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Vascular Biology |
From the Molecular Oncology Laboratory (V.A.C., A.L.H.) and Molecular Angiogenesis Laboratory (L.L.N., R.B.), Cancer Research UK, the Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Oxford, UK.
Correspondence to Adrian L. Harris, John Radcliffe Hospital, Headington, Oxfordshire, OX3 9DS United Kingdom. E-mail aharris.lab{at}cancer.org.uk
| Abstract |
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Methods and Results K2P inhibited basic fibroblast growth factor-induced human endothelial cell proliferation and migration. Inhibition was not dependent on the protease activity of K2P because similar results were obtained with catalytically inactivated K2P. Purification of the kringle 2 domain derived from elastase cleavage of K2P at the Arg275Ile276 bond revealed that inhibition was mediated by this domain. In addition, K2P inhibited angiogenesis in vivo and increased endothelial cell apoptosis.
Conclusions Wound healing and angiogenesis are severely compromised by K2P. These data provide new mechanistic insights into the bleeding complications observed in some patients while undergoing thrombolytic therapy with this drug. In addition, we identify the kringle 2 domain of tPA as a novel target for antiangiogenic therapy.
In this study, we report that wound healing and angiogenesis are compromised with the fibrinolytic drug, Reteplase, and show that these effects are critically dependent on the kringle 2 domain. These data provide new mechanistic insights into the bleeding complications that can occur in some patients with this drug.
Key Words: antiangiogenesis reteplase kringle 2 endothelial cells wound healing
| Introduction |
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Kringles are triple-loop structures of
80 amino acids.7 Recent studies have shown that isolated kringle domains of proteins involved in the hemostatic system are antiangiogenic. These include plasminogen, which has 5 kringle domains,8 hepatocyte growth factor, which has 4,9 prothrombin, which has 2 kringles,10 and urokinase plasminogen activator (uPA), which has just 1.11 Angiostatin, consisting of kringles 1 to 4 of plasminogen, was first shown to inhibit basic fibroblast growth factor (bFGF)-mediated endothelial cell proliferation and tumor angiogenesis.12 Further studies have shown that the individual plasminogen kringles have varying efficacy on endothelial cells. Kringles 1 to 3 and kringle 5 inhibit endothelial cell growth,13,14 whereas the kringle 4 domain is a weaker inhibitor of cell growth but significantly blocks endothelial cell migration.13,15 Angiostatin-specific binding sites have been identified on endothelial cells, including ATP-synthase and angiomotin,16,17 and it has been reported that angiostatin induces apoptosis in endothelial cells,18 suggesting a potential mechanism of action. In support of this is a recent study that links the specific binding of kringles 1 to 5 of plasminogen to ATP-synthase on endothelial cells with induction of apoptosis and caspase activation.19
Recently, the combined kringle 1 to 2 domains of tPA were expressed in a bacterial and yeast expression system and were shown to inhibit bFGF-stimulated endothelial cell proliferation.20 However, the individual contributions of the kringle 1 and 2 domains of tPA on angiogenesis were not investigated in this study or the mechanism of action. In this report, we describe that the fibrinolytic drug, K2P, inhibits endothelial cell growth, migration, and in vivo angiogenesis. We show that inhibition is dependent on the kringle 2 domain and that K2P induces endothelial cell apoptosis in vivo.
| Materials and Methods |
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Purification of tPA Kringle 2 Domain
K2P was incubated with porcine pancreatic elastase in a molar ratio of K2P:elastase of 3.5:1 overnight at room temperature with gentle shaking. The digest was extensively dialyzed against column binding buffer (50 mmol/L tris-HCl, 50 mmol/L NaCl, pH 7.7) before addition of 1 mmol/L final concentration DTT and incubated for 3 hours at 37°C. Thereafter, the digest was applied to a lysine-Sepharose column previously equilibrated with binding buffer, washed, and the adsorbed kringle 2 domain was eluted in binding buffer containing 0.2 mol/L
-amino-n-caproic acid. Eluted kringle 2-containing fractions were pooled and dialyzed with binding buffer to remove
-amino-n-caproic acid. To confirm purity, eluted kringle 2 was analyzed by SDS-PAGE, N-terminal sequence analysis, Western blot with polyclonal anti-tPA IgG #387 (American Diagnostica), and monoclonal antikringle 2 antibody 7VPA (Technoclone Inc) at 1:1000 and 1:100 dilutions, respectively. Correct conformation of kringle 2 was confirmed by nuclear magnetic resonance. Possible contaminating endotoxin was removed from K2 preparations with PROSEP-RemTox (Millipore) according to manufacturers instructions.
Inactivation of K2P
Twenty-five mU K2P was catalytically inactivated with 2 rounds of either 2 mmol/L PMSF or 100 µmol/L PPACK, each for 1 hour at 37°C in inactivation buffer (50 mmol/L tris-HCl, pH 7.4, 100 mmol/L NaCl, 100 mmol/L L-arginine, 5 mmol/L EDTA, and 0.01% tween 80), followed by extensive dialysis with the same buffer to remove excess inhibitor. To confirm inhibition of protease activity, 10 µL K2P were incubated with 50 µL Spectrozyme tPA chromogenic substrate (American Diagnostica) and 40 µL assay buffer (25 mmol/L tris-HCl, 200 mmol/L NaCl, pH 8.4) for 10 minutes at 37°C. Absorbance was measured at 405 nm.
In Vitro Cell Proliferation Assays
Cells (3x103) were seeded in 96-well plates and allowed to attach overnight. Cells were left in minimal growth medium (M199 with 2% FBS) for 24 hours. Thereafter, reagents were added to wells and incubated for 4 days. Cell number was quantified colorimetrically by the addition of 20 µL CellTiter 96 AQueous One Solution Cell Proliferation Assay (Promega) and measured at absorbance 492 nm.
Endothelial Cell Migration Assay
Endothelial cell migration was analyzed in a scratch wound assay as previously described with some modifications.21 Endothelial cells (1x106) were seeded onto gelatin-coated 3.5-cm dishes and left overnight. Media was aspirated the next day and cells were scratched with a P200 pipette tip along the diameter of the dish. Cells were washed twice with PBS before addition of fragments of tPA in M199 and low serum (5% FBS) and incubated at 37°C and 5% CO2. Wound diameters were photographed at t=0, t=24 hours, and t=48 hours. Wound closure was determined by measuring the diameter of wounds at 3 equidistant points along the length of wounds and was expressed as a percentage of wound diameter at the start of the experiment.
Mouse Sponge Angiogenesis Assay
C57 black mice were implanted with a sterile polyether sponge (15x5x5 mm) under the dorsal skin as previously described.22 PBS, bFGF, or test reagents were injected daily through the skin into the sponge in a volume of 100 µL for 20 days. Sponges were dissected on day 21 and fixed in 3.7% formaldehyde, embedded in paraffin, cut in sections of 4 µm, and stained with hematoxylin and eosin. Morphometric analysis of fibrovascular growth (microvessels and fibroblasts) into sponges was performed as previously described with some modifications.23 A grid graticule of 1-mm2 divisions with a total field area of 100 mm2 was used to determine the volume fraction of fibrovascular growth contained in sponges.
Immunohistochemistry
Dewaxed and rehydrated paraffin sections were processed for immunohistochemistry as previously described with some modifications.22 Sections were microwaved in antigen retrieval buffer (0.01 mol/L sodium citrate, pH 6) for 15 minutes before incubation with ratanti-mouse CD34 IgG (Ab8158; Abcam) or antiKi-67 (Vector Labs). Sections were subsequently incubated with biotinylated anti-rat IgG (DAKO) and horseradish peroxidase-conjugated avidinbiotin complex (DAKO) before staining with DAB (Sigma) and counterstaining with 50% Mayer hematoxylin. The total number of vessels in CD34-stained sponges were counted at x20 magnification in 4 representative fields per sponge and data are given as mean±SD.
Apoptosis Assay
Apoptosis was determined on dewaxed and rehydrated sections with an in situ cell death detection kit (Roche) by means of terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL) staining according to manufacturers instructions. Briefly, sections were microwaved with 0.1 mol/L sodium citrate, pH 6, for 5 minutes before incubation with 0.1 mol/L tris-HCl, pH 7.5, containing 3% bovine serum albumin and 20% normal bovine serum for 30 minutes at room temperature. Slides were rinsed in PBS and incubated with 50 µL TUNEL reaction mixture for 1 hour at 37°C. Slides were rinsed with PBS, incubated with 50 µL converter POD for 30 minutes at 37°C, rinsed again, and processed with metal-enhanced DAB substrate (Sigma). Apoptotic cells displayed a strong blue/black nuclear stain and were counted at x40 magnification in 3 representative fields per sponge.
| Results |
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30 kDa and 10 kDa. Complete cleavage of K2P was obtained at a molar ratio of 10:1 K2P:elastase (Figure IA, available online at http://atvb.ahajournals.org). N-terminal sequence analysis revealed that elastase cleaved K2P at the Arg275Ile276 bond, the activation cleavage site of single-chain tPA to 2-chain tPA. The N-terminus of the 30-kDa band was identified as IKGGLF corresponding to residues 276 to 281 of the protease domain of tPA and that of the 10-kDa band as SYQGN corresponding to the Ser-Tyr-Gln segment followed by Gly176 and Asn177 of kringle 2 of tPA. We purified this kringle 2 fragment (Ser-Tyr-Gln-Gly176-Arg275) by lysine-Sepharose affinity chromatography. SDS-PAGE revealed that the protease domain initially coeluted with the kringle 2 domain (Figure IB, lane 5), indicating that this domain was still attached to the kringle 2 module most likely by the Cys264-Cys395 disulphide bond. Western blot with an anti-elastase antibody showed that the eluted material was not contaminated with elastase (Figure IC, lane 5). Eluted material from lane 5 was subsequently treated with 1 mmol/L DTT to selectively reduce the Cys264-Cys395 disulphide bond for 3 hours at 37°C. The conditions of DTT treatment were obtained by carefully optimizing the concentration of DTT, kinetics, and temperature conditions to effectively separate the kringle 2 domain from the protease domain without compromising the conformational integrity of the kringle 2 module. Final separation of the kringle 2 domain from the protease domain was achieved after a further purification round on lysine-Sepharose. Purity of kringle 2 preparations was confirmed by Western blot with polyclonal anti-tPA IgG (Figure ID, lane 3) and with monoclonal anti-K2 IgG (data not shown).
Fragments of tPA Inhibit Endothelial Cell Proliferation
K2P was incubated with human umbilical vascular endothelial cells (HUVECs) for 4 days at increasing concentrations in the presence of bFGF. Figure 1A shows that K2P significantly decreased bFGF induced endothelial cell proliferation. Similar results were obtained with HDMEC and BAMEC (data not shown). This effect was specific for endothelial cells because no inhibition of cell growth was observed with vascular smooth muscle cells, normal fibroblasts (MRC-5), or the breast and prostate tumor cell lines MCF-7 and DU145, respectively (Figure 1D). To determine whether the inhibition of bFGF-induced endothelial cell proliferation was dependent on the proteolytic activity of K2P, it was catalytically inactivated so that it was no longer able to activate plasminogen. Catalytically inactivated K2P (K2Pi) also significantly inhibited bFGF-induced HUVEC growth in a similar manner to K2P (Figure 1B), indicating that the proteolytic activity of K2P was not responsible for the inhibition of cell growth observed. The inhibition of bFGF-induced cell growth mediated by K2P and K2Pi was comparable to that of kringles1 to 4 of plasminogen (angiostatin) (Figure 1C). Figure 1E shows the effects of full-length wild-type rtPA on HUVECs, MCF-7, and DU145 cells for comparison. Inhibition of bFGF-mediated HUVEC proliferation was observed with rtPA, but this was not specific for endothelial cells because a similar degree of inhibition was obtained with both MCF-7 and DU145 cells. This indicates there was no specific endothelial cell inhibition by wild-type tPA.
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To determine whether the kringle domain of K2P was responsible for the inhibition observed, K2P was incubated with HUVECs in the presence of an antikringle 2 antibody. Figure 2A shows that the inhibitory activity of K2P was reversed in the presence of antikringle 2, indicating that the kringle 2 domain mediated the inhibition of HUVEC proliferation. This was confirmed with the purified kringle 2 domain obtained from elastase cleavage of K2P. Purified kringle 2 significantly inhibited both vascular endothelial growth factor (VEGF)-induced and bFGF-induced HUVEC growth (Figure 2B). Specificity of the kringle 2-mediated effects for endothelial cells was confirmed as no inhibition of K2 was observed with the nonendothelial cell types, human vascular smooth muscle cells, Bowes melanoma cell line, and the human fibrosarcoma cell line HT-1080 (Figure 2C).
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Fragments of tPA Inhibit Endothelial Cell Migration
Endothelial cell migration was analyzed in a scratch wound assay. Figure 3A shows the effects of K2P on microvascular PMBEC migration. All wound diameters were similar after initial scraping of cells (t=0 hour). K2P inhibited cell migration in a time-dependent and concentration-dependent manner. Graphical representation is given in Figure 3B. At 24 hours and 48 hours after cell scraping, statistically significant inhibition of cell migration was observed with 2.5 µmol/L K2P. Figure 3C shows the effects of K2P, K2Pi, and K2 on VEGF-stimulated and bFGF-stimulated HUVEC migration. All fragments of tPA significantly inhibited HUVEC migration to a similar extent.
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Fragments of tPA Inhibit Angiogenesis
After confirming that both human and mouse endothelial cell migration was inhibited in vitro by kringle 2-containing fragments of tPA, we analyzed their effects in a mouse sponge angiogenesis model in vivo. Purified kringle 2 at 0.1 µmol/L, 1 µmol/L, or 5 µmol/L was administered daily into sponges for a total of 20 days, either in the absence or presence of daily injections of bFGF. Control treated sponges received daily injections of PBS alone or daily injections of bFGF as a positive control. Specific CD34 vessel staining allowed quantification of the number of microvessels contained within sponge sections. The mean number of vessels±SD determined in 0.1 µmol/L, 1 µmol/L, or 5 µmol/L K2-treated sponges in the absence of bFGF was 7.5±4.7, 4.5±1.3, and 1.5±0.6, respectively, which was statistically significant (P<0.05, ANOVA, n=4). A similar trend was observed in the presence of bFGF, where the mean number of vessels±SD determined in 0.1 µmol/L, 1 µmol/L, or 5 µmol/L K2-treated sponges was 13.8±1.9, 5.3±1.5, and 1.5±1.0, respectively (P<0.01, ANOVA, n=4). Figure 4 shows representative hematoxylin and eosinstained (left panel) and CD34-stained (right panel) sections of sponges treated with PBS, bFGF, or bFGF and 5 µmol/L K2. As well as a significant decrease in bFGF-induced angiogenesis in the sponge assay, it was also observed that the extent of invading mouse stromal tissue that had migrated into the sponge was also inhibited by K2P and purified kringle 2. The volume fraction of fibrovascular growth of K2P-treated sponges was consistently <50% of the total available growth area. Control sponges from mice treated with PBS or bFGF typically displayed volume fractions of fibrovascular growth in the region of 70% and 95%, respectively.
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We wanted to identify potential mechanisms of action of K2P on angiogenesis inhibition. Kringle domains of plasminogen have been shown to induce apoptosis of endothelial cells.18 To identify whether K2P could also induce apoptosis in vivo, TUNEL staining was performed on K2P-treated sponges. Representative sections of sponge are given in Figure 5 for TUNEL (left panel) and Ki-67, which was used as a marker of proliferation (right panel). No difference in the number of Ki-67stained cells was found between K2P-treated sponges and control treated; however, the mean number±SD of apoptotic cells was significantly greater in K2P-treated sponges (34±8) as compared with PBS-treated controls (17±4, P<0.05) (Figure II and Table I, available online at http://atvb.ahajournals.org). We also compared the effects of wild-type rtPA, both in the presence and absence of bFGF, and found no endothelial cell apoptosis in rtPA-treated sponges.
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| Discussion |
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Human and mouse endothelial cell migration was significantly reduced in a scratch wound assay after treatment with K2 containing tPA fragments, as was in vivo angiogenesis in a mouse sponge angiogenesis assay. Of particular interest was the very significant reduction of mouse stromal fibroblasts that had invaded into sponges after tPA fragment treatment. We found no effects of K2P on normal fibroblast proliferation in vitro or Ki-67 proliferating cells in vivo indicating that the reduction of total fibrovascular growth in sponges was not caused by toxicity, but most likely caused by the significant loss of vascularity in the sponges. In support of this are previous studies using disc25 and sponge23 angiogenesis models, which have shown that fibrovascular growth in these models is directly proportional to vessel growth, suggesting a dependency of fibroblast density on the number of blood vessels. In addition, we have also demonstrated increased overall apoptosis in the K2P-treated sponges, both in the absence and presence of bFGF, suggesting a potential mechanism of action of K2P. Although we observed inhibition by wild-type tPA in our assays, this was not specific for endothelial cells and may have been caused by other mechanisms, such as proteolytic degradation. That different mechanisms were in operation is supported by the fact that we found no endothelial cell apoptosis with wild-type tPA in the sponge assay. This indicates that the antiangiogenic activity is differentially available in K2P. Figure III (available online at http://atvb.ahajournals.org) compares the amino acid sequence of the K2 domain of tPA with kringle domains of plasminogen, uPA, and with the kringle 1 domain of tPA. K2 of tPA has the highest identity with K1 of tPA (53%) and with the kringle domain of uPA (47%). Considerable sequence identity is also observed with the kringle domains of plasminogen (37% to 43%). Despite these similarities, a common structural motif that might confer the antiangiogenic properties of kringle domains has not been determined. However, it cannot be excluded that the antiangiogenic activity is caused by the secondary structure of these domains in their interaction with the endothelial cell surface.
tPA fibrinolytic drugs are used to treat acute myocardial infarction, pulmonary embolism, and stroke.5 However, complications of fibrinolytic therapy include bleeding, of which intracranial hemorrhage is the most serious. K2P has a reduced plasma clearance and prolonged half-life compared with full-length tPA as the finger, epidermal growth factor-like domain, and the kringle 1 domain, which confer recognition by clearance receptors, have been deleted. Loss of the finger domain also results in decreased fibrin specificity of K2P that can lead to more extensive systemic plasminogen activation and bleeding. Our data suggest that inhibition of endothelial cell growth and migration of cells into areas of damaged endothelium may contribute to bleeding complications observed during thrombolytic therapy with Reteplase. In addition, our findings suggest that the kringle 2 domain of tPA may have use as an angiogenic inhibitor, which we are currently evaluating as a therapeutic target.
| Acknowledgments |
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| Footnotes |
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Received April 9, 2004; accepted January 19, 2005.
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