gene is ...
); however, this point has not been directly established for EFS.


Disease association

The well-studied CAS proteins
BCAR1 Breast cancer anti-estrogen resistance protein 1 is a protein that in humans is encoded by the ''BCAR1'' gene. Gene BCAR1 is localized on chromosome 16 on region q, on the negative strand and it consists of seven exons. Eight different gene is ...
and
NEDD9 Neural precursor cell expressed developmentally down-regulated protein 9 (NEDD-9) is a protein that in humans is encoded by the ''NEDD9'' gene. NEDD-9 is also known as enhancer of filamentation 1 (EF1), CRK-associated substrate-related protein (CA ...
have important roles in cancer and other pathological conditions, which have been addressed in many studies and reviews. EFS has attracted less study. However, the conserved functional properties of EFS relevant to cellular adhesion and migration, and RTK signaling, suggest changes in activity of this protein may also be relevant to cancer and other disease states, influencing prognosis and therapeutic response. The changes in EFS expression and post-translational modification in the context of disease discussed below are summarized in Table 2.


Role in inflammation and T-Cell function

EFS regulates
T-cell A T cell is a type of lymphocyte. T cells are one of the important white blood cells of the immune system and play a central role in the adaptive immune response. T cells can be distinguished from other lymphocytes by the presence of a T-cell rec ...
function and maturation, preventing expansion of autoreactive clones and pathological immune responses. Two studies that have reported that EFS expression in medullar thymus epithelial cells is important for negative selection of T-cells during their development, which implies an important role of EFS in maintaining immune homeostasis and autoimmunity prevention. In these studies, mice with defective EFS progressed normally during embryogenesis but then developed massive inflammatory lesions in multiple tissues that bore a striking histological resemblance to inflammatory bowel diseases such as Crohn’s disease. Mechanistically, EFS expressed in medullary thymic epithelial cells (mTECs) is crucial for their functional maturation and growth factor-mediated expansion. mTECs are important for proper T-cell maturation and negative selection of autoreactive clones, required for development of immunological self-tolerance. EFS has mostly a repressive role of EFS on processes associated with the activation of mature T-cells, including IL-2 pro-inflammatory cytokine secretion and IL-2-dependent clonal expansion of T cells. Upon
T-cell receptor The T-cell receptor (TCR) is a protein complex found on the surface of T cells, or T lymphocytes, that is responsible for recognizing fragments of antigen as peptides bound to major histocompatibility complex (MHC) molecules. The binding b ...
(TCR) stimulation, EFS dephosphorylation and release of the SRC family kinase FYN and phospholipase C-γ normally lead to self-limitation of the immune response. Consistent with this mechanism, EFS overexpression in T cell-derived cell lines decreased IL-2 concentration in supernatants in response to TCR stimulation, while T cells derived from mice lacking EFS gene showed increased IL-2 production. A dual role of EFS in mature T cells function has been proposed because both overexpression and siRNA knockdown of this protein in cell models resulted in decreased transcriptional activation of IL-2 dependent promoters following TCR stimulation. Altered EFS function has been associated with various human immunopathological conditions. Although an initial genome-wide association studies (GWAS) study of
Crohn’s disease Crohn's disease is a type of inflammatory bowel disease (IBD) that may affect any segment of the gastrointestinal tract. Symptoms often include abdominal pain, diarrhea (which may be bloody if inflammation is severe), fever, abdominal distension, ...
did not identify EFS, EFS single nucleotide polymorphisms (SNPs) were subsequently linked to Crohn’s disease. SNPs linked to EFS are trans-acting, potentially affecting the level of EFS expression but not its coding sequence. Another study suggested that EFS might contribute to acute
rheumatic fever Rheumatic fever (RF) is an inflammatory disease that can involve the heart, joints, skin, and brain. The disease typically develops two to four weeks after a streptococcal throat infection. Signs and symptoms include fever, multiple painful jo ...
susceptibility. In this work, peripheral blood mononuclear cells (PBMCs) from patients with rheumatoid heart disease (RHD) and control subjects that had never experienced acute rheumatoid fever were stimulated with rheumatogenic and non-rheumatogenic
group A streptococci Group A streptococcal infections are a number of infections with ''Streptococcus pyogenes'' a group A streptococcus (GAS). ''S. pyogenes'' is a species of beta-hemolytic gram-positive bacteria that is responsible for a wide range of infections t ...
(GAS) strains. EFS was one of only four genes with significantly increased expression in both arms of the study: 1) RHD patient versus control PBMCs after stimulation of both groups with rheumatogenic GAS and 2) RHD patient PBMC stimulated with rheumatogenic versus non-rheumatogenic GAS. Another study has implicated EFS in the Chediak-Higashi syndrome (CHS). This rare and severe autosomal recessive disorder associated with partial albinism, peripheral neuropathy, mild coagulation defects and propensity to recurrent bacterial and fungal infections, caused by incomplete phagocytosis due to failure in phagolysosome formation. This work identified a direct interaction ''in vitro'' and ''in vivo'' between EFS and
LYST Lysosomal trafficking regulator is a vesicular transport protein associated with Chédiak–Higashi syndrome. In melanocytic cells LYST gene expression may be regulated by MITF Microphthalmia-associated transcription factor also known as class ...
(lysosomal trafficking regulator, aka CHS1 - Chediak-Higashi syndrome 1), a large protein that regulates the intracellular trafficking of proteins through endosomes that is mutated in CHS. These results may imply the role of EFS as a disease progression modifier, although further testing and establishment of mechanism is necessary.


Cancer

At the level of EFS mRNA expression, the local and systemic recurrence of
prostate cancer Prostate cancer is cancer of the prostate. Prostate cancer is the second most common cancerous tumor worldwide and is the fifth leading cause of cancer-related mortality among men. The prostate is a gland in the male reproductive system that sur ...
is associated with CpG site hypermethylation of number of genes, including
FLNC The National Liberation Front of Corsica ( co, Fronte di liberazione naziunale di a Corsica or ; french: Front de libération nationale corse, abbreviated FLNC) was a militant group that advocates an independent state on the island of Corsica, s ...
and EFS (p ≤ .03), both genes involved in cell attachment, and is predicted to result in reduction of gene expression. EFS expression was strongly downregulated in hormonal therapy resistant PC346DCC, PC346Flu1 and PC346Flu2 prostate cancer cells compared to therapy responsive PC346C cells. Another study found that decreased EFS mRNA expression levels are observed in higher
Gleason score The Gleason grading system is used to help evaluate the prognosis of men with prostate cancer using samples from a prostate biopsy. Together with other parameters, it is incorporated into a strategy of prostate cancer staging which predicts pr ...
prostate cancer Prostate cancer is cancer of the prostate. Prostate cancer is the second most common cancerous tumor worldwide and is the fifth leading cause of cancer-related mortality among men. The prostate is a gland in the male reproductive system that sur ...
samples. Low EFS expression also correlated with malignant behavior of the PC-3 and LNCaP prostate cancer cells. In another study, methylation of the EFS CpG island was observed in 69% of cases of
uveal melanoma Uveal melanoma is a type of eye cancer in the uvea of the eye. It is traditionally classed as originating in the Iris (anatomy), iris, choroid, and ciliary body, but can also be divided into class I (low metastatic risk) and class II (high metasta ...
(UM) and only UM with EFS methylation gave rise to metastases. RT-PCR expression analysis revealed a significant inverse correlation between EFS mRNA expression with EFS methylation in UM. EFS methylation was tissue-specific with full methylation in peripheral blood cells, but no methylation in other tissues such as fetal muscle, kidney and brain. The EFS gene is one of more than 100 of the genes located in a centromeric 10.21 Mb “minimal critical region” on Chromosome 14 that are highly expressed in
gestational choriocarcinoma Gestational choriocarcinoma is a form of gestational trophoblastic neoplasia, which is a type of gestational trophoblastic disease (GTD), that can occur during pregnancy. It is a rare disease where the trophoblast, a layer of cells surrounding the ...
. The EFS mRNA was also identified as differentially expressed in two of the three groups of
glioblastoma multiforme Glioblastoma, previously known as glioblastoma multiforme (GBM), is one of the most aggressive types of cancer that begin within the brain. Initially, signs and symptoms of glioblastoma are nonspecific. They may include headaches, personality ch ...
as identified by gene expression profiles (GEPs). EFS was differentially expressed in the GEP1 and GEP3 groups, which were associated with worse prognosis, with more significant cytogenetic abnormalities and genomic instabilities observed in this groups. At the level of the EFS protein, a study of BT474
breast cancer Breast cancer is cancer that develops from breast tissue. Signs of breast cancer may include a lump in the breast, a change in breast shape, dimpling of the skin, milk rejection, fluid coming from the nipple, a newly inverted nipple, or a re ...
cells found significant increases in expression of EFS and other proteins relevant to SRC kinase signaling, including CDCP1/Trask and
Paxillin Paxillin is a protein that in humans is encoded by the ''PXN'' gene. Paxillin is expressed at focal adhesions of non-striated cells and at costameres of striated muscle cells, and it functions to adhere cells to the extracellular matrix. Mutation ...
, in
trastuzumab Trastuzumab, sold under the brand name Herceptin among others, is a monoclonal antibody used to treat breast cancer and stomach cancer. It is specifically used for cancer that is HER2 receptor positive. It may be used by itself or together wit ...
(Herceptin) resistant versus sensitive cells Importantly, EFS knockdown with siRNA restored
trastuzumab Trastuzumab, sold under the brand name Herceptin among others, is a monoclonal antibody used to treat breast cancer and stomach cancer. It is specifically used for cancer that is HER2 receptor positive. It may be used by itself or together wit ...
sensitivity. Reflecting the importance of post-translational modification of CAS proteins, in a study of cell lines and tumor tissue in
malignant melanoma Melanoma, also redundantly known as malignant melanoma, is a type of skin cancer that develops from the Biological pigment, pigment-producing cells known as melanocytes. Melanomas typically occur in the skin, but may rarely occur in the mouth, i ...
, EFS phosphorylation and activity significantly decreased (p<0.05) in response to
vemurafenib Vemurafenib (INN, marketed as Zelboraf) is an inhibitor of the B-Raf enzyme developed by Plexxikon (now part of Daiichi-Sankyo) and Genentech for the treatment of late-stage melanoma.; The name "vemurafenib" comes from V600E mutated BRAF in ...
treatment in '' BRAF'' wild-type melanoma tumors comparing to ones with '' BRAF ''(V600E-vemurfenib resistant) mutation. Finally, in a 2013 study of castration-resistant
prostate cancer Prostate cancer is cancer of the prostate. Prostate cancer is the second most common cancerous tumor worldwide and is the fifth leading cause of cancer-related mortality among men. The prostate is a gland in the male reproductive system that sur ...
, EFS was identified as having significantly increased gross phosphorylation levels in samples from androgen-deprived (AD), long-term AD treated, or castration-resistant prostate carcinoma xenografts, versus in androgen deprivation therapy-naıve xenografts


Clinical significance

Based on the above discussion, it is possible that therapeutic benefits can be achieved by using EFS expression or phosphorylation as a marker of disease progression and prognosis in some forms of cancer. Further assessment of EFS expression, mutational status, and potential polymorphic variants may be of use in understanding the biology and developing treatment strategies for immune system pathologies such as CHS. There are currently no therapeutic approaches targeting EFS, and given the protein lacks a catalytic domain and extracellular moieties, it may be challenging to generate such agents.


Notes


References

{{Reflist, 33em Proteins