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Prepublished online as a Blood First Edition Paper on May 1, 2003; DOI 10.1182/blood-2002-12-3733.
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Blood, 1 September 2003, Vol. 102, No. 5, pp. 1619-1621
CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC
TRIALS Brief report
Microsatellite polymorphism in heme oxygenase-1 gene promoter is associated with susceptibility to oxidant-induced apoptosis in lymphoblastoid cell lines
Hisao Hirai,
Hiroshi Kubo,
Mutsuo Yamaya,
Katsutoshi Nakayama,
Muneo Numasaki,
Seiichi Kobayashi,
Satoshi Suzuki,
Shigeki Shibahara, and
Hidetada Sasaki
From the Departments of Geriatric and Respiratory Medicine, Tohoku
University School of Medicine; Department of Thoracic Surgery, Institute of
Development, Aging and Cancer, Tohoku University; and Molecular Biology and
Applied Physiology, Tohoku University School of Medicine, Sendai, Japan.
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Abstract
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Heme oxygenase-1 (HO-1) confers cytoprotection against oxidative stress. A
(GT)n dinucleotide repeat in the 5'-flanking region of human HO-1 gene
shows length polymorphism, which was classified into S (< 27 GT), M (27-32
GT), and L alleles ( 33 GT). Polymorphism in the HO-1 gene promoter was
shown to be associated with susceptibility to pulmonary emphysema and
restenosis after angioplasty. However, the biologic mechanism underlying these
associations is still unclear. To examine this issue, we established
lymphoblastoid cell lines (LCLs) from subjects possessing S/S or L/L
genotypes. HO-1 mRNA expressions and HO activities induced by oxidative stress
were significantly higher in LCLs with S/S than those with L/L. Furthermore,
LCLs with S/S were significantly more resistant to oxidant-induced apoptosis
than those with L/L. These findings suggested that the polymorphism of the
HO-1 gene is associated with the strength of antiapoptotic effects of HO-1,
resulting in an association with susceptibility to oxidative
stressmediated diseases.
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Introduction
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Heme oxygenase (HO) catalyzes the rate-limiting step in the oxidative
degradation of heme into carbon monoxide (CO), iron, and
biliverdin,1 which
is metabolized to bilirubin by biliverdin reductase. Whereas HO-2 is
constitutively expressed, HO-1 is the only inducible
isoform.1 HO-1 is
highly induced under oxidative stress and confers protection against
oxidant-induced injury in various
tissues.2-6
There have been studies on the cytoprotective mechanisms of HO-1 against
oxidative stress in recent years. Both biliverdin and bilirubin possess
antioxidant
properties.7 CO has
been described as mediating the anti-inflammatory and antiapoptotic effects of
HO-1 in vitro8 and
in vivo.9
The human HO-1 gene has a polymorphic (GT)n repeat in the 5'-flanking
region. The distribution of the number of (GT)n repeats was trimodal, with one
peak located at 23 GT repeats and the other 2 peaks located close together at
30 and 33 GT repeats. Therefore, the allele type is grouped into 3 classes
according to the (GT)n repeat size, as follows: short alleles (S: < 27 GT),
middle alleles (M: 27-32 GT), and long alleles (L: 33
GT).10 We recently
reported that the population of subjects with L allele was significantly
higher in smokers with chronic pulmonary emphysema (CPE) than in smokers
without CPE.10
Furthermore, it was published that patients with short (< 25) GT repeats
showed a significantly reduced risk for restenosis after percutaneous
transluminal
angioplasty.11
These studies suggested that the 5'-flanking polymorphism in the HO-1
gene is associated with the development of oxidative stressmediated
diseases. However, the biologic mechanism underlying the association between
the length polymorphism and susceptibility to disease is still unclear. In
this study, we established lymphoblastoid cell lines (LCLs) from human
subjects possessing S/S or L/L genotype in the HO-1 gene and examined the HO-1
mRNA expressions and HO-1 activities by hydrogen peroxide
(H2O2) stimulation. Furthermore, we examined the
oxidative stressmediated apoptosis in the LCLs to assess the biologic
significance of HO-1 activities.
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Study design
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Subjects and cell preparation
In our database of 1262 people, 206 had S/S alleles and 29 had L/L alleles.
We recruited 12 healthy subjects (6 people with S/S and 6 people with L/L) who
signed informed consent for the present study
(Table 1). This study was
approved by the Tohoku University Ethics Committee. LCLs were prepared by
transforming peripheral lymphocytes from each subject using supernatant from
B95-8 as described
elsewhere.12 LCLs
were further cloned by a limiting dilution method. Five different clones
derived from each subject were used for analyses.
Real-time quantitative PCRs
To quantify the expression of HO-1 mRNA, we applied the technique of
real-time quantitative reverse transcription-polymerase chain reaction
(RT-PCR) by using the ABI PRISM 7700 apparatus (Applied Biosystems, Foster
City, CA). After exposing LCLs to 900 µM H2O2 for 10
hours, total RNA was isolated from LCLs using RNA-Bee (Tel-Test, Friendswood,
TX). A one-step RT-PCR was performed with HO-1 forward primer
(5'-AGGCCAAGACTGCGTTCCT-3'), reverse primer
(5'-GGTGTCATGGGTCAGCAGC-3'), and TaqMan probe
(5'-FAM TCAACATCCAGCTCTTTGAGGAGTTGCAG-3'-TAMURA) according to the
manufacturer's protocol. At the same time, 18S rRNA as an internal control was
amplified using a commercially available kit (rRNA primers and VIC-labeled
probe, Applied Biosystems). The amount of mRNA in each sample was calculated
as the ratio between the HO-1 and the endogenous control, 18S rRNA.
HO activity
HO activity was measured as described
previously.13 After
exposing human LCLs to H2O2 at 900 µM for 18 hours,
cells were collected, and microsome fractions were
prepared.14
Microsomes (100 µg) were incubated for 20 minutes at 37°C in 200 µL
potassium phosphate
buffer13 containing
15 µM hemin, and 100 µg/mL of a partially purified biliverdin
reductase.14 The
amount of bilirubin formed was measured with a double-beam spectrophotometer
(U-2000, Hitachi, Tokyo, Japan) with an optical density at 464 to 530 nm
(excitation coefficient, 43.5/mM/cm for bilirubin). HO activity was expressed
as nanomoles of bilirubin formed per milligram of protein.
Apoptosis assay
Oxidant-induced apoptosis in LCLs was measured by TUNEL
assay.15 Viability
of each LCL was more than 90% before exposure to H2O2.
Each LCL was cultured with H2O2 at 300, 600, or 900
µM for 24 hours. To detect DNA fragmentation in apoptosis, we used
FACScaliber (Becton Dickinson, Franklin Lakes, NJ) and the APO-BRDU kit
(Molecular Probes, Eugene, OR) according to the supplied
protocol.16 To
determine whether HO-1 was involved in oxidant-induced apoptosis, LCLs were
preincubated with 10 µM zinc protoporphyrin IX (ZnPP-9; OxisResearch,
Portland, OR), competitive inhibitors of HO-1, then H2O2
stimulation and apoptosis detection were performed as described.
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Results and discussion
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In this study, we established LCLs from each subject with S/S or L/L
genotypes and examined the HO-1 mRNA expression, HO enzyme activity, and
antiapoptotic effect against oxidative injury. Because LCLs have normal
diploids in karyotypes and no
tumorgenicity,17
studies on LCLs are expected to show endogenous promoter activities of the
human genome. As shown in Table
1, there was no significant difference in HO-1 mRNA expression
between S/S and L/L at baseline (0.75 ± 0.14 versus 0.81 ± 0.06,
P > .50). After H2O2 stimulation, however,
the S/S group showed a 2.10 ± 0.49-fold increase in HO-1 mRNA
expression, whereas the L/L group showed only a 1.03 ± 0.17-fold
increase (P < .05). Compatible with the results of HO-1 mRNA
expression, HO activity was not significantly different between S/S and L/L at
the baseline (1.27 ± 0.32 versus 1.13 ± 0.44 nmol bilirubin/mg
protein/h; P > .50). After H2O2 stimulation,
however, the S/S group showed a 2.4 ± 0.6-fold increase in HO activity,
whereas the L/L group showed only a 1.0 ± 0.2-fold increase (P
< .05). Treatment with H2O2 at different
concentrations hardly induced any apoptosis in the S/S group even after 24
hours of culture (Figure 1).
Conversely, marked cell death was observed in the L/L group. There were
significant differences in apoptotic cell death between the S/S group and the
L/L group at 900 µM H2O2 (4.33% ± 1.61% versus
21.56% ± 2.68%, P < .05). Adding ZnPP-9 increased apoptotic
cell death in the S/S group (data not shown). These results demonstrated for
the first time that the length polymorphism in the HO-1 gene promoter has a
regulatory effect on the inductivity of HO-1 mRNA and HO activity and on the
strength of the antiapoptotic effects of HO-1.

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Figure 1.. Apoptosis assay. LCLs from subjects with L/L (filled symbols) and
with S/S (open symbols) were cultured for 24 hours with different
concentrations of H2O2. Apoptotic cells were detected by
the TUNEL method using a flow cytometer. Results are reported as means
± SDs among 5 lymphoblastoid cell clones from each subject.
*Significantly greater than baseline (0 µM H2O2),
P < .05.
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Recently, the first human case of HO-1 deficiency reported was a 6-year-old
boy with growth retardation, anemia, iron deposition, and vulnerability to
oxidative stress.18
The LCLs from the patient showed no HO-1 production and severe vulnerability
to apoptosis induced by oxidative stress. Conversely, the subjects with the
L/L genotype in our study had no anemia or abnormality of iron metabolism.
Cultured LCLs with an L/L genotype showed a background expression of the HO-1
gene and marginal induction of it after H2O2
stimulation. Taken together, subjects with L/L have enough HO-1 expression to
prevent iron metabolism abnormality and multiorgan failure in childhood.
However, through years of life with oxidative circumstances or heavy smoking,
subjects with L/L could be prone to accumulating tissue injury due to
oxidative stress, resulting in higher susceptibility to pulmonary emphysema or
cardiovascular disease. Analysis of the polymorphism of the HO-1 gene promoter
as well as conventional risk factors could provide useful information for
strategies in education and treatment for individuals with susceptibility to
oxidative stressmediated diseases.
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Footnotes
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Submitted December 10, 2002;
accepted April 19, 2003.
Prepublished online as Blood First Edition Paper, May 1, 2003; DOI
10.1182/blood-2002-12-3733.
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: Hidetada Sasaki, Department of Geriatric and Respiratory
Medicine, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku,
Sendai 980-8574, Japan; e-mail:
dept{at}geriat.med.tohoku.ac.jp.
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