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J Biol Chem, Vol. 274, Issue 33, 23541-23548, August 13, 1999
From the Yamanouchi Research Institute, Littlemore Park, Armstrong
Road, Oxford OX4 4SX, United Kingdom
Several members of the ABC family of proteins
have been implicated in multidrug resistance associated with cancer
therapies. A novel member of this gene family, designated pABC11, has
been identified using degenerate polymerase chain reaction. The
full-length cDNA spans 5881 base pairs and encodes an open reading
frame of 1437 amino acids predicted to contain two sets of
transmembrane domains and two nucleotide binding domains characteristic
of ABC proteins. The nucleotide sequence described herein extends that of three recently reported sequences, MRP5 (Kool, M., de Haas, M.,
Scheffer, G., Scheper, R., van Eijk, M., Juijn, J., Baas, F., and
Borst, P. (1997) Cancer Res. 57, 3537-3547), SMRP (Suzuki, T., Nishio, K., Sasaki, H., Kurokawa, H., Saito-Ohara, F., Ikeuchi, T.,
Tanabe, S., Terada, M., and Saijo, N. (1997) Biochem. Biophys. Res. Commun. 238, 790-794), and MOAT-C (Belinsky, M., Bain, L., Balsara, B., Testa, J., and Kruh, G. (1998) J. Natl. Cancer
Inst. 90, 1735-1741), in the 5' direction. Northern blot
analysis detected five transcripts that were differentially expressed
in several tissue types, and the gene encoding pABC11 was mapped to
chromosome 3. Confocal imaging of HEK293 cells expressing a green
fluorescent protein-pABC11 construct confirmed plasma membrane
localization of the fusion protein. Overexpression of pABC11 resulted
in reduced labeling with the fluorochromes 5-chloromethylfluorescein
diacetate, fluorescein diacetate, and 2',7'-bis-(2-carboxyethyl)-5
(and-6)-carboxyfluorescein acetoxymethyl ester but not with calcein or
rhodamine derivatives, consistent with pABC11 being an anion
transporter. Fluorochrome export was ATP-dependent but
glutathione-independent. We also show that this export pump does not
confer resistance to various classes of cytotoxic drugs but does
provide small but significant resistance to CdCl2 and
potassium antimonyl tartrate.
The ABC gene family encodes a group of structurally related
proteins typically composed of one or two transmembrane domains (containing several membrane spanning regions) and one or two nucleotide binding domains characterized by Walker motifs (A and B) and
an ATP-binding cassette signature (1, 2). Although structurally
homologous, diverse biological functions have been ascribed to
different members of this gene family. Some ABC proteins are involved
in ion channel formation and/or regulation, such as the sulfonylurea
receptors (SUR1, SUR2A, and SUR2B), which form KATP
channels (3), and cystic fibrosis transmembrane conductance regulator,
which functions as a chloride channel (4). Other members of this family
are known to confer resistance to toxic substances. In
Saccharomyces cerevisiae yeast cadmium resistance factor
(YCF1) contributes to CdCl2, antimony and arsenic
resistance and has been shown to transport the glutathione-arsenic
complex (5, 6). Studies in Caenorhabditis elegans have shown
that targeted inactivation of the homologue of human multidrug
resistance-associated protein
(MRP),1 mrp-1,
results in increased sensitivity to both CdCl2 and
NaAsO2 (7). P-glycoprotein (Pgp) and MRP are known to be
involved in the resistance of some cancerous cell lines to certain
cytotoxic drugs (8-11). Although these two proteins share only
approximately 18% amino acid identity, they are both able to confer
resistance to a broad spectrum of cytotoxic agents. There is some
overlap in the substrate specificities of Pgp and MRP, although the
latter has a preference for more anionic substrates, particularly
glutathione conjugates (11). However, with observations that drug
resistance can often occur in cells not expressing Pgp or MRP, it has
become increasingly apparent that these two drug pumps alone cannot
account for all of the drug resistance observed. Recently, other ABC
proteins have been implicated, including BCRP in anthracycline
resistance and MXR1 and MXR2 in mitoxantrone resistance (12-14).
Additional members of the MRP family have also been described (15, 16), and investigations have shown that MRP2 (canalicular multispecific organic anion transporter (cMOAT)), when overexpressed in Madin-Darby canine kidney cells, has drug export activity (17). Therefore, it seems
that the resistance profile of a given cell line may well involve the
activity of several different efflux pumps, and an understanding of the
substrate specificity of candidate drug resistance genes would help to
unravel the complexities of multidrug resistance.
In this study, we isolated a novel member of the ABC gene family,
designated pABC11, using a degenerate polymerase chain reaction strategy. During the course of our work, an almost identical sequence, MOAT-C, has been published (18); therefore, differences between the two
sequences will be highlighted in this paper. Our sequence also extends
that of an expressed sequence tag (277145) previously identified as an
ABC protein (19), which Kool et al. (15) termed MRP5.
Examination of a panel of drug-resistant cell lines revealed that MRP5
was up-regulated in three cisplatin-resistant lines but unchanged in
others, leading to the conclusion that the role of MRP5 in this kind of
drug resistance is uncertain (15). In this study, we have developed a
stable cell line that overexpresses pABC11 (MOAT-C/MRP5), examined the
subcellular localization of the heterologous protein, and investigated
whether it is able to confer resistance to cytotoxic agents. Our
results demonstrate that expression of pABC11 results in increases in
fluorochrome transport and resistance to certain heavy metal compounds.
Cloning of pABC11--
1 µg of human pancreas total RNA
(CLONTECH) was reverse transcribed using
Superscript II reverse transcriptase (Life Technologies, Inc.) and an
oligo(dT)16 primer (Perkin-Elmer). This first strand cDNA was used as a template for polymerase chain reaction using degenerate primers NDG1 (5'-1) and NDG4 (3'-1) (20). AmpliTaq polymerase (Perkin-Elmer) was used with the following cycling parameters: 2 cycles of 94 °C for 30 s, 45 °C for 30 s,
and 72 °C for 30 s followed by 33 cycles of 94 °C for
30 s, 50 °C for 30 s, and 72 °C for 30 s and 1 cycle of 72 °C for 5 min. A diagnostic restriction digest
(HindIII and BamHI) was used to eliminate cystic fibrosis transmembrane conductance regulator products, and the remaining fragments were cloned into pCR2.1 (Invitrogen) and sequenced using a dRhodamine terminator cycle sequencing kit and a 310 Genetic Analyser (PE Applied BioSystems). A brain cDNA library
using first strand cDNA synthesized from 1 µg of
poly(A)+ mRNA (CLONTECH) driven by
oligo(dT) with avian myeloblastosis virus reverse transcriptase XL (NBL
Gene Sciences) (1 h at 42 °C) was constructed and screened with
novel fragments. Three sequential rapid amplification of cDNA ends
reactions (Brain RACE-ready cDNA, CLONTECH)
were required to obtain a full-length cDNA using the following
gene-specific primers: 5'-GTGCTGCCTACATTCAGCATG-3' (nt 2814-2794);
5'-CAGGTGGATGTGCTTGCCTTCTTC-3' (nt 1903-1879) and 5'-AAAGCCCAGCATTGTCCACT-3' (nt 515-496). The full-length cDNA was
inserted into the EcoRI site of the expression vector
pEGFP-C1 (CLONTECH).
Cell Culture and Stable Cell Line Generation--
All reagents
were from Life Technologies, Inc., unless otherwise stated. HEK293
cells (a gift from Professor M Ashford, University of Aberdeen) were
cultured in Dulbecco's modified Eagle's medium with Glutamax-1,
sodium pyruvate, and 1 mg/ml glucose supplemented with 50 µg/ml
streptomycin, 50 units/ml penicillin, 2 mM glutamine, and
10% (v/v) fetal calf serum. Monolayers were dispersed with 0.25%
trypsin, 0.02% EDTA in PBS (Imperial). Transfections were performed
using LipofectAMINE reagent according to the manufacturer's instructions. Stable cell lines were selected in the above medium supplemented with 2 mg/ml G418 sulfate added 24 h after
transfection. Single clones were obtained by limiting dilution and
clonal populations viewed for EGFP fluorescence with an Axiovert 135 inverted microscope (Zeiss).
Confocal Imaging--
Cells were seeded at approximately 1 × 105 cells/well of a six-well tissue culture plate (Nunc)
containing 25-mm-diameter round coverslips and incubated overnight in
Dulbecco's modified Eagle's medium without phenol red, supplemented
as above with the addition of 20 mM HEPES. Cells were
transferred to a prewarmed heating stage maintained at 37 °C and
viewed with an Axiovert 135 inverted microscope (Zeiss) equipped with
either a × 40 or a × 63 oil immersion lens (Neofluar).
Fluorescent images were captured with a digital camera (Hammamatsu
C4792 10-bit gray scale CCD camera). Deconvolved images were obtained
using an OpenLab 2.0.3 image analysis package (Improvision) by taking
1-µm optical sections through the z axis, and background
fluorescence was removed using digital deconvolution.
Western Blot Analysis--
After SDS-polyacrylamide gel
electrophoresis on a 7.5% gel with Laemmli buffers (21), samples were
transferred to nitrocellulose (Hybond ECL, Amersham Pharmacia Biotech)
by a semidry blotter (Bio-Rad). Blots were blocked with 3% dried milk
powder in PBS, 1% Tween-20, probed overnight with Northern Blot Analysis--
Multiple tissue Northern (MTN) blots
containing 2 µg of poly(A)+ RNA of various tissues per
lane (CLONTECH and Origene technologies Inc.) were
probed with pABC11-specific fragments originating from 5' (nt
104-1904), mid (nt 2421-2880), and 3' (nt 3943-4395) regions of the
cDNA. DNAs were radiolabeled with [ Chromosomal Localization--
A monochromosomal somatic cell
hybrid DNA panel (human on a mouse/hamster background) was obtained
from Human Genome Mapping Project Resource Center (Hinxton Hall,
Cambridge, UK). A primer pair combination that yielded species-specific
products was used to amplify the panel: 5'-AGGAGCATCCCAAGGGAAAG-3' (nt
417-436) and 5'-GAAAGCCACGAAAAAGTCATACAG-3' (nt 543-520). 200 ng of
each DNA was used per 25-µl polymerase chain reaction with cycling parameters of 95 °C for 15 min, followed by 33 cycles of 95 °C for 1 min, 55 °C for 2 min, and 72 °C for 3 min, and a final
cycle of 72 °C for 10 min.
Cytotoxicity Assay--
This was as described previously, with
slight modifications (22). Cells were plated in 100 µl of medium
(2.5 × 104/ml). After overnight culture, cytotoxic
compounds were added in 100 µl of medium and incubated for a further
48 h. Remaining adherent cells were fixed with formaldehyde (3.5%
(v/v) in PBS) and stained with crystal violet (0.1% (w/v) in PBS), and
the amount of staining was quantitated at 550 nm absorption in a
Molecular Devices plate reader. Each agent was tested at several
concentrations with three replicates per concentration, and the
percentage of cytotoxicity was calculated from the formula
100(a Fluorochrome Uptake as Measured by Flow
Cytometry--
5-Chloromethylfluorescein diacetate (CMFDA),
fluorescein diacetate (FDA),
2',7'-bis-(2-carboxyethyl)-5(and-6)-carboxyfluorescein acetoxymethyl
ester (BCECF.AM), and tetramethylrosamine chloride (TMR) were obtained
from Molecular Probes; other reagents were obtained from Sigma. Cells
were detached by minimal treatment with 0.25% trypsin, 0.02% EDTA and
suspended at 106/ml in medium. Unless specified otherwise,
500 µl of cell suspension was incubated with 500 µl of fluorochrome
at 5 µM in medium for 20-30 min at 37 °C, washed
twice with PBS, and resuspended in 600 µl of 1% formaldehyde in PBS.
Samples were analyzed by flow cytometry using a FACScan with the Fl1
setting for fluorescein derivatives and Fl2 for TMR and daunomycin. In
some experiments, a modified protocol was used to measure efflux in
which the cells were labeled at 4 °C, washed in cold PBS, and
resuspended in medium. Replicate cultures were then analyzed after
incubation at 37 °C for various times thereafter.
Fluorochrome Uptake as Measured by 96-Well Plate
Fluorometer--
Cells were plated in 100 µl of medium (3 × 105/ml) and cultured overnight, and 100 µl of
fluorochrome (5 µM in medium) was added. After incubation
for 30 min at 37 °C, wells were washed twice with Dulbecco's
modified Eagle's medium without phenol red, fixed in 100 µl of 1%
formaldehyde in PBS, and analyzed with a Fluostar plate fluorometer
(excitation at 485 nm and emission at either 520 nm for fluorescein
derivatives or 640 nm for TMR). Assays were set up with four or five
replicates, and the data are expressed as the mean ± S.D. after
subtraction of background, which was fluorescence exhibited by cells in
the absence of fluorochrome.
Cloning of a Novel ABC Protein--
A novel ABC-related sequence,
pABC11.1 (377 bp in length) containing a putative ABC signature
(FSVGERQLLCIARAL), together with a Walker B motif (ILILD), was
amplified from pancreatic cDNA. A brain-derived expressed sequence
tag clone (H17207) was found to be 97% identical to pABC11.1;
therefore, we screened a brain cDNA library in order to obtain a
full-length cDNA. The resulting clone together with a series of
overlapping rapid amplification of cDNA ends products yielded a
cDNA that was 5881 bp in length (GenBankTM accession
number AF146074) and encoded an open reading frame of 1437 amino acids.
During the course of this work, three sequences of varying lengths were
deposited in GenBankTM that are almost identical to pABC11:
MOAT-C (AF104942) (18), 5838 bp; SMRP (AB005659) (23), 4939 bp; and
MRP5 (U83661) (15), 2058 bp. Our sequence extends the longest of these,
MOAT-C, by 71 bp in the 5' direction, and in addition, the first 19 bp of MOAT-C differ from the corresponding sequence in pABC11. There are a
further six nt changes between our sequence and that of MOAT-C. One of
these differences lies within the predicted 5' untranslated region (nt
186 pABC11/nt 115 MOAT-C); two other alterations are silent and do not
result in amino acid substitutions (nt 919 pABC11/nt 848 MOAT-C and nt
1342 pABC11/1271 MOAT-C); and a further difference (G at 1939 pABC11
compared with A at 1866 MOAT-C) results in a conservative substitution
of Val in pABC11 to Ile in MOAT-C. However, 2-bp alterations within a
single codon result in a nonconservative substitution of a Ser in
pABC11 for a Gly in MOAT-C (nt 1394 and 1396 of pABC11/nt 1323 and 1325 of MOAT-C). The sequence of SMRP (23) confirms the pABC11 sequence in
the latter two positions. SMRP begins at nt 1049 of pABC11 and contains
an insert of 114 bp at position 1601. This insert contains a stop codon
in frame with the longest possible open reading frame, which led Suzuki and colleagues (23) to predict that a truncated ABC protein would
result from this cDNA.
A series of pairwise global alignments were performed between pABC11
and the ABC proteins SUR1, MRP1, cMOAT, and YCF1 using CLUSTAL.W
(parameters: gap penalty, 3; cost to open gap, 5; cost to lengthen gap,
25; and PAM250 matrix). pABC11 shared a similar degree of identity with
cMOAT (29%), MRP (28%), SUR1 (27%), and YCF1 (27%).
Northern Blot Analysis Indicates Differential Expression of
Multiple Species of mRNA and the Chromosome Mapping Panel Confirms
Location of Gene on Chromosome 3--
Probing of MTN blots with
various pABC11 fragments revealed that several species of pABC11 are
expressed at different levels in a variety of tissues (labeled A-E in
Fig. 1). The largest of these
transcripts, species A (>10 kb), hybridized to both 5' and 3' probes.
Species B (approximately 6.0 kb) was considered to correspond to our
cloned cDNA (5.8 kb), as it hybridized to both 5' and 3' probes.
Two additional species, C (5.5 kb) and D (2.4 kb), hybridized to the 5'
probe but not the 3' probe.
The relative proportions of the various transcripts differed between
the tissue types tested. For instance, skeletal muscle expresses almost
equal quantities of A and B, whereas B is the predominant species in
brain. Similarly high levels of A, B, C, and D are seen in fetal liver,
whereas only very low amounts of A and B are detected in adult liver.
Species E was detected in heart, liver, skeletal muscle, and kidney
after hybridization to the 3' probe but not the 5' probe, and its
estimated size is 1.2 kb.
To test whether pABC11 homologues exist in other species, we probed a
rat MTN with a fragment corresponding to the least conserved region of
this cDNA (probe MID). Even after washing at high stringency, an
intense signal was seen in thymus and brain (Fig. 1D), with at least two transcripts cross-hybridizing and most similar in size to
the human A and B forms.
Using gene-specific primers, we mapped pABC11 to chromosome 3. This
confirmed the chromosomal location reported by previous authors (15,
18, 23).
Establishment of a Stable Cell Line Expressing an EGFP-pABC11
Fusion Protein and Subcellular Distribution of EGFP-pABC11--
A
stable, clonal cell line HEKc10 was established after transfection of
wild type HEK293 cells with an EGFP-tagged pABC11 construct and
selection in G418. A control G418-resistant clone that did not
overexpress EGFP-pABC11, HEKc5, was also obtained from the same
transfection experiment. Cells were viewed by fluorescent microscopy,
and digital images were captured. As expected, there was no difference
in endogenous fluorescence of HEKc5 cells when compared with wild type
HEK293 cells. The majority of fluorescence in HEKc10 cells could be
visualized at the plasma membrane (Fig. 2). Some punctate fluorescence was also
observed; it most probably corresponds to protein trafficking through
the Golgi. The distribution of fusion protein in HEKc10 cells was
clearly different from that of wild type EGFP, which could be seen in
abundance throughout the cell, including within the nucleus (results
not shown). Confirmation that HEKc10 cells were expressing the fusion
protein was obtained by fluorescence-activated cell sorter (see Fig. 4)
and Western blot analysis (Fig. 2, inset, lane 2). The band
visualized on our Western blot was diffuse and was estimated to be 220 kDa, which is larger than the predicted molecular mass of 166 kDa. This
increase in size and diffuse appearance is characteristic of
glycosylated proteins (there are eight potential glycosylation sites in
pABC11).
Resistance to Cytotoxic Agents by EGFP-pABC11-overexpressing HEKc10
Cells--
Because of the sequence homology of pABC11 toYCF1, which
confers resistance to Cd+2 in yeast, we initially assessed
the cytotoxic effects of CdCl2 on HEKc10 cells compared
with our control cells. As shown in the single experiment in Fig.
3A, HEKc10 cells demonstrated
a slight increase in resistance to CdCl2 toxicity at 1 µM compared with three control clones. Because all three
control clones behaved similarly, only HEKc5 was used subsequently. In
an additional seven experiments, HEKc10 demonstrated increased
resistance to 1 µM CdCl2 relative to HEKc5
(Fig. 3B). HEKc10 cells did not show enhanced resistance to
the cytotoxic agents daunomycin, vincristine, mitoxantrone, etoposide,
cisplatin, colchicine, chloroquine, CDNB, calcein, sodium arsenite, and
sodium arsenate (Table I). However, some
resistance to potassium antimonyl tartrate was seen (Table I and Fig.
3C). The data in Fig. 3C are from a
representative experiment but were confirmed in two additional
experiments. This suggests that EGFP-pABC11 may have transporter
activity, but it is clearly distinguishable in specificity from Pgp,
MRP, and the less well characterized mitoxantrone and cisplatin
transporters (13, 24-28).
Fluorochrome Accumulation/Efflux by HEKc10 Cells--
Labeling
with fluorochromes enables a more direct measurement of drug efflux.
Initially HEKc5 and HEKc10 cells were incubated with fluorochromes at
37 °C and washed, and uptake was measured by fluorometry using
either a flow cytometer or 96-well plate reader. In this variant of the
assay (uptake assay), it is assumed that fluorochrome uptake is passive
and that the amount of labeling reflects active transport out of the cell.
As analyzed by flow cytometry, HEKc5 and HEKc10 cells labeled
comparably with calcein·AM, TMR, or daunomycin (Fig.
4), all of which can be exported by MRP-
or Pgp-type transporters (28-30). Because there were no differences
between the clones, EGFP-pABC11 does not seem to transport these
agents. However, on labeling with CMFDA, a known substrate for MRP
(31), a clear difference emerged, with HEKc10 cells having much reduced
labeling (Fig. 4).
These results were confirmed and extended using a 96-well plate assay
(Fig. 5). Again, there were no
differences between the clones in terms of calcein·AM, TMR, or
rhodamine 123 labeling, but labeling of HEKc10 cells with CMFDA and FDA
was greatly reduced, whereas labeling with BCECF·AM was reduced by
about 50% (Fig. 5). Several conclusions can be drawn from this. First,
EGFP-pABC11 is an organic anion transporter. Second, increasing the
negative charge (or size) of the substrate as in BCECF and calcein
reduces transport efficiency, as does introduction of a positive charge (TMR). Finally, the observation that HEKc10 cells are labeled equally
poorly by FDA and CMFDA shows that the chloromethyl group on CMFDA is
not a structural requirement. This is significant in that it is this
group that is required for conjugation to reduced glutathione (GSH) for
transport as a GSH conjugate by MRP. Therefore GSH conjugation may not
be necessary for transport by EGFP-pABC11, and this is discussed
further under "Discussion."
Modulation of EGFP-pABC11-mediated Fluorochrome
Efflux--
Fluorochrome efflux by Pgp can be blocked by verapamil,
and MRP-mediated efflux can be blocked by probenecid and sulfinpyrazone (28, 32, 33). With FDA labeling of HEKc10 cells, verapamil and
probenecid had minimal effects, whereas sulfinpyrazone had a small
effect (Fig. 6A). In contrast,
in HEKc5 cells, which do not overexpress EGFP-pABC11, the MRP blockers
probenecid and sulfinpyrazone markedly enhanced FDA labeling, implying
that HEK293 cells constitutively express a fluorochrome exporter
(perhaps of the MRP type).
The requirement for GSH conjugation in drug transport can be tested by
depleting cells of GSH by treatment with the GSH synthesis inhibitor
DL-buthionine-(S,R)-sulfoximine (BSO) (28, 34). BSO treatment enhanced labeling of HEKc5 cells with CMFDA but not
HEKc10 cells (Fig. 6B). For HEKc5 cells, this can be
interpreted as follows: GSH depletion inhibits conjugation of the
fluorochrome with GSH and its subsequent export by the constitutive GSH
conjugate transporter. In the EGFP-pABC11-overexpressing HEKc10 cells,
export of CMFDA appears to be much less GSH-dependent, in
keeping with the observations above. Similar results were obtained on
labeling with FDA rather than CMFDA (data not shown).
Depletion of intracellular ATP resulted in enhanced labeling of HEKc10
cells with FDA (Fig. 6C), consistent with EGFP-pABC11 being
an ATP-dependent transporter.
Decreased Fluorochrome Labeling of HEKc10 Cells Is Due to Increased
Efflux Rather Than Reduced Uptake--
In the above labeling
experiments, the assumption has been made that the differences observed
in fluorochrome labeling between HEKc5 and HEKc10 clones are due to
enhanced efflux by HEKc10 cells. To test this directly, cells were
labeled with FDA at reduced temperature (to prevent efflux), washed,
and then incubated for various periods at 37 °C to measure efflux.
When labeling was performed at 10 °C, HEKc10 cells showed reduced
initial labeling relative to HEKc5 cells. This could be due either to
differences in dye uptake or to residual efflux activity in HEKc10 at
this temperature. The latter seems more likely because reactions
carried out at 4 °C resulted in comparable labeling. When efflux was
subsequently measured in the presence of probenecid (to block the
constitutively expressed transporter), HEKc10 cells lost their label
much faster than HEKc5 (Fig. 7),
confirming that EGFP-pABC11 is involved in drug efflux. In this
experiment, the increase in fluorescence with HEKc5 cells at 7.5-15
min is due to conversion of unhydrolyzed (nonfluorescent) FDA to
fluorescent fluorescin. In HEKc10 cells, this increase was not seen,
presumably due to the efflux rate of fluorescin being higher than the
rate of hydrolysis of FDA to fluorescin.
Decreased FDA Labeling of HEKc10 Cells Is Due to Preferential
Export of the Hydrolyzed Product Rather Than FDA
Itself--
Fluorochrome labeling was done in the standard 96-well
assay with two modifications. First, phenol red-free medium was used so
that changes in fluorescence of the whole well contents (cells + supernatant) could be monitored, and second, probenecid was included in
the medium to block the constitutive transporter. If EGFP-pABC11
exports FDA (nonfluorescent) in preference to its hydrolysis product
fluorescin (fluorescent), then the whole well contents for HEKc10
should exhibit much lower fluorescence than for HEKc5. If anything,
HEKc10 cultures had increased fluorescence (data not shown), indicating
that EGFP-pABC11 preferentially exports fluorescin relative to FDA.
A novel member of the ABC family of proteins has been cloned. We
predict that the initiating codon begins at nt 198 resulting in a
protein of 1437 amino acids. Although the sequence surrounding this
putative initiating Met, 5'-AAGAUGA-3', is not identical to a consensus
Kozak sequence, 5'-ACCAUGG-3', the dominant purine at position Although pABC11 may be closest in amino acid composition to a subgroup
of ABC proteins, its mRNA expression profile is very different. For
example, cMOAT expression is restricted mainly to the liver (17),
whereas multiple transcripts of pABC11 are observed in several tissue
types. Although it has not been conclusively proven, we suspect that
these multiple species arise through alternative splicing of a single
gene, a phenomenon already reported for other ABC proteins, including
SUR2 (35-37), the major histocompatibility complex-encoded peptide
transporter Tap2 (38), MRP3 (39), and MRP (40). Valuable but limited
information can be gained from the protein sequence, mRNA tissue
distribution, and homology searching with respect to the function of
this novel ABC protein. Therefore, to get further insight into its
function, the effect of overexpression of the protein in HEK293 cells
was investigated.
Overexpression of EGFP-pABC11 fusion protein did not increase
resistance to a range of anticancer drugs or arsenic. However, small
but statistically significant increases in resistance to CdCl2 (2.4×) and potassium antimonyl tartrate (2.9×) were
seen, although it is debatable whether these increases are biologically relevant. This pattern of resistance differs from that found for overexpression of other ABC proteins. For example, with MRP (24, 41),
similar levels of resistance to potassium antimonyl tartrate were
found, but high levels of resistance to anticancer drugs (in the range
5-25×) were also found. This suggests a difference in specificity
between pABC11 and other transporters, but other possibilities must be
considered. For example, does EGFP tagging affect function? We cannot
answer this question for pABC11 because attempts to express untagged or
His-tagged protein were unsuccessful. However, for other ABC proteins,
tagging was consistent with function (42-44). Cell background is
another possible variable, but the studies on MRP cited above were also
done in HEK293 cells (24). These reservations on the function of
overexpressed, tagged protein also apply to its subcellular
localization, which may be altered relative to the native protein, as
has been seen for MRP (discussed by Tommasini et al.
(45)).
Our studies on fluorochrome transport also suggest that pABC11 differs
in specificity from MRP and Pgp. Like MRP, EGFP-pABC11 overexpression
results in reduced labeling with BCECF·AM and CMFDA (31, 46): BCECF
is also a substrate for Pgp (47). A striking observation in our study
is the failure of EGFP-pABC11 to reduce labeling by calcein·AM and
rhodamine derivatives, both classes of compounds being substrates for
MRP and Pgp, albeit with differing efficiencies (29). For EGFP-pABC11,
there was a clear structure activity relationship for fluorochrome
export (Fig. 5) with an increase in size and/or positive charge
resulting in decreased efflux. Like MRP (28), EGFP-pABC11 appears to
have a preference for the anionic hydrolysis products of fluorochromes
rather than the uncharged ester, which is preferred by Pgp (46). In
this context, it is significant that antimonyl tartrate is also an organic anion.
Glutathione is necessary for transport of many substrates by MRP and
its homologues (reviewed by Ishizawa et al. (48)) but not
for calcein or BCECF (28, 46). In our studies, BSO treatment to deplete
glutathione did not affect fluorochrome transport by EGFP-pABC11 (but
did inhibit activity of the constitutively expressed transporter). This
shows that glutathione is not necessary for EGFP-pABC11 efflux of the
fluorochromes FDA and CMFDA, but we cannot exclude the possibility that
it may be required for other substrates.
Although EGFP-pABC11 is functionally different from MRP, it has more in
common with MRP than Pgp, as expected from the amino acid homologies.
However, one final piece of evidence highlights the distinction between
MRP and EGFP-pABC11. Probenecid and sulfinpyrazone are broadly reactive
anion transport inhibitors that effectively block MRP when used in the
mM range, but at this concentration, these compounds had
minimal effect on EGFP-pABC11.
In conclusion, EGFP-pABC11 is an organic anion transporter that appears
to be functionally different from previously described ABC
transporters. However, it must be stressed that the studies described
here were performed using an overexpression system, and the next step
is to see whether they can be confirmed with the native protein in a
more physiological setting.
We thank James Murray for invaluable help
with the confocal microscopy and Mark Woodmansey for technical
assistance. We also thank the Human Genome Mapping Project Resource
Center for supplying the somatic cell hybrid mapping panel.
*
The costs of publication of this
article were defrayed in part by the
payment of page charges. The article
must therefore be hereby marked
"advertisement" in
accordance with 18 U.S.C. Section
1734 solely to indicate this fact.
The nucleotide sequence(s) reported in this paper has been submitted to the GenBankTM/EMBL Data Bank with accession number(s) AF146074.
The abbreviations used are:
MRP, multidrug
resistance-associated protein;
BCECF, 2',7'-bis-(2-carboxyethyl)-5(and-6)-carboxyfluorescein acetoxymethyl
ester;
bp, base pair(s);
BSO, DL-buthionine-(S,R)-sulfoximine;
CMFDA, 5-chloromethylfluorescein diacetate;
EGFP, enhanced green fluorescent
protein;
FDA, fluorescein diacetate;
kb, kilobase pair(s);
MTN, multiple tissue Northern;
nt, nucleotide(s);
PBS, phosphate-buffered
saline;
Pgp, P-glycoprotein;
TMR, tetramethylrosamine chloride;
AM, acetoxymethyl ester.
pABC11 (Also Known as MOAT-C and MRP5), a Member of the ABC
Family of Proteins, Has Anion Transporter Activity but Does Not Confer
Multidrug Resistance When Overexpressed in Human Embryonic Kidney 293 Cells*
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ABSTRACT
TOP
ABSTRACT
INTRODUCTION
EXPERIMENTAL PROCEDURES
RESULTS
DISCUSSION
REFERENCES
![]()
INTRODUCTION
TOP
ABSTRACT
INTRODUCTION
EXPERIMENTAL PROCEDURES
RESULTS
DISCUSSION
REFERENCES
![]()
EXPERIMENTAL PROCEDURES
TOP
ABSTRACT
INTRODUCTION
EXPERIMENTAL PROCEDURES
RESULTS
DISCUSSION
REFERENCES
monoclonal anti-GFP (CLONTECH 8362-1) and then
anti-mouse Ig peroxidase (Amersham Pharmacia Biotech
NA931), and finally developed with ECL reagent (Amersham Pharmacia
Biotech RPN2106).
-32P]dCTP using
Rediprime reagent and hybridized overnight in Rapid-Hyb buffer
(Amersham Pharmacia Biotech) at 60 °C. Blots were washed in 0.2×
SSC at 60 °C (twice, 15 min each) and autoradiographed at
80 °C
for varying lengths of time. Blots were also incubated with a control
-actin probe.
b)/a, where a
and b are the mean absorbances of wells without and with the test agent, respectively.
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RESULTS
TOP
ABSTRACT
INTRODUCTION
EXPERIMENTAL PROCEDURES
RESULTS
DISCUSSION
REFERENCES

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Fig. 1.
A, MTN blots probed with the 3' probe
described under "Experimental Procedures." Three species of
transcripts were clearly visible: A, >10 kb; B,
6.0 kb; and E, 1.2 kb. B, the three MTN blots
shown in A were stripped according to the manufacturer's
instructions, and a control film was exposed to ensure that there was
no residual signal left. Blots were then probed with the 5' probe. Two
additional transcripts, C and D, were observed.
C, immune Northern blot probed with the 5' probe.
D, rat MTN hybridized to the least conserved region of
pABC11 (probe MID). Arrows mark two cross-hybridizing
transcripts most similar in size to the human A and B forms. Levels of
-actin mRNA are also shown.

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Fig. 2.
Digital images of the EGFP-pABC11 expressing
HEKc10 cells, displaying most fluorescence at the plasma membrane.
The inset in the right panel shows a Western blot
of whole cell extracts from HEKc5 (lane 1) and HEKc10 cells
(lane 2) that has been developed with an anti-GFP antibody
as described under "Experimental Procedures." The arrow
indicates EGFP-pABC11 fusion protein.

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Fig. 3.
A, CdCl2 cytotoxicity to
clones HEKc5 (
), HEKc10 (
), HEKc11 (
), and HEKc13 (
).
EGFP-pABC11 expression was high in HEKc10, low in HEKc11 and HEKc13,
and undetectable in HEKc5. Data are mean ± S.D. of triplicates in
a single experiment. B, CdCl2 cytotoxicity to
HEKc5 and HEKc10 at 1 µM; mean ± S.D. of seven
independent experiments. C, potassium antimonyl tartrate
cytotoxicity to HEKc5 (
) and HEKc10 (
). Results of a
representative experiment of three performed. Data are mean ± S.D. of triplicates in a single experiment.
Comparison of the susceptibility of HEKc5 and HEKc10 cells to various
cytotoxic agents

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Fig. 4.
FACScan profiles of HEKc5 and HEKc10 cells
either unlabeled (
) or labeled (+) with calcein·AM
(A), TMR (B), daunomycin
(C), or CMFDA (D). Note that the
scale of fluorescent intensity is logarithmic.

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Fig. 5.
Labeling of clones HEKc5 and HEKc10 by FDA,
CMFDA, BCECF, calcein·AM, rhodamine 123, and TMR. The structures
shown are those of the expected intracellular hydrolysis products.
BCECF is a mixture, and the structure shown is one of the three
possible hydrolysis products.

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[in a new window]
Fig. 6.
Modulation of fluorochrome labeling of clones
HEKc5 and HEKc10. A, FDA labeling of cells in the
presence of 1 mM probenecid, 1 mM
sulfinpyrazone, or 25 µM verapamil. B, CMFDA
labeling of cells pretreated for 24 h with 50 µM BSO
to reduce intracellular GSH concentrations. C, FDA labeling
of cells after ATP depletion. For ATP depletion, cells were incubated
for 20 min in glucose-free medium with 50 mM 2-deoxyglucose
and 15 mM sodium azide before addition of FDA in the same
medium.

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Fig. 7.
Loss of fluorochrome label at 37 °C as a
function of time. FDA labeling of HEKc5 (
) and HEKc10 (
)
cells was done at 4 °C with cells in suspension. Probenecid (1 mM) was included in the medium during the 37 °C
incubation to inhibit the constitutive transporter. Fluorescence was
measured by flow cytometry as the geometric mean of 10,000 cells per
time point, and results are expressed as the percentage of the values
at zero time.
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DISCUSSION
TOP
ABSTRACT
INTRODUCTION
EXPERIMENTAL PROCEDURES
RESULTS
DISCUSSION
REFERENCES
3 is
present, rendering the nucleotides at positions
2,
1, and +4 less
influential in determining the translational start site. Pairwise
alignments indicate that this protein shares similar degrees of
homology with several ABC proteins of diverse function, including SUR1,
YCF1, and MRP, and that the majority of conserved residues lie within
the nucleotide binding domains and the second transmembrane domain,
with the NH2-terminal transmembrane domain being the most
divergent portion of the protein.
![]()
ACKNOWLEDGEMENTS
![]()
FOOTNOTES
To whom correspondence should be addressed. Tel.: 44-1865-747100;
Fax: 44-1865-748974; E-mail: nmatthews@yam-res.co.uk.
![]()
ABBREVIATIONS
![]()
REFERENCES
TOP
ABSTRACT
INTRODUCTION
EXPERIMENTAL PROCEDURES
RESULTS
DISCUSSION
REFERENCES
1.
Higgins, C.
(1992)
Annu. Rev. Cell Biol.
8,
67-113[CrossRef]
2.
Decottignies, A.,
and Goffeau, A.
(1997)
Nat. Genet.
15,
137-145[CrossRef][Medline]
[Order article via Infotrieve]
3.
Aguilar-Bryan, L.,
Clement, J.,
Gonzalez, G.,
Kunjilwar, K.,
Babenko, A.,
and Bryan, J.
(1998)
Physiol. Rev.
78,
227-245 4.
Riordan, J.,
Rommens, J.,
Kerem, B.,
Alion, N.,
Rozmahel, R.,
Grzelczak, Z.,
Zielenski, J.,
Lok, S.,
Plavsic, N.,
Chou, J.,
Drumm, M.,
Iannuzzi, M.,
Collins, F.,
and Tsui, L.
(1989)
Science
245,
1066-1072 5.
Szczypka, M.,
Wemmie, J.,
Moye-Rowley, W.,
and Thiele, D.
(1994)
J. Biol. Chem.
269,
22853-22857 6.
Ghosh, M.,
Shen, J.,
and Rosen, B.
(1999)
Proc. Natl. Acad. Sci. U. S. A.
96,
5001-5006 7.
Broeks, A.,
Gerrard, B.,
Allikmets, R.,
Dean, M.,
and Plasterk, R.
(1996)
EMBO J.
15,
6132-6143[Medline]
[Order article via Infotrieve]
8.
Riordan, J.,
Deuchars, K.,
Kartner, N.,
Alon, N.,
Trent, J.,
and Ling, V.
(1985)
Nature
16,
817-819
9.
Higgins, C.,
Callaghan, R.,
Linton, K.,
Rosenberg, M.,
and Ford, R.
(1997)
Semin. Cancer Biol.
8,
135-142[CrossRef][Medline]
[Order article via Infotrieve]
10.
Higgins, C.
(1993)
Curr. Opin. Cell Biol.
5,
684-687[CrossRef][Medline]
[Order article via Infotrieve]
11.
Cole, S.,
and Deeley, R.
(1998)
BioEssays
20,
931-940[CrossRef][Medline]
[Order article via Infotrieve]
12.
Chen, Y.,
Mickley, L.,
Schwartz, A.,
Acton, E.,
Hwang, J.,
and Fojo, A.
(1990)
J. Biol. Chem.
265,
10073-10080 13.
Doyle, L.,
Yang, W.,
Abruzzo, L.,
Krogmann, T.,
Gao, Y.,
Rishi, A.,
and Ross, D.
(1998)
Proc. Natl. Acad. Sci. U. S. A.
95,
15665-15670 14.
Miyake, K.,
Mickley, L.,
Litman, T.,
Zhan, Z.,
Robey, R.,
Cristensen, B.,
Brangi, M.,
Greenberger, L.,
Dean, M.,
Fojo, T.,
and Bates, S.
(1999)
Cancer Res.
59,
8-13 15.
Kool, M.,
de Haas, M.,
Scheffer, G.,
Scheper, R.,
van Eijk, M.,
Juijn, J.,
Baas, F.,
and Borst, P.
(1997)
Cancer Res.
57,
3537-3547 16.
Kool, M.,
van der Linden, M.,
de Haas, M.,
Baas, F.,
and Borst, P.
(1999)
Cancer Res.
59,
175-182 17.
Evers, R.,
Kool, M.,
van Deemter, L.,
Janssen, H.,
Calafat, J.,
Oomen, L.,
Paulusma, C.,
Oude Elferink, R.,
Baas, F.,
Schinkel, A.,
and Borst, P.
(1998)
J. Clin. Invest.
101,
1310-1319[Medline]
[Order article via Infotrieve]
18.
Belinsky, M.,
Bain, L.,
Balsara, B.,
Testa, J.,
and Kruh, G.
(1998)
J. Natl. Cancer Inst.
90,
1735-1741 19.
Allikmets, R.,
Gerrard, B.,
Hutchinson, A.,
and Dean, M.
(1996)
Hum. Mol. Genet.
5,
1649-1655 20.
Taniguchi, K.,
Wada, M.,
Kohno, K.,
Nakamura, T.,
Kawabe, T.,
Kawakami, M.,
Kagotani, K.,
Okumura, K.,
Akiyama, S.,
and Kuwano, M.
(1996)
Cancer Res.
56,
4124-4129 21.
Laemmli, U. K.
(1970)
Nature
227,
680-685[CrossRef][Medline]
[Order article via Infotrieve]
22.
Neale, M.,
and Matthews, N.
(1989)
Eur. J. Cancer Clin. Oncol.
25,
133-137[CrossRef][Medline]
[Order article via Infotrieve]
23.
Suzuki, T.,
Nishio, K.,
Sasaki, H.,
Kurokawa, H.,
Saito-Ohara, F.,
Ikeuchi, T.,
Tanabe, S.,
Terada, M.,
and Saijo, N.
(1997)
Biochem. Biophys. Res. Commun.
238,
790-794[CrossRef][Medline]
[Order article via Infotrieve]
24.
Stride, B.,
Grant, C.,
Loe, D.,
Hipfner, D.,
Cole, S.,
and Deeley, R.
(1997)
Mol. Pharmacol.
52,
344-353 25.
Shen, D.,
Pastan, I.,
and Gottesman, M.
(1998)
Cancer Res.
58,
268-275 26.
Chen, Z.,
Mutoh, M.,
Sumizawa, T.,
Furukawa, T.,
Haraguchi, M.,
Tani, A.,
Saijo, N.,
Kondo, T.,
and Akiyama, S.
(1998)
Exp. Cell Res.
240,
312-320[CrossRef][Medline]
[Order article via Infotrieve]
27.
Vezmar, M.,
and Georges, E.
(1998)
Biochem. Pharmacol.
56,
733-742[CrossRef][Medline]
[Order article via Infotrieve]
28.
Versantvoort, C.,
Bagrij, T.,
Wright, K.,
and Twentyman, P.
(1995)
Int. J. Cancer
63,
855-862[Medline]
[Order article via Infotrieve]
29.
Feller, N.,
Kuiper, C.,
Lankelma, J.,
Ruhdal, J.,
Scheper, R.,
Pinedo, H.,
and Broxterman, H.
(1995)
Br. J. Cancer
72,
543-549[Medline]
[Order article via Infotrieve]
30.
Eytan, G.,
Regev, R.,
Oren, G.,
Hurwitz, C.,
and Assaraf, Y.
(1997)
Eur. J. Biochem.
248,
104-112[Medline]
[Order article via Infotrieve]
31.
Roelofsen, H.,
Vos, T.,
Schippers, I.,
Kuipers, F.,
Koning, H.,
Moshage, H.,
Jansen, P.,
and Muller, M.
(1997)
Gastroenterology
112,
511-521[CrossRef][Medline]
[Order article via Infotrieve]
32.
Konen, P.,
Currier, S.,
Rutherford, A.,
Gottesman, M.,
Pastan, I.,
and Willingham, M.
(1989)
J. Histochem. Cytochem.
37,
1141-1145[Abstract]
33.
Evers, R.,
Zaman, G.,
van Deemter, L.,
Jansen, H.,
Calafat, J.,
Oomen, L.,
Oude Elferink, R.,
Borst, P.,
and Schinkel, A.
(1996)
J. Clin. Invest.
97,
1211-1218[Medline]
[Order article via Infotrieve]
34.
Lutzky, J. A. M.,
Taub, R. N.,
Baker, M. A.,
Bhalla, K.,
Gervasoni, J. E., Jr.,
Rosado, M.,
Stewart, V.,
Krishna, S.,
and Hindenburg, A. A.
(1989)
Cancer Res.
49,
4120-4125 35.
Bryan, J.,
and Aguilar-Bryan, L.
(1997)
Curr. Opin. Cell Biol.
9,
553-559[CrossRef][Medline]
[Order article via Infotrieve]
36.
Isomoto, S.,
Kondo, C.,
Yamada, M.,
Matsumoto, S.,
Higashiguchi, O.,
Horio, Y.,
Matsuzawa, Y.,
and Kurachi, Y.
(1996)
J. Biol. Chem.
271,
24321-24324 37.
Inagaki, N.,
Gonoi, T.,
Clement, J.,
Wang, C.,
Aguilar-Bryan, L.,
Bryan, J.,
and Seino, S.
(1996)
Neuron
16,
1011-1017[CrossRef][Medline]
[Order article via Infotrieve]
38.
Yan, G.,
Shi, L.,
and Faustman, D.
(1999)
J. Immunol.
162,
852-859 39.
Fromm, M.,
Leake, B.,
Roden, D.,
Wilkinson, G.,
and Kim, R.
(1999)
Biochim. Biophys. Acta
1415,
369-374[Medline]
[Order article via Infotrieve]
40.
Grant, C.,
Kurz, E.,
Cole, S.,
and Deeley, R.
(1997)
Genomics
45,
368-378[CrossRef][Medline]
[Order article via Infotrieve]
41.
Cole, S.,
Sparks, K.,
Fraser, K.,
Loe, D.,
Grant, C.,
Wilson, G.,
and Deeley, R.
(1994)
Cancer Res.
54,
5902-5910 42.
Li, Z.,
Szczypka, M.,
Lu, Y.,
Thiele, D.,
and Rea, P.
(1996)
J. Biol. Chem.
271,
6509-6517 43.
Chang, X.,
Hou, Y.,
and Riordan, J.
(1997)
J. Biol. Chem.
272,
30962-30968 44.
Makhina, E.,
and Nichols, C.
(1998)
J. Biol. Chem.
273,
3369-3374 45.
Tommasini, R.,
Evers, R.,
Vogt, E.,
Mornet, C.,
Zaman, G.,
Schinkel, A.,
Borst, P.,
and Martinoia, E.
(1996)
Proc. Natl. Acad. Sci. U. S. A.
93,
6743-6748 46.
Draper, M.,
Martell, R.,
and Levy, S.
(1997)
Eur. J. Biochem.
243,
219-224[Medline]
[Order article via Infotrieve]
47.
Homolya, L.,
Hollo, Z.,
Germann, U.,
Pastan, I.,
Gottesman, M.,
and Sarkadi, B.
(1993)
J. Biol. Chem.
268,
21493-21496 48.
Ishikawa, T.,
Li, Z.,
Lu, Y.,
and Rea, P.
(1997)
Biosci. Rep.
17,
189-207[CrossRef][Medline]
[Order article via Infotrieve]
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