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Blood, Vol. 96 No. 3 (August 1), 2000:
pp. 1113-1118
RED CELLS
From the Howard Hughes Medical Institute and Department of
Pathology, Children's Hospital and Harvard Medical School, Boston, MA.
Hypotransferrinemic (Trfhpx/hpx)
mice have a severe deficiency in serum transferrin (Trf) as the result
of a spontaneous mutation linked to the murine Trf locus. They
are born alive, but before weaning, die from severe anemia if they are
not treated with exogenous Trf or red blood cell transfusions. We have
determined the molecular basis of the hpx mutation. It results
from a single point mutation, which alters an invariable nucleotide in
the splice donor site after exon 16 of the Trf gene. No normal
Trf messenger RNA (mRNA) is made from the hpx allele. A
small amount of mRNA results from the usage of cryptic splice sites
within exon 16. The predominant cryptic splice site produces a
Trf mRNA carrying a 27-base pair (bp), in-frame deletion. Less
than 1% of normal levels of a Trf-like protein is found in the serum
of Trfhpx/hpx mice, most likely
resulting from translation of the internally deleted mRNA. Despite
their severe Trf deficiency, however,
Trfhpx/hpx mice initially
treated with transferrin injections can survive after weaning without
any further treatment. They have massive tissue iron overload develop
in all nonhematopoietic tissues, while they continue to have severe
iron deficiency anemia. Their liver iron burden is 100-fold greater
than that of wild-type mice and 15- to 20-fold more than that of mice
lacking the hemochromatosis gene, Hfe.
Trfhpx/hpx mice thus provide an
additional model with a defined molecular defect for
the study of genetic iron disorders.
(Blood. 2000;96:1113-1118)
Iron is necessary for a wide spectrum of biologic
functions, including oxygen transport, mitochondrial electron transfer, and DNA synthesis. However, because of its insolubility at physiologic pH and its ability to generate free radicals, iron in biologic systems
must be tightly complexed by proteins. The plasma glycoprotein Trf
accounts for the majority of the iron-binding capacity in blood. Trf
not only serves a protective role, but also facilitates the delivery of
iron to tissues via the Trf cycle (reviewed by Andrews1).
Iron-loaded Trf specifically binds the Trf receptor (Trfr), initiating
receptor-mediated endocytosis. Acidification of specialized Trf cycle
endosomes aids in the dissociation of iron from Trf, and potentiates
the apo-Trf-Trfr interaction. Iron exits the endosome through a
transmembrane transporter, DMT1 (formerly Nramp2 or DCT1).2
The apo-Trf-Trfr complex is recycled to the plasma membrane, where
neutral pH favors the release of apo-Trf back into the circulation.
Hypotransferrinemic (Trfhpx/hpx)
mice carry a spontaneous mutation linked to the Trf
locus.3 With the use of immunologic methods, circulating
Trf levels have been measured to be about 1% of normal. Newborn
Trfhpx/hpx mice are viable, albeit
profoundly anemic, and can survive for up to 2 weeks after birth
without red blood cell transfusions or Trf replacement. When treated,
however, their development is normal, apart from subtle architectural
changes in the central nervous system and iron overload in multiple
organs.4-6 The degree of anemia and rate of iron absorption
are inversely proportional to the extent to which the animals are
treated.7 A similar iron-overloaded anemic phenotype has
been observed in human patients with congenital
atransferrinemia.8-11 However, the molecular basis of human
atransferrinemia has not been defined.
It is likely that the Trf cycle is essential for normal erythropoiesis
because it provides a mechanism of iron uptake sufficient to support
high levels of hemoglobin production. The receptor for Trf, Trfr, is
expressed at levels that vary with the physiologic and developmental
needs of each tissue. Developing erythroid cells express very high
levels of Trfr. Our laboratory recently generated mice carrying a
disrupted Trfr allele, and showed that homozygous mice lacking
Trfr (Trfr The genetic defect in Trfhpx/hpx
mice was previously unknown. However, linkage to the Trf locus
on chromosome 9 suggested that it involved the Trf
gene.3 A previous report postulated a defect in Trf
messenger RNA (mRNA) splicing, because nuclear RNA from Trfhpx/hpx brain contained a
5-kilobase (kb) Trf transcript that inappropriately retained
the last 2 introns of the Trf gene.13 Nonetheless, the molecular details of the
Trfhpx/hpx mutation were not
described. We have now identified the Trfhpx
mutation: a G-to-A transition at the +1 position of the
splice donor site of the last intron in the Trf gene. When this
mutation is present, a small amount of a near-normal-sized transcript
can be detected by Northern blot analysis, but this transcript results from use of a cryptic splice donor site 27-base pair (bp) upstream from
the normal intron 16 splice donor site. Western blot analysis shows a
small amount of Trf protein in the plasma of
Trfhpx/hpx mice, which is likely the
result of translation of this abnormal Trf mRNA.
Animals
RNA isolation and analysis
Reverse transcriptase-polymerase chain reaction and Southern blot analysis Reverse transcriptase (RT)-PCR was performed by using 1 µg total RNA. cDNA samples were prepared from Trfhpx/hpx, Trfhpx/+, and Trf+/+ mice using oligo-dT and random hexamers and the Superscript Preamplification kit (GIBCO/BRL, Bethesda, MD), according to the manufacturer's instructions. PCR of the full-length Trf transcript was performed by using primers 5'-GAAGCGGGTCGGTCTGTACTCCCC-3' and 5'-CTGTCTCCACCACAGT GGCAACCC-3'. By homology to the human and rabbit Trf genes,14,15 we inferred the intron/exon boundaries for exons 13 to 17 of the murine Trf gene. The presence of introns at the expected locations was confirmed by comparing the results of PCR from genomic DNA and cDNA from wild-type animals. RT-PCR across the splice junction of intron 15 was performed by using primers 5'-CCCAAGCTCCAAAC CATGTTGTGG-3' and 5'-GTGGTACCCTCTGGAAGTTTAACG-3'. PCR across the splice junction of intron 16 was performed by using primers 5'-CGTTAAACTTCCAGAGGGTACCAC-3' and 5'-CTGTCTCCACCACAGTGGCAACC C-3'. All PCR reactions were carried out for 40 cycles using an annealing temperature of 55°C. DNA sequences were determined by direct PCR (cycle) sequencing of the PCR products by using an automated ABI sequencer (Howard Hughes Medical Institute Biopolymer Facility at Harvard Medical School). Aliquots of PCR products were further analyzed by agarose gel electrophoresis and Southern blot hybridization. Blots were hybridized with 106 cpm/mL of a 32P-end-labeled oligonucleotide probe in QUIKHYB solution (Stratagene, LaJolla, CA) at 49°C, and washed to 0.1X SSC, 0.1% SDS at 45°C. The oligonucleotide probes used were 24 nucleotides in length: probe A: 5'-GCTCAACCTCACGACTCCTG GAAG-3'; probe B: 5'-TGCAATCTGTCGGACTCCTGGAAG-3'.Genomic DNA analysis Genomic DNA was amplified by PCR with primers flanking the mutation: 5'-CGTTAAACTTCCAGAGGGTACCAC-3' and 5'-CTGCCTTAGTATCCTGGGTCTGC G-3'. PCR products were subcloned using the TOPO-TA kit (Invitrogen, Carlsbad, CA), according to manufacturer's instructions. The DNA sequence of each subclone insert was determined with the primer 5'-CTGGAATGGTAGTTACAAGAACTC-3' by using the 35S-dideoxy-nucleotide method with the Sequenase version 2.0 (United States Biochemical, Cleveland, OH), according to the manufacturer's instructions. DNA sequence analysis was carried out on 11 subclones from an obligate Trfhpx/+ animal. Single subclones were sequenced from PCR reactions by using genomic DNA from 3 phenotypically affected Trfhpx/hpx animals, as well as 19 additional inbred strains: A/J, AKR/J, BALB/cJ, BALB/cByJ, BUB/BnJ, C3H/HEJ, C57BL/6J, CAST/Ei, CBA/J, CFO, DBA/2J, FL/1ReJ, FL/4ReJ, LP/J, SEC/1ReJ, SPRET/Ei, ST/bJ, WB/1ReJ, and YBR/Ei. The genomic PCR products were also analyzed for evidence of single strand conformational polymorphisms (SSCPs) using a nondenaturing gel system. Radiolabeled PCR reaction mixtures, generated with a 32P-end-labeled oligonucleotide, were loaded onto a 5% polyacrylamide, 0.5X TBE gel and fractionated at 30 W at 4°C for approximately 6 hours. The gel was exposed to x-ray film for visualization of conformational polymorphisms.Genotyping Genotype determinations for animals used in these studies were performed by sequence analysis of genomic PCR products, SSCP analysis, measurement of serum Trf (TIBC), or a combination of these methods. There were no inconsistencies in the results. TIBC levels were measured with the Iron and Iron-Binding Capacity kit (Sigma, St Louis, MO), according to the manufacturer's instructions.Western blot analysis Mouse Trf-specific antibodies were affinity purified from a sheep antimouse Trf antiserum (Chemicon International, Temecula, CA) with a SulfoLink Coupling Gel column (Pierce, Rockford, IL) coupled with 5 mg of purified mouse Trf (Chemicon International), according to the manufacturer's instructions. For Western blots, 0.5 µL of mouse serum containing approximately 25 µg of total protein was separated on a 7.5% acrylamide SDS-PAGE minigel. Purified mouse (0.05 µg) and human (1 µg) Trfs were used as controls. The protein was transferred onto a PVDF membrane (Amersham Pharmacia Biotech) with the use of a Semi-Phor apparatus (Hoefer Scientific, San Francisco, CA) with transfer buffer (25 mmol/L Tris.HCl, 192 mmol/L glycine, 10% methanol). The membrane was blocked in 3% bovine serum albumin (BSA) before incubating with the affinity purified primary antibody in TBS-T (100 mmol/L Tris, 150 mmol/L NaCl, 0.1% Tween 20, pH 8.0), containing 0.5% BSA for 1 hour at room temperature. Excess primary antibody was removed by washing in TBS-T before incubation with a 1:20 000 dilution of a donkey antisheep HRP-conjugated secondary antibody (Jackson ImmunoResearch Laboratories, West Grove, PA) in TBS-T, followed by washing in TBS-T. Visualization was accomplished by using ECL+Plus (Amersham Pharmacia Biotech) chemiluminescent detection agent, according to the manufacturer's instructions.Histology and tissue iron analysis Mouse tissues were fixed in phosphate-buffered formaldehyde (3.7%) before dehydration and paraffin embedding using standard methodology. Sections were cut at 4 µm and stained with hematoxylin and eosin or Perl's stain.16 Iron determination was performed on fresh frozen liver samples as previously described.17
The Trf hpx/hpx mutation dramatically reduces Trf mRNA levels On the basis of previous reports,3,13 it seemed likely that the mutation responsible for mouse hypotransferrinemia lay within the Trf gene. To explore this hypothesis, we reevaluated the expression of TrfmRNA in BALB/cJ-Trfhpx mice. Total RNA was extracted from livers of 10-week-old BALB/cJ-Trfhpx/hpx, -Trfhpx/+, and -Trf+/+ mice. A Northern blot containing 20 µg of total RNA was hybridized to a probe from the 5' end of the mouse Trf cDNA. All samples showed hybridization to a 2.5-kb band, consistent with the size of the full-length Trf transcript (Figure 1). The signal detected by using RNA from Trf+/+ mice was comparable to that of the BALB/cJ controls. In contrast, phosphorimager analysis (Molecular Dynamics, Sunnyvale, CA) showed that the signal from the Trfhpx/+ animals was approximately 50% as strong as the controls, whereas in Trfhpx/hpx animals, the 2.5-kb species was reduced to approximately 5% of wild-type levels. No larger transcripts were detected in total liver RNA from the mutant animals. These data findings reconfirmed that the Trfhpx allele significantly abrogates the expression of Trf mRNA.
The hypotransferrinemia phenotype is due to a splice donor site mutation Huggenvik et al13 described a nuclear RNA species from Trfhpx/hpx brain that, when analyzed by Northern hybridization, appeared to contain introns 15 and 16 of the Trf gene. To evaluate whether introns 15 and 16 were not properly excised from Trfpre-mRNAs in Trfhpx/hpx animals, RT-PCR was performed on total liver RNA from BALB/cJ-Trfhpx/hpx and BALB/cJ-Trf+/+ mice. Similar to the Northern blot analysis, full-length RT-PCR products from homozygous mutant and control RNAs produced single bands approximately 2.2 kb in length that were indistinguishable by agarose gel electrophoresis (data not shown). Sequencing plasmid subclones of these products, however, showed that they were different: the Trfhpx/hpx subclone contained a 27-bp deletion (coding nucleotides 2032-2058) located within exon 16 (Figure 2).
The Trf hpx/hpx mutation completely eliminates
normal Trf mRNA splicing
Trf hpx/hpx mice survive without therapy after weaning, but develop massive hemosiderosis Without serum, purified Trf injections or red blood cell treatments, newborn Trfhpx/hpx mice die of complications of anemia. Mice maintained on routine treatment protocols have been reported to live up to 15 weeks,3 but the survival and phenotype of adult animals from which protein or blood treatments have been withdrawn have not been described. We reasoned that, by the time of weaning, Trfhpx/hpx mice should have passed through the period of maximal growth and iron demand. To investigate the possibility that they might no longer be dependent on treatments for viability, we reared a cohort of mice with no hematologic support after 4 weeks of age. In the absence of exogenous Trf or transfusions, these animals continued to grow although they remained runted and pale compared with their littermates. One of 5 Trfhpx/hpx mice died in the first 2 months after weaning. By 6 months of age, all the remaining animals developed severe kyphosis of the cervical and thoracic spine and a distinct red-brown hue to exposed areas of skin, particularly the ears. When killed at 8 to 9 months of age, all lacked appreciable body fat and most organs, including skeletal muscle, had taken on a rusty tinge. The liver and pancreas were particularly noteworthy for their dark brown color. Peripheral blood smears showed extremely hypochromic red cells. Tissues were examined histologically for nonheme iron deposition. As shown in Figure 4, there was massive iron accumulation in the liver, kidney, and heart of Trfhpx/hpx mice compared with wild-type controls. Liver iron deposition was seen in both Kupffer cells and hepatocytes. Kidney iron deposition localized to a distinct band at the corticomedullary junction, likely representing deposition in a specific population of tubular epithelial cells. Cardiac iron deposition was seen in both macrophages and cardiac myocytes. Abnormal iron accumulation was also found in the adrenal medulla and the exocrine pancreas, but the pancreatic islets were spared (Figure 5). Strikingly, in no tissue was there histologically detectable fibrosis (data not shown). Despite the marked iron accumulation in many tissues, the spleen contained very scant stainable iron (data not shown).
Untreated Trf hpx/hpx mice have a limited amount of immunoreactive Trf Our genetic and expression analysis indicated that Trfhpx/hpx mice do not produce detectable amounts of correctly spliced TrfmRNA. To look for Trf-related protein in their sera, approximately 25 µg of total serum protein was tested for the presence of immunoreactive Trf by Western blot analysis that used an antimouse Trf antibody. Trfhpx/hpx mice used in this analysis were last treated with human Trf 6 to 8 months earlier. By Western blot, sera from homozygous mice contained a small amount of a Trf-like protein, whose electrophoretic migration was not discernibly different from the protein present in wild-type animals (Figure 6). With dilutions of serum from a Trf+/+ animal as a reference, Trfhpx/hpx animals have between 0.5% and 1% the normal amount of immunoreactive transferrin.
We have shown that the spontaneous mutation responsible for
murine hypotransferrinemia disrupts a splice donor site at the end of
exon 16 of the Trfgene. This mutation can fully account for the observed abnormalities in Trf mRNA levels and splicing seen in these animals. The mutation precludes normal excision of intron
16, resulting in the usage of a cryptic splice donor site 27-bp
upstream of the normal splice junction (Table 1). No mRNA
with intron 16 correctly excised can be detected. The low levels of
TrfmRNA seen by Northern blot may reflect the
inefficient use of the nonconsensus, cryptic splice site.
Alternatively, it may be that the internally deleted mRNA is less
stable than the wild type. In addition to this aberrant splice, we and
others13 identified a subset of transcripts containing
introns 15 and/or 16. Although the mutation directly affects the donor
site for exon 16, it could also be expected to result in retention of
intron 15 in some RNAs, as mutations in 5' splice donor sites can
lead to inefficient splicing of the preceding intron.18 In
any case, only a trace amount of a Trf-related protein can be detected
by Western blot analysis of serum from
Trfhpx/hpx mice. Considering the
fact that no normal mRNA is detectable, yet the electrophoretic
migration of the Trf-related protein is indistinguishable from that of
the wild-type protein, it appears that the slightly smaller, deleted
message is translated. We infer that an aberrant protein, containing a
9 amino acid internal deletion removing residues 679 to 687 near the
carboxyl-terminus of the 697 residue Trf protein (including the leader
sequence), circulates in Trfhpx/hpx
mice.
We thank Dr Jerry Kaplan for providing Trfhpx/hpx mice and Dr Adriana Donovan for assistance with the preparation of the figures. We thank Dr Robin Reed for discussing splicing aberrancies with us. C.C.T. is currently a medical student at the University of Tennessee, Memphis.
Submitted January 27, 2000; accepted March 17, 2000.
Supported by the Howard Hughes Medical Institute and grant number HL51057 from the National Institutes of Health to N.C.A.
Reprints: Nancy C. Andrews, Children's Hospital, Enders 720, 300 Longwood Ave, Boston, MA 02115; e-mail: nandrews{at}rascal.med.harvard.edu.
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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