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Prepublished online as a Blood First Edition Paper on October 10, 2002; DOI 10.1182/blood-2002-02-0522.
PHAGOCYTES
From the Sanquin Research at Central Laboratory of the
Netherlands Blood Transfusion Service, Landsteiner Laboratory, and Emma
Children's Hospital, Academic Medical Center, University of Amsterdam,
Amsterdam, The Netherlands; and Medical Academy, Nizhniy
Novgorod, Russia.
Tumor necrosis factor Tumor necrosis factor The mechanism of apoptosis induction by TNF- In our study, investigating the effects of TNF- PMN purification and culturing
Cytoplast preparation and culturing
Measurement of cell death After 6 hours of incubation, PMNs were split into 2 portions, which were washed once in ice-cold PBS. One portion was stained with the annexin-V-fluorescein isothiocyanate (FITC)/propidium iodide (PI) apoptosis assay kit (Bender MedSystems, Vienna, Austria) and analyzed by fluorescence-activated cell sorter scan (FACScan; Becton Dickinson, San Jose, CA) as described previously.24 Dead cells were defined as positive for annexin-V-FITC or for annexin-V-FITC/PI staining. Cell death was expressed as a percentage of dead cells in relation to the total number of counted cells. The number of cells recovered after culture was similar under all conditions tested and was close to 90% of the initial input of cells. Another portion of PMNs (2-3 × 105 cells) was used for preparation of cytospins stained with May-Grünwald-Giemsa solution. The cytospins were estimated by light microscopy for morphologic changes in PMNs (described in "Results"). A minimum of 300 cells was scored for each sample, and the percentages of dead PMNs were determined. Cytoplast death was assessed by annexin-V-FITC binding as described earlier, without the PI step, with 4 × 105 cytoplasts for each preparation. Annexin-V+ cytoplasts were considered to be dead.Western blotting The cleavage of caspase-8 and caspase-3 was determined by Western blotting. Whole cell lysates were obtained by boiling 0.5 × 106 PMNs in sodium dodecyl sulfate (SDS) sample buffer with 2% mercaptoethanol for 5 minutes. Proteins were resolved on 15% SDS-polyacrylamide gel by electrophoresis (PAGE) and were electrotransferred to Immun-Blot polyvinylidene diflouride (PVDF) membrane (BioRad Laboratories, Hercules, CA). The blots were sequentially probed with monoclonal mouse antihuman-caspase-8 Abs (clone 1C12; Cell Signaling Technology, Beverly, MA), which recognize full-length caspase-8 as well as its fragments; with polyclonal rabbit antihuman-caspase-3 Abs (Pharmingen, San Diego, CA), which recognize both inactive procaspase-3 and its cleavage product; and with polyclonal rabbit antihuman-Bax Abs (Pharmingen). All indicated Abs were used at a final dilution of 1:1000. After exposure to each primary Ab, the blots were incubated with appropriate secondary Abs conjugated with horseradish peroxidase (Amersham, Arlington Height, IL) at a final dilution of 1:2500, followed by band visualization with an enhanced chemiluminescence kit as described by the manufacturer (Amersham). This reprobing was successful because of a different exposition time required for visualization of the proteins of interest. For caspase-8-related bands it was approximately 30 minutes, for caspase-3 and its cleavage product 5 minutes, and for Bax protein less than 1 minute.Agarose gel electrophoresis of DNA DNA was extracted from 5 × 106 freshly isolated PMNs or from PMNs treated under conditions indicated in Figure 3 by a PureGene DNA isolation kit (Gentra Systems, Minneapolis, MN) in accordance with the manufacturer's instructions. Isolated DNA was electrophoresed in a 1.2% agarose gel containing ethidium bromide, and the gels were photographed under ultraviolet light.Assessment of p38 MAP kinase phosphorylation in PMNs and cytoplasts After purification, PMNs and cytoplasts were resuspended in culture medium at final concentrations of 2 × 106/mL and 8 × 106/mL, respectively, and were incubated without or with 20 ng/mL TNF- for 10 minutes in a water-bath at 37°C.
Thereafter, whole cell lysates were prepared, and Western blotting was
performed as described earlier with 1 × 106 cytoplast or
0.5 × 106 PMN equivalents per lane. The blots were
probed with phosphospecific polyclonal rabbit Abs against human p38
mitogen-activated protein (MAP) kinase (Cell Signaling
Technology), which selectively recognize phosphorylated p38. To
determine protein loading, reprobe was performed with polyclonal rabbit
Abs against total p38 (Santa Cruz Biotechnology, Santa Cruz, CA), which
bind to p38 irrespectively of its phosphorylation state.
Confocal laser scanning microscopy (CLSM) For the mitochondrial staining, MitoTracker GreenFM (Molecular Probes, Eugene, OR) was used. To estimate mitochondrial morphology, unfixed PMNs were stained with 100 µM MitoTracker GreenFM and were analyzed by a confocal laser scanning microscope (LSM510; Carl Zeiss, Heidelberg, Germany) as described.24 To obtain simultaneous staining of mitochondria and Bax protein, PMNs were stained with 1 mM MitoTracker GreenFM. Thereafter, the cells were fixed with 2% paraformaldehyde, permeabilized in staining buffer containing 0.1% saponin (wt/vol; Calbiochem) and 1% (wt/vol) bovine serum albumin (Sigma), and were labeled by polyclonal rabbit antihuman-Bax Abs (final dilution 1:250; Pharmingen) followed by secondary staining with AlexaFluor-568-conjugated goat antirabbit immunoglobulin G (Molecular Probes) at a final concentration of 2.5 µg/mL as has been previously described.24 After staining, at least 300 PMNs were counted in each sample, and the percentages of cells with prevailing morphology (images shown in Figures 4-5) were determined, as indicated in the legends of Figures 4-5.Statistics Where applicable, values were compared by one-way analysis of variance (ANOVA) with Bonferroni posttest using GraphPad Prism version 3.0 software. Differences were accepted as significant at P < .05.
TNF- ,
the fraction of annexin-V+ PMNs slightly but significantly
increased to 40.0% ± 4.3% (Figure 1A, TNF- ). When scored by
morphologic changes, the proportion of PMNs with classical apoptotic
features amounted to 74.0% ± 4.3% in the presence of TNF-
(Figure 1B, top right). These data are consistent with previous
observations that at early time points TNF- is indeed able to induce
apoptosis in PMNs.11,13,14
Inhibition of caspases in the presence of TNF- caused a more pronounced activation of
caspase-8 and caspase-3. The 57- to 55-kd procaspase-8 was completely
degraded into smaller fragments, including the active 18-kd
fragment28 (Figure 2A, lane 4), and the 32-kd procaspase-3
was entirely processed to the active 17-kd product (Figure 2B,
lane 4).
Next, we checked whether inhibition of caspases could abrogate
the proapoptotic effects of TNF- Unexpectedly, addition of zVAD-fmk to TNF- To investigate the role of protein synthesis in the
TNF- Taken together, these results indicate that TNF- No DNA laddering in TNF- for 6 hours demonstrated a typical
laddering pattern, indicating internucleosomal cleavage characteristic
for apoptosis (Figure 3). In contrast,
the electrophoretic pattern of DNA extracted from
TNF- /zVAD-fmk-treated PMNs was similar to that of fresh, untreated,
or zVAD-fmk-treated cells, cultured for 6 hours (Figure 3). Thus, also
in this respect, TNF- /zVAD-fmk-induced PMN death appeared to be
different from typical apoptosis.
zVAD-fmk prevents Fas-receptor-induced apoptosis in PMNs The Fas/Apo-1/CD95 system shares common death signaling pathways with the TNF- -receptor. Both receptors belong to the TNF/nerve growth factor receptor family33 and can recruit the
same adapter protein, FADD, forming the DISC to mediate death
signals to the caspase cascade.20,21 As shown in Figure
1C, ligation of the Fas-receptor with agonistic anti-Fas monoclonal Abs
CH-1123,34 led PMNs after a 6-hour culture to pronounced
apoptosis, with 59.9% ± 4.7% of annexin-V+ cells and
83.3% ± 5.2% of cells with a typical apoptotic morphology (compare
with Figure 1C, No stimulus). However, induction of apoptosis by
anti-Fas monoclonal Abs was almost completely prevented by zVAD-fmk
(Figure 1C; 21.9% ± 3.8% annexin-V+ and
17.5% ± 2.7% morphologically apoptotic PMNs; compare with Figure
1C, zVAD-fmk alone). Thus, despite the fact that Fas and TNF- -receptors engage common upstream death pathways, Fas
receptor-mediated death signals are strictly caspase dependent and can
be blocked by a caspase inhibitor, whereas TNF- has the potential to
bypass the caspase cascade, causing atypical death in PMNs in the
presence of zVAD-fmk.
TNF- alone was present in the culture medium, the mitochondria changed into large unstructured aggregates (Figure 4, top right) typical for apoptosis.24 Interestingly, the proportion of
cells with clustered mitochondria closely correlated with the
proportion of cells with an apoptotic morphology (data not presented),
indicating that changes in the mitochondrial structure form an early
and reliable marker of apoptosis. The TNF- /zVAD-fmk combination also altered the appearance of the mitochondria (Figure 4, bottom right), leading to clustering and degradation of these organelles, although these mitochondrial aggregates were smaller in comparison to the aggregates in PMNs treated with TNF- alone.
When PMNs were costained for mitochondria and Bax protein, most of the
untreated cells showed after the 6-hour incubation a punctate
localization of Bax, remaining separate from mitochondria (Figure
5, top panel), as was also observed in
fresh PMNs.24 In PMNs after 6 hours of culture in the
presence of zVAD-fmk, Bax protein maintained a staining pattern similar
to fresh and to untreated cultured cells, visible as a punctate
distribution separate from mitochondria (data not shown). In contrast,
treatment with TNF-
Taken together, these results demonstrate that TNF- PMN-derived cytoplasts lacking mitochondria do not display
TNF- /zVAD-fmk-induced death, we used PMN-derived cytoplasts, which
are cellular vesicles from which mitochondria have been
eliminated.24,39 First, we determined whether the TNF-
receptors were functional on the cytoplast surface. As a read-out, the
TNF- receptor-mediated phosphorylation of p38 MAP kinase was
used.40 Figure 6 (top panel)
demonstrates that TNF- induced phosphorylation of p38 MAP kinase
both in cytoplasts and PMNs. Next, cytoplasts were cultured under
various conditions. Untreated and TNF- -treated cytoplasts after
culture exposed phosphatidyl serine on the outer layer of the plasma
membrane, which was evident by annexin-V positivity of
54.2% ± 4.9% and 50.3% ± 5.7% cytoplasts, respectively
(Figure 7, top left and top right plots,
respectively). zVAD-fmk reduced the number of annexin-V+
cytoplasts to 7.2% ± 1.9% (Figure 7, bottom left plot). Similar values were found in the experiments with PMNs (Figure 1C). However, in
contrast to PMNs, cytoplasts treated with a combination TNF- /VAD-fmk remained "alive," with only 11.0% ± 1.3%
annexin-V+ cells (Figure 7, bottom right plot). Thus,
addition of TNF- to zVAD-fmk had no effect on cytoplast survival.
This finding indicates that TNF- was not able to induce a
caspase-independent death in cytoplasts in the absence of the
mitochondria, despite the intact receptor signaling, and the caspase
inhibitor completely preserved its prosurvival effect. Also, this
finding demonstrates that the TNF- /zVAD-fmk combination itself is
not nonspecifically toxic for the cells.
NADPH oxidase system-independent ROS are involved in the
TNF- /zVAD-fmk-induced PMN death. How do these organelles contribute to this death pathway? One
possibility is ROS production by the mitochondria in response to
TNF- stimulation, which mediates, at least in part, cytotoxic effects of this cytokine.41-43 NAC, a well-characterized
ROS scavenger,34,44,45 had no effect on spontaneous
apoptosis of PMNs, reduced TNF- -induced apoptosis, and almost
completely abrogated the TNF- /zVAD-fmk death effects (Figure
8 and data not shown). NAC significantly (P < .05) reduced the number of annexin-V+
PMNs in TNF- /zVAD-fmk-treated PMNs and completely prevented the
appearance of morphologically aberrant cells (not shown). The ROS
scavenger tiron,43 which is unrelated to NAC, also
prevented TNF- /zVAD-fmk-induced cell death (data not shown). The
mitochondrial origin of ROS was further supported by experiments, in
which we used inhibitors of the mitochondrial electron transport
(respiratory) chain, ie, inhibitors of the mitochondrial ROS
production.41 Rotenone stopped the death-inducing effects
of the TNF- /zVAD-fmk combination, preventing plasma membrane
flip-flop (Figure 8; P < .05) and aberrant morphologic
changes in the TNF- /zVAD-fmk-treated PMNs (data not shown). Two
other mitochondrial inhibitors, sodium azide and TTFA, demonstrated a
similar effect of rescuing PMNs from TNF- /zVAD-fmk-mediated cell
death (data not shown). Importantly, these mitochondrial inhibitors,
when added alone, influenced neither the basal level of PMN apoptosis
nor PMN adenosine triphosphate (ATP) levels, measured by a
luciferase-based assay46 (not shown). The latter result
can be explained by the fact that PMNs mainly use glycolysis rather
than mitochondrial oxidative phosphorylation for their energy
supply.47
The most powerful source of ROS in PMNs is the nicotinamide adenine
dinucleotide phosphate (NADPH) oxidase system, which provides a
rapid and a dramatic increase in ROS generation known as the respiratory burst. To check whether ROS produced by NADPH oxidase participates in the TNF-
Most forms of programmed cell death proceed through the activation
of caspases, which can be blocked by the general caspase inhibitor
zVAD-fmk. In this study we describe an as yet unidentified form of PMN
death induced by TNF- Further experiments demonstrated the involvement of ROS in the
TNF- Several studies have shown that blockade of caspases in some cell lines
sensitize them to TNF- We conclude from our data that TNF- Our present data raise another issue. Caspases are attractive targets
for pharmacologic intervention in vivo in disease states that have been
associated with enhanced apoptosis.60,61 Caspase inhibitors, predominantly zVAD-fmk-like active-site mimetic peptide ketones, have been extensively used in animal models of human diseases.
These inhibitors have shown beneficial effects in various types of
ischemia-reperfusion injury,62-64 but also in infectious conditions, including bacterial meningitis and
sepsis.65,66 The promising approach of using caspase
inhibitors as anti-inflammatory agents should, however, be considered
with caution because of the possible adverse effects.61
For example, during ischemia-reperfusion injury and particularly during
generalized infections, inflammation proceeds through a massive
activation of PMNs and generation of inflammatory cytokines. Under many
generalized inflammatory conditions, TNF-
We are grateful to Dr P. Hordijk for his comments while preparing the manuscript, to Dr R. S. Weening for his help in obtaining blood from CGD patients, and to Dr S. Albracht for his gift of mitochondrial inhibitors.
Submitted February 15, 2002; accepted October 3, 2002.
Prepublished online as Blood First Edition Paper, October 10, 2002; DOI 10.1182/blood-2002-02-0522.
Supported by a grant from Nuffic (N.A.M.). T.W.K. is a research fellow of the Royal Dutch Academy of Sciences.
The publication costs of this article were defrayed in part by page charge payment. Therefore, and solely to indicate this fact, this article is hereby marked "advertisement" in accordance with 18 U.S.C. section 1734.
Reprints: Taco Kuijpers, Central Laboratory of the Netherlands Blood Transfusion Service (CLB), Department of Experimental Immunohematology, Plesmanlaan 125, 1066 CX Amsterdam, The Netherlands; e-mail: t_kuijpers{at}clb.nl.
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© 2003 by The American Society of Hematology.
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