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Blood, Vol. 93 No. 7 (April 1), 1999:
pp. 2404-2410
By
From the Department of Pediatrics, University of California San
Francisco, San Francisco, CA; the Department of Pediatrics, Yale
University School of Medicine, New Haven, CT; the Lawrence Berkeley
National Laboratory, Berkeley, CA; and the Childrens Hospital Oakland
Research Institute, Oakland, CA.
To examine the relationship between erythrocyte membrane protein
7.2b deficiency and the hemolytic anemia of human hereditary stomatocytosis, we created 7.2b knock-out mice by standard gene targeting approaches. Immunoblots showed that homozygous knock-out mice
completely lacked erythrocyte protein 7.2b. Despite the absence of
protein 7.2b, there was no hemolytic anemia and mouse red blood cells
(RBCs) were normal in morphology, cell indices, hydration status,
monovalent cation content, and ability to translocate lipids. The
absence of the phenotype of hereditary stomatocytosis implies that
protein 7.2b deficiency plays no direct role in the etiology of this
disorder and casts doubt on the previously proposed role of this
protein as a mediator of cation transport in RBC.
HEREDITARY stomatocytosis is a rare
inherited abnormality of human red blood cells (RBCs) that greatly
increases permeability to monovalent cations. Because the accumulation
of intracellular Na+ exceeds the loss of intracellular
K+, there is an increase in intracellular cations
accompanied by a movement of water into the cell, cell swelling, a
stomatocytic shape change, increased osmotic fragility, and a shortened
RBC life span. The result is a moderate to severe lifelong hemolytic anemia.1 The nature of the membrane defect responsible for the strikingly abnormal cation permeability that underlies the disorder
is unknown.
Lande, Thiemann, and Mentzer2 were the first to show a
deficiency in RBC membrane protein 7.2b in several individuals with hereditary stomatocytosis, a deficiency subsequently found in many,3-5 but not all6 patients with this
disorder. This association has given rise to the notion that protein
7.2b, or "stomatin," as it has come to be known7, is
a structural or regulatory component of an ion transport pathway whose
function is compromised when protein 7.2b is absent. Proteolytic
digestion studies of protein 7.2b, a 31 kD integral
membrane polypeptide, which can be palmitylated and exhibits cyclic
adenosine monophosphate (cAMP)-dependent phosphorylation,8
indicate a very large cytoplasmic tail, but little or no extracellular
domain.9 The C-terminus has been localized to the
cytoplasmic side of the membrane and the presence of the single
phosphorylation site at serine 9 in the N-terminal domain suggests that
this end of the molecule is also cytoplasmic.10 These
results are compatible with a hairpin-like insertion of the hydrophobic
stretch into the bilayer or anchoring through bound
lipid.10 The envisioned monotopic insertion into the lipid bilayer has seemed more consistent with a regulatory role than an
actual transport channel. The finding that the central portion of a
protein (MEC-2) necessary for mechanosensation in Caenorhabditis elegans has considerable homology to human 7.2b
(65% identity, 85% similarity) lends support to a channel regulatory
role for 7.2b, as MEC-2 appears to function through its linkage of
cytoskeletal proteins to degenerin channels.11
The human 7.2b gene consists of seven exons distributed over 40 kb of
DNA,12 while the murine protein 7.2b gene is encoded by
seven exons spread over about 25 kb of genomic DNA.13 The sequence of human 7.2b cDNA has been reported by several groups and
predicts a polypeptide of 287 amino acids consisting of a 24-residue
N-terminal sequence, a 29-residue hydrophobic stretch, and a
234-residue C-terminus with a molecular weight of 31,709 kD.5,14 Analysis of cDNA from several protein
7.2b-deficient hereditary stomatocytosis patients has shown no
differences from normal.5,15,16 The murine cDNA sequence
obtained from C57BL/6J(B6) mice predicts a 7.2b protein of 284 amino
acids (four fewer than the human protein) that is 87% identical (and
94% similar) at the amino acid level to the human
protein.17 BALB/c mice have a protein 7.2b amino acid
sequence that is 98% identical to C57BL/6J, differing in only six
amino acids.18 The striking homology between human and
murine RBC protein 7.2b provided a way for us to explore the
hypothetical cause and effect relationship between 7.2b deficiency and
stomatocytosis by creating knock-out mice that totally lack 7.2b and
then defining their RBC phenotype. As described in this report, we
found that such mice had normal RBCs and did not exhibit the hereditary
stomatocytosis phenotype, suggesting that protein 7.2b plays no direct
role in the etiology of this disorder and casting doubt on its putative
role in regulating ion transport in RBCs.
Construction of 7.2b Targeting Vector
Generation of Gene Targeted ES Cell Clones and Chimeric Mice
Genotyping of Wild-Type, Heterozygous, and Homozygous 7.2b Knock-out Mice Genotyping of mice was performed by Southern blot analysis using probe A or by using the following three primer PCR screening scheme. Primers: 7.2KO-8: 5'-GTGGATAATACAAACTTCACGAGG-3' (located at the 3' side of the 1.5-kb region of homology); 7.2K0-10: 5'-AATGGAGGAGAAGACACGC-3' (located within the 637 bp region deleted by the targeting event); PGK-T.rev: 5'-CATAGCCTGAAGAACGAGATC-3' (located in the PGK polyA-signal/terminator portion of the PGKneo cassette). PCR conditions: 0.5 µmol/L primer 7.2KO-8, 0.25 µmol/L primer 7.2bKO-10, 0.25 µmol/L primer PGK-T.rev, 200 µmol/L each dNTP, 1 U Taq polymerase, 20 µL reaction volume, 35 cycles at 96°C (10 seconds), 58°C (10 seconds), 72°C (30 seconds). Under these PCR conditions, PCR product sizes are 506 bp for 7.2KO-8 7.2KO-10 and 740 bp for 7.2KO-8 PGK-T.rev. PCR product sizes for the three different
genotypes are as follows: a single product of 506 bp for wild-type, two
products of 740 bp and 506 bp for heterozygotes, and a single product
of 740 bp for homozygotes.
Determination of the RBC Phenotype Blood from adult mice was collected in EDTA-coated blood collection tubes.Western blots. The absence of protein 7.2b in 7.2b knock-out mouse RBCs was verified by immunoblotting of RBC membrane proteins after separation by sodium dodecyl sulfate (SDS) PAGE on 5% to 15% gels.23 The two anti-7.2b antibodies used were an affinity-purified rabbit polyclonal antihuman 7.2b antibody (kindly provided by Dr Robert Johnson, Department of Biochemistry, Wayne State School of Medicine, Detroit, MI)8 and a murine monoclonal antimouse 7.2b antibody that reacted with the cytoplasmic region of 7.2b (kindly provided by Dr Gary Lewin, Max Delbrueck Centrum for Molecular Medicine, Berlin, Germany). Hematology. RBC indices and reticulocyte percentage were determined with an automated hematology analyzer (H*3 System, Bayer Diagnostics, Tarrytown, NY), using a 330 mOsm buffer standardized for mouse RBC, and the hematocrit was measured by centrifugation.24 Osmotic gradient ektacytometry. Intact RBCs were studied using osmotic gradient ektacytometry, in which RBC deformation is measured as a function of osmolality of the suspending medium.24,25 For each sample, the degree of maximal deformability (DImax), the hypotonic osmolality at which minimal deformability is found (Omin), and hypertonic osmolality (Ohyp) at which DI = 1/2*DImax was recorded. Intracellular Na and K concentrations. RBC electrolyte concentrations were measured by flame photometry (Corning M480; Corning, NY) of RBCs washed in choline chloride buffer (172 mmol/L choline chloride, 10 mmol/L MgCl2, 10 mmol/L Tris-Mops, pH 74., 330 mOsm) as described by Armsby et al26 and by Joiner et al.27 Phosphatidyl serine exposure. Phospholipid asymmetry is well maintained in the normal RBC, and phosphatidyl serine (PS) is located exclusively on the inside of the membrane lipid bilayer. The exposure of PS on the surface of RBCs was measured using fluorescent Annexin V.28 RBCs were suspended in buffer to a final concentration of 4 × 106 cells/mL, and 4 µL of a 500-µmol/L fluorescein isothiocyanate (FITC)-labeled annexin V solution was added to 0.5 mL of this suspension in the presence of 2 mmol/L Ca2+. The samples were incubated for 30 minutes at room temperature and subsequently washed with buffer to remove unbound annexin. The labeled cells were resuspended to approximately 106 cells per 250 µL in buffer for flow cytometric analysis on a Becton Dickinson FACScan flow cytometer (Becton Dickinson, San Jose, CA). Calcium and ionophore treatment will induce membrane lipid scrambling and exposure of PS on the surface of RBCs.28 RBCs at a 16% hematocrit were equilibrated in incubation buffer with 1 mmol/L calcium for three minutes at 37°C. Subsequently, calcium ionophore A23187 was added to the RBC suspension to a final concentration of 4 µmol/L. The process was stopped by a wash with 5 mmol/L EDTA to remove calcium. Subsequently, the cells were washed in buffer containing 1% bovine serum albumin (BSA) to remove the ionophore and resuspended in buffer without BSA. Calcium-treated cells were used as controls for PS exposing RBCs.
Disruption of the 7.2b Gene by Gene Targeting As shown in Fig 1A, exon 1 of the murine 7.2b gene is 151 bp in length, contains the initiation of translation start site (ATG), and is flanked on the 3' side by a 10.5-kb intron (Fig 1A).13 A murine (129 strain) P1 clone containing the entire 7.2b gene was used in the construction of a targeting vector designed to delete the putative 7.2b promoter, as well as the translation initiator ATG (Fig 1B). In addition to causing this 637-bp deletion, the targeting vector was designed to insert a human growth hormone polyA-signal/terminator and a neomycin gene expression cassette in place of the deleted region to increase the likelihood of completely shutting down 7.2b expression. The structure of the targeting event is shown in Fig 1C. After electroporation of ES cells, properly targeted clones were identified and injected into C57BL/6 blastocysts to generate chimeric mice. Germline transmission was obtained, and mice heterozygous for the targeting event were identified among these progeny. Heterozygotes were intercrossed to produce mice homozygous for the targeting event (Fig 1D). Homozygotes were normal in appearance, activity, and fertility.
Documentation of the Absence of Protein 7.2b in Knock-out Mouse RBCs As shown in Fig 2, no immunoreactive protein 7.2b could be detected in knock-out mouse RBC membranes, using a rabbit polyclonal antihuman 7.2b antibody that readily detected 7.2b in normal human or murine RBC membranes. To confirm this finding, a monoclonal antimouse 7.2b antibody that reacts with the cytoplasmic tail of protein 7.2b was used. Protein 7.2b was readily detected in normal mouse RBCs, but not in knock-out RBCs. A cross-reacting protein at 66 kD was noted in both normal and 7.2b-deficient mouse RBCs.
RBC phenotype.
Mice lacking detectable protein 7.2b did not exhibit hemolytic anemia
(Table 1). Their RBC morphology was normal
and in particular, stomatocytes were absent
(Fig 3). Ektacytometry curves for control and 7.2b knock-out mice are shown in Fig 4.
The curves overlap, and no significant difference was found in the
values of DImax, Omin, or Ohyp.
Thus, the absence of protein 7.2b had no effect on the cellular
deformability of the RBCs, indicating that the surface area to volume
ratio, state of cellular hydration, and membrane mechanical properties
are not changed as a result of the absence of this protein. In keeping
with this finding, the RBC indices (mean corpuscular volume [MCV] and
mean corpuscular hemoglobin concentration [MCHC])
were normal as was the RBC monovalent cation (Na+ and
K+) content (Table 1). Thus, 7.2b-deficient mice did not
exhibit the hereditary stomatocytosis phenotype seen in 7.2b-deficient humans.
The central finding of this report is that murine RBCs that lack
membrane protein 7.2b do not exhibit the phenotype of hereditary stomatocytosis that is seen in human RBCs deficient in this protein. We
interpret this to indicate that protein 7.2b does not play an important
or direct role in cation transport. Its absence in human hereditary
stomatocytosis may point to an abnormality in a partner binding protein
necessary for the insertion and retention of 7.2b in the erythrocyte
membrane. The abnormality in the partner binding protein rather than
the lack of 7.2b then would be responsible for abnormal cation
transport, stomatocytosis, and hemolytic anemia. Because there should
be no alteration in the putative binding protein in the 7.2b-deficient
mice we created, the stomatocyte phenotype would not be generated.
There is precedence for this type of phenomenon in RBCs, namely the
interaction between P55, protein 4.1, and glycophorin C. The complete
deficiency of P55 observed in RBCs deficient in either protein 4.1 or
glycophorin C has been taken to indicate that in the absence of either
protein 4.1 or glycophorin C, P55 cannot associate with the RBC
membrane.31 The identity of the 7.2b binding protein is
purely speculative, because despite extensive biochemical
investigation, little is known about interactions between protein 7.2b
and neighboring erythrocyte membrane proteins. Because it is extremely
difficult to solubilize, its associations and binding interactions with other membrane constituents remain largely undefined. Cross-linking studies suggest that it does not interact with cytoskeletal
proteins,32 but detergent-prepared cytoskeletal
preparations do contain immunoreactive protein 7.2b.5 A
potential interaction between 7.2b and
Submitted September 1, 1998; accepted November 23, 1998.
Supported by Grants No. DK 26263, DK 32094, HL 31579, and HL 55213 from the National Institutes of Health, Bethesda, MD.
Y.Z. and C.P. contributed equally to this project.
The publication costs of this article were defrayed in part by page charge payment. This article must therefore be hereby marked "advertisement" in accordance with 18 U.S.C. section 1734 solely to indicate this fact.
Address reprint requests to William C Mentzer, MD, Room 331, Bldg 100, San Francisco General Hospital, 1001 Potrero Ave, San Francisco, CA 94110; e-mail: wmentzer{at}sfghpeds.ucsf.edu.
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