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CT-1 Kenneth R. Chien* Department of Medicine, Center for Molecular Genetics, University of California, San Diego, School of Medicine, 9500 Gilman Drive, La Jolla, CA 92093, USA *corresponding author tel: 619-534-6835, fax: 619-534-8081, e-mail: [email protected] DOI: 10.1006/rwcy.2000.06006. SUMMARY cell hypertrophy assay led to the isolation of clones encoding the novel cytokine, CT-1. Althoughcardiotropin1(CT-1)wasisolatedusingan Structure in vitro assay system for cardiac cell hypertrophy, the expression pattern of CT-1 and pleiotropic activities suggestthatitmayhaveimportantfunctionsnotonly Sequence similarity data and structural considera- in the cardiac context, but in extracardiac tissues as tions suggested that CT-1 is a novel member of the well.TheanalysisofCT-1knockoutmicemaygiveus IL-6 family of cytokines. The members of the IL-6 further insights into its role in vivo. cytokine family are distantly related with regard to their primary amino acid sequence (14–24% amino acid identity), and are predicted to share a common four helix bundle topology. BACKGROUND Main activities and Discovery pathophysiological roles Theinitial characterizationofCT-1 was based on the CT-1 activates a distinct form of cardiac muscle cell development of an in vitro model system of cardiac hypertrophy from the phenotype seen after (cid:11)- muscle cell hypertrophy (Pennica et al., 1995a). As a adrenergic stimulation through the shared signaling basis for the isolation and characterization of novel subunit, gp130. In addition to its hypertrophic hypertrophic stimuli, a miniaturized high-throughput activity, it also enhances survival of cardiomyocyte hypertrophy assay system was developed in neonatal and different neuronal populations (see reviews by rat myocardial cells. In the initial search for novel Pennica et al., 1996b; Wollert and Chien, 1997). sourcesofcytokinesthatwouldactivatecardiacmyo- cyte hypertrophy, an in vitro model of embryonic GENE AND GENE REGULATION stem (ES) cell cardiogenesis was utilized. These toti- potent stem cells can differentiate into multicellular Accession numbers cystic embryoid bodies (EBs). Since these EBs spon- taneously beat and display cardiac-specific markers, it has been suggested that they may serve as a vital Mouse cDNA: GenBank U18366 (Pennica et al., sourceofnovelfactorsthatcaninduceahypertrophic 1995a) responseinvitroand/orinvivo.Inordertoidentifythe Rat cDNA: DDBJ, EMBL, and GenBank D78591 hypertrophic factor elaborated by mouse EBs, 6–7- (Ishikawa et al., 1996) day differentiated ES cells were used to prepare a Human cDNA: GenBank U43030 (Pennica et al., cDNA library in a mammalian expression vector. 1996a) Transfectionofpoolsofthislibraryinto293cellsand 50 flanking region of the human CT-1 gene: EMBL assay of the conditioned medium in the myocardial AJ002743 (Erdmann et al., 1998) 600 Kenneth R. Chien Chromosome location (C2/C7, Sol8, and 129CB3) CT-1 mRNA was detected by RT-PCR (Pennica et al., 1996c). Early in murine embryogenesis, there is preferential expres- The chromosomal location of the human CT-1 gene sion of CT-1 in the heart, with negative expression in was determined by fluorescence in situ hybridization the other embryonic tissues (Sheng et al., 1996). (FISH) and by hybridization to genomic DNA from Later, CT-1 expression becomes more widespread. somatic cell hybrid lines. Northern blotting with adult RNA reveals wide- By FISH, two spots indicative of CT-1 hybridiza- spread expression in a variety of cardiac and non- tion were found on the short arm of chromosome 16. cardiacsystems(Pennicaetal.,1995a,1996a;Ishikawa This hybridization was localized to the region et al., 1996; see Table 1). 16p11.1–p11.2 (Pennica et al., 1996a). Relevant linkages PROTEIN The leukemia-inhibitory factor (LIF) and oncostatin Sequence M (OSM) genes have been mapped to chromosome 22q12, and the ciliary neurotropic factor (CNTF), IL-6, and IL-11 genes are at 11q12, 7p21, and 19q13, See Figure 1. showing that the human CT-1 gene is not linked to other members of the IL-6 cytokine family. Description of protein Regulatory sites and corresponding Sequence similarity data and structural considera- transcription factors tions suggested that CT-1 is a novel member of the IL-6 family of cytokines. The members of the IL-6 The 50 flanking region of the human CT-1 gene has cytokine family are distantly related with regard to been cloned. Databank research revealed several cis- their primary amino acid sequence (14–24% amino active DNA elements (SP-1, CREB, C/EBP, AP-1- acid identity), and are predicted to share a common likeandAP-2-like,andGATA)intheproximal1.1kb four helix bundle topology. region (Erdmann et al., 1998). Discussion of crystal structure Cells and tissues that express the gene Analysis of the helices predicted for CT-1 based on thesequencealignmentindicatesthattheyareamphi- In undifferentiated myoblasts and differentiated pathic, as would be expected for a member of this myotubes prepared from three different muscle lines family. Table 1 Tissue distribution of RNA encoding CT-1 Mouse CT-1 mRNA (1.4kb) ++ Heart, skeletal muscle, liver, lung, kidney + Testis, brain (cid:255) Spleen Human CT-1 mRNA (1.7kb) ++ Heart, skeletal muscle, prostate, ovary + Lung, kidney, pancreas, thymus, testis, small intestine (cid:255) Brain, placenta, liver, spleen, colon, peripheral blood leukocytes Rat CT-1 mRNA (1.4kb) ++ Heart, skeletal muscle, lung, liver, stomach, urinary bladder + Brain, colon, testis (cid:255) Spleen, thymus CT-1 601 Figure 1 Alignment of mouse, human, and rat CT-1 protein sequences. A hCT-1 1 ...................MSRREGSLEDPQTDSSVSLLPHLEAKIRQTH hLIF 1 MKVLAAGVVPLLLVLHWKHGAOSPLPITPVNATCAIRHPCHNNLMNQIRS hCNTF 1 .............................MAFTEHSPLTPHRRDLCSRSI hCT-1 32 SLAHLLTKYAEQLLQEYVQLQGDPFGLPSFSPPRLPVAGLSAPAPSHAGL hLIF 51 QLAQLNGS-ANALFILYYTAQGEPF..PN.NLDKLCGPNVTDFPPFHANG hCNTF 22 WLARKIRSDLTALTESYVKHQGLNKNINLDSADGMPVA....STDQWSEL B C hCT-1 82 PVHERLRLDAAALAALPPLLDAVCRRQAE.LNPRAPRLLRRLEDAARQAR hLIF 97 TEKAKLVELYRIVVYLGTSLGNITRDQKI.LNPSALSLHSKLNATADILR hCNTF 68 TEAERLQENLQAYRTFHVLLARLLEDQQVHFTPTEGDFHQAIHTLLLQVA D hCT-1 131 ALGAAVEALLAALGAANRGPRAEPPAATASAASATGVFPAKVLGLRVCGL hLIF 146 GL...LSNVLCRLCSKYHVGHVD..VTYGPDTSGKDVFQKKKLGCQLLGK hCNTF 118 AFAYQIEELMILL..EYKIPRNE.ADGMPINVGDGGLFEKKLWGLKVLQE hCT-1 181 YREWLSRTEGDLGQLLPGGSA hLIF 191 YKQIIAVLAQAF........................ hCNTF 165 LSQWTVRSIHDLRFISSHQRGIPARGSHYIANNKKM Important homologies CELLULAR SOURCES AND TISSUE EXPRESSION TheaminoacidsequenceofCT-1hassomesimilarity with that of LIF (24% identity) and CNTF (19% Cellular sources that produce identity). These proteins are members of a family including OSM, IL-6, and IL-11. Although these Using antibodies directed against a CT-1 fusion cytokines share biological activities and receptor protein,ithasbeenshownthatCT-1ispredominantly subunits, alignment of the amino acid sequence of expressed in the primitive mouse heart tube at E8.5, CT-1 and other members of the IL-6 cytokine family while other tissues display a background level of ex- reveals that they are only distantly related in primary pression(Figure2).Withintheheart,CT-1isexpressed sequence (15–25% identity). There is little conserva- exclusively in the atrial and ventricular muscle seg- tion of the cysteine residues and only a partial ments of the heart tube, while the endocardium maintenance of the exon–intron boundaries, but they remains negative.Until E10.5,thehearttube remains are predicted to have similar tertiary structures con- the dominant site of CT-1 expression. This unique taining four amphipathic helices. CT-1, like CNTF, expression pattern cannot simply be explained by the lacks a hydrophobic N-terminal secretion signal se- fact that the heart is one of the first organs to form quence. The individual family members are more duringmammalianembryogenesis,sinceseveralother conservedacrossspecies(41–88%aminoacididentify embryonic structures, such as the neural tube, noto- from mouse to human). chord, and somites, are essentially negative. At later developmental stages (post-E11.5), the myocardium continues to express CT-1 at relatively high levels, Posttranslational modifications whereas most of the other organs, such as brain, kidney,andlung,displayrelativelylowlevelsofCT-1 Purified recombinant CT-1 produced in human 293 expression (Sheng et al., 1996) (Table 2). Thus, in cells migrated with an apparent molecular weight of contrast to other members of the IL-6 subfamily, 30kDa in western blots. It corresponds to a glycosyl- CT-1 appears to be expressed in a relatively cardiac- ated form of the 22kDa polypeptide (Pennica et al., restricted manner at a relatively early stage of 1996c). mouse cardiogenesis. Although LIF and CT-1 share 602 Kenneth R. Chien Figure 2 Expression of CT-1 during mouse cardiogenesis. (A) Immunofluorescence with an anti-CT-1 antibody in an E9.0 embryonic mouse heart. (B) Immunofluorescence with an anti-CT-1 antibody in an E14.0 embryonic mouse heart. HT, heart; V, ventricle; OT, outflow tract; AV, atrioventricular cushion; A, atrium. CT-1 603 Table 2 Tissue distribution of immunohistochemically detectable aCT-1 in later stages of mouse organogenesis Tissue Localization E11.5 E13.5 E15.5 Central nervous system Brain (cid:255) +/(cid:255) + Pituitary (cid:255) (cid:255) (cid:255) Choroid plexus ND (cid:255) + Peripheral nervous system Spinal cord (cid:255) (cid:255) + Dorsal root ganglia ++ ++ +++ Thymus gland (cid:255) (cid:255) (cid:255) Esophagus ND + ++ Cartilage ++ ++ +++ Tongue + +++ +++ Heart Atrial +++ +++ +++ Ventricle +++ +++ +++ Cushion tissues (cid:255) (cid:255) (cid:255) Outflow tract (cid:255) (cid:255) (cid:255) Arterial vasculature Smooth muscle + + + Skeletal muscle + ++ +++ Adrenal ND ++ +++ Kidney ND ND + Liver (cid:255) + +++ Skin + ++ +++ Lung Epithelial cells (cid:255) (cid:255) (cid:255) Smooth muscle cells +/(cid:255) + + Intestine Mucosal epithelium (cid:255) (cid:255) +/(cid:255) Smooth muscle cells + + + Testes ND ND + E(cid:136)Embryoageindays;ND(cid:136)notdetermined. overlapping in vitro biological effect on cardiac hypertrophic phenotype observed following G muscle cells, LIF is expressed at high levels only in protein-dependent stimulation with (cid:11)-adrenergic the uterus and weakly in other tissues, including the agonist (phenylephrine, Phe), endothelin-1 (ET-1), myocardium. and angiotensin II (AngII) (Wollert et al., 1996). On For a cellular source, CT-1 is detected in the asingle-celllevel,heterotrimericGprotein-dependent conditioned medium of EB and the differentiated pathways induce a form of hypertrophy with a rela- C2/C7 myotubes (Pennica et al., 1996c). tively of new myofibrils in parallel. In contrast, CT-1 inducesanincreaseinmyocytesizecharacterizedbya marked increase in cell length, but little or no change IN VITRO ACTIVITIES in cell width. To characterize the effects of gp130-dependent In vitro findings stimulation on the myofibrillar cytoarchitecture, cardiomyocytesweredual-stainedforthick((cid:11)myosin Cardiomyocyte: CT-1 Induced Myocardial Cell heavy chain) and thin (F-actin) myofilaments, and Hypertrophy viewedbyconfocallasermicroscopy.Cardiomyocytes We have provided clear evidence that CT-1-induced stimulated with CT-1 and LIF displayed a high hypertrophic phenotype is distinct from the degree of myofibrillar organization: myofibrils were Figure3 Sarcomericorganization.Neonatalratventricularcardiomyocyteswereplatedwith1nMCT-1,1nMLIF,100mMphenylephrine(Phe)andnoaddition(Cont.). Cells were labeled with rhodamine phalloidine. CT-1 605 organized in a strictly sarcomeric pattern, oriented The transfection of a MAP kinase kinase 1 (MEK1) along the longitudinal cell axis, and extended to the dominant negative mutant cDNA into myocardial cell periphery (Figure 3). Importantly, the increase cells blocked the antiapoptotic effects of CT-1, in cell size and length was not accompanied by a indicating a requirement of the MAP kinase pathway changeintheaveragesarcomerelength,stronglysug- for the survival effect of CT-1. A MEK-specific gesting that the cell elongation in response to CT-1 inhibitor (PD098059) is capable of blocking the acti- results from an addition of new sarcomeric units in vationofMAPkinase,aswellasthesurvivaleffectof series. CT-1. In contrast, this inhibitor did not block the On a molecular level, gp130-dependent stimulation activationofSTAT3,nordidithaveanyeffectonthe and (cid:11)-adrenergic stimulation result in distinct pat- hypertrophic response elicited following stimulation terns of embryonic gene myosin light chain 2v of CT-1. Therefore, CT-1 promotes cardiac myocyte (MLC2v), and immediate-early gene expression. The survival via the activation of an anti-apoptotic sig- reactivation of an embryonic pattern of gene expres- naling pathway that requires MAP kinases, whereas sion is a central feature of cardiomyocyte hypertro- the hypertrophy induced by CT-1 may be mediated phy. Members of the embryonic gene program, such by alternative pathways, e.g. JAK kinase/STAT or as atrial natriuretic peptide (ANP) and skeletal (cid:11)- MEK kinase/c-Jun N-terminal protein kinase. actin, are abundantly expressed in the ventricular With regard to the downstream CT-1 inducing the myocardium during embryonic development, but target that mediates antiapoptotic events, the treat- their expression is downregulated shortly after birth. ment of cultured neonatal cardiomyocytes with CT-1 Stimulation of cardiomyocytes with CT-1 induced induces the enhanced synthesis of the heat shock ANP and brain natriuretic peptide (BNP) gene proteins hsp70 and hsp90, with hsp70 levels being expression (Kuwahara et al., 1998). However, in con- enhanced 3-fold and hsp90 levels being enhanced trastto(cid:11)-adrenergicstimulation,CT-1didnotinduce 7-fold. Such CT-1-treated cells are protected against skeletal (cid:11)-actin expression. Growth factors, signaling subsequent exposure to severe thermal or ischemic through G protein-coupled receptors, including (cid:11)- stress (Stephanou et al., 1998). adrenergic agonists, ET-1, and AngII, induce ANP, BNP, and skeletal (cid:11)-actin in a coordinate fashion. A HepG2 and H35 (Hepatocyte-derived Cell Line) recent study compared the expression pattern of distinct members of the embryonic gene program in CT-1 elicits a dose-dependent induction of protein pressure overload versus volume overload hypertro- synthesis in primary rathepatocytes, with effective phy in vivo in the rat myocardium. As shown prev- concentrations ranging from 0.1 to 100ng/mL iously, pressure overload resulted in the coordinate (Richards et al., 1996). Production of a number of induction of ANP and skeletal (cid:11)-actin. However, acute-phase proteins, including haptoglobin, fibrino- volume overload hypertrophy was associated with a gen, (cid:11) -acid glycoprotein, (cid:11) -macroglobulin, (cid:11) - 1 2 1 selective increase in ANP expression, and no induc- cysteine proteinase inhibitor ((cid:11) -CPI), (cid:11) -proteinase 1 1 tionofskeletal(cid:11)-actin,suggestingthattheregulation inhibitor((cid:11) -Pi),wasmarkedlyincreasedat48and72 1 of distinct embryonic genes in vivo is related to the hours of cytokine stimulation (Peters et al., 1995). In hypertrophicstimulus.Thepatternofembryonicgene rat H35 cells, CT-1 stimulated (cid:11) -Pi and (cid:11) -CPI 1 1 expression inducedby CT-1 incardiomyocyteculture protein production and upregulated (cid:11) -CPI mRNA 1 therefore resembles the pattern observed in volume levels with similar potency. These results show that overload hypertrophy. CT-1isastrongacute-phasemediatorforrathepato- cytes in vitro. Cardiomyocyte: CT-1 Promotes Cardiac Neuronal Cell Myocyte Survival TheabilityofCT-1toinducethephenotypicswitchin Recent studies have demonstrated that CT-1 is also neuronsfromnoradrenergictocholinergic–achange able markedly to promote the survival of either that is accompanied by the induction of several neu- embryonic or neonatal cardiac myocytes at subnano- ropeptides, including substance P, somatostatin, and molar concentrations (Sheng et al., 1997) (Figure 4). vasoactive intestinal polypeptide in the transmitter To explore the potential downstream pathways that phenotype – was determined with cultured rat sym- might be responsible for this effect, we documented pathetic neurons. CT-1 inhibited the tyrosine hydro- that CT-1 activated both signal transducer and xylase activity (a noradrenergic marker) and slightly activator of transcription 3 (STAT3)- and mitogen- stimulated the choline acetyltransferase activity (a activatedprotein (MAP) kinase-dependentpathways. cholinergic marker) of these cells, effects that Figure4 InhibitionofapoptosisincardiacmyocytesbyCT-1after5daysofserumdeprivation.A–C,inthepresenceofCT-1;D–F,intheabsenceofCT-1.AandD, stainedwithMLC-2Vantibody.BandE,TUNEL-stainedmyocytes.CandF,nuclearstainingwithHoescht33258dye.Arrowsshowcellswithevidenceofapoptosis, including chromatin condensation and nuclear fragmentation. CT-1 607 paralleled the actions of LIF. Thus, CT-1 is active in Regulatory molecules: inhibitors modulating the phenotype of sympathetic neurons and enhancers (Pennica et al., 1995b). Using the possibilities for long-term analysis, motoneurons were cultured in the presence and The introduction of mutations into human LIF that absence of CT-1 for periods up to 16 days in vitro reduced the affinity for gp130 while retaining affinity (Pennica et al., 1996c). In the presence of CT-1, for LIFR has generated antagonists for LIF. In the motoneurons developed rapidly in culture and after recent study by Vernallis et al. (1997), a LIF antag- 3 days had developed long axons and multipolar onistthatwasfreeofdetectableagonisticactivitywas morphology. After longer periods in the presence of tested for antagonism against the family of LIFR CT-1, morphological development of motoneurons ligands. On cells that express LIFR and gp130, all was even more pronounced. At 9–11 days of culture, LIFR ligands including CT-1 were antagonized. surviving neurons showed a highly multipolar mor- Ligand-triggered tyrosine phosphorylation of both phology, with axon-like processes often several milli- LIFR and gp130 was blocked by the antagonist. The meters in length and tapering, and displaying thick antagonist is therefore likely to work by preventing dendrite-likeprocesseswithmanysecondarybranches. receptor oligomerization. The theoretical age of E14 motoneurons cultured for 11 days was postnatal day 4; their morphology suggests that many aspects of their maturation Bioassays used occurred normally in culture in the presence of CT-1. Insixindependentexperimentscountedbetween9and In brief, ventricular cardiac myocytes were isolated 16 days of culture, the fraction of motoneurons sur- fromneonatalratsbycollagenasedigestionandPercoll viving in the presence of CT-1 was 43%(cid:6)1%. The gradient purification. These cells were suspended at corresponding value for cultures without trophic 75cells/mL in Dulbecco’s modified Eagle’s medium/ factor was 6%(cid:6)2%. In the same experiment, glial Ham’s nutrient mixture F-12 supplemented with cell line-derived neurotrophic factor (GDNF), the mostpotentsurvivalfactorformotoneuronsinshort- transferrin, insulin, aprotinin, L-glutamine, penicillin, and streptomycin and were plated in aliquots of term culture, maintained only 24%(cid:6)6% of moto- 200mL in a 96-well plate that had been previously neurons that initially developed in culture. coated with supplemented DMEM/F-12 containing Unlike CNTF, CT-1 was found to promote the 4% fetal bovine serum for 8 hours at 37(cid:14)C. After survivalofratdopaminergicneurons,althoughitwas culture for 24 hours, test substances (ex. CT-1) were not as potent as GDNF (Pennica et al., 1995b). added, and the cells were cultured for an additional Interestingly, the synergic effect of CT-1 and 48 hours. The cells were then stained with crystal GDNF was reported. Study on the survival of puri- violet, and the hypertrophy was scored visually. fied embryonic day 14.5 rat motoneurons in culture For historical reasons, a score of 3 is given to cells indicatesGDNFfromtheSchwanncelllineandCT-1 incubated without a hypertrophy factor; a score of from a muscle cell line in this synergy. Their expres- 7 is for maximal hypertrophy, such as that induced sion in the environment of the motoneuron is com- by 0.1mM phenylephrine. The activity of CT-1 can partmentalized: GDNF transcripts are expressed be detected with 0.1nM (Pennica et al., 1995a) principally in Schwann cell lines, whereas CT-1 (Table 3). mRNA is present in myotubes. Blocking antibodies to GDNF inhibit the trophic activity of Schwann cell line-conditioned media by 75%, whereas CT-1 antibodies diminish the myotube-derived activity by IN VIVO BIOLOGICAL 46%. CT-1 and GDNF actsynergistically toenhance motoneuron survival in vitro. GDNF and CT-1, ACTIVITIES OF LIGANDS IN therefore, are major components of the trophic sup- ANIMAL MODELS port provided by the Schwann and muscle cells, respectively (Arce et al., 1998). Normal physiological roles Others TheeffectsofchronicadministrationofCT-1tomice CT-1 inhibits the growth of a mouse myeloid (0.5 or 2mg by intraperitoneal injection, twice a day leukemia cell line, M1 and the differentiation of for 14 days) were previously reported (Jin et al., mouse embryonic stem cells (Pennica et al., 1995b). 1996). 608 Kenneth R. Chien Table 3 Hypertrophy score Test cytokine Concentration (nM) Hypertrophy scorea EB conditioned mediumb 3c 7 Unconditioned medium 3c 3 None 0 3 CT-1 fusion 0.05 6 0.1 5 0.25 6 0.5 6.5 1.0 7 Mouse LIF 0.05 4 0.25 5.5 2.5 6 Human IL-11 0.1 3.5 0.2 4.5 0.5 4.5 1.0 4.5 2.0 5.5 Human OSM 6.25 4.5 12.5 4.5 25 5 50 6 Mouse IL-6 50 3.5 100 3.5 Rat CNTF 25 4 100 4 Endothelin 1 5 10 5 100 5 Angiotensin II 10 3 100 3 1000 3 aAscoreof3isnohypertrophy;7ismaximalhypertrophy. bConditionedmediumof6-to7-dayembryoidbodies. cFoldconcentrationofthemedium. General Observations Effects of CT-1 on the Heart There was no difference in body weight before and after treatment. Mice injected with CT-1 did not A dose-dependent increase in both the heart weight exhibit behavioral changes. andventricularweighttobodyratioswasobservedin

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