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Blood, Vol. 95 No. 2 (January 15), 2000:
pp. 666-673
PHAGOCYTES
From the Central Laboratory of The Netherlands Red Cross Blood
Transfusion Service, the Laboratory of Experimental and Clinical
Immunology, and the Emma Children's Hospital, Academic Medical Center,
University of Amsterdam, Amsterdam, The Netherlands; the Department of
Biomolecular Sciences, Laboratory of Biochemistry, Wageningen
University, Wageningen, The Netherlands; Wilhelmina
Children's Hospital, Utrecht, The Netherlands; the Department of
Pediatrics, Sachs' Children's Hospital, Stockholm Söder
Hospital, Stockholm, Sweden; the Department of Medicine, the Center for
Inflammation and Hematology Research, Huddinge University Hospital,
Huddinge, Sweden; the Department of Clinical Immunology,
Children's Memorial Hospital, Warsaw, Poland; and the Institute of
Child Health, University College London, London, Great Britain.
The superoxide-forming nicotinamide adenine dinucleotide phosphate
reduced (NADPH) oxidase of human phagocytes comprises membrane-bound and cytosolic proteins, which, upon cell activation, assemble on the
plasma membrane to form the active enzyme. Patients with chronic
granulomatous disease (CGD) are defective in one of the phagocyte
oxidase (phox) components, p47-phox or
p67-phox, which reside in the cytosol of resting phagocytes, or
gp91-phox or p22-phox, which constitute the
membrane-bound cytochrome b558. In four X-linked CGD patients we have identified novel missense mutations in
CYBB, the gene encoding gp91-phox. These mutations were
associated with normal amounts of nonfunctional cytochrome
b558 in the patients' neutrophils. In
phorbol-myristate-stimulated neutrophils and in a cell-free
translocation assay with neutrophil membranes and cytosol, the
association of p47-phox and p67-phox with
the membrane fraction of the cells with Cys369
Phagocytic leukocytes use reactive oxygen metabolites
to kill ingested microorganisms. The first step in the production of these compounds is the generation of superoxide by the nicotinamide adenine dinucleotide phosphate reduced (NADPH) oxidase enzyme in these
cells. For an active NADPH oxidase, at least 5 different proteins are
required: the membrane-bound cytochrome b558 (a
flavocytochrome consisting of the subunits gp91-phox and
p22-phox)1,2 and 3 cytosolic proteins,
p47-phox,3 p67-phox,4 and a
low-molecular-weight guanosine
5'-triphosphate-binding (GTP-binding) protein
rac.5,6 A fourth cytosolic oxidase component,
namely, p40-phox,7,8 has been described. However,
this latter protein is not essential for oxidase activity because
complete reconstitution of oxidase activity in a cell-free assay is
achieved by purified cytochrome b558 with
recombinant p47-phox, p67-phox, and rac
protein.9
In resting neutrophils, most of the cytochrome b558
resides in the membrane of specific granules or secretory
vesicles.10,11 Upon cell activation, these organelles fuse
with the plasma membrane, which results in expression of cytochrome
b558 in the plasma membrane. At the same time, a
complex of cytosolic phox proteins translocates to the plasma
membrane and forms an enzymatically active complex with cytochrome
b558.12-14
Patients suffering from chronic granulomatous disease (CGD) typically
lack p47-phox, p67-phox, p22-phox, or
gp91-phox (reviewed elsewhere15,16). X-linked CGD
patients bear mutations in CYBB, the gene encoding
gp91-phox. In some of these patients, normal amounts of
nonfunctional gp91-phox are found; such patients are designated
X 91+ CGD patients.
Thus far, 6 X91+ CGD patients have been described
(reviewed elsewhere17). Two of these patients have
mutations leading to substitutions in the N-terminal part of
gp91-phox (R54S and A57E), which affect heme binding and/or
stable interaction with p22-phox.18,19 The remaining 4 X91+ patients bear mutations in the
cytosolic C-terminal part of gp91-phox. This region of
gp91-phox is important for FAD and NADPH binding and is also
involved in recruitment of cytosolic phox proteins. From
sequence comparison between the C-terminal half of gp91-phox and the ferredoxin-NADP+ reductase flavoenzyme family, the
putative location of these FAD-binding and NADPH-binding domains within
gp91-phox have been deduced.20-22 In
2 X91+ patients, there are substitutions in regions of
gp91-phox predicted to be involved in NADPH binding: P415H and
a replacement of residues 507-509 by
HisIleTrpAla.23-24
The last 2 X91+ patients thus far described carry
mutations in the cytosolic part of gp91-phox outside the
putative binding regions for FAD or NADPH: a deletion of amino acids
488-497 and a D500G substitution.25-26 These
mutations reside in a surface loop exposed to the cytosol as predicted
by a structural model of gp91-phox.27 This suggests
a role for this region of gp91-phox in the recruitment of
cytosolic phox proteins. Indeed, the translocation of
p47-phox and p67-phox to the plasma membranes of the
neutrophils of the patient with the D500G substitution was abrogated in
intact neutrophils as well as in the cell-free system.26
The other patient has not been studied in this respect. Residue 500 of
gp91-phox is the only residue to date that has been proven to
be critical for interaction with the cytosolic oxidase components.
In the present report, we characterize an additional 4 X91+
CGD patients. One of these patients has a substitution (T341K)
in an FAD-binding region, the other patients have substitutions C369R, G408E, and E568K, which are predicted to be involved in NADPH binding
or interaction with the cytosolic proteins p47-phox and p67-phox. We have studied the translocation of cytosolic
proteins in these 4 patients. Indeed, the 3 latter patients have a
strongly disturbed translocation of cytosolic phox proteins to
the plasma membrane. Only the membranes harboring the T341K
substitution supported a normal translocation, which indicates another
cause of the oxidase defect in this patient, probably decreased FAD binding. With the help of these unique CGD patients we can verify predictions for the different binding regions derived from the structural model of gp91-phox and gain more insight into the
complex interactions within the NADPH oxidase.
Clinical history
Experimental procedures
Materials.
We used the following materials: guanosine
5'-3-O-(thio)triphosphate (GTP- Classification of CGD patients.
Nitroblue tetrazolium (NBT) slide tests with PMA were performed on the
neutrophils of the 4 patients,29 and respiratory burst
activity after stimulation with opsonized yeast particles or PMA was
determined by the rate of oxygen consumption30 and chemiluminescence with lucigenin.31 Cytochrome
b558 contents were determined by absorption
spectroscopy32 and immunodetection on Western
blot.28 For immunodetection, 2 µg of protein from a
neutrophil membrane fraction were dissolved in SDS sample buffer (125 mmol/L Tris, pH 6.8; 20% (w/v) SDS and 10% (v/v)
Preparation of RNA and DNA.
Total RNA was purified from mononuclear leukocytes as
described,34 and cDNA was synthesized with reverse
transcriptase. The cDNA of the coding region of gp91-phox was
amplified with PCR in 3 overlapping fragments as
described,35,36 and it was subsequently sequenced
(Sequenase Version 2.0 kit; US Biochemical, Cleveland,
OH).37 Genomic DNA was isolated from circulating blood
leukocytes37 of the 4 CGD patients.
Isolation and fractionation of leukocytes.
Human neutrophils were prepared on 4 different occasions from 20 to 50 mL of citrated blood from the 4 CGD patients after obtaining informed
consent. Neutrophils from a healthy donor were isolated in parallel on
each occasion as previously described.38 Subsequently,
sonicated neutrophils were fractionated over a sucrose gradient as
described.26
Translocation of cytosolic proteins in intact neutrophils.
Cells (20 × 106) of a patient and a healthy donor
were incubated with PMA (100 ng/mL) or without PMA for 10 minutes at
37°C. The cells were then resuspended and sonicated in 1 mL of
ice-cold oxidase buffer containing: sodium chloride (NaCl, 75 mmol/L); 4-(2-Hydroxyethyl)-1-piperazineethanesulfonic acid (HEPES, 10 mmol/L);
sucrose (170 mmol/L); magnesium dichloride (MgCl2, 1 mmol/L); ethyleneglycoltetraacetic acid (EGTA, 0.5 mmol/L); adenosine triphosphate (ATP, 10 µmol/L); and azide (2 mmol/L, pH 7.0) with GTP Superoxide assay.
NADPH oxidase activity with neutrophil membranes and cytosol was
measured as the SOD-sensitive reduction of cytochrome c in a
spectrophotometer (Lambda 2, Perkin Elmer, Norwalk, CT).
The contents of 6 cuvettes measured in parallel were stirred
continuously and were thermostatted at 28°C. Plasma membranes (10 µg of protein) and cytosol (200 µg of protein) were incubated in
oxidase buffer (0.8 mL) and cytochrome c (60 µmol/L). After 2 minutes of incubation, oxidase assembly was induced by addition of SDS
(100 µmol/L) and GTP- Translocation of cytosolic proteins in the cell-free system.
Neutrophil plasma membranes (20 µg protein) were mixed with
neutrophil cytosol (400 µg of protein) in oxidase buffer (1 mL). Subsequently, SDS (100 µmol/L) and GTP- Oxygen consumption in plasma membranes without cytosol according to
Koshkin and Pick.
41
Sequence alignment.
A multiple sequence alignment of the structurally known members of the
ferredoxin-NADP+ reductase (FNR) family was performed by
superimposing the structures with the program
TOP.42 The sequence incorporation of the
cytosolic C-terminal half of gp91-phox into the alignment
profile of the FNR family was based on a previous sequence alignment of
gp91-phox with FNR.27
Diagnosis of CGD patients
Superoxide production in the cell-free assay
Genetic analysis of CGD patients
Translocation of p47-phox and p67-phox in
neutrophils of CGD patients
Effect of point mutations on oxide assembly
Oxygen consumption in neutrophil plasma membranes without
cytosol
Location of amino acid substitutions in gp91-phox
Cytochrome b558 of human phagocytes is a
membrane-bound heterodimer of p22-phox and gp91-phox.
The cytochrome has an NADPH-binding site and bears a flavin group that
acts as the initial acceptor of a pair of electrons from
NADPH.20-22 Two heme groups embedded in the flavocytochrome
mediate the 1-electron transfer from FAD to molecular oxygen, thus
generating superoxide (O2-).50
Sequence-homology studies between the C-terminal half of gp91-phox and the ferredoxin-NADP+ reductase
flavoenzyme family suggest that both FAD and NADPH are bound by
specific domains within this part of
gp91-phox.20-22
We thank Dr U. Ermler for providing us with the coordinates of the
flavohemoglobin structure (1fhp) and Dr A.W. Segal for the coordinates
of the structural model of the globular portion of gp91-phox.
Submitted April 28, 1999; accepted September 15, 1999.
Supported by grants from The Netherlands Fund for Preventive Medicine
(Praeventiefonds) and from the German Research Foundation (Deutsche
Forschungsgesellschaft) to C.M..
Reprints: D Roos, Central Laboratory of the Netherlands
Red Cross Blood Transfusion Service, Plesmanlaan 125, 1066 CX
Amsterdam, The Netherlands; e-mail: d_roos{at}clb.nl.
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.
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