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Blood, 1 January 2009, Vol. 113, No. 1, pp. 224-232.
Prepublished online as a Blood First Edition Paper on September 23, 2008; DOI 10.1182/blood-2008-06-165746.


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Submitted June 26, 2008
Accepted August 30, 2008

Central role of Sp1-regulated CD39 in hypoxia / ischemia protection

Holger K. Eltzschig*, David Kohler, Tobias Eckle, Tianqing Kong, Simon C. Robson, and Sean P. Colgan

Department of Anesthesiology and Perioperative Medicine, University of Colorado Health Sciences Center, Denver, CO, United States
Department of Anesthesiology and Intensive Care Medicine, University Hospital, Tubingen, Germany
Renal Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
Gastroenterology Division, Beth Israel Deaconess Hospital and Harvard Medical School, Boston, MA, United States
Mucosal Inflammation Program, Department of Medicine, University of Colorado Health Sciences Center, Denver, CO, United States

* Corresponding author; email: holger.eltzschig{at}uchsc.edu.

Hypoxia is common to a number of inflammatory diseases, where multiple cell types release adenine-nucleotides (particularly ATP/ADP). ATP/ADP is metabolized to adenosine through a two-step enzymatic reaction initiated by CD39 (ecto-nucleoside-triphosphate-diphosphohydrolase-1). Thus, extracellular adenosine becomes available to regulate multiple inflammatory endpoints. Here, we hypothesized that hypoxia transcriptionally upregulates CD39 expression. Initial studies revealed hypoxia-dependent increases in CD39-mRNA and immunoreactivity on endothelia. Examination of the human CD39 gene-promoter identified a region important in hypoxia-inducibility. Multiple levels of analysis, including site-directed mutagenesis, chromatin-immunoprecipitation and inhibition by antisense revealed a critical role for transcription-factor Sp1 in hypoxia-induction of CD39. Using a combination of cd39-/--mice and Sp1 siRNA in in vivo cardiac ischemia models revealed Sp1-mediated induction of cardiac CD39 during myocardial ischemia. In summary, these results identify a novel Sp1-dependent regulatory pathway for CD39 and indicate the likelihood that CD39 is central to protective responses to hypoxia / ischemia.


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