Originally published In Press as doi:10.1074/jbc.M204901200 on September 24, 2002
J. Biol. Chem., Vol. 277, Issue 49, 47826-47833, December 6, 2002
Fas Activation Induces Renal Tubular Epithelial Cell
8 Integrin Expression and Function in the Absence of
Apoptosis*
George
Jarad
,
Bingcheng
Wang
§,
Shenaz
Khan
,
Jay
DeVore
,
Hui
Miao
,
Karen
Wu
,
Stephen L.
Nishimura¶,
Barbara A.
Wible
,
Martha
Konieczkowski
,
John R.
Sedor
**, and
Jeffrey R.
Schelling

From the Departments of
Medicine,
§ Pharmacology,
Biochemistry, and
** Physiology and Biophysics, Rammelkamp Center for Education
and Research, MetroHealth Medical Center Campus, Case Western Reserve
University School of Medicine, Cleveland, Ohio 44109-1998 and the
¶ Departments of Pathology and Lung Biology, Pulmonary Division,
University of California at San Francisco School of Medicine,
San Francisco, California 94143
Received for publication, May 17, 2002, and in revised form, September 3, 2002
 |
ABSTRACT |
Cell fate following Fas (CD95) ligand or
agonistic anti-Fas antibody stimulation is determined by multiple
factors, including Fas expression level, microdomain localization, and
modulating cytokines. Highly expressed Fas clusters and activates a
canonical apoptosis signaling pathway. In less susceptible cells, Fas
transduces apoptosis-independent signals, which are not well defined,
but have been linked to inflammation, angiogenesis, and fibrosis. To
identify apoptosis-independent Fas pathways, cultured renal tubular
epithelial cells were stimulated with agonistic anti-Fas antibodies
under conditions that did not cause cell death. Analysis of filter
cDNA microarrays revealed
8 integrin subunit
mRNA induction in Fas-stimulated cells.
8 integrin
mRNA expression increased within 3-6 h of Fas ligation due to
enhanced mRNA stabilization, and mRNA increases were sustained
for 48-72 h. Expression of plasma membrane
8 integrin,
as well as its heterodimer partner
v, was increased by
Fas activation with a similar kinetic pattern. Fas-induced
v
8 expression correlated with increased
migration to vitronectin, the ligand for
v
8. Results from studies with
function-blocking antibodies against other
v
integrins or suppression of
8 integrin expression by RNA
interference demonstrated that induced
8 integrin expression mediated Fas-stimulated migration. We conclude that
v
8 integrin induction defines an
unexpected role for Fas in cell migration, rather than as a cell death receptor.
 |
INTRODUCTION |
Fas (CD95, APO-1) is a ubiquitously expressed member of the
tumor necrosis factor receptor superfamily, which mediates diverse cellular responses, including proliferation, inflammation,
angiogenesis, and apoptosis. We have previously demonstrated that
Fas-dependent renal tubular epithelial cell
(RTC)1 apoptosis mediates
tubular atrophy (1, 2), a hallmark of progressive renal disease. Plasma
membrane Fas is expressed as a pre-assembled glycoprotein homotrimer
(3, 4). In highly susceptible (type I) cells, Fas binding by Fas ligand
in vivo or agonistic anti-Fas antibodies in vitro
causes clustering of Fas multimers within ceramide-rich lipid rafts and
ezrin-containing cytoskeletal compartments (5-7), which leads to
apoptosis following rapid aggregation of adaptor molecules and caspase
complexes at the cytoplasmic Fas death domain. Fas-overexpressing cells
have even been associated with ligand-independent apoptosis (8), suggesting that Fas surface density and caspase proximity promote apoptosis signaling within microdomains (9).
There is a spectrum of Fas responses, however. In contrast to type I
cells, which rapidly activate caspases through signals generated at the
plasma membrane, type II cells are relatively resistant to Fas-induced
apoptosis, with a more prolonged signal transduction cascade that
ultimately involves release of cytochrome c, Apaf-1, and
apoptosis-inducing factor from mitochondria, leading to apoptosome
formation, activation of cytosolic caspases, and DNA degradation. A
third group, characterized by the RTC, is even more resistant to
Fas-dependent apoptosis, despite constitutive Fas surface
expression (2, 10, 11), although these cells can be converted to a type
I or II phenotype upon induction of Fas expression (1, 2, 10, 12,
13).
Multiple explanations for diminished basal RTC apoptosis sensitivity
have been proposed, such as inadequate clustering of Fas under
conditions of low surface density and altered intracellular pro- and
anti-apoptotic molecule activities (13); but the physiologic role of
constitutively expressed RTC Fas is not understood. One theory is that
apoptosis is a default process, whereby the continuous presence of
survival factors is required for evasion of apoptosis (14), and when
RTC undergo pathologic cell death, in the context of acute or chronic
renal failure, apoptosis programs must be efficiently executed, without
abrupt need for synthesis of cell death machinery. According to this
paradigm, the sole function for constitutively expressed RTC Fas would
be as a death receptor that is perpetually poised for activation.
Alternatively, RTC Fas could regulate cell death-independent processes
under homeostatic or pathophysiologic circumstances and only rarely
function as a death receptor after survival factors have been depleted,
such as in RTC deletion associated with tubular atrophy. Indeed, Fas activation has been associated with multiple apoptosis-independent processes in other tissues, including proliferation, fibrosis, inflammation, and cytokine secretion (reviewed in Ref. 15); angiogenesis (16); and in RTC, c-Jun NH2-terminal kinase
(JNK) activation (13). These observations suggest that RTC Fas may transduce dual apoptosis and non-apoptosis pathways, similar to other
family members such as the tumor necrosis factor receptor and CD40.
To identify RTC Fas-regulated, apoptosis-independent pathways, we
utilized a high throughput, cDNA hybridization array strategy. Unexpectedly,
v
8 integrin expression and
function were found to be up-regulated by RTC Fas stimulation. Although
there is precedence for cross-talk between apoptosis and integrin
pathways inasmuch as apoptosis has been associated with integrin
detachment from extracellular matrix ligand (17) or unligated
integrins in adherent cells (18), our results represent the first
description of adhesion molecule up-regulation by a death receptor.
 |
MATERIALS AND METHODS |
Antibodies--
Rabbit antiserum was generated against the human
8 integrin cytoplasmic domain according to previously
described methods (19). Anti-
v
3 (clone
LM609), anti-
v
5 (clone P1F6),
anti-
v
6 (clone 10D5), and
anti-
v (AV1) antibodies were purchased Chemicon International, Inc. (Temecula, CA). Agonistic anti-human Fas IgM (clone
CH11) was from Kamiya (Seattle, WA). Agonistic anti-human Fas IgG
(clone DX2), agonistic anti-mouse Fas IgG (clone Jo2), and
anti-poly(ADP-ribose) polymerase IgG were obtained from
Pharmingen. Anti-lamin A/C IgG (clone sc-7292) was from Santa Cruz
Biotechnology (Santa Cruz, CA). Anti-
-tubulin IgG (clone B-5-1-2)
was a product of Sigma.
Cell Lines--
HRPT cells (a gift from Dr. L. C. Racusen) were derived from human proximal tubules and have been
extensively characterized, including demonstration of constitutive Fas
expression (1, 2, 20). HRPT cells were maintained in DMEM/nutrient
mixture F-12 (Invitrogen) supplemented with 10% fetal bovine
serum (Hyclone Laboratories, Logan, UT), penicillin G (100 units/ml),
and streptomycin sulfate (100 µg/ml) (both from
Sigma). MCF-7 breast carcinoma cells (American Type Culture
Collection, Manassas, VA) were maintained in minimal essential
medium supplemented with 10% fetal bovine serum and 1%
insulin/transferrin/selenium. Stable
8 integrin transfectants were generated from HRPT cells, which were cultured to
50% confluence in 10-cm dishes and then transfected with 2 µg of
human
8 integrin cDNA subcloned into the
pcDNAIneo vector (21) plus cationic liposomes (40 µl/dish;
Superfect, QIAGEN Inc.) for 3 h in serum-free DMEM. Cells were
cultured in complete medium containing G418 (Sigma). Individual
G418-resistant clones were isolated, subcultured, and assayed for
8 integrin expression by biotin surface labeling. Stable
transfectants with persistent
8 integrin overexpression
were utilized after three to five passages.
cDNA Microarray--
Total RNA was extracted from HRPT cells
by established methods (22); poly(A) RNA was isolated using Oligotex
beads (QIAGEN Inc.); and 0.5 µg of poly(A) RNA was labeled with
[
-33P]dCTP and incubated with chemokine and
cytokine microarray filters (R&D Systems, Minneapolis, MN) according to
the manufacturer's instructions. Individual hybridization bands were
digitized by a PhosphorImager (Amersham Biosciences), quantified with
ImageQuant Version 5 software (Amersham Biosciences), and normalized to
-actin mRNA intensity from the same filter.
Northern Blot Analysis--
Methods have previously been
described in detail (23). Poly(A) RNA was isolated as described above;
and 2.0 µg of poly(A) RNA/lane was fractionated on a denaturing 1.0%
agarose gel containing 0.67% formaldehyde, transferred to nylon
membranes, and cross-linked by UV light exposure. To assess
8 integrin mRNA levels, full-length human
8 cDNA probes (24) were labeled with
[
-32P]dCTP to a specific activity of
1.0 × 108 cpm/µg of DNA (RTS Random Prime DNA labeling system,
Invitrogen). Hybridization and high stringency washes were conducted
according to previously described methods (23). Blots were stripped and rehybridized with a 300-nucleotide PCR product amplified from human
-actin cDNA as a control for housekeeping gene expression.
Detection of Proteins Surface-labeled with
125I--
Cells cultured in 10-cm dishes were washed with
phosphate-buffered saline, lifted with trypsin/EDTA, washed again, and
resuspended in 1 ml of phosphate-buffered saline. Cell surfaces were
labeled by incubation with lactoperoxidase (200 µl, 1 mg/ml),
Na125I (3000 mCi/mmol, 0.5 mCi/106 cells), and
hydrogen peroxide (20 µl, 0.12%) for 5 min on ice with mild
agitation every 30-60 s. Additional hydrogen peroxide (20 µl,
0.12%) was added, and the cell suspension was incubated on ice for 5 min. Cells were lysed with Triton X-100 buffer (25 mM Tris
(pH 7.4), 50 mM NaCl, 25 mM NaF, 10% glycerol,
and 1% Triton X-100). Lysates were precleared with rabbit serum, and
v and
8 integrins surface-labeled with
125I were immunoprecipitated from aliquots with equal
radioactivity using 1 µg of monoclonal anti-
v IgG and
2 µl of anti-
8 antiserum, respectively, and resolved
by 8% SDS-PAGE under nonreducing conditions according to previously
described methods (25). Gels were dried and exposed to film overnight.
Detection of Proteins Surface-labeled with Biotin--
Cells
were washed with ice-cold phosphate-buffered saline and surface-labeled
with 1 mg/ml EZ-Link sulfosuccinimidyl 6-(biotinamido)hexanoate (Pierce). The labeling reaction was quenched with 0.1 M
glycine, and cells were lysed with Triton X-100 buffer.
Surface-biotinylated integrins were immunoprecipitated with specific
anti-integrin antibodies, resolved by 6% SDS-PAGE under nonreducing
conditions, transferred to PVDF membranes according to previously
described methods (25), and probed with peroxidase-conjugated
streptavidin (Pierce).
Apoptosis Assays--
RTC were rendered susceptible to
Fas-dependent apoptosis by transfection and overexpression
of mouse fas cDNA according to previously
described methods (13). Transfected and untransfected control cells
were then incubated with agonistic anti-mouse Fas IgG (clone Jo2; 5 µg/ml, 48 h, 37 °C). Whole cell lysates (20 µg of
protein/lane) were resolved by SDS-PAGE and immunoblotted with mouse
anti-human poly(ADP-ribose) polymerase IgG and peroxidase-conjugated goat anti-mouse IgG as described above. Apoptosis was defined by
cleavage of poly(ADP-ribose) polymerase, which is a caspase-3 substrate.
Transcription and Translation Assays--
In initial
experiments, RTC were pretreated with actinomycin D (0.5 µg/ml,
1 h, 37 °C) or cycloheximide (5 µg/ml, 1 h, 37 °C),
followed by stimulation with agonistic anti-Fas antibodies (clone CH11;
150 ng/ml, 6 h, 37 °C) in the continued presence of actinomycin
D or cycloheximide. Plasma membrane
8 integrin protein
expression was then determined by biotin surface labeling. For mRNA
stability assays, RTC were stimulated with or without agonistic
anti-Fas antibodies (clone CH11; 150 ng/ml, 6 h, 37 °C), and
then actinomycin D (0.5 µg/ml) was added for up to 12 h.
Steady-state
8 integrin and
-actin mRNA levels
were determined by Northern blotting, digitized by a PhosphorImager,
and quantified with ImageQuant Version 5 software. Normalized values
were plotted on a logarithmic scale against time of actinomycin D incubation.
Migration Assay--
Haptotaxis migration assays were performed
as previously described (26). Briefly, RTC were stimulated with
agonistic anti-Fas antibodies (clone CH11; 150 ng/ml, 18 h,
37 °C) and then plated at a density of 1.2 × 105
cells/well in the upper chamber of permeable supports (8.0-µm pore,
Corning Costar, Corning, NY) precoated on the underside with
vitronectin (100 ng/10 µl), which was purified from human plasma
according to previously described methods (27). Nonspecific binding was
blocked with bovine serum albumin (2%, 3 h, room temperature). In
some experiments, function-blocking antibodies against
v
3 or
v
5
were added to the upper and lower chambers according to previously
described methods (28, 29). Cells were fixed in paraformaldehyde (4%,
30 min, room temperature) and stained with crystal violet (0.5% in
20% methanol, 30 min, room temperature). Cells that did not migrate
were gently removed from the upper chamber with a Q-tip. While blinded
to the experimental condition, we viewed migrating cells at
magnification ×40 and counted them. Mean values from six randomly
selected fields per insert are reported. For filters containing cells,
which were too dense to count, crystal violet was eluted with 1 ml of
sodium acetate (100 mM in 50% ethanol at pH 5.2), and the
absorbance was quantitated by spectrophotometry (
= 550 nm).
Standard curves generated with serially diluted, crystal violet-stained
cells yielded linear values up to A = 0.5.
Small Interfering RNA (siRNA) Transfection--
siRNA design and
transfection protocol were conducted according to the methods of
Elbashir et al. (30). The siRNA oligonucleotide sequence
targeting
8 integrin (AAACCAGGTACAAGGCATCTA)
corresponded to nucleotides 1859-1879 in the coding region of the
human cDNA sequence (24). An NCBI Protein Database BLASTn search
revealed only the
8 integrin cDNA as an exact match
with the selected sense or antisense sequences. Lamin double-stranded
RNA transfection, according to published methods (30), was used as a
control for nonspecific effects of siRNA incorporation. Synthetic,
annealed, double-stranded RNA constructs containing a 3'-dTdT overhang
were purchased from Dharmacon Research, Inc. (Lafayette, CO).
Oligonucleotide transfection was conducted according to the
manufacturer's recommendations (Invitrogen). Briefly, HRPT cells were
plated in 24-well dishes in antibiotic-free DMEM supplemented with 10%
fetal bovine serum. At 24 h, cells at ~50% confluence were
incubated with 150 µl of Opti-MEM (Invitrogen)/well. Oligonucleotides
(3 µl, 20 µM stock) suspended in 50 µl of Opti-MEM
were combined with OligofectAMINE reagent (Invitrogen) and maintained
at room temperature for 25 min. The siRNA and OligofectAMINE mixture
was supplemented with Opti-MEM and incubated with each well (4 h,
37 °C), followed by addition of DMEM plus 30% fetal bovine serum
for 24 h. Wells were washed with phosphate-buffered saline and
incubated for an additional 24 h in DMEM plus 10% fetal bovine
serum. Transfected cells were analyzed for expression of
8 integrin and lamin A/C and migration as described above.
Statistics--
Data are representative of two to four
experiments for each condition. Histogram results are expressed as
means ± S.E. Comparisons between groups were made by one-way
analysis of variance with Bonferroni's test for multiple comparisons.
Statistical significance is defined as p < 0.05.
 |
RESULTS |
Fas Activation Induces
8 Integrin mRNA
Expression--
We have previously demonstrated in experimental models
that activation of up-regulated RTC Fas contributes to apoptosis and renal disease progression (1, 2). On the other hand, stimulation of
constitutively expressed, low level RTC Fas transduces intracellular signals (13), but does not lead to apoptosis (2, 11), suggesting that
Fas may regulate pathophysiologically relevant RTC functions in the
absence of apoptosis.
To identify apoptosis-independent Fas pathways in RTC, cultured HRPT
cells, which constitutively express Fas (1), were stimulated with
either agonistic anti-Fas IgM or isotype control IgM (150 ng/ml, 6 h, 37 °C) under conditions that did not cause apoptosis, as
determined by previously described poly(ADP-ribose) polymerase cleavage
methods (13) (data not shown). mRNA expression patterns from both
groups were screened by hybridization array using nylon filters spotted
with 375 chemokine and cytokine cDNAs. This strategy was chosen
because previous reports indicated that Fas stimulation induces
cytokine and chemokine synthesis and secretion (15). The arrays
revealed induction of four gene products in Fas-stimulated cells, and
no genes were down-regulated by Fas activation (data not shown). Of the
Fas-induced transcripts,
8 integrin subunit mRNA
expression was most markedly increased, with a mean 3-fold elevation.
The kinetics of Fas-dependent
8 integrin
gene expression were examined in RTC stimulated with agonistic anti-Fas
IgM or isotype control IgM for durations ranging from 3 to 48 h,
and mRNA expression was determined by Northern analysis. As shown
in Fig. 1, steady-state
8
integrin mRNA was detected in unstimulated cells at all time points, consistent with previous data demonstrating constitutive expression in kidney (24). Fas-stimulated
8 integrin
mRNA levels were slightly increased at 3 h, peaked between 6 and 18 h, and remained elevated at 48 h.

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Fig. 1.
Fas activation induces
8 integrin mRNA expression.
HRPT cells were stimulated with agonistic anti-Fas IgM (150 ng/ml,
37 °C) or isotype control IgM (150 ng/ml, 37 °C) for the
indicated time periods. Poly(A) RNA (2 µg/lane) was fractionated by
formaldehyde-containing 1% agarose gel electrophoresis and transferred
to nylon membranes as described under "Materials and Methods."
Blots were probed with 32P-labeled full-length human
8 integrin cDNA (upper panels) or a
300-nucleotide PCR product amplified from human -actin cDNA
(lower panels). Results are representative of four different
experiments.
|
|
Fas Activation Stimulates Surface
v
8
Integrin Protein Expression--
Integrins are heterodimeric, single
transmembrane-spanning receptors for extracellular matrix ligands, and
the
8 integrin subunit dimerizes exclusively with the
v subunit (24). To determine whether RTC Fas activation
induces plasma membrane
v
8 protein expression, cells were stimulated with agonistic anti-Fas antibodies or
isotype control IgM, surface-labeled with 125I, and
immunoprecipitated with anti-
v integrin IgG or
anti-
8 integrin antiserum. As shown in Fig.
2A, anti-
v
immunoprecipitates contained 150- and 90-kDa bands, suggesting that
v
8 is induced by Fas activation. Although
the smaller band could represent other similarly sized
v
partners such as
3 and
5 integrin
subunits, immunoprecipitation with anti-
8 integrin
antiserum yielded identical results (Fig. 2A), indicating
that Fas stimulation up-regulates surface
v
8 expression. Concordant increases in
v and
8 integrins may result from
increased association of endogenous
v with newly synthesized
8, in agreement with previous observations
for
v
3 (31). However, the
anti-
v immunoprecipitation data from Fig. 2A
suggest that
v expression may actually be induced by Fas
stimulation.

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Fig. 2.
Fas activation stimulates surface
v 8
integrin protein expression. A, subconfluent HRPT cell
monolayers were stimulated with agonistic anti-Fas IgM (150 ng/ml,
6 h, 37 °C) or isotype control IgM (150 ng/ml, 6 h,
37 °C) and then surfaced-labeled with 125I as described
under "Materials and Methods." Cell lysates were precleared with
preimmune serum, and aliquots with equal radioactivity were
immunoprecipitated (IP) with anti- v IgG
(first and second lanes) or anti- 8
integrin antiserum (third and fourth lanes) and
resolved by SDS-PAGE. Gels were dried and exposed to film as described
under "Materials and Methods." Results are representative of three
different experiments. B, subconfluent HRPT cell monolayers
were stimulated with agonistic anti-Fas IgM (150 ng/ml, 37 °C) or
isotype control IgM (150 ng/ml, 37 °C) for the indicated time
periods and then surfaced-labeled with biotin as described under
"Materials and Methods." Cell lysates were immunoprecipitated with
anti- v integrin IgG (upper panels) or
anti- 8 integrin antiserum (lower panels),
resolved by SDS-PAGE, transferred to PVDF membranes, and probed with
peroxidase-conjugated streptavidin. Results are representative of four
different experiments. C, subconfluent HRPT cell monolayers
were stimulated with isotype control IgG (1 µg/ml, 18 h,
37 °C), agonistic anti-Fas IgG (clone DX2; 1 µg/ml, 18 h,
37 °C), isotype control IgM (150 ng/ml, 18 h, 37 °C), or
agonistic anti-Fas IgM (clone CH11; 150 ng/ml, 18 h, 37 °C) and
surfaced-labeled with biotin. Cell lysates were immunoprecipitated with
anti- 8 integrin antiserum, resolved by 6% SDS-PAGE,
transferred to PVDF membranes, and probed with peroxidase-conjugated
streptavidin. Results are representative of three different
experiments.
|
|
To determine whether Fas-induced plasma membrane
v
8 integrin expression is sustained, RTC
were stimulated with agonistic anti-Fas IgM or isotype control
IgM for 6-48 h, surface-labeled with biotin, and immunoprecipitated
with anti-
v IgG and anti-
8 integrin
antiserum. Fig. 2B demonstrates that Fas activation
stimulated plasma membrane
v and
8
integrin expression at 6 h, and Fas-mediated
8
integrin expression was observed for up to 48 h, which parallels the Fas-induced
8 integrin mRNA expression kinetics.
The specificity of
8 integrin induction by Fas
activation with the agonistic anti-Fas IgM stimulus was assessed by
determination of cell-surface
8 integrin expression in
RTC incubated with a different agonistic antibody (clone DX2).
Fas activation under these conditions did not stimulate apoptosis (data
not shown). More importantly, DX2 exposure induced
8
integrin expression (Fig. 2C), consistent with results
generated with the anti-Fas IgM clone CH11. We conclude that
8 integrin induction is not restricted to specific
agonistic antibody stimuli, but is a general phenomenon of Fas activation.
Fas Induction of
8 Integrin Expression Is Unique to
Apoptosis-independent Conditions and RTC--
To determine
whether Fas-regulated
8 integrin induction is specific
to apoptosis-independent conditions,
8 integrin
expression was determined in HRPT cells stimulated to undergo apoptosis
following transient transfection with mouse fas
cDNA and incubation with agonistic anti-mouse Fas IgG, as
previously described (13). Fas stimulation under these conditions was
associated with an increase in apoptosis as defined by poly(ADP-ribose)
polymerase cleavage, but
8 integrin expression was
unchanged following apoptosis stimulation with agonistic anti-Fas
antibodies (Fig. 3A). These data indicate that Fas induction of
8 integrin
expression is restricted to RTC with low basal Fas expression levels,
which are relatively resistant to Fas-dependent apoptosis
(2, 10, 11, 13).

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Fig. 3.
Fas induction of
8 integrin expression is unique to
apoptosis-independent conditions and RTC. A, HRPT cells were
transiently transfected with a murine fas cDNA
expression vector (mFas transfect.; 2 µg/well), followed
by incubation with or without agonistic anti-mouse Fas IgG (clone Jo2;
5 µg/ml, 18 h, 37 °C). Untransfected, unstimulated cells
served as a control. Cell lysates were immunoprecipitated with
anti- 8 integrin antiserum, resolved by 6% SDS-PAGE,
transferred to PVDF membranes, and probed with peroxidase-conjugated
streptavidin. Apoptosis was determined by immunoblot analysis of the
same lysates for poly(ADP-ribose) polymerase (PARP) cleavage
(depicted by the arrow). Results are representative of three
separate experiments. B, MCF-7 cells were exposed to
agonistic anti-Fas antibodies (clone CH11; 150 ng/ml, 6 h,
37 °C) or isotype control IgM (150 ng/ml, 6 h, 37 °C) and
surfaced-labeled with biotin. Unstimulated, biotin-labeled HRPT cells
were included as a control for relative 8 integrin
expression levels. Cell lysates were immunoprecipitated with
anti- 8 integrin antiserum, resolved by 6% SDS-PAGE,
transferred to PVDF membranes, and probed with peroxidase-conjugated
streptavidin. Results are representative of two separate
experiments.
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|
To investigate whether Fas-dependent
8
integrin induction is a generalized epithelial cell phenomenon, MCF-7
breast carcinoma cells were exposed to agonistic anti-Fas antibodies,
and
8 integrin expression was determined by
immunoprecipitation of surface-biotinylated protein with
anti-
8 integrin antiserum. MCF-7
8
integrin expression was detectable, but base-line levels were
diminished compared with HRPT cells (Fig. 3B). Moreover,
8 integrin expression was not regulated by Fas
stimulation in MCF-7 cells, suggesting that
8 integrin
induction by Fas activation is specific to RTC.
Fas Induces
8 Integrin Expression by an Enhanced
mRNA Stabilization Mechanism--
To determine the mechanism of
Fas-dependent
8 integrin induction, surface
8 integrin protein expression was measured in RTC
co-incubated with agonistic anti-Fas antibodies and/or the mRNA
transcription inhibitor actinomycin D or the protein translation inhibitor cycloheximide. Exposure of either actinomycin D or
cycloheximide to anti-Fas antibodies for >12 h resulted in significant
cell death (data not shown), in agreement with previous reports of enhanced Fas-dependent apoptosis in selected cell lines due
to inhibition of endogenous anti-apoptotic proteins (32, 33). Fig.
4A confirms that
8 integrin expression was induced in response to
agonistic anti-Fas IgG or anti-Fas IgM. Actinomycin D co-incubation had
no effect on
8 integrin induction (Fig. 4B),
suggesting that Fas-induced
8 integrin expression is
post-transcriptionally regulated. Cycloheximide completely inhibited
Fas-dependent increases in surface
8 subunit
expression (Fig. 4C), indicating that Fas modulation of
8 integrin expression requires new protein
synthesis.

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Fig. 4.
Fas induces
8 integrin expression by an enhanced
mRNA stabilization mechanism. A, subconfluent HRPT cell
monolayers were stimulated with agonistic anti-Fas IgG (clone DX2; 1 µg/ml, 6 h, 37 °C) or agonistic anti-Fas IgM (clone CH11; 150 ng/ml, 6 h, 37 °C) and then surfaced-labeled with biotin. Cell
lysates were immunoprecipitated with anti- 8 integrin
antiserum, resolved by 6% SDS-PAGE, transferred to PVDF membranes, and
probed for surface 8 integrin expression with
peroxidase-conjugated streptavidin. Results are representative of two
different experiments. B, subconfluent HRPT cells were
pretreated with actinomycin D (0.5 µg/ml, 1 h, 37 °C),
stimulated with agonistic anti-Fas IgG (clone DX2; 1 µg/ml, 6 h,
37 °C) or agonistic anti-Fas IgM (clone CH11; 150 ng/ml, 6 h,
37 °C) in the continued presence of actinomycin D, and then
surfaced-labeled with biotin. Cell lysates were probed for surface
8 integrin expression as described for A.
Results are representative of three different experiments.
C, subconfluent HRPT cells were pretreated with
cycloheximide (5 µg/ml, 1 h, 37 °C), stimulated with
agonistic anti-Fas IgG (clone DX2; 1 µg/ml, 6 h, 37 °C) or
agonistic anti-Fas IgM (clone CH11; 150 ng/ml, 6 h, 37 °C) in
the continued presence of cycloheximide, and then surfaced-labeled with
biotin. Cell lysates were probed for surface 8 integrin
expression as described for A. Results are representative of
three different experiments. D, HRPT cells were stimulated
with or without agonistic anti-Fas IgM (150 ng/ml, 6 h, 37 °C).
Actinomycin D (0.5 µg/ml, 37 °C) was then added for the indicated
time periods. Steady-state 8 integrin and -actin
mRNA levels were determined by Northern blotting as described under
"Materials and Methods." Band intensities were quantitated by
PhosphorImager analysis. Results represent mean of 8
integrin mRNA/ -actin mRNA ratios (expressed on a logarithmic
scale along the y axis) from two experiments. Data are
normalized to mRNA ratios at the 0-h time point. *,
p < 0.05 compared with anti-Fas IgM-treated cells at
the same time point.
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To determine the mechanism of post-transcriptional regulation,
8 integrin mRNA stability was determined in
Fas-stimulated versus unstimulated RTC. Fig. 4D
shows steady
8 integrin mRNA decay in the control
group from 0 to 12 h, whereas
8 integrin mRNA
levels were relatively unchanged in Fas-stimulated cells over the same
time period. These data demonstrate that Fas activation induces
8 integrin expression by an enhanced mRNA
stabilization mechanism.
Fas Activation Does Not Regulate Expression or Function of Other
v Integrin Heterodimers--
Before determining the
functional consequences of
v
8
induction by Fas (29), we first characterized the expression of other RTC
v
integrins that could potentially mimic
v
8 effects such as cell migration (21,
34). Basal and Fas-induced surface expression of
v
1,
v
3,
v
5, and
v
6
were determined by biotin surface labeling and immunoprecipitation.
v
3 and
v
5
were abundant under basal (no additions) and control (isotype control
antibody exposure) conditions, consistent with previous reports in
cortical RTC (35). In contrast to
v
8, Fas
activation did not induce expression of either
v
3 or
v
5
(Fig. 5A).
v
1 and
v
6
were undetectable in basal or Fas-stimulated cells (data not
shown).

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Fig. 5.
Fas activation does not regulate expression
or function of other v integrin
heterodimers. A, subconfluent HRPT cells were
stimulated with agonistic anti-Fas IgM (150 ng/ml, 18 h, 37 °C)
or isotype control IgM (150 ng/ml, 18 h, 37 °C) and
surfaced-labeled with biotin. Lysates were immunoprecipitated with
anti- v 3 IgG (upper panel),
anti- v 5 IgG (middle panel), or
anti- 8 integrin antiserum (lower panel).
Results are representative of four different experiments. B,
HRPT cells were plated in the upper chamber of permeable supports at
1.2 × 105 cells/well. The underside of the support
was precoated with 10 µg/ml vitronectin. Function-blocking
anti- v 3 IgG was added to the media in the
upper and lower chambers at the indicated concentrations at time point
0. Cells migrating to the lower chamber were fixed after 12 h,
stained with crystal violet, and counted. Results represent means ± S.E. from six fields viewed at magnification ×40 in two different
experiments. Results are representative of three different experiments.
C, the experiment was identical to that described for
B, except that function-blocking
anti- v 5 IgG was added to the upper and
lower chambers. *, p < 0.05 compared with
control and isotype IgG groups. Results are representative of
three different experiments. HPF, high power (×40)
field.
|
|
To assess the functional significance of
v
3 and
v
5,
RTC haptotaxis on vitronectin-coated permeable supports was
quantitatively assayed in the presence of function-blocking
anti-
v
3 and
anti-
v
5 antibodies.
Anti-
v
3 IgG incubation had no effect on
migration (Fig. 5B), even after exceeding concentrations
that have been shown to prevent motility in cells that abundantly
express
v
3 (28). In contrast, haptotaxis
was inhibited by ~50% with anti-
v
5 IgG
(Fig. 5C). The results demonstrate that basal RTC migration to vitronectin is partly mediated by
v
5,
with no contribution from
v
3. However,
these findings do not preclude other functions for RTC
v
3 such as stable adhesion formation.
Fas Activation Stimulates RTC Migration by a
8
Integrin-dependent Mechanism--
To test whether
Fas-regulated
8 integrin is functional, RTC were exposed
to isotype control IgM or agonistic anti-Fas IgM, and cell migration to
vitronectin matrix was assayed. Fas stimulation for 4-6 h was
associated with 15-20% increases in the number of migrating cells
(data not shown). Greater increases in migration were observed after
18 h (Fig. 6A). Migration
was increased in proportion to surface
8 integrin
expression levels in Fas-stimulated and
8
integrin-transfected RTC (Fig. 6, A and B),
suggesting that Fas transduces a migratory phenotype through induction
of
v
8 integrin function.

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Fig. 6.
Fas activation stimulates RTC migration by
a 8 integrin-dependent
mechanism. A, HRPT cells were pretreated with no additions
(Control), isotype control IgM (150 ng/ml, 18 h,
37 °C), or agonistic anti-Fas IgM (150 ng/ml, 18 h, 37 °C)
and then plated in the upper chamber of permeable supports at 1.2 × 105 cells/well. The underside of the support was
precoated with vitronectin (10 µg/ml). HRPT cells stably transfected
with human 8 integrin cDNA
( 8 transf.) were included as a
positive control group. Cells migrating to the lower chamber were fixed
after 18 h and stained with crystal violet, which was eluted and
quantitated by spectrophotometry as described under "Materials and
Methods." Results represent means ± S.E. of absorbance readings
from four experiments. *, p < 0.05 compared with
control (no additions) and isotype IgM groups. B, HRPT cells
were treated as described for A with no additions, isotype
control IgM (150 ng/ml, 18 h, 37 °C), or agonistic anti-Fas IgM
(150 ng/ml, 18 h, 37 °C) or stably transfected with human
8 integrin cDNA and then surfaced-labeled with
biotin. Cell lysates were immunoprecipitated with anti- 8
integrin antiserum, resolved by 6% SDS-PAGE, transferred to PVDF
membranes, and probed with peroxidase-conjugated streptavidin. Results
are representative of four different experiments. C, HRPT
cells treated with agonistic anti-Fas IgM (150 ng/ml, 18 h,
37 °C) or isotype control IgM (150 ng/ml, 18 h, 37 °C) were
plated in the upper chamber of permeable supports at 1.2 × 105 cells/well. The support was precoated on the underside
with vitronectin (10 µg/ml). The indicated groups were co-incubated
with function-blocking anti- v 5 IgG (1 µg/ml) in both the upper and lower chambers at the time of plating.
Cells migrating to the lower chamber were fixed after 18 h,
stained with crystal violet, and counted. Results represent means ± S.E. from six fields viewed at magnification ×40 in three different
experiments. *, p < 0.05 compared with control and
isotype IgM groups.
|
|
v
8 ligand specificity was examined by
determining migration on an alternative extracellular matrix protein,
fibronectin, which has been implicated as a ligand for
v
8 in other systems (36). RTC migration
to fibronectin was not observed in basal, Fas-stimulated, or
8 integrin-overexpressing RTC (data not shown), indicating that fibronectin is not a ligand for RTC
v
8. The data are consistent with previous
affinity chromatography studies showing that epithelial cell
v
8 does not bind fibronectin (21), as
well as with the recent report by Mu et al. (37), who
demonstrated that epithelial cell
v
8
ligands are restricted to vitronectin and TGF-
1.
Because
v
5 was the only other
v integrin to affect RTC migration (Fig. 5), the
specificity of Fas-induced
v
8 for RTC migration to vitronectin was addressed by haptotaxis assays in the
presence of inhibitory anti-
v
5
antibodies. This strategy has previously been employed to assess
8 integrin function in astrocytes, wherein residual
migration after
v
5 inhibition was attributed to
v
8 (29). As shown in Fig.
6C, RTC Fas stimulation induced a significant increase in
haptotaxis. Co-incubation with function-blocking
anti-
v
5 IgG resulted in diminution of
base-line migration by 50%, in agreement with data from Fig. 5.
However, the Fas-induced, 1-fold increase in haptotaxis was maintained in anti-
v
5 IgG-treated cells, indicating
that
v
5 contributes to basal (but not
Fas-dependent) migration and that Fas-dependent migration is due to functional up-regulation of
v
8.
To more directly determine the functional effect of Fas-induced
8 integrin expression, migration to vitronectin matrix
was assessed in RTC with
8 integrin expression
down-regulation by RNA interference. Fig.
7A demonstrates the inhibition
of basal and Fas-stimulated surface
8 integrin protein
expression in RTC transfected with a
8 integrin-targeted
siRNA construct. Fas-stimulated increases in RTC migration were
completely blocked by
8 integrin siRNA preincubation
(Fig. 7B), whereas suppressed expression of an irrelevant
gene (lamin A/C) by siRNA had no effect on basal or RTC
Fas-dependent
8 integrin expression or
migration (data not shown). The results demonstrate that Fas activation
induces
8 integrin expression and function.

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Fig. 7.
Fas-activated RTC migration is inhibited
by 8 integrin RNA interference.
A, HRPT cells were transfected in duplicate wells with
OligofectAMINE in the absence of double-stranded RNA
(Control) or with 8 integrin siRNA according
to the protocol described under "Materials and Methods." After
24 h, the medium was changed, and agonistic anti-Fas IgM (150 ng/ml, 18 h, 37 °C) was added to one well for each condition.
Cells were surface-labeled with biotin, lysed, and probed for
8 integrin expression by immunoprecipitation with
anti- 8 integrin antiserum (upper panel) or
immunoblotted for -tubulin expression as a loading control
(lower panel). Results are representative of four different
experiments. B, HRPT cells were transfected in duplicate
wells with OligofectAMINE in the absence of double-stranded RNA or with
8 integrin siRNA and incubated with anti-Fas IgM as
described for A. Cells were then plated in the upper chamber
of permeable supports at 1.2 × 105 cells/well. The
support was precoated on the underside with vitronectin (10 µg/ml).
Cells migrating to the lower chamber were fixed after 18 h and
stained with crystal violet, which was eluted and quantitated by
spectrophotometry as described under "Materials and Methods."
Results are representative of four different experiments. *,
p < 0.05 compared with all other groups.
|
|
 |
DISCUSSION |
Among receptor-mediated apoptosis pathways, signals transduced by
Fas stimulation have been so extensively characterized that Fas is
viewed as the prototypical death receptor in susceptible cells (3).
However, in some cell types, Fas may mediate apoptosis-independent processes such as proliferation, angiogenesis, fibrosis, and
inflammation (15, 16). Perhaps the most striking example of
apoptosis-independent Fas function is derived from transgenic mouse and
pancreatic islet cell transplantation studies in which
-cells were
genetically engineered to express Fas ligand in an effort to confer
immune privilege through apoptotic deletion of invading, Fas-expressing T-cells (38-40). These studies surprisingly revealed extensive neutrophil infiltration and islet cell destruction, rather than preserved pancreatic morphology. In RTC, stimulation of overexpressed Fas transmits typical apoptosis signals (2, 13), whereas apoptosis-independent signals such as JNK activation are generated through constitutively expressed, low abundance Fas (13). Our study
extends these observations by demonstrating that
8
integrin induction is an additional pathway that is regulated by
constitutively expressed RTC Fas.
Although Fas stimulation of
8 integrin expression and
function was unexpected, apoptosis and integrin pathways have
previously been linked, albeit in an antagonistic fashion, whereby
cells undergo apoptosis when integrins are no longer ligated to
appropriate extracellular matrix or matrix-embedded growth factors.
Frisch and Francis (17) described the process of anoikis, a specific type of apoptosis that is initiated upon integrin detachment from the
extracellular matrix, which normally serves as a survival factor. More
recently, Stupack et al. (18) demonstrated another form of
integrin-related cell death in
v
3-expressing cells maintained within a
three-dimensional collagen gel, which is an inappropriate ligand for
v
3. Under these conditions, caspase-8
docked at the cytoplasmic domain of the unligated
3
integrin, resulting in cell death receptor-independent apoptosis. In
contrast to these observations of detached or unligated integrins
causing apoptosis, we now demonstrate, for the first time, that an
integrin is up-regulated by death receptor activation. Furthermore,
results from studies with apoptosis-sensitive HRPT and MCF-7 cells
revealed that Fas-dependent
8 integrin
induction is restricted to apoptosis-independent conditions, thereby
defining a new role for Fas in a context other than cell death.
Of the genes regulated by agonistic anti-Fas antibodies in our
hybridization array experiments,
8 integrin was selected
for further study because it was induced by the greatest magnitude and
because of potential pathophysiologic relevance since
integrin-extracellular matrix interactions are pivotal in renal disease
pathogenesis. In chronic renal diseases, increased RTC
v
expression is associated with histologic damage and disease progression
(41). Furthermore, mRNA expression of the
v ligand
vitronectin is not present in normal kidney, but becomes detectable
within the tubular basement membrane and interstitium in renal diseases
(reviewed in Ref. 42). The tubular basement membrane usually acts as a
barrier for RTC migration to the interstitium. However, regions of
tubular basement membrane disruption have recently been identified in chronic renal disease biopsies (43, 44), suggesting that tubular atrophy, a strong predictor of renal disease progression, can be
initiated by a mechanism involving RTC Fas-regulated induction of
v
8 expression, which leads to directional
RTC motility from a luminal location to the fibrotic, vitronectin-rich
renal interstitium. Alternatively, up-regulated
8
integrin-dependent RTC motility could represent an adaptive
process by facilitating migration of regenerating,
v
8-expressing RTC along denuded regions
of intact, vitronectin-containing tubular basement membrane.
Recent studies have demonstrated that, in addition to serving as a
stimulus for cell motility,
v
8 also
modulates cell growth and differentiation (37, 45). In the studies of
lung epithelial cells by Cambier et al. (45),
v
8 expression was associated with cell
cycle withdrawal and inhibition of proliferation, which was not due to
increased apoptosis. This same group subsequently showed that the
negative cell growth regulation was mediated, at least in part, by
v
8 binding of latent TGF-
1 and
metalloproteinase-dependent TGF-
1 activation (37). These
studies raise the intriguing possibility that RTC
v
8 could act as a TGF-
1 receptor and
potentially play a role in the pathogenesis of interstitial fibrosis
since renal fibrogenesis is regulated by TGF-
1 (46).
After establishing that
8 integrin was induced by Fas
activation, we determined the mechanism to be enhanced mRNA
stabilization, which is consistent with regulatory mechanisms for
3 and
5 integrin synthesis (35, 47).
Although post-transcriptional mRNA regulation has not
been as extensively investigated as transcriptional regulation mechanisms, Chen et al. (48) have described
cis-elements within the 5'- and 3'-untranslated regions of
the interleukin-2 gene that mediate mRNA stability, although
specific binding sequences were not identified. These investigators
subsequently identified two RNA-binding proteins that are targeted by
the JNK signaling pathway to specifically bind to the 5'-untranslated
region and the initial portion of the coding region and that
confer a prolonged interleukin-2 mRNA half-life in activated
T-cells (49). A similar mechanism for
8 integrin
mRNA regulation is plausible inasmuch as previous reports from our
laboratory demonstrate Fas-dependent JNK activation in the
absence of apoptosis (13). Alternatively, there are several domains
within the 3'-untranslated region of the
8 integrin
mRNA that contain consensus AU-rich response elements, which have
been associated with cytokine mRNA stabilization by JNK-independent
signals (50).
Our data were generated from cells stimulated with agonistic anti-Fas
antibodies; and although this has been a widely accepted strategy to
achieve Fas-activated apoptosis in vitro and in
vivo (51), agonistic anti-Fas IgG does not cluster Fas as
effectively as transmembrane Fas ligand in some systems (4, 6, 52, 53),
suggesting that apoptosis-independent pathways can be triggered by a
less potent stimulus. This is unlikely in our system because
8 integrin expression was induced by both agonistic
anti-Fas IgG and anti-Fas IgM, and pentameric anti-Fas IgM should be
sufficient to cluster Fas and to induce apoptosis in susceptible cells
(6, 54). We speculate that in apoptosis-resistant cells, Fas signals transduced by agonistic antibodies may more closely mimic in
vivo soluble Fas ligand-stimulated pathways because soluble Fas
ligand has similarly been shown to bind Fas without stimulating
apoptosis (52, 55). In support of this possibility, soluble Fas ligand and agonistic anti-Fas antibodies both induce apoptosis-independent JNK
activation in RTC (13).2
Another potentially confounding issue related to agonistic anti-Fas antibodies is whether
8 integrin induction could be due
to immunoglobulin receptor stimulation rather than to specific Fas
activation. Because Fc receptors have not been identified in RTC, this
is an unlikely explanation for our findings. Nevertheless, to address
nonspecific effects of immunoglobulins on
8 integrin
induction, most studies included isotype IgG or IgM control groups.
Because isotype immunoglobulin controls had no effect on
8 integrin expression or function compared with
unstimulated control cells, we conclude that
8 integrin induction is specifically due to Fas activation.
In conclusion, we have defined a new role for Fas in the facilitation
of
v
8 integrin-dependent cell
migration. These findings are unique inasmuch as synergism between cell
death receptor and integrin pathways has not previously been described
and suggest that additional apoptosis-independent cell phenotypes may
be mediated by receptors traditionally relegated to cell death functions.
 |
FOOTNOTES |
*
This work was supported by National Institutes of Health
Grants DK54178, DK38558, DK57933, and CA96533 and United States
Department of Defense Grant DAMD17-99-1-9019.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.

Established Investigator of the American Heart Association. To
whom correspondence should be addressed: Case Western Reserve University, Rammelkamp Center for Education and Research, MetroHealth Medical Center Campus, 2500 MetroHealth Dr., G531, Cleveland, OH
44109-1998. Tel.: 216-778-4993; Fax: 216-778-8248; E-mail: jrs15@po.cwru.edu.
Published, JBC Papers in Press, September 24, 2002, DOI 10.1074/jbc.M204901200
2
G. Jarad, S. Khan, and J. R. Schelling,
unpublished data.
 |
ABBREVIATIONS |
The abbreviations used are:
RTC, renal
tubular epithelial cell(s);
HRPT, human renal proximal tubule;
JNK, c-Jun NH2-terminal kinase;
DMEM, Dulbecco's modified
Eagle's medium;
PVDF, polyvinylidene difluoride;
siRNA, small
interfering RNA;
TGF-
1, transforming growth factor-
1.
 |
REFERENCES |
| 1.
|
Schelling, J. R.,
Nkemere, N.,
Kopp, J. B.,
and Cleveland, R. P.
(1998)
Lab. Invest.
78,
813-824[Medline]
[Order article via Infotrieve]
|
| 2.
|
Khan, S.,
Cleveland, R. P.,
Koch, C. J.,
and Schelling, J. R.
(1999)
Lab. Invest.
79,
1089-1099[Medline]
[Order article via Infotrieve]
|
| 3.
|
Nagata, S.
(1997)
Cell
88,
355-365[CrossRef][Medline]
[Order article via Infotrieve]
|
| 4.
|
Siegel, R. M.,
Frederiksen, J. K.,
Zacharias, D. A.,
Chan, F. K. M.,
Johnson, M.,
Lynch, D.,
Tsien, R. Y.,
and Lenardo, M. J.
(2000)
Science
288,
2354-2357[Abstract/Free Full Text]
|
| 5.
|
Parlato, S.,
Giammarioli, A. M.,
Logozzi, M.,
Lozupone, F.,
Matarrese, P.,
Luciani, F.,
Falchi, M.,
Malorni, W.,
and Fais, S.
(2000)
EMBO J.
19,
5123-5134[CrossRef][Medline]
[Order article via Infotrieve]
|
| 6.
|
Huang, D. C. S.,
Hahne, M.,
Schroeter, M.,
Frei, K.,
Fontana, A.,
Villunger, A.,
Newton, K.,
Tschopp, J.,
and Strasser, A.
(1999)
Proc. Natl. Acad. Sci. U. S. A.
96,
14871-14876[Abstract/Free Full Text]
|
| 7.
|
Grassmé, H.,
Jekle, A.,
Riehle, A.,
Schwarz, H.,
Berger, J.,
Sandhoff, K.,
Kolesnick, R.,
and Gulbins, E.
(2001)
J. Biol. Chem.
276,
20589-20596[Abstract/Free Full Text]
|
| 8.
|
Boldin, M. P.,
Mett, I. L.,
Varfolomeev, E. E.,
Chumakov, I.,
Shemer-Avni, Y.,
Camonis, J. H.,
and Wallach, D.
(1995)
J. Biol. Chem.
270,
387-391[Abstract/Free Full Text]
|
| 9.
|
Salvesen, G. S.,
and Dixit, V. M.
(1999)
Proc. Natl. Acad. Sci. U. S. A.
96,
10964-10967[Abstract/Free Full Text]
|
| 10.
|
Ortiz-Arduan, A.,
Danoff, T. M.,
Kalluri, R.,
Gonzalez-Cuadrado, S.,
Karp, S. L.,
Elkon, K.,
Egido, J.,
and Neilson, E. G.
(1996)
Am. J. Physiol.
271,
F1193-F1201[Medline]
[Order article via Infotrieve]
|
| 11.
|
Boonstra, J. G.,
Van der Woude, F. J.,
Wever, P. C.,
Laterveer, J. C.,
Daha, M. R.,
and Van Kooten, C.
(1997)
J. Am. Soc. Nephrol.
8,
1517-1524[Abstract]
|
| 12.
|
Schelling, J. R.,
and Cleveland, R. P.
(1999)
Kidney Int.
56,
1313-1316[CrossRef][Medline]
[Order article via Infotrieve]
|
| 13.
|
Khan, S.,
Koepke, A.,
Jarad, G.,
Schlessman, K.,
C |