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J. Biol. Chem., Vol. 277, Issue 9, 6888-6897, March 1, 2002
From the
Received for publication, August 9, 2001, and in revised form, November 7, 2001
The receptor for advanced glycation end products
(RAGE), a member of the immunoglobulin superfamily, is known to
interact with amphoterin. This interaction has been proposed to play a role in neurite outgrowth and process elongation during
neurodifferentiation. However, there is as yet no direct evidence of
the relevance of this pathway to neurodifferentiation under
physiological conditions. In this study we have investigated a possible
role of RAGE and amphoterin in the retinoic acid-induced
differentiation of neuroblastoma cells. The functional inactivation of
RAGE by dominant negative and antisense strategies showed that RAGE is
not required for process outgrowth or differentiation, although
overexpression of RAGE accelerates the elongation of neuritic
processes. Using the antisense strategy, amphoterin was shown to be
essential for process outgrowth and differentiation, suggesting that
amphoterin may interact with other molecules to exert its effect in
this context. Interestingly, the survival of the neuroblastoma cells treated with retinoic acid was partly dependent on the expression of
RAGE, and inhibition of RAGE function partially blocked the increase in
anti-apoptotic protein Bcl-2 following retinoic acid treatment. Based
on these results we propose that a combination therapy using RAGE
blockers and retinoic acid may prove as a useful approach for
chemotherapy for the treatment of neuroblastoma.
Retinoic acid (RA)1, a
derivative of vitamin A, exerts profound effects on the
differentiation, morphogenesis, and survival of many cell types,
including neuronal precursor cells (1-3). RA is a natural
morphogen that determines anterioposterior axial patterning and
induces neuronal differentiation during embryogenesis (4, 5). Human and
mouse neuroblastoma cells extend neurites and elongate axons following
RA exposure. RA accomplishes most of its biological functions through
interaction with two classes of nuclear receptors, the RA receptors
(RAR) and retinoid X receptors (RXR) (6-8). Of the naturally occurring
retinoids, all-trans-retinoic acid (ATRA) binds to
both RAR and RXR, whereas 9-cis-retinoic acid binds to RXR.
The signal is then transduced by the formation of RXR/RAR heterodimers,
which bind to RA response elements to activate the transcription of
RA-responsive genes.
Retinoic acid-induced differentiation leads ultimately to apoptosis
in many cell types indicating close links between the molecular
pathways of cell differentiation and those of cell death. Indeed, ATRA
reduces the growth of human neuroblastoma by inducing differentiation
and apoptosis (3, 9, 10) together with growth arrest at the
G1 phase of the cell cycle (11, 12). This makes retinoic
acid treatment an attractive approach for differentiation therapy of
cancers that resist surgery. Clinical trials are in progress to
determine the efficacy of retinoids in cancer such as neuroblastoma,
which accounts for 15% of cancer deaths in children (13, 14). The
receptor for advanced glycation end products (RAGE) is a member of the
immunoglobulin superfamily, which binds to amphoterin, a member of high
mobility group protein, to initiate neurite outgrowth in cortical
neurons (15, 16). The RAGE-amphoterin interaction elicits Rac and cdc42
activation and stimulates neurodifferentiation in RAGE-expressing cells
cultured on amphoterin-coated plates (17). RAGE-amphoterin is localized at the leading edge of differentiating neurons, suggesting a role in
axonal and dendritic elongation.
Although retinoic acid-induced neurodifferentiation is mediated by
interaction with nuclear receptors, the molecular details of how
exactly the nuclear message leads to axonal and dendritic outgrowth at
the cell membrane level is still not clearly understood. An improved
knowledge of the pathways that link differentiation and apoptosis
during retinoic acid-induced differentiation would provide a basis for
the development of better therapeutic approaches for neuroblastoma
treatment. The present investigation was designed to study the role of
RAGE in retinoic acid-induced neurodifferentiation. The mouse
neuroblastoma Neuro2a and human SH-SY5Y cell lines chosen as the model
for this study extend processes and also undergo apoptosis following
retinoic acid treatment. The results presented here show that
RAGE-amphoterin interaction plays a critical role in growth retardation
and survival of neuroblastoma cells following retinoic acid treatment.
The results also suggest that RAGE has a supplementary rather than an
essential role in process outgrowth during retinoic acid-induced differentiation.
Plasmids and Oligonucleotides--
Human RAGE cDNA was a
gift from Dr. David Stern, Columbia University, New York. The
cytoplasmic deletion mutant of RAGE was prepared by as previously
described (14).
Phosphorothioate antisense oligonucleotides were obtained from
Sigma-Genosys Ltd., UK. The oligos were 5'-labeled with fluorescein to
follow transfection efficiency. The names, sequences, and orientation of the sense and antisense oligos used in this study are presented below in Table I.
Cell Culture and Transfections--
The mouse neuroblastoma cell
line Neuro2a and the human neuroblastoma cell line SH-SY5Y (Deutsche
Sammlung von Mikroorganismen und Zellkulturen GmbH, Germany)
were maintained in DMEM containing heat-inactivated 10% FCS,
L-glutamine, penicillin, and streptomycin. Endogenous RAGE
expression in both the cell lines was confirmed by Western and Northern analyses.
Construction of Stable Cell Lines--
Transfection of Neuro2a
cells was carried out with FuGENE 6 transfection reagent (Roche
Molecular Biochemicals, Germany) and plasmid at the ratio of 3:1.
Stable cell lines expressing full-length RAGE (RAGE-FL), RAGE
cytoplasmic deletion mutant (RAGE- Antisense Experiments--
Antisense oligos (see Table I)
were included in the medium for passive cellular uptake. The cells were
pre-treated for 24 h with the required concentration of oligos,
the presence of oligos was maintained throughout the duration of the
experiment, and fresh medium containing oligos was added every second
day. Uptake of oligos was monitored using a fluorescence microscope. In
general, it was observed that the cellular uptake started from 12 h and the nucleotides were detectable undegraded for 60-72 h after the initial treatment.
Differentiation Analyses--
Neuro2a cells were seeded at a
density of 2 × 105 cells/well in a six-well plate and
cultured for 24 h. The medium was then replaced with DMEM
containing 2% serum and 20 µM ATRA (Sigma). After the
required time period of incubation, the percentage of differentiation
was analyzed by counting the number of cells that showed neurite-like
processes. Cells that showed bidirectional or multidirectional
outgrowths were counted. Five random fields were counted for each
observation. The percentage of differentiation was calculated from the
number of cells that showed process outgrowth divided by the total
number of cells in each field. Cells bearing neurite-like processes
longer than the diameter of cell body were considered differentiated
after 48 h, and cells bearing neurites with length at least double
that of cell diameter were considered differentiated after 7 days.
Neurite outgrowth was also studied by staining F-actin with
FITC-Phalloidin. Neuro2a cells at a density of 5 × 104 per well were seeded in two-well chamber slides (Nunc
Lab-Tek) and cultured for 24 h. The medium was then replaced with
DMEM containing 2% FCS and 20 µM ATRA. After the
required time period of incubation the cells were fixed in 4%
paraformaldehyde. The fixed cells were subsequently permeabilized with
0.2% Triton X-100 blocked with 1% FCS and stained with FITC-labeled
phalloidin (Sigma). The results were analyzed in a conventional
fluorescence microscope (Zeiss, Axiovert 25).
Protein Extraction and Western Blots--
Immediately after the
incubation period, the cells were washed twice with PBS and scraped off
the plates in lysis buffer (50 mM Tris, pH 7.4, 150 mM NaCl, Triton X-100 1.0%, SDS 0.1% + protease inhibitor
mixture from Roche Molecular Biochemicals) with a cell scrapper. The
protein concentration of the lysates was determined by using the BCA
protein assay reagent (Pierce). Equal amounts of protein were subjected
to SDS-PAGE and transferred to nitrocellulose membrane in a semi-dry
blotting apparatus (Sigma). The membranes were blocked with synthetic
blocking agent Roti-Block (Roth, Germany) for RAGE detection and 5%
(w/v) nonfat dry milk for all other proteins. The membrane was then
incubated with the primary antibody followed by secondary antibody
conjugated with alkaline phosphatase. The bands were subsequently
detected following the addition of the sensitive coloring agents nitro
blue tetrazolium and 5-bromo-4-chloro-3-indolyl phosphate-p-toluidine. Primary antibodies used: Anti-RAGE
antibody was a gift from Dr. Neeper (Merck Sharp & Dohme Research
Laboratories, Germany). Antiamphoterin antibody and
recombinant rat amphoterin were produced and purified as has been
described previously (18). Anti-Bcl-2, Bcl-XL, and
proliferation cell nuclear antigen (PCNA) were purchased from
PharMingen. Dr. Larry Denner (Texas Biotechnology Corp.) donated the
Anti-sRAGE antibody.
Immunocytochemistry--
Cells grown on 2-well chamber slides
were fixed with 4% paraformaldehyde for 10 min, washed with PBS, pH
7.4, permeabilized with 0.1% Triton X-100, blocked in PBS with 1%
FCS, and then incubated with primary antibody for 1 h. The slides
were washed with PBS and incubated with secondary antibody, Alexa fluor
488 (Molecular Probes, The Netherlands) for 1 h. Slides were then
washed with PBS and mounted with mountant containing 1%
pphenylenediamine (Sigma) prior to analysis using a
fluorescence microscope.
Cell Viability and Apoptosis Detection--
Cell viability was
studied by the MTT assay, and apoptosis was detected by analyses of DNA
fragmentation by agarose gel electrophoresis.
MTT Reduction Assay--
At the end of each experiment, 10 µl
of MTT (5 mg/ml) was added to each well and incubated at 37 °C in
95% air/5% CO2 for 4-5 h. The insoluble formazan formed
was dissolved in isopropanol/0.01 M HCl, and the absorbance
was measured in a spectrophotometer at 570 nm with a background reading
of 660 nm. The percentage of cell survival was calculated relative to
control (taken as 100%).
Agarose Gel for DNA Fragmentation--
The detached cells and
the adherent cells were processed together for DNA extraction. Detached
cells floating in the medium were centrifuged at 500 × g for 10 min and washed with PBS once. Adherent cells were
trypsinized, washed with PBS, and pelleted. The pellet was digested in
proteinase K and RNase A at 50 °C for overnight. After addition of
DNA extraction solution, DNA was obtained by isopropanol and ethanol
precipitation. DNA (10 µg) was examined on 1.5% agarose gel, stained
with ethidium bromide. DNA size calibration was performed using a
100-bp marker.
RAGE Is Not Required for Retinoic Acid-induced
Neurodifferentiation, but RAGE Overexpression Increases the Length of
Process Outgrowth
Previous reports (17, 19) on the effect of RAGE on neurite
outgrowth in neuroblastoma cells were made using cells that do not
express endogenous RAGE. In this study, we chose cells that express
endogenous RAGE to study its contribution to cellular differentiation
and outgrowth under the influence of a physiological agent, retinoic
acid. We constructed stable Neuro2a cell lines expressing either
full-length RAGE (RAGE-FL) or a cytoplasmic domain deletion mutant of
RAGE incapable of signaling (RAGE- Neurite Outgrowth after 48 h of
Differentiation--
Neuro2a cells treated with ATRA showed sprouting
within 12 h, and process outgrowth was clearly observed from 24 to
48 h in agreement with previous findings (20). FITC-phalloidin
staining to visualize filamentous actin (Fig.
2A) showed no significant difference in morphology between mock (pcDNA3), RAGE-FL (RAGE full-length), and RAGE- Neurite Outgrowth after 7 Days of Differentiation--
Continuing
the ATRA treatment for a week resulted in extensive outgrowth and
elaborate network of the processes (Fig.
3A), and the percentage of
differentiation remained significantly higher in RAGE-FL (20.8 ± 3.1%) compared with mock (15.6 ± 1.0%) or RAGE- Survival of Retinoic Acid-treated Cells Is RAGE dependent; RAGE Plays a Role in Bcl-2 Production during Retinoic acid-induced Neurodifferentiation Although RAGE-
RAGE- RAGE Transmits an Anti-apoptotic Signal during Retinoic
Acid-induced Differentiation--
The level of expression of
anti-apoptotic molecules of the Bcl-2 family proteins is a critical
factor known to influence the susceptibility of a cell to undergo
apoptosis. Changes in the expression levels of Bcl-2 family proteins
have been reported (22-24) during the retinoic acid-induced
differentiation of neuroblastoma cells and are likely to contribute to
the altered susceptibility of these cells to apoptosis (24). We
therefore studied the expression of Bcl-XL/Bcl-2 proteins
to examine the molecular mechanism underlying the increased
susceptibility of RAGE-
Antisense Inhibition of Amphoterin Expression Prevents Neurite Outgrowth and Reduces Survival of Retinoic Acid-treated Neuroblastoma Cells RAGE-mediated neurite outgrowth is known to be propagated by its
interaction with the ligand amphoterin (15-17). Because the down-regulation of RAGE showed no significant effect on neurite outgrowth and differentiation, we then studied the role of amphoterin in this process. An antisense strategy was employed to inhibit the
expression of amphoterin. Immunostaining revealed high concentrations of amphoterin in the nucleus (Fig.
7A), indicating its role as a
chromatin-associated protein. Treatment of Neuro2a cells with AS-AMP (3.0 µM) (Table I), for 48 h significantly
down-regulated amphoterin expression (>70%) as indicated by the
reduced intensity of fluorescence (Fig. 7A). The effect of
amphoterin inhibition on retinoic acid-induced neurite outgrowth and
differentiation was subsequently analyzed. The inhibition of amphoterin
expression prevented retinoic acid-induced differentiation and neurite
outgrowth, as detected by FITC-phalloidin staining (Fig.
7B). However, AS-AMP-treated cells showed early signs of
differentiation (i.e. sprouting), demonstrating that
amphoterin inhibition prevents the elongation of neurites rather than
the early events. Neuro2a cells treated with sense oligos, such
as S-AMP, showed 11.9 ± 1.0% of differentiation, whereas cells
treated with antisense oligos showed only 4.9 ± 0.8% (Fig.
7C). This shows that, although RAGE is not essential for
retinoic acid-induced neurite outgrowth, its putative ligand amphoterin
does play an essential role. It also suggests that the functions of
amphoterin in neurite outgrowth are not necessarily mediated through
RAGE.
Because RAGE-FL cells showed extensive process outgrowth and elongation of neuritic processes, we speculated that retinoic acid might increase the expression or secretion of amphoterin during differentiation. To clarify this the expression of amphoterin following ATRA addition was monitored by Western analysis. However, we were unable to detect changes in the expression following ATRA treatment (Fig. 7D). We then addressed the role of amphoterin in cellular survival during
retinoic acid-induced differentiation. As observed by the MTT reduction
assay, cells treated with sense oligos (S-AMP) showed 48.0 ± 3.2% (of retinoic acid-untreated control) of survival whereas
amphoterin inhibition using antisense oligos (AS-AMP) significantly
reduced the percentage of survival to 35.5 ± 0.7% (Fig.
8A). This result was further
confirmed by DNA fragmentation analyses, wherein characteristic DNA
laddering was observed in AS-AMP-treated cells following 5 days of ATRA
treatment (Fig. 8B). Consistent with the results obtained
from RAGE-
Both dominant negative inhibition of RAGE and antisense inhibition of
amphoterin resulted in significant reduction in the survival of Neuro2a
cells following ATRA treatment. However, there is a discrepancy between
the absolute values obtained from MTT reduction analyses of the
individual experiments. Treatment with ATRA for 7 days resulted in more
than 90% inhibition of cellular survival of RAGE- Involvement of RAGE in Retinoic Acid-induced Differentiation and Survival in Neuro2a Cells Is Reproduced in SH-SY5Y Cells Having studied the role of RAGE in the murine Neuro2a cells, we
wanted to establish whether or not the function of RAGE in cellular
survival during retinoic acid-induced differentiation is also observed
in the human neuroblastoma cell line. To this end we chose the human
neuroblastoma cell line SH-SY5Y, which is well established as a model
for in vitro neurodifferentiation studies (25, 26). An
antisense strategy was employed to block the expression of RAGE. As
shown in Fig. 9A inclusion of
phosphorothioate oligonucleotides, AS-hRAGE (3 and 5 µM),
in the medium for 48 h resulted in 50-70% inhibition of the
expression of RAGE in SH-SY5Y cells (Fig. 9A). ATRA
treatment in the presence of sense oligos, S-hRAGE, for 7 days showed
extensive differentiation of SH-SY5Y cells, as judged by shrinkage of
cell body and extension of neuritic processes (Fig. 9B).
Consistent with the results obtained with Neuro2a cells, inhibition of
RAGE expression by AS-hRAGE oligos showed no effect on differentiation,
as judged from the morphology and neurite extension of differentiated
cells (Fig. 9B). The notion that RAGE plays a role in
cellular survival during retinoic acid-induced differentiation received
additional support from the cellular survival experiments conducted on
SH-SY5Y cells. Treatment of SH-SY5Y cells with ATRA for 7 days reduced
the number of surviving control cells to 46.0 ± 2.8% of an
untreated control. Under similar conditions inhibition of RAGE by
antisense oligos reduced survival to 16.7 ± 0.7% (Fig.
9D). The observation was further supported by the
analysis of expression of Bcl-2: Inhibition of RAGE reduced the extent
of Bcl-2 induction in ATRA-treated SH-SY5Y cells (Fig. 9C).
RAGE Blocking Antibodies Reduce Growth of Neuroblastoma Cells Treated with Retinoic Acid Having established the role of RAGE in cellular survival during retinoic acid-induced differentiation of neuroblastoma cells, we then asked if the RAGE blocking antibodies, raised against the soluble RAGE (sRAGE) could in principle serve as an agent, together with ATRA, for combination therapy to treat neuroblastoma tumors. Taguchi et al. (21) have recently demonstrated, using a mouse model, that RAGE blocking antibodies prevent tumor growth and metastasis by inhibiting RAGE-amphoterin signaling. Therefore, we hypothesize that a combination therapy using retinoic acid and RAGE blockers may exert the double effect of early cell death and prevention of metastasis. Inclusion of anti-sRAGE antibodies at a concentration of 50 µg/ml
together with ATRA significantly reduced the cellular survival of
Neuro2a as determined by MTT reduction analysis. Treatment of Neuro2a
cells with ATRA alone for 4 days reduced the percentage of survival to
52.0 ± 5.6% of untreated control cells (taken to be 100%). The
presence of anti-sRAGE antibodies under similar conditions
significantly reduced the percentage of survival to 33.0 ± 4.2%
(Fig. 10A). A similar effect
was observed in the RAGE-overexpressing RAGE-FL cells: The percentage
of survival was reduced to 37.0 ± 4.2% in these cells. Similar
results were obtained with the human neuroblastoma cells SH-SY5Y.
However, these cells required a higher concentration of antibody to
demonstrate the effect. Treatment with ATRA for 8 days reduced the
percentage of survival to 55.0 ± 2.1% of untreated control cells
whereas the inclusion of 100 µg/ml anti-sRAGE antibodies reduced the
percentage of survival to 43.0 ± 2.1% (Fig. 10B). The
difference in the required concentration of antibody may be due to the
difference in the time period required for the cell lines to undergo
differentiation, because Neuro2a cells undergo differentiation within
48 h of ATRA treatment, whereas the SH-SY5Y cells took more than a
week.
Some recent reports (15, 17) have suggested that the interaction between RAGE and amphoterin plays a prominent role in neuritic process extension and outgrowth in neuroblastoma cells and/or neurons . It should be noted that these observations were made by culturing RAGE-expressing cells on amphoterin-coated plates and hence establishing a direct contact between RAGE and amphoterin in vitro. The role of RAGE-amphoterin interaction in neurite outgrowth or axonal elongation induced by physiological differentiation inducers, such as retinoic acid, nerve growth factor, and others, remains unknown. Such experiments on the role of RAGE-amphoterin interaction in neurite outgrowth under the influence of physiological agents are necessary to assess the contribution of RAGE in neural development. A detailed understanding of the role of RAGE-amphoterin interaction in neurite outgrowth under the influence of physiological regulators would provide profound knowledge on the molecular biology of neuronal differentiation. Therefore, the purpose of this investigation was to study the role of RAGE and amphoterin in retinoic acid-induced neurodifferentiation, a process widely believed to play an essential role during early neural development (3-5, 27, 28). To achieve this, we have used dominant negative and antisense strategies to functionally inactivate RAGE and an antisense strategy to suppress amphoterin expression in Neuro2a cells. The effect of RAGE was further confirmed by antisense strategy in human neuroblastoma SH-SY5Y cells. It is widely accepted that the nuclear receptors for retinoic acid, RAR and RXR, mediate most of the initiating events in retinoic acid-induced neurodifferentiation (8, 29). Yet, the various molecular mechanisms that translate the nuclear message to axonal and dendritic outgrowth are poorly understood. Data presented here show that amphoterin, which has been shown to localize to the leading edge of a migrating cell (30), is essential for retinoic acid-induced process outgrowth. The blockage of amphoterin expression by antisense oligos significantly prevented process outgrowth. However, functional inactivation of RAGE, the putative receptor for amphoterin, either by dominant negative or antisense strategies, failed to prevent retinoic acid-induced neurite outgrowth, raising the possibility that amphoterin may interact with one or more other molecules to exert its effect on outgrowth. Indeed, previous reports have shown that amphoterin does in fact interact with other molecules, including syndecan (31) and sulfoglycolipids (32), although the relevance of these interactions in neurite outgrowth remains uncertain. The possibility of amphoterin interacting with an as yet unidentified molecule may not be ruled out. The observation made in this study, that blockage of amphoterin expression prevented only neurite elongation without any effect on early sprouting, indicates that the early signals of retinoic acid-induced differentiation are controlled by mechanisms not linked to amphoterin. Middlemas et al. (33) have shown that ATRA induces differentiation of neuroblastoma cells by establishing an autocrine loop involving brain-derived neurotrophic factor and trkB. Early sprouting of neurites may be controlled by trkB activation followed by G protein activation, and the subsequent messages may be transmitted to a pathway that requires amphoterin for neurite outgrowth. On the other hand, because the overexpression of RAGE dramatically increased the length of neurites after retinoic acid treatment, it is possible that RAGE participates in the process outgrowth but the role of RAGE might be in the elongation rather than the initiation phase of neurite growth. The observation that the overexpression of RAGE stimulates extensive
outgrowth of neurites also suggests that RAGE may provide an additive
effect on axonal elongation, provided its expression is increased. RAGE
is known to be able to increase its own expression through an
NF The most interesting observation made in this study is the role of RAGE-amphoterin interaction in the survival of retinoic acid-treated neuroblastoma cells, which may have implications for chemotherapy, because differentiation therapy by retinoic acid treatment is one of the widely tested current modes of cancer treatment (13). The data presented here show that RAGE-amphoterin interaction plays a positive regulatory role in the survival of retinoic acid-treated neuroblastoma cells. Inhibition of RAGE resulted in early growth arrest and cell death in both Neuro2a and SH-SY5Y cells. Because the expression levels of anti-apoptotic molecules have been shown to increase during differentiation of neuroblastoma cells (22-24), we hypothesized that RAGE-amphoterin interaction may transmit signals necessary for the increased expression of anti-apoptotic molecules. Recently, Huttunen et al. (19) have shown that RAGE-amphoterin interaction in N18 neuroblastoma cells favors cell survival through the expression of Bcl-2. Consistent with this we observed that RAGE blockage in cells resulted in failure to substantially increase expression of Bcl-2 in retinoic acid-treated neuroblastoma cells. These observations suggest that RAGE-amphoterin interaction contributes to the survival of cells undergoing retinoic acid-induced neurodifferentiation. If RAGE and/or amphoterin contribute to Bcl-2 expression during
retinoic acid-induced differentiation, what could be the possible mechanism? Signal transduction pathways involving protein kinase C
(PKC) activation have been implicated in Bcl-2 production during differentiation (24, 36). Modulators of PKC activation have been shown
to alter the expression levels of Bcl-2 family proteins and thus
modulate susceptibility to apoptosis (24). In SH-SY5Y cells, the
enhanced expression of Bcl-2 after retinoic acid treatment was blocked
by PKC inhibitors, staurosporine or calphostin C (36). In
addition, PKC activation is also reported to result in phosphorylation of Bcl-2 in myeloid leukemia cells thus rendering the cells resistant to apoptosis (37). The available literature suggests a prominent role
for PKC in the expression and phosphorylation of Bcl-2 protein. Against
this background, it is interesting to note that Melloni et
al. (38) have shown that an amphoterin-like protein activates PKC- One interesting question that arises from the present study is whether the signal that passes through RAGE during retinoic acid-induced differentiation is involved in cellular growth arrest or cell death. The observation that inactivation of RAGE results in reduced PCNA expression and appearance of DNA laddering clearly suggests that RAGE is involved in both pathways. It is widely known that the molecular mechanisms involved in growth arrest and apoptosis are closely linked. However, the modulatory roles of retinoic acid in these pathways remain to be elucidated. Further studies in this area would provide insight into signaling pathways that are propagated through RAGE during retinoic acid-induced growth arrest and apoptosis. The increased expression of Bcl-2 family proteins during differentiation reduces the susceptibility of neuroblastoma cells to apoptosis (24, 40). On the other hand, the antisense inhibition of Bcl-2 expression induces retinoic acid-induced cell death in human neural precursor cells (41). Therefore, improved knowledge of the mechanisms that inhibit increased expression of anti-apoptotic proteins following retinoic acid treatment would provide better therapeutic strategies for neuroblastoma, which accounts for 15% of cancer-related deaths in children (14). Although the presently available chemotherapy for neuroblastoma is partly successful, the majority of the patients subsequently relapse. Alternative therapeutic approaches using retinoic acid and other agents like histone deacetylase inhibitors as combination therapy are being studied (42). Based on our present results we hypothesized that a combination of retinoic acid and RAGE blockers may substantially increase cell death in neuroblastoma cells. As a preliminary approach, we studied the effect of a combination of RAGE blocking antibody and retinoic acid treatment on Neuro2a and SH-SY5Y cells and observed that RAGE blockage significantly prevents the growth and survival of these cells. If these results are further proved in other neuroblastoma or tumor cells, a combination therapy of retinoic acid and RAGE blockers may be a useful approach for the treatment of neuroblastoma. In conclusion, the results presented in this work suggest that RAGE is
not required for retinoic acid-induced neurite outgrowth but plays a
significant role in the elongation of neurites and cellular survival
during the process of differentiation. However, amphoterin, a known
ligand of RAGE, is essential for both neurite outgrowth and cellular
survival, raising the possibility that amphoterin might interact with
other molecules to exert its effect on neurite outgrowth. Thus there is
a disassociation between the effects of RAGE and amphoterin upon
retinoic acid-induced neurite outgrowth but not in cellular survival in
Neuro2a cells. Based on these results it is proposed that blocking
the function of RAGE together with retinoic acid treatment may be used
as a therapeutic approach for early growth arrest and cell death in neuroblastoma.
The financial assistance from the Alexander von Humboldt Foundation is gratefully acknowledged. We thank Prof. Peter Riederer, University of Würzburg, for helpful and stimulating discussions. We also thank Dr. Michael Cross, Interdisziplinäres Zentrum für Klinische Forschung, for valuable suggestions to improve the text.
* This work was supported by the Bundesministerium für Bildung, Forschung und Technologie, Interdisziplinäres Zentrum für Klinische Forschung (IZKF), at the University of Leipzig (01KS9504, Project N1) and by the Alexander von Humboldt Foundation (to G. S.).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.
¶ To whom correspondence should be addressed: Neuroimmunologische Zellbiologie, IZKF, Leipzig Johannisallee 30a, Leipzig 04103, Germany. Tel.: 49-341-97-15945; Fax: 49-341-97-15949; E-mail: mueg@medizin.uni-leipzig.de.
Published, JBC Papers in Press, December 5, 2001, DOI 10.1074/jbc.M107627200
The abbreviations used are: RA, retinoic acid; RAGE, receptor for advanced glycation end products; RAGE-FL, RAGE full-length; RAGE-DN, RAGE dominant negative; sRAGE, soluble RAGE; ATRA, all-trans-retinoic acid; PCNA, proliferating cell nuclear antigen; PKC, protein kinase C; RAR, RA receptor; RXR, retinoid X receptor; DMEM, Dulbecco's modified Eagle's medium; FCS, fetal calf serum; FITC, fluorescein isothiocyanate; PBS, phosphate-buffered saline; MTT, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium.
Copyright © 2002 by The American Society for Biochemistry and Molecular Biology, Inc. This article has been cited by other articles:
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