Thrombosis |
From the Thrombosis and Haemostasis Laboratory (E.d.D., G.G., H.v.d.V., J.D., C.K., J.-W.N.A.), Department of Haematology, University Medical Center Utrecht and Institute for Biomembranes, Utrecht University, Utrecht, and the Department of Biochemistry and Human Biology (J.W.M.H.), Maastricht University, Maastricht, The Netherlands, and the Department of Molecular Neurobiology (K.M.), Institute of Medical Science, Tokyo University, Tokyo, Japan.
Correspondence to Els den Dekker, Thrombosis and Haemostasis Laboratory, Department of Haematology, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands. E-mail e.dendekker{at}lab.azu.nl
| Abstract |
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Key Words: calcium cAMP stem cells megakaryocytes Rap1
| Introduction |
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IIbß3 (glycoprotein IIb/IIIa, or CD41/CD61), together with the disappearance of the stem cell marker CD34.1 A second early event is the synthesis of von Willebrand factor (vWF), which starts in immature, both CD61+ and CD34+ megakaryocytes. At a later stage, the vWF receptor, glycoprotein Ib
(CD42b), is expressed, which marks the beginning of polyploidization.1 The transition from proliferating to differentiating megakaryocytes is accompanied by loss of nuclear-associated acetylcholinesterase activity.2 The megakaryoblastic cell lines MEG-01, DAMI, and CHRF-288-11 have properties in common with normal megakaryocytes at different stages of maturation.3 The immature MEG-01 cells already show an increase in cytosolic Ca2+ concentration, [Ca2+]i, on stimulation by thrombin and platelet-activating factor. The more mature DAMI and CHRF-288-11 cells upregulate this property and, in addition, become sensitive to thromboxane A2. These cells respond to the prostacyclin analogue iloprost with an increase in cAMP, a response that is also upregulated in the more mature cell lines. Hence, the immature megakaryoblast already has the capacity to regulate Ca2+ and cAMP via mechanisms also seen in platelets. An interesting exception is that in MEG-01 cells, iloprost-induced cAMP formation is accompanied by a rise in [Ca2+]i. This is in sharp contrast with platelets, which do not raise [Ca2+]i when treated with prostacyclin and show Ca2+ responses by thrombin and other platelet-activating agents that are completely blocked by an increase in cAMP.4
In the present study, we aimed to clarify how prostacyclin raises [Ca2+]i in immature megakaryoblasts. Studies were focused on iloprost-induced signaling pathways to [Ca2+]i and on the small GTPase Rap1, which has been implicated in Ca2+ regulation in platelets in the same way that phospholamban regulates Ca2+ signaling in cardiac and muscle cells. Earlier studies have shown that megakaryoblastic cell lines express the prostacyclin receptor5 Rap16 and the 97-kDa sarco/endoplasmic reticulum Ca2+-ATPase SERCA3b, which functions in Ca2+ sequestration in platelets.6 The data show that in addition to MEG-01 cells, human stem cells and immature megakaryocytes respond to iloprost with an increase in cAMP and a rise in [Ca2+]i and that cAMP controls cytosolic Ca2+, possibly via Rap1-GTP.
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| Results |
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2-fold higher (Figures 1A and 1B). These data are consistent with the concept that cell maturation is accompanied by the downregulation of iloprost-induced Ca2+ increases and the upregulation of iloprost-induced cAMP formation. Stimulation of MEG-01 cells with thrombin induced a Ca2+ response similar to that of iloprost. Thrombin induced a 3-fold higher Ca2+ response in CHRF-288-11 than in MEG-01 cells, illustrating that the failure of iloprost to raise [Ca2+]i in CHRF-288-11 cells was not caused by abnormalities in Ca2+ storage or influx. To assess the contributions of Ca2+ mobilization and influx in the total [Ca2+]i increase, experiments were repeated in Ca2+-free medium. Ca2+ mobilization by iloprost and thrombin was 42±6% and 31±12%, respectively, of the peak Ca2+ level in MEG-01 cells; for CHRF-288-11 cells, these values were 18±3% and 22±2%, respectively. As expected, stimulation with thrombin failed to raise cAMP levels in both cell lines. Interestingly, in MEG-01 cells, iloprost was able to induce a further Ca2+ rise after thrombin (Figure 1C), suggesting that these 2 agonists raise [Ca2+]i by a different mechanism.
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Iloprost Induces a Ca2+ Increase in Megakaryocytes
To investigate whether iloprost induced similar increases in Ca2+ and cAMP in megakaryocytes, CD34+ stem cells were immunomagnetically purified from umbilical cord blood and cultured in vitro with recombinant human thrombopoietin and recombinant human stem cell factor. After 7 and 14 days, immature and mature megakaryocytes were isolated by a second immunomagnetic sorting based on expression of CD61 and CD42b, respectively. The 3 isolation procedures resulted in almost pure (>95%) suspensions of CD34-, CD61-, and CD42b-expressing cells. The CD34+ cells were predominantly diploid and contained few megakaryocytes. The immature megakaryocytes, represented by the CD61-expressing cells, were diploid (77%) and tetraploid (23%) and contained properties of stem cells (44%) and mature megakaryocytes (25%), illustrating an intermediate stage of megakaryocyte maturation. The mature megakaryocyte suspension consisted for >95% of CD61+ and CD42b+ cells, without a further increase in ploidy. For a detailed characterization of the cell suspensions, please see Table I at http://www.atvb.ahajournals.org. As shown in Figure 2A (upper panel), iloprost induced a Ca2+ response in stem cells as well as in immature and mature megakaryocytes. This response was the sum of Ca2+ mobilization (60%) and influx (40%), and the peak value of [Ca2+]i was higher in stem cells (36±13 nmol/L) and immature megakaryocytes (33±3 nmol/L) than in mature megakaryocytes (12±6 nmol/L), illustrating a similar downregulation as observed in mature megakaryoblastic cell lines. Similar results were found with prostacyclin (data not shown). To investigate whether the Ca2+ measurements in cell suspensions reflected the responses of the individual cells, studies were repeated in single cells. These measurements showed that
30% (11 of 37) of the stem cells responded to iloprost with a Ca2+ response (Figure 2A, lower panel). This percentage was the same for immature megakaryocytes (7 of 23) but decreased to 15% for mature megakaryocytes (8 of 54). Both the number of iloprost-responsive cells and the magnitude of the Ca2+ increase declined during cell maturation, which is in line with the findings in cell suspensions. No such downregulation was observed for the thrombin-induced Ca2+ increases (Figure 2B). Stem cells responded to thrombin with a rise in [Ca2+]i of 85±15 nmol/L, and in immature and mature megakaryocytes, the increases were 285±34 and 440±35 nmol/L, respectively (Figure 2B, upper panel). Analysis of single-cell responses showed that 95% of the stem cells (35 of 37), 91% of the immature megakaryocytes (31 of 34), and 90% (36 of 40) of the mature megakaryocytes responded to thrombin and that the Ca2+ responses increased with increasing cell maturity (Figure 2B, lower panel). The same studies in MEG-01 cells showed that iloprost and thrombin induced a Ca2+ increase in 96±4% and 95±2%, respectively, of the cells (not shown).
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Iloprost-Induced Ca2+ Signaling Is Mimicked by cAMP-Elevating Agents
Iloprost is known to bind with high affinity to receptors of the IP class (which bind prostaglandins of the I type) and with a low affinity to receptors of the EP1 class (which bind prostaglandins of the E type).7 To clarify which receptor takes part in iloprost signaling to Ca2+, experiments were repeated with carbaprostacylin, which is a more specific agonist of IP receptors than is iloprost.8 Figure 3A shows that carbaprostacylin induced an increase in [Ca2+]i in immature megakaryocytes, consisting of several Ca2+ spikes. The response was observed in 38% (11 of 29) of the cells. The increase was also seen in nominally Ca2+-free buffer (Figure 3A, insert), illustrating that carbaprostacylin triggered both mobilization and influx. Stimulation of IP receptors is known to activate Gs, the trimeric G protein that activates adenylyl cyclase. To investigate whether this enzyme takes part in iloprost-induced Ca2+ signaling, immature megakaryocytes were stimulated with the adenylyl cyclase activator forskolin. In 23% (11 of 48) of the cells, this treatment induced a Ca2+ response (Figure 3B) and Ca2+ mobilization (Figure 3B, insert) similar to that of iloprost, indicating that iloprost presumably signals to Ca2+ by way of adenylyl cyclase.
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In MEG-01 cells, forskolin (40 to 100 µmol/L) induced a Ca2+ increase of 105±20 nmol/L (Figure 3C, left panel). The structurally dissimilar compound isobutylmethylxanthine (IBMX, 500 µmol/L), which inhibits phosphodiesterases and thereby prevents cAMP breakdown, also induced an increase in [Ca2+]i, although this response was much lower than the forskolin-induced Ca2+ increase (Figure 3C, middle panel). A similar, albeit weaker, Ca2+ increase was also induced by dibutyryl cAMP (data not shown). To further investigate the role of cAMP in Ca2+ increases, the effect of an inhibitor of cAMP metabolism was investigated. MEG-01 cells were preincubated with IBMX (500 µmol/L, 5 minutes, 37°C) and subsequently treated with iloprost (1 µmol/L). As shown in Figure 3C (right panel), IBMX treatment potentiated the iloprost-induced rise in Ca2+ by 15%, strongly supporting the concept that cAMP plays a role in the iloprost-induced Ca2+ increase.
As expected, stimulation of IP receptors and direct activation of adenylyl cyclase induced formation of cAMP in cultured megakaryocytes (please see Table II at http://www.atvb.ahajournals.org). Thus, the increase in [Ca2+]i by these treatments was accompanied by an increase in cAMP.
The Forskolin-Induced Ca2+ Increase Does Not Involve IP3 Receptors or Protein Kinase A
To investigate whether increases in intracellular inositol triphosphate (IP3) levels mediated the forskolin-induced Ca2+ response, MEG-01 cells in nominally Ca2+-free buffer were treated with the IP3 receptor antagonist 2-aminoethoxydiphenylborate (2-APB). In platelets, 100 µmol/L 2-ABP completely abolished thrombin- and thromboxane A2-induced Ca2+ responses (Figure 4A, left panel).9 At concentrations of 50 µmol/L (not shown) and 100 µmol/L (Figure 4A), 2-APB partially inhibited the forskolin-induced Ca2+ increases (middle panel) and totally inhibited the thrombin-induced Ca2+ increases (right panel) in MEG-01 cells. Similar results were obtained with immature megakaryocytes (data not shown). Thus, in contrast to thrombin, which fully depended on IP3 receptors for raising [Ca2+]i, forskolin-induced Ca2+ increases were partly independent of IP3 receptors.
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To investigate whether the forskolin-induced Ca2+ increase also involved protein kinase A (PKA), MEG-01 cells were treated with the PKA inhibitor H89. As shown in Figure 4B (left panel), the forskolin-induced phosphorylation of vasodilator-stimulated phosphoprotein (VASP) was completely abolished by pretreatment with H89, indicating that H89 is a good inhibitor of PKA in MEG-01 cells. Treatment with H89, however, did not abolish the forskolin-induced Ca2+ increase. Instead, a slight but consistent increase in the release of Ca2+ from intracellular stores was observed (Figure 4B, middle panel). PKA inhibition thus "unmasks" a slight suppression of Ca2+ increases by PKA. The same effect was seen when MEG-01 cells were stimulated with thrombin (Figure 4B, right panel). Immature megakaryocytes reacted the same way as MEG-01 cells did (data not shown). The specific PKA activator Sp-5,6-DCl-cBIMPS induced the same extent of VASP phosphorylation as forskolin (Figure 4C, left panel) but did not raise [Ca2+]i in MEG-01 cells (Figure 4C, right panel). Even after stimulation of PKA with Sp-5,6-DCl-cBIMPS, forskolin induced a Ca2+ increase (Figure 4C, right panel). These findings argue in favor of a direct effect of cAMP on Ca2+ homeostasis, without involvement of PKA.
Iloprost and Thrombin Induce Rap1 Activation
The small GTPase Rap1 has been implicated in the regulation of Ca2+ sequestration, because (1) it coimmunoprecipitates with the sarco/endoplasmic reticulum Ca2+-ATPase isoform 3b (SERCA3b) and (2) binding of GTP
S to Rap1 has been suggested to be related to SERCA3b activity.10,11 Because the guanine nucleotide exchange factor (GEF) for Rap1, Epac1/2, is a target for PKA-independent signaling by cAMP, Rap1 could be the link between cAMP and Ca2+.12,13 Using a pulldown technique based on the specific binding of active, GTP-bound Rap1 to the Rap-binding domain of RalGDS, we investigated the effect of iloprost and forskolin on Rap1 activation. Because the quantities of cultured megakaryocytes were below the detection limit of this technique, the studies were performed with MEG-01 and CHRF-288-11 cells only. Results from different experiments were related to internal standards as defined in the legend to Figure 5. In MEG-01 cells, addition of iloprost induced a 10-fold, sustained increase in GTP-Rap1 (Figure 5A). A much weaker 5-fold activation of Rap1 was observed on stimulation with thrombin, which was transient and disappeared after 1 minute. Incubation of blots with antibodies that specifically recognize Rap1a or Rap1b showed that iloprost activated both Rap1a and Rap1b to the same extent and with the same kinetics (Figure 5B). In CHRF-288-11 cells, the responses were completely different. In these cells, iloprost induced only little Rap1 activation, but thrombin induced a 15-fold increase in GTP-Rap1, which remained high throughout the incubation period (Figure 5C). Thus, the downregulation of iloprost-induced Ca2+ responses and upregulation of thrombin-induced Ca2+ responses, observed when immature and mature megakaryoblastic cell lines were compared, were accompanied by similar changes in the formation of GTP-Rap1, suggesting that these responses go hand in hand.
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cAMP Induces Rap1 Activation and Ca2+ Signaling in MEG-01 but Not in CHRF-288-11 Cells
To investigate whether direct activation of cAMP formation induced similar changes in [Ca2+]i and GTP-Rap1 as seen with iloprost, MEG-01 and CHRF-288-11 cells were treated with forskolin. In agreement with the effect of iloprost, forskolin induced an increase in [Ca2+]i and formation of GTP-Rap1 in MEG-01 but not in CHRF-288-11 cells (Figures 6A, 6B, left panel, and 6C). The onset of forskolin-induced Ca2+ increases in MEG-01 cells was
10 seconds later than the beginning of Rap1 activation, suggesting that Rap1 activation precedes the Ca2+ increase. Rap1 was also activated by the phosphodiesterase inhibitor IBMX (Figure 6B, right panel), although activation was much weaker and slower than that induced by forskolin. This difference corresponds with the difference in Ca2+ responses induced by these compounds (Figure 3C, left and middle panels).
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To clarify the role of PKA in the forskolin-induced Rap1 activation, studies were repeated in the presence of the PKA inhibitor H89. As shown in Figure 6D, the forskolin-induced Rap1 activation was not affected by this inhibitor. To determine whether Rap1 activation is an upstream step of Ca2+ increases or a result of changes in [Ca2+]i, Ca2+ increases were prevented by treating the cells with 1,2-bis(2-aminophenoxy)ethane-N,N,N',N',-tetraacetic acid (BAPTA)-AM. The Ca2+-chelating capacity of BAPTA-AM was sufficient to abolish the forskolin-induced Ca2+ increase completely (data not shown). As also shown in Figure 6D, this treatment failed to interfere with the activation of Rap1. Together, these data favor the concept that Rap1 is activated by a rise in cAMP and that this activation is independent of changes in [Ca2+]i.
cAMP-Induced Rap1 Activation Is Not Accompanied by Phosphorylation
To determine whether Rap1 phosphorylation by PKA occurs concurrently with Rap1 activation, MEG-01 cells were treated with forskolin (100 µmol/L), and Rap1 phosphorylation was determined by a gel-shift assay (Figure 6E, upper panel). Because Rap1 has been described to be phosphorylated in iloprost-treated platelets after 15 minutes, control samples of platelets treated with iloprost (5 µmol/L) were analyzed for Rap1 phosphorylation (Figure 6E, lower panel). At the times when forskolin induced Rap1 activation in MEG-01 cells (between 5 and 25 seconds), Rap1 was not phosphorylated. However, at later times (15 and 30 minutes), weak phosphorylation was visible (not shown). In platelets, a clear iloprost-induced phosphorylation of Rap1 was observed after 15 and 30 minutes, which corresponds with results from previous studies.14,15
| Discussion |
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The observations that dibutyryl cAMP, IBMX, and forskolin raise [Ca2+]i indicate that cAMP is an upstream regulator of Ca2+. Elevated cAMP levels have been shown to induce Ca2+ mobilization in HEK-293 cells, hepatocytes, neuronal cells, and articular chondrocytes.1619 In these cells, the increase in [Ca2+]i was caused by PKA-mediated phosphorylation of IP3 receptors. This resulted in sensitization for IP3, leading to a 4-fold leftward shift of the dose-response curve of IP3-mediated Ca2+ release.17
The present findings in MEG-01 cells and immature megakaryocytes differ from those observations, because neither PKA nor IP3 receptors seem to be involved in the cAMP-induced [Ca2+]i increase. The PKA inhibitor H89, which inhibits PKA-mediated suppression of IP3-induced Ca2+ responses in rat megakaryocytes20 and completely suppresses forskolin-induced VASP-Ser157 phosphorylation in MEG-01 cells, did not suppress the forskolin-induced Ca2+ response. Moreover, direct activation of PKA by the specific activator Sp-5,6-DCl-cBIMPS induced the same extent of PKA activation as forskolin, but this did not result in an increase in [Ca2+]i. This indicates that PKA activation does not lead to a Ca2+ increase. The IP3 receptor inhibitor 2-APB, which abolishes thrombin- and thromboxane A2mediated Ca2+ responses in platelets,9 also blocked the thrombin-induced Ca2+ response in megakaryocytes. However, this inhibitor only partly blocked the forskolin-induced Ca2+ response, illustrating IP3-dependent as well as IP3-independent routes. Cerebellar microsomes,9 which express predominantly the type 1 IP3 receptor, and submandibular gland cells, which possess mainly type 2 and type 3 IP3 receptors,21 show the same sensitivity to 2-APB for IP3-mediated Ca2+ responses (authors unpublished results, 2001). Thus, it is unlikely that forskolin raises Ca2+ via an IP3 receptor subtype that is resistant to 2-APB inhibition. An explanation for the IP3 receptor-mediated Ca2+ response might be sought in the Ca2+-induced Ca2+ release triggered by the cAMP-mediated release of Ca2+ from intracellular stores. Although these responses occur independently of PKA, it is clear that phosphorylation of IP3 receptors by this kinase plays a role in MEG-01 cells like it does in platelets.22 PKA inhibition leads to increased Ca2+ rises, illustrating suppression of Ca2+ mobilization by PKA-mediated phosphorylation of IP3 receptors.
The findings in this report reveal a novel mechanism by which cAMP directly regulates [Ca2+]i, independent of PKA and IP3 receptors. Interestingly, iloprost further increases [Ca2+]i after thrombin in MEG-01 cells, indicating that these 2 compounds activate different Ca2+-mobilizing mechanisms. Few PKA-independent effects of cAMP have been reported so far. Recently, De Rooij et al12 and Kawasaki et al13 described that the small GTPase Rap1 is activated by cAMP via cAMP-sensitive guanine nucleotide exchange factors (cAMP GEFs). Two types of cAMP GEF for Rap1 have been reported: cAMP-GEF-I, also called exchange protein, directly activated by cAMP (Epac), and cAMP-GEF-II. Interestingly, earlier work by Corvazier et al11 and Lacabaratz-Porret et al10 indicated that Rap1 might be involved in Ca2+ regulation in platelets. First, proteins in crude platelet plasma membrane vesicles, ranging in molecular mass from 22 to 29 kDa, bound GTP
S. One of these proteins was identified as Rap1, and GTP
S binding was accompanied by inhibition of Ca2+-ATPases in these vesicles. Second, Rap1 coimmunoprecipitated with the sarco/endoplasmic reticulum Ca2+-ATPase isoform 3b (SERCA3b), suggesting a physical interaction of these 2 proteins. The association of Rap1 with SERCA3b was lost on PKA-mediated phosphorylation of Rap1 on Ser179. The present results show that Rap1 activation is correlated with the release of Ca2+ from stores in stem cells and immature megakaryocytes. The cAMP-elevating agents iloprost, forskolin, and IBMX induce an increase in the active, GTP-bound Rap1 together with Ca2+ release from stores in MEG-01 cells. Both Rap1a and Rap1b were activated by iloprost, indicating that cAMP-mediated Rap1 activation does not involve a specific subtype. The Rap1 activation and Ca2+ increase have similar kinetics and are independent of PKA, as shown by the insensitivity to H89. Rap1 was not phosphorylated by forskolin in MEG-01 cells within the time range (5 to 25 seconds) when this compound induced a Ca2+ increase and Rap1 activation. This result corresponds with that obtained in platelets, in which iloprost and prostacyclin induced Rap1 phosphorylation after a lag time of 15 minutes or later.14 Furthermore, Rap1 activation was not affected by PKA-mediated phosphorylation.15 Because the Ca2+ chelator BAPTA-AM did not suppress the cAMP-induced Rap1 activation, it is unlikely that Rap1 is downstream of Ca2+ increases. These findings are in correspondence with the hypothesis that Rap1 is a molecular "switch" that regulates SERCA activity: the cAMP-induced Rap1 activation is correlated with the inhibition of SERCA and a rise in [Ca2+]i (present data), and the PKA-mediated phosphorylation of Rap1 relieves the inhibition, resulting in activation of Ca2+-ATPases and a decrease in [Ca2+]i.10,11 The latter property is also observed in Ca2+ regulation by phospholamban in cardiac and muscle cells.23,24 Phosphorylation of this 24-kDa protein by PKA triggers stimulation of cardiac sarcoplasmic reticulum Ca2+-ATPases, leading to a fall in [Ca2+]i.
In CHRF-288-11 cells, the Rap1 activation and release of Ca2+ from stores by forskolin had disappeared, suggesting that one of the steps in cAMP-induced Rap1 activation is downregulated during maturation and is probably absent in platelets. Indeed, previous studies indicated that cAMP does not induce Rap1 activation in platelets.15 Although the expression of Rap1 is upregulated during megakaryocytopoiesis,6,10,25 the mechanism of cAMP-mediated Rap1 activation is downregulated. A likely candidate to be downregulated is a cAMP-dependent GEF for Rap1. However, we were unable to demonstrate expression of cAMP-GEF-I and cAMP-GEF-II mRNA in MEG-01 cells, CHRF-288-11 cells, or platelets by reverse transcription-polymerase chain reaction (data not shown). This suggests that either another subtype of cAMP-dependent GEF may exist or that downregulation of a yet-unknown cAMP-inhibitable GTPase-activating protein for Rap1 causes the loss of cAMP-induced Ca2+ rises during megakaryocyte maturation.
In MEG-01 and CHRF-288-11 cells, thrombin induced Rap1 activation, a process that is upregulated during maturation. This points to a major difference between Rap1 activation by forskolin and that by thrombin. In platelets, the first phase of thrombin-induced Rap1 activation critically depends on a rise in Ca2+ and is followed by an activation phase, in which PKC, phosphatidylinositol-3-kinase, and the integrin
IIbß3 play a role.15,26 The first phase of Rap1 activation appears to be present already in MEG-01 cells, possibly reflecting the activity of Ca2+-dependent GEFs, such as Ca2+- and diacylglycerol-dependent GEF. The higher thrombin-induced activation of Rap1 in CHRF-288-11 cells is probably due to the higher Ca2+ response compared with that in MEG-01 cells. The sustained Rap1 activation in CHRF-288-11 cells may arise from a more sustained PKC or phosphatidylinositol-3-kinase activity in these more mature cells.
An interesting question is whether prostacyclin-induced Rap1 activation also occurs in vivo and what its role might be in megakaryocytopoiesis. Functions of active Rap1 include induction of cell adhesion,27 inhibition of gene expression,28 and inhibition of cell proliferation by suppression of Ras-mediated activation of Raf and mitogen-activated protein kinase.29,30 It is possible that immature megakaryocytes become exposed to prostacyclin in vivo, because bone marrow stromal cells, which are in close proximity to maturing megakaryocytes, may produce prostacyclin on stimulation by interleukin-1ß.31,32 Thus, stromal cells may regulate megakaryocyte gene expression and proliferation via prostacyclin-induced Rap1 activation.
The present report shows that in immature megakaryocytes, cAMP, independent of PKA, induces release of Ca2+ from intracellular stores, a property that is downregulated during megakaryocyte maturation. Rap1 activation might play a role in the cAMP-induced [Ca2+]i increase, but further studies are needed to provide definite proof. Together these data reveal a novel mechanism for the regulation of cytosolic Ca2+ concentration, in stem cells and immature megakaryocytes, in which cAMP plays a central role.
| Acknowledgments |
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Received February 8, 2001; accepted October 4, 2001.
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