Originally published In Press as doi:10.1074/jbc.M300401200 on May 5, 2003
Originally published In Press as doi:10.1074/jbc.M300401200 on April 16, 2003
J. Biol. Chem., Vol. 278, Issue 29, 26929-26937, July 18, 2003
Ethanol Impairs Insulin-stimulated Neuronal Survival in the Developing Brain
ROLE OF PTEN PHOSPHATASE*
Julia Xu,
Jong Eun Yeon,
Howard Chang,
Geoffrey Tison,
Guo Jun Chen,
Jack Wands and
Suzanne de la Monte
From the
Departments of Medicine and Pathology, Rhode Island Hospital, Brown
Medical School, Providence, Rhode Island 02903
Received for publication, January 14, 2003
, and in revised form, March 30, 2003.
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ABSTRACT
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Gestational exposure to ethanol causes fetal alcohol syndrome, which is
associated with cerebellar hypoplasia. Previous in vitro studies
demonstrated ethanol-impaired neuronal survival with reduced signaling through
the insulin receptor (IR
). We examined insulin signaling in an
experimental rat model of chronic gestational exposure to ethanol in which the
pups exhibited striking cerebellar hypoplasia with increased apoptosis.
Immunoprecipitation and Western blot analyses detected reduced levels of
tyrosyl-phosphorylated IR
, tyrosyl-phosphorylated insulin receptor
substrate-1 (IRS-1), and p85-associated IRS-1 but no alterations in IR
,
IRS-1, or p85 protein expression in cerebellar tissue from ethanol-exposed
pups. In addition, ethanol exposure significantly reduced the levels of total
phosphoinositol 3-kinase, Akt kinase, phospho-BAD (inactive), and
glyceraldehyde-3-phosphate dehydrogenase and increased the levels of glycogen
synthase kinase-3 activity, activated BAD, phosphatase and tensin homolog
deleted in chromosome 10 (PTEN) protein, and PTEN phosphatase activity in
cerebellar tissue. Cerebellar neurons isolated from ethanol-exposed pups had
reduced levels of insulin-stimulated phosphoinositol 3-kinase and Akt kinase
activities and reduced insulin inhibition of PTEN and glycogen synthase
kinase-3 activity. The results demonstrate that cerebellar hypoplasia produced
by chronic gestational exposure to ethanol is associated with impaired
survival signaling through insulin-regulated pathways, including failure to
suppress PTEN function.
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INTRODUCTION
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Ethanol exposure during development is one of the leading causes of mental
retardation in Europe and North America. Heavy gestational exposure to ethanol
can cause fetal alcohol syndrome, which encompasses a broad array of
neurologic and systemic lesions including central nervous system (CNS)
malformations such as microencephaly, reduced cerebral white matter volume,
ventriculomegaly, cerebellar hypoplasia, and disorders of neuronal migration
(1). Experimental models of
fetal alcohol syndrome have demonstrated that the accompanying CNS
abnormalities are associated with impaired neuronal survival, growth,
synaptogenesis, maturation, neurotransmitter function, and intracellular
adhesion
(27).
Even with shorter durations and lower levels of exposure, ethanol can be
neurotoxic during development and substantially reduce the populations of CNS
neurons (2).
Previous experiments demonstrated that neuronal loss following ethanol
exposure was mediated by apoptosis
(810)
or mitochondrial dysfunction
(1012),
and recent studies correlated these adverse effects of ethanol to inhibition
of growth factor-stimulated survival signaling
(9,
1113).
In the developing CNS, insulin and insulin-like growth factor type 1
(IGF-1)1 receptors are
abundantly expressed
(1416),
and the corresponding growth factor-stimulated responses are critical
mediators of neuronal growth, viability, energy metabolism, and synapse
formation. Because insulin and IGF-1 signaling pathways are among the
important targets of ethanol neurotoxicity in immature nervous system
(9,
13,
17,
18), neuronal loss associated
with microencephaly in ethanol-exposed fetuses may be caused, in part, by
ethanol inhibition of insulin/IGF-1stimulated survival mechanisms.
The stimulatory effects of insulin and IGF-1 are mediated through complex
pathways, beginning with ligand binding and activation of intrinsic receptor
tyrosine kinases (19,
20), which phosphorylate
specific cytosolic molecules, including two of their major substrates, the
insulin receptor substrate types 1 (IRS-1) and 2 (IRS-2)
(21,
22). Tyrosyl-phosphorylated
IRS-1 (PY-IRS-1) transmits intracellular signals that mediate growth,
metabolic functions, and viability by interacting with downstream Src homology
2-containing molecules through specific motifs located in the C-terminal
region of IRS-1 (21,
22). The 897YVNI
motif of IRS-1 binds to the Grb2 (growth factor
receptor-bound protein 2) adapter molecule
(23,
24). The 1180YIDL
motif binds to Syp protein tyrosine phosphatase, and the 613YMPM
and 942YMKM motifs bind to the p85 subunit of phosphatidylinositol
3-kinase (PI3 kinase) (25).
Binding of PY-IRS-1 to p85 stimulates glucose transport
(26) and inhibits apoptosis by
activating Akt/protein kinase B
(27,
28) or inhibiting glycogen
synthase kinase-3 (GSK-3)
(29). Akt kinase inhibits
apoptosis by phosphorylating GSK-3
(29,
30) and BAD
(31), rendering them inactive.
Low levels of Akt kinase and high levels of GSK-3 activity or activated BAD
are associated with increased neuronal death
(3234).
BAD inactivates anti-apoptotic Bcl family proteins, rendering the
mitochondrial membrane more susceptible to pro-apoptotic molecules that
promote membrane permeabilization, cytochrome c release, and caspase
activation (35). Perturbations
in mitochondrial membrane permeability increase cellular free radicals that
cause mitochondrial DNA damage, impair mitochondrial function, and activate
pro-apoptosis cascades (36,
37).
Our previous studies (11,
13) using in vitro or
in vivo models demonstrated that ethanol profoundly inhibits
insulin-stimulated survival and mitochondrial function in cultured neuronal
cells. The present study was designed to examine the effects of chronic
gestational exposure to ethanol on insulin-, IRS-1-, and PI3 kinase-mediated
signaling in the intact brain to determine the extent to which abnormalities
in these pathways correlate with ethanol-induced developmental defects in the
CNS. PTEN expression and activity were also examined, because PTEN
dephosphorylates and negatively regulates PI3 kinase function
(38), and the effects of
ethanol on phosphatase and tensin homolog deleted in chromosome 10 (PTEN) were
unknown. Cerebellar tissue was studied, because it represents a major in
vivo target of ethanol neurotoxicity
(2,
39).
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EXPERIMENTAL PROCEDURES
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In Vivo Model of Chronic Ethanol ExposureLong-Evans female
rats were adapted to an ethanol-containing or isocaloric control liquid diet
(BioServ, Frenchtown, NJ) over a 3-week interval, after which they were mated
with normal males. Ethanol comprised 11.8, 23.6, and 35.4% of the caloric
content of the feedings during the first, second, and third weeks of
adaptation. The 35.4% ethanol-containing or control diets were maintained
throughout pregnancy. Using this protocol, the serum ethanol concentrations in
the rats ranged from 25 to 43 mM, which is within the range
observed in human disease states
(40). Rats were monitored
daily to ensure equivalent caloric consumption and maintenance of body weight.
Typically, in the ethanol-fed group, the litter sizes were reduced by 20%, and
pup mean body weight was reduced by 10 to 15%. Studies were conducted with
cerebella harvested from control and ethanol-exposed postnatal day 2 (P2) pups
to evaluate the effects of ethanol in the early postnatal period and prior to
the occurrence of any major compensatory developmental responses. Cerebellar
tissue was fixed in Histochoice fixative (Amresco, Solon, OH) and embedded in
paraffin. Histological sections were stained with hematoxylin and eosin to
detect morphological abnormalities. Fresh cerebellar tissue was snap-frozen in
liquid nitrogen and stored at 80 °C for use in protein studies,
assays of kinase or phosphatase activity, and measurement of PTEN mRNA
levels.
In Situ Assays for ApoptosisThe terminal transferase dUTP
end-labeling (TUNEL) assay was used to detect nicked or fragmented DNA in
cryostat sections of cerebella. TUNEL assays were performed using
fluorescein-labeled dUTP ([Fl]dUTP; Invitrogen) and terminal deoxynucleotide
transferase (17). The labeled
DNA was detected with biotinylated secondary antibody, alkaline
phosphatase-conjugated Streptavidin, and 5-bromo-4-chloro-3-indolyl
phosphate/nitroblue tetrazolium (BCIP/NBT) as the substrate. To detect nuclear
pyknosis and fragmentation characteristic of apoptosis, adjacent sections were
stained with Hoechst H33258
[GenBank]
(1 µg/ml in phosphate-buffered saline) for 2
min at room temperature. The slides were rinsed thoroughly in
phosphate-buffered saline, cover-slipped with Vectashield mounting medium
(Vector Laboratories, Burlingame, CA), and examined by fluorescence
microscopy. Adjacent sections were immunostained with polyclonal antibodies to
activated (cleaved) caspase-3 (Cell Signaling, Beverly, MA). Histological
sections were prepared for immunostaining according to the manufacturer's
protocol. Immunoreactivity was detected with biotinylated secondary antibody,
alkaline phosphatase-conjugated Streptavidin, and the BCIP/NBT substrate.
Western Blot Analysis and Immunoprecipitation StudiesFor
Western blot analysis, tissue from individual cerebella were polytron
homogenized in radioimmunoprecipitation assay buffer (50 mM
Tris-HCl, pH 7.5, 1% Nonidet P-40, 0.25% sodium deoxycholate, 150
mM NaCl, 1 mM EDTA, 2 mM EGTA) containing
protease and phosphatase inhibitors (1 mM NaF, 1 mM
Na4P2O7, 2 mM
Na3VO4, 1 mM phenylmethylsulfonyl fluoride, 1
µg/ml each of aprotinin, pepstatin A, and leupeptin)
(41). For
immunoprecipitations, homogenates were prepared in Triton lysis buffer (50
mM Tris-HCl, pH 7.5, 10 mM EDTA, 1% Triton X-100)
containing protease and phosphatase inhibitors as indicated. Cellular debris
was pelleted by centrifuging the samples at 14,000 x g for 15
min at 4 °C, and supernatant fractions were used in the studies. Protein
concentration was measured with the bis-chloracetate (BCA) assay (Pierce). 60-
or 100-µg protein aliquots were used for Western blot analysis
(17,
42,
43), and 500-µg samples
were used for immunoprecipitation/Western immunoblotting or kinase assays
(11,
17). Immunoreactivity was
detected with horseradish peroxidase-conjugated secondary antibody and
SuperSignal enhanced chemiluminescence reagents (Pierce). Immunoreactivity was
quantified using the Eastman Kodak Co. Digital Science Imaging Station
(PerkinElmer Life Sciences).
Kinase AssaysPI3 kinase activity was measured in p85
immunoprecipitates (42)
obtained from individual 500-µg protein samples using rabbit polyclonal
anti-p85 (1 µg/ml) and protein A-Sepharose (Amersham Biosciences).
Immunoprecipitates complexed with protein A-Sepharose were suspended in 50
µl of TNE buffer (10 mM Tris-HCl, pH 7.4, 150 mM
NaCl, 5 mM EDTA), and reactions were initiated by sequentially
adding 20 µg of sonicated phosphatidylinositol (10 µl), 10 µl of 100
mM MgCl2, and 5 µl of [
-32P]ATP
working solution composed of 0.88 mM [
-32P]ATP
(30 µCi of [
-32P]ATP/3000 Ci/mmol), 20 mM
MgCl2, and 150 mM cold ATP. Reactions were incubated for
10 min at 37 °C and 300 rpm and stopped by adding 15 µl of 6
N HCl. Phospholipids extracted with chloroform/methanol were
analyzed by thin layer chromatography using plates pre-coated with 1%
potassium oxalate (Merck). PI3 kinase activity was detected by film
autoradiography and quantified using the Kodak Digital Science Imaging
Station.
To measure Akt and GSK-3
kinase activities, corresponding
immunoprecipitates captured onto protein A-Sepharose beads
(41) were suspended in 10
µl of 5x assay dilution buffer (ADB; 100 mM MOPS, pH 7.2,
125 mM
-glycerol phosphate, 5 mM EGTA, 5
mM sodium orthovanadate, and 5 mM dithiothreitol).
Reactions were performed by sequentially adding 10 µl each of
Mg2+/ATP mixture (100 mM non-radioactive ATP,
75 mM MgCl2 in ADB), [
-32P]ATP
(diluted to a final concentration of 1 µCi/µl using
Mg2+/ATP mixture), and 10 nM synthetic
peptide substrate. Crosstide (Upstate Biotechnology, Inc., Lake Placid, NY)
was used to measure Akt activity, and cAMP-response element-binding protein
(New England Biolabs, Beverly, MA) was used as the substrate for GSK-3
(Upstate Biotechnology). Reactions were incubated for 10 (GSK-3) or 15 (Akt)
min at 30 °C and 300 rpm and then terminated by adding 5 µl of 0.5
M EDTA. 10 µl of each reaction were spotted in duplicate onto
P81 phosphocellulose. Nonspecific counts were removed by washing the P81 three
times in 0.85% phosphoric acid
(41) followed by 95% ethanol.
[
-32P]ATP incorporation was measured in a TopCount machine
(Packard Instrument Co., Meriden, CT).
PTEN StudiesPTEN expression was measured by Western blot
analysis and real-time quantitative reverse-transcribed (RT)-PCR assays. In
addition, PTEN phosphatase activity was measured in PTEN immunoprecipitates
using the Biomol Green Reagent according to the manufacturer's protocol.
Phosphatase inhibitors were omitted from the lysis buffer. For the real-time
RT-PCR studies, total RNA was isolated from cerebellar tissue homogenates
using TRIzol reagent (Invitrogen) according to the manufacturer's protocol.
Samples containing 2 µg of RNA were reverse-transcribed using the AMV First
Strand cDNA synthesis kit (Roche Molecular Biochemicals) and random
oligodeoxynucleotide primers. Highly conserved regions of PTEN and 18 S cDNAs
isolated from rat cerebellar tissue by RT-PCR were cloned into the PCRII
vector (Invitrogen) and used to generate standard curves for determining
transcript abundance. PCR amplifications were performed using 25-µl
reaction volumes containing 20 ng of RT product, 0.4 µM each of
forward and reverse primers (Table
I), and SYBR Green I PCR reagent (Applied Biosystems, Foster, CA).
The amplified signals were detected continuously with the Bio-Rad iCycler and
iCycler iQ MultiColor Real Time PCR Detection System (Hercules, CA). The
following real-time PCR amplification protocol was used: 1) initial
denaturation, 95 °C for 10 min; 2) a three-segment amplification and
quantification program consisting of 40 cycles of 95 °C x 60 s, 60
°C x 45 s and 72 °C for 30 s; and 3) a cooling step down to 4
°C.
In Vitro ExperimentsIn vitro experiments were used to
examine the effects of ethanol on PTEN expression, phosphorylation, and
phosphatase activity in CNS neurons and to determine whether the responses
observed in vivo were mediated by impaired insulin or IGF-1
signaling. Primary neuronal cultures were generated with cerebellar tissue
harvested from P2 pups (44).
Fluorescence-activated cell sorting demonstrated that greater than 95% of
cells isolated from control or ethanol-exposed pup cerebella were neuronal as
evidenced by the immunoreactivity with antibodies to HuC/HuD neuron-specific
RNA binding protein (45)
(Molecular Probes, Eugene, OR). Cultures were maintained in Dulbecco's
modified Eagle's medium supplemented with 5% fetal calf serum, 2 mM
glutamine, 10 mM non-essential amino acid mixture (Invitrogen), 25
mM KCl, and 9 g/liter glucose. After overnight seeding, cells were
treated with 6 µM cytosine arabinoside to inhibit DNA synthesis.
Cultures were exposed to 50 mM ethanol or nothing for 2 days using
sealed humidified chambers
(17,
42), after which they were
serum-starved for 12 h and then stimulated with 50 nM insulin
(Humulin; Eli Lilly & Co., Indianapolis, IN) or 25 nM IGF-1 for
0, 15, 30, 60, or 120 min in the presence or absence of 50 mM
ethanol. PTEN protein was detected by Western blot analysis. PTEN
phosphorylation was evaluated by PTEN Western blot analysis of
anti-phospho-serine/phospho-threonine immunoprecipitates. PTEN phosphatase
activity was measured in PTEN immunoprecipitates using the Biomol Green
Reagent (Cell Signaling, Beverly, MA).
To examine the effects of ethanol on insulin-stimulated viability and
kinase activity, primary neuronal cultures were generated with cerebella
harvested from control or ethanol-exposed P1 pups. However, to mimic the
in vivo model in which the ethanol exposure was discontinued after
birth, the cultured cells were not further exposed to ethanol. Micro-cultures
(96-well plates) in which 5 x 104 viable cells (determined by
Trypan Blue exclusion) were seeded per well were used for viability assays,
and 60-mm Petri dish cultures were used for kinase or PTEN phosphatase assays.
To measure insulin-stimulated responses, after 1 day in culture, the cells
were serum-starved for 12 h and then stimulated with 50 nM insulin
(Humulin; Eli Lilly & Co., Indianapolis, IN). Viability was measured after
24 h of insulin stimulation using the crystal violet assay
(13,
17,
42). IRS-1-associated PI3
kinase, total PI3 kinase, Akt kinase, GSK-3 kinase, and PTEN phosphatase
activities were measured in corresponding immunoprecipitates from cells
stimulated with insulin for 0, 5, 15, or 30 min.
Source of ReagentsMonoclonal antibodies to phospho-tyrosine
(PY20) and phospho-serine were purchased from Transduction Laboratories
(Lexington, KY). Polyclonal antibodies to p85, IR
, IRS-1, and PTEN
phosphatase were purchased from Upstate Biotechnology, Inc. (Lake Placid, NY).
Phospho-specific antibodies to Akt, GSK-3
, and BAD were obtained from
Cell Signaling (Beverly, MA). Protein A-Sepharose was purchased from Amersham
Biosciences. Monoclonal antibodies to glyceraldehyde-3-phosphate dehydrogenase
(GAPDH) and GSK-3
were purchased from Chemicon Corp. All other reagents
were purchased from CalBiochem or Sigma-Aldrich.
Statistical AnalysisData depicted in the graphs represent
the mean ± S.D. of results. Inter-group comparisons were made with the
Student's t test or analysis of variance and the Fisher least
significance post hoc significance test using Number Cruncher Statistical
Systems (Dr. Jerry L. Hintze, Kaysville, UT).
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RESULTS
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Ethanol-induced Cerebellar HypoplasiaHistological studies
of the cerebellar tissue revealed well developed folia and distinct laminar
architecture in control pups (Fig. 1A,
C, and E) and hypoplasia with marked simplification
of the folia and poor lamination of the cortex in ethanol-exposed pups
(Fig. 1, B, D, and
F). Adjacent sections stained with H33258
[GenBank]
revealed
uniform nuclear morphology and only occasional apoptotic bodies in control
cerebella (1G) and reduced cell densities with increased nuclear condensation,
pyknosis, and fragmentation in ethanol-exposed cerebella
(Fig. 1H).
Correspondingly, TUNEL assays revealed conspicuously increased nuclear
labeling consistent with genomic DNA damage
(Fig. 2, A and
B), and immunohistochemical staining detected increased
levels of activated caspase-3 (Fig. 2,
C and D) in cerebella from ethanol-exposed pups.
In the ethanol-exposed brains, the activated caspase-3 was mainly localized
within nuclei. Previous studies showed that nuclear translocation is required
for caspase induction of apoptosis
(46).

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FIG. 1. Ethanol-induced cerebellar hypoplasia. Pregnant rats were fed with a
35.4% ethanol-containing or isocaloric control liquid diet. Histological
sections of cerebella from P2 control pups revealed well developed folia
(A, C, and E, arrows) and cortical lamination (C
and E). Cerebella from P2 ethanol-exposed pups were hypoplastic
(B, arrow) with simplified folia (D and F, arrows),
and incomplete cortical lamination (F). Adjacent sections stained
with Hoechst H33258
[GenBank]
revealed uniform nuclear morphology and rare condensed
nuclei (G) in control cerebella and conspicuous nuclear condensation
and pyknosis, consistent with apoptosis (H, arrows) in cerebella from
ethanol-exposed pups.
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FIG. 2. Ethanol-induced neuronal apoptosis. Histological sections were
either labeled using the TUNEL assays to detect nicked or fragmented DNA
(A and B) or immunostained to detect activated caspase-3
(C and D). Reaction products were detected with biotinylated
secondary antibody, alkaline phosphatase-conjugated Streptavidin, and BCIP/NBT
substrate (blue precipitate). Cerebella from control pups (A
and C) had only scattered TUNEL+ or activated caspase-3
immunoreactive cells in the cortex. In contrast, cerebella from
ethanol-exposed pups had conspicuous TUNEL+ (B) and activated
caspase-3 immunoreactive (D) nuclei. Insets in Panels
A and B show higher magnification images of nuclei in sections
labeled using the TUNEL assay.
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Reduced PY of IR
in Cerebella of Ethanol-exposed Rat
PupsPrevious in vitro studies linked ethanol-induced
neuronal loss to inhibition of insulin signaling through its receptor
(17,
47). To characterize potential
mechanisms by which chronic gestational exposure to ethanol inhibits insulin
signaling in vivo, the levels of IR
and PY-IR
were
examined in cerebellar tissue homogenates by direct Western blot analysis and
Western blot analysis of immunoprecipitates, respectively. Digital image
quantification of results obtained with 12 brains in each group demonstrated
significantly reduced levels of PY-IR
in ethanol-exposed relative to
control samples (p < 0.01; see
Fig. 3, A and
C) but similar levels of total IR
protein in
control and ethanol-exposed cerebella (Fig.
3, B and D).
Ethanol Inhibition of Insulin-responsive Gene Expression To
examine the downstream effects of ethanol on insulin signaling, we measured
cerebellar tissue expression of GAPDH, which is an important
insulin-responsive gene product
(48). Western blot analysis
using denaturing and reducing conditions detected a single
37-kDa protein
corresponding to monomeric GAPDH (Fig.
4A). Digital image quantification of results obtained
with 12 brains in each group demonstrated significantly reduced GAPDH
expression in ethanol-exposed relative to control cereballa (p <
0.01; see Fig.
4B).
Reduced Levels of PY-IRS-1 in Cerebella of Ethanol-exposed
PupsMajor effects of insulin are mediated through IRS-1, which
transmits signals downstream to regulate growth, survival, and energy
metabolism. To determine whether gestational exposure to ethanol inhibits
tyrosyl phosphorylation of IRS-1 in cerebellar tissue, PY-IRS-1 and IRS-1
protein levels were examined by immunoprecipitation/Western blot analysis
(n = 12 per group). The studies demonstrated significantly reduced
mean levels of PY-IRS-1 following gestational exposure to ethanol (p
< 0.001; see Fig. 5, A and
C) but similar mean levels of IRS-1 protein in
ethanol-exposed and control cerebella (Fig.
5, B and D).

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FIG. 5. Reduced levels of PY-IRS-1 in cerebella from ethanol-exposed relative to
control rat pups. A, IRS-1 protein was immunoprecipitated from
cerebellar homogenates using polyclonal anti-IRS-1. Immunoprecipitates were
subjected to Western blot analysis using monoclonal anti-PY. B,
direct Western blot analysis of cerebellar tissue was used to detect IRS-1
protein. Each corresponding lane in Panels A and B
corresponds to an individual brain. Immunoreactivity corresponding to PY-IRS-1
(C) or IRS-1 (D) was quantified with digital imaging, and
results obtained from 12 pups/group are depicted graphically (mean number of
pixels ± S.D.; *, p < 0.001).
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Reduced PI3 Kinase Signaling in Cerebella from Ethanol-exposed
PupsNeuronal survival is mediated through PI3 kinase, which can be
activated through both IRS-1-dependent and IRS-1-independent mechanisms.
IRS-1-associated PI3 kinase activity was assessed by measuring p85
interactions with PY-IRS-1 by Western blot analysis of IRS-1
immunoprecipitates, and total PI3 kinase activity was measured in p85
immunoprecipitates. Chronic gestational exposure to ethanol resulted in
significantly reduced levels of both IRS-1-associated p85 (p <
0.001; see Fig. 6, A and
C) and total PI3 kinase (p < 0.001; see
Fig. 6, E and
F) activities. In contrast, p85 protein levels were
similar in control and ethanol-exposed cerebella
(Fig. 6, B and
D).

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FIG. 6. Reduced levels of IRS-1-associated and total PI3 kinase activities in
cerebellar tissue from ethanol-exposed rat pups. A, IRS-1 protein
was immunoprecipitated from cerebellar homogenates and analyzed by Western
blotting with polyclonal anti-p85. B, p85 protein was detected by
direct Western blot analysis. Each lane in Panels A and
B corresponds to an individual brain. Western blot signals
corresponding to p85-associated IRS-1 (C) and p85 (D)
protein were quantified using the Kodak Digital Image Station, and the results
from 12 pups/group are depicted graphically (mean number of pixels ±
S.D.; *, p < 0.001). E, PI3 kinase activity was measured
in p85 immunoprecipitates. Radiolabeled phospholipids were separated by
thin-layer chromatography and detected by autoradiography. Each lane
corresponds to an individual brain. F, the autoradiographic signals
corresponding to PI3 kinase activity were quantified by densitometry using the
Kodak Digital Image Station, and the results from 12 pups/group are depicted
graphically (mean number of pixels ± S.D.; *, p <
0.001).
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PTEN Phosphatase ExpressionPTEN phosphatase is an important
negative regulator of PI3 kinase signaling down-stream through Akt
(27,
38). Therefore, high levels of
PTEN activity would be expected to inhibit survival signaling down-stream of
PI3 kinase. However, the effect of ethanol on PTEN expression in the brain has
not been investigated. Western blot analysis detected the expected
45-kDa
PTEN protein in all samples (Fig.
7A). Digital image analysis of the Western blot signals
demonstrated significantly higher mean levels of PTEN in ethanol-exposed
relative to control cerebella (p < 0.001, n = 12 per
group; see Fig. 7B).
Correspondingly, the mean level of PTEN phosphatase activity was significantly
higher in cerebellar tissue from ethanol exposed relative to control pups
(p < 0.001) (Fig.
7C).

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FIG. 7. Ethanol modulation of PTEN. A, PTEN protein ( 45 kDa)
expression was examined in cerebellar tissue by Western blot analysis. Each
lane corresponds to an individual sample. B,
immunoreactivity was quantified using the Kodak Digital Science Image Station,
and the results from 12 pups/group are depicted graphically (mean number of
pixels ± S.D.; *, p < 0.001). C, phosphatase
activity was measured in PTEN immunoprecipitates from cerebellar tissue.
Phosphate release was measured using the BioMol malachite green-based assay. A
standard curve generated with known amounts of phosphatase was used to
calculate phosphate release (reflecting phosphatase activity) in the unknown
samples. The graphed values depict the mean ± S.D. of results for each
group (*, p < 0.001). D, real-time quantitative RT-PCR
was used to measure PTEN mRNA and 18 S RNA expression in cerebellar tissue.
Standard curves generated with known copy numbers of recombinant plasmid DNA
were used to quantify transcripts. The PTEN mRNA/18 S RNA percentages (based
on ng of cDNA) were calculated for each sample, and results obtained from 10
samples per group are depicted graphically (mean ± S.D.; p =
0.183).
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Real-time quantitative RT-PCR was used to determine whether PTEN mRNA
levels were increased in the ethanol-exposed relative to control brains. PTEN
and 18 S RNA transcripts were quantified in parallel reactions using RT
products generated from 20 ng of total RNA. Serial dilutions of plasmid DNA
(0.002 to 20 ng) containing PTEN or 18 S cDNA target sequences were used as
standards in all experiments. Graphs relating the threshold cycle values and
input target DNA amounts (ng) resulted in standard curves that were linear
over the 5 orders of magnitude tested and had correlation coefficients
(r2) of 0.99 for 18 S and 0.97 for PTEN. Equations
generated from the standard curves were used to calculate 18 S and PTEN mRNA
abundance in the samples. No template and total RNA controls were included in
all experiments. In addition, studies showed that rat genomic DNA could not be
amplified using the conditions employed for real-time RT-PCR. All reactions
were performed in triplicate, and all assays were repeated at least three
times.
The mean threshold cycle value for PTEN was 25.4 ± 1.43 for the
control group and 26.2 ± 1.2 in the ethanol-exposed group. The mean
threshold cycle value for 18 S was 12.8 ± 3.2 in the control group and
12.1 ± 1.5 in the ethanol-exposed group. The PTEN mRNA/18 S RNA ratios
were calculated for each sample to normalize for small difference in RNA
content in the initial reactions. Inter-group comparisons made using Student's
t test analysis demonstrated that the mean percentages of PTEN/18 S
for control (1.35 ± 0.06) and ethanol-exposed (1.55 ± 0.1)
brains were not statistically significant (p = 0.183; see
Fig. 7D).
To more directly evaluate the roles of ethanol and impaired insulin/IGF-1
signaling in relation to PTEN expression and function, experiments were
conducted using primary cerebellar neuron cultures. Insulin was found to be
more effective than IGF-1 in stimulating Ser phosphorylation of PTEN
(Fig. 8, A and
B) and suppressing PTEN phosphatase activity (data not
shown). In contrast, PTEN protein expression was not modulated by short term
insulin or IGF-1 stimulation (Fig.
8A). In the in vitro ethanol-treated cultures,
insulin-stimulated levels of phospho-PTEN were reduced by 7080%
(p < 0.001), and IGF-1-stimulated levels of phospho-PTEN were
reduced by 1520% (p < 0.01) relative to control
(Fig. 8, C and
D). Correspondingly, in vitro ethanol treatment
was associated with reduced insulin and IGF-1 suppression of PTEN phosphatase
activity, with greater impairment of insulin compared with IGF-1-mediated
responses (Fig. 8, E and
F).

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FIG. 8. PTEN modulation by insulin and IGF-1 in cultured primary cerebellar
granule neurons. Cultures were serum-starved for 12 h and then stimulated
with only 50 nM insulin or 25 ng/ml IGF-1 for 060 min.
A, p-PTEN detected by PTEN Western blot analysis of
anti-phospho-Serine immunoprecipitates and total PTEN protein was detected by
direct Western blot analysis. B, the autoradiographic signals from
studies shown in Panel A were quantified using the Kodak Digital
Science Image Station, and the calculated mean ratios of p-PTEN/PTEN observed
in insulin- or IGF-1-stimulated cultures were depicted graphically.
Inter-group comparisons were made using analysis of variance (*, p
< 0.001). C, p-PTEN and total PTEN levels were examined in control
and ethanol-treated cells that were stimulated with insulin or IGF-1 for 5 or
15 min as described. Prior to the stimulation studies, the cultures were
exposed to 50 mM ethanol or nothing for 2 days (see
"Experimental Procedures"). Ethanol exposure was maintained
throughout the study. D, mean levels (number of pixels ± S.D.)
of p-PTEN measured in four replicate cultures by densitometric analysis of the
Western blot signals (*, p < 0.001; , p <
0.01). E and F, phosphatase activity (nmol of phosphate
released) was measured in PTEN immunoprecipitates from control and
ethanol-treated, insulin-(E) or IGF-1-stimulated (F)
cultures using the Biomol Green reagent (see legend for
Fig. 7C and
"Experimental Procedures") (*, p < 0.001; ,
p < 0.01; , p < 0.05).
|
|
Ethanol Inhibits Survival Signaling Downstream of PI3
KinasePI3 kinase mediates survival by phosphorylating Akt and
GSK-3
, which results in activation of Akt kinase
(28,
49) and inhibition of
GSK-3
activity (50). Akt
kinase also phosphorylates and inactivates GSK-3
, as well as BAD
(29,
31,
32), which are both
pro-apoptotic. To determine whether the hypoplasia and increased apoptosis
observed in cerebella from ethanol-exposed pups were associated with impaired
signaling downstream of PI3 kinase, we examined Akt, phospho (p)-Akt, GSK,
pGSK, BAD, and pBAD protein levels by Western blot analysis and measured Akt
and GSK-3
kinase activities in corresponding immunoprecipitates. Chronic
gestational exposure to ethanol resulted in significantly reduced levels of
pAkt, pGSK-3
, pBAD, and Akt kinase activity and increased levels of
total BAD protein and GSK-3
kinase activity (p < 0.05 or
p < 0.001; see Fig.
9). In contrast, the levels of Akt and GSK-3
proteins were
similar in control and ethanol-exposed cerebella.
Chronic Gestational Exposure to Ethanol Impairs Insulin-stimulated
Survival Signaling in the BrainIn vitro studies were used to help
validate the in vivo observations and demonstrate that chronic
gestational exposure to ethanol inhibits insulin-stimulated survival
mechanisms in CNS neurons. Cultures generated from ethanol-exposed pups had
significantly reduced levels of insulin-stimulated neuronal viability
(p < 0.005), IRS-1-associated PI3 kinase, total PI3 kinase, and
Akt kinase (all p < 0.001) activities and increased levels of
GSK-3 activity (p < 0.001) relative to neuronal cultures generated
from control pups (Fig. 10,
AC, E, and F). In addition, insulin
significantly suppressed PTEN phosphatase activity in control cultures
(p < 0.01), whereas in cultures generated from ethanol-exposed
pups, the basal levels of PTEN were significantly higher than control
(p < 0.001), and insulin failed to suppress the phosphatase
activity (Fig.
10D).

View larger version (56K):
[in this window]
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|
FIG. 10. Chronic gestational exposure to ethanol inhibits insulin-stimulated
neuronal viability and down-stream signaling through PI3 kinase. Primary
cerebellar neuron cultures were generated from control and ethanol-exposed
postnatal day 1 pups. To mimic the in vivo model, the cells were not
further exposed to ethanol. After 12 h of serum deprivation, the cultures were
stimulated with 50 nM insulin for either 24 h to measure viability
or 030 min to assess insulin-stimulated signaling. A,
viability was measured using the crystal violet (CV) assay.
B, IRS-1-associated and total PI3 kinase activities were measured in
IRS-1 (IRS-1/PI3K) and p85 (p85/PI3K) immunoprecipitates,
respectively. Radiolabeled phospholipids were separated by thin-layer
chromatography. C, PI3 kinase autoradiographic signals were
quantified by densitometry. The graph depicts the mean number of pixels
(±S.D.) detected in each group. D, PTEN phosphatase activity
was measured in PTEN immunoprecipitates as described in the legend to
Fig. 7C. The
above the 15-min control bar indicates significant
difference from control values at other time points. Akt kinase (E)
and GSK-3 (F) activities were measured in immunoprecipitates
using cAMP-response element-binding protein and Crosstide as substrates for
phosphorylation. Incorporation of [ -32P]ATP was quantified
in a TopCount machine, and results from four samples per group are depicted
graphically (mean cpm ± S.D.) (*, p < 0.001; **, p
< 0.005; , p < 0.01; , p < 0.05).
|
|
 |
DISCUSSION
|
|---|
Ethanol impairs neuronal growth and viability in the developing CNS by
inhibiting growth factor-stimulated signaling mechanisms
(9,
11,
13,
18,
51). Previous in
vitro studies showed that ethanol inhibition of insulin-stimulated cell
growth and viability were mediated by reduced activation of mitogen-activated
protein kinase (42,
43) and PI3 kinase
(11,
47). Although similar
inhibitory effects of ethanol have been demonstrated with respect to IGF-1
(9,
18), our studies suggested
that ethanol may have a more potent inhibitory effect on insulin compared with
IGF-1-stimulated signaling in neuronal cells
(17). Therefore, in the
present studies, we utilized an in vivo model to evaluate the effects
of chronic gestational exposure to ethanol on the integrity of insulin
signaling through pathways that mediate neuronal survival in the CNS. The
gestational exposure to ethanol produced major structural abnormalities in the
CNS including cerebellar hypoplasia with associated incomplete foliation and
poor lamination of the cortex and increased apoptosis with activation of
caspase-3. These effects resemble the abnormalities described in human cases
and other experimental models of fetal alcohol syndrome
(4,
8).
The finding that chronic gestational exposure to ethanol resulted in
reduced levels of PY-IR
yet had no significant effect on IR
protein expression corresponds with previous in vitro results
(47,
52) and indicates that the
inhibitory effects of ethanol on insulin signaling in the developing brain
begin at the level of IR
function rather than IR
expression. These
results are consistent with findings in a previous report
(53) demonstrating that
chronic gestational exposure to ethanol impaired IGF-1 receptor function but
not the receptor expression. Potential consequences of impaired insulin
signaling include inhibition of insulin-responsive gene expression and
cellular functions such as proliferation, neurite outgrowth, glucose
utilization, phospholipid metabolism, and amino acid transport. In this
regard, we demonstrated that ethanol-exposed cerebella had significantly
reduced levels of an important insulin-responsive gene, GAPDH
(48), suggesting that CNS
glucose utilization and energy metabolism may have been impaired. In addition
to regulating glucose utilization, insulin stimulates glucose uptake. Glucose
uptake is mediated by glucose transporter molecules termed GLUTs
(54), and previous studies
(5557)
demonstrated that chronic gestational exposure to ethanol inhibits expression
and function of glucose transporter molecules GLUT1 and GLUT3 in the brain.
Together, these observations potentially link ethanol-impaired insulin
signaling and neuronal loss to deficiencies in uptake and utilization of
glucose in the developing brain.
Our finding of reduced PY-IRS-1 levels in cerebellar tissue from
ethanol-exposed pups indicates that chronic gestational exposure to ethanol
impairs IRS-1 signaling, which could lead to reduced activation of growth and
survival mechanisms. In this regard, we also detected reduced binding of the
p85 subunit of PI3 kinase to IRS-1 in cerebellar tissue and reduced levels of
insulin-stimulated IRS-1-associated PI3 kinase activity in cultured cerebellar
neurons from ethanol-exposed pups. These results indicate that IRS-1-mediated
survival mechanisms, including those stimulated by insulin, were significantly
impaired by ethanol, consistent with previous results obtained using in
vitro ethanol exposure models
(9,
17,
42,
47,
58,
59). However, further studies
demonstrated that ethanol caused even greater reductions in total PI3 kinase
activity, both in vivo and following insulin stimulation in
vitro. Therefore, PI3 kinase was likely inhibited through both
IRS-dependent and IRS-independent, e.g. PTEN, pathways. Indeed,
impaired signaling through IRS-2 is another candidate for mediating the
IRS-dependent effects, because insulin-stimulated tyrosyl phosphorylation of
IRS-2 can activate PI3 kinase
(60), IRS-2 is expressed in
the brain and functionally active in CNS neurons
(61), and ethanol inhibits
growth factor signaling through IRS-2
(62). The results from both
the in vivo and in vitro experiments showed that ethanol
inhibited PI3 kinase activity and suggest that inhibition of insulin signaling
through IRS-dependent and IRS-independent pathways contributed to the observed
impairments in survival signaling and development of cerebellar
hypoplasia.
PI3 kinase promotes survival by phosphorylating Akt and activating its
kinase (27,
28), which then phosphorylates
Ser and Thr residues on target pro-apoptosis molecules, including GSK-3
(50), BAD
(31), and caspase-9
(63,
64), and rendering them
inactive. Our experiments demonstrated that ethanol impaired survival
signaling downstream of PI3 kinase, as was manifested by the reduced levels of
phospho-Akt, phospho-BAD, phospho-GSK-3
, and Akt kinase activity, and
increased levels of activated BAD and GSK-3
activity. Further in
vitro studies showed that insulin activation of Akt kinase and inhibition
of GSK-3
were impaired by ethanol. Therefore, these studies linked
ethanol impairment of insulin-stimulated survival signaling downstream of PI3
kinase to the increased cell loss, apoptosis, and cerebellar hypoplasia
observed in vivo.
Further studies revealed that PTEN phosphatase activation represents an
additional non-IRS-1 mechanism by which survival signaling downstream of PI3
kinase could be inhibited by ethanol in CNS neurons. PTEN dephosphorylates and
reverses the activation of PI3 kinase
(38,
65), whereas inactivation of
PTEN promotes membrane recruitment of Akt, leading to increased Akt
phosphorylation and kinase activity
(38,
65). PTEN expression and
phosphatase activity are negatively regulated by phosphorylation of PTEN
protein (66); however, the
effects of ethanol exposure and growth factor stimulation on PTEN expression
and function were previously unknown. Our in vivo studies
demonstrated significantly higher levels of PTEN protein and phosphatase
activity, without correspondingly increased PTEN mRNA expression in
ethanol-exposed cerebella, indicating post-transcriptional modulation of PTEN
by ethanol. In addition, the magnitude of increased PTEN expression was
similar to that of GSK-3
activity, corresponding with the expected
inhibitory effects of PTEN on survival signaling downstream of PI3 kinase.
In vitro studies were used to characterize the effects of ethanol
on the levels of PTEN protein, phosphorylation, and phosphatase activity and
to determine whether the adverse effects of ethanol on PTEN were linked to
impaired insulin signaling. Insulin, and to a lesser extent IGF-1, stimulated
PTEN phosphorylation and correspondingly inhibited PTEN phosphatase activity
in control cerebellar neuron cultures. Chronic gestational exposure to ethanol
impaired the insulin-stimulated phosphorylation of PTEN and suppression of
PTEN phosphatase activity. Therefore, the adverse effect of ethanol on insulin
signaling to inhibit the function of PTEN in CNS neurons probably represents
an important mechanism of impaired survival and increased apoptosis.
The results from our in vivo and in vitro experiments
linked chronic gestational exposure to ethanol to aberrantly increased
expression and enzymatic activity of PTEN, which has a pivotal role in
regulating PI3 kinase-activated survival signaling. Although PTEN has been
shown to inhibit insulin-stimulated Akt phosphorylation without affecting
IR
activation of IRS-1
(67), other more recent data
(68) suggest that PTEN can
also inhibit insulin-stimulated IRS-1 phosphorylation and the attendant
downstream signaling. Therefore, in the ethanol-exposed cerebella, the
impaired survival signaling may have been mediated by the combined effects of
the following: 1) ethanol inhibition of IR
phosphorylation and function,
2) PTEN inhibition of IRS-1 phosphorylation, and 3) PTEN inhibition of Akt
kinase. These studies suggest important mechanisms by which ethanol-impaired
insulin signaling could promote the development of cerebellar hypoplasia in
fetal alcohol syndrome.
 |
FOOTNOTES
|
|---|
* Supported by National Institutes of Health COBRE Grant P20RR15578 and
Grants AA02666, AA-02169, AA-11431, and AA12908. The costs of publication of
this article were defrayed in part by the payment of page charges. This
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: Pierre Galletti Research Bldg.,
Rhode Island Hospital, 55 Claverick St., Rm. 419, Providence, RI 02903. Tel.:
401-444-7364; Fax: 401-444-2939; E-mail:
Suzanne_DeLaMonte_MD{at}Brown.edu.
1 The abbreviations used are: IGF-1, insulin-like growth factor type 1;
IRS-1, insulin receptor substrate-1; PY, tyrosyl-phosphorylated; PI3 kinase,
phosphatidylinositol 3-kinase; GSK-3, glycogen synthase kinase-3; P, postnatal
day; TUNEL, terminal transferase dUTP endlabeling; BCIP/NBT,
5-bromo-4-chloro-3-indolyl phosphate/nitroblue tetrazolium; MOPS,
4-morpholinepropanesulfonic acid; RT, reversetranscribed; IR
, insulin
receptor
; GAPDH, glyceraldehyde-3-phosphate dehydrogenase; p,
phospho. 
 |
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