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The Oxytocin Receptor Antagonist Atosiban Inhibits Cell Growth via a “Biased Agonist” Mechanism*

  • Alessandra Reversi
    Affiliations
    Consiglio Nazionale delle Ricerche (CNR) Institute of Neuroscience, Cellular and Molecular Pharmacology Section, 20129 Milan
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  • Valeria Rimoldi
    Affiliations
    Consiglio Nazionale delle Ricerche (CNR) Institute of Neuroscience, Cellular and Molecular Pharmacology Section, 20129 Milan
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  • Tiziana Marrocco
    Affiliations
    Department of Biomedical Sciences and Human Oncology, University of Turin, 10126 Turin
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  • Paola Cassoni
    Affiliations
    Department of Biomedical Sciences and Human Oncology, University of Turin, 10126 Turin
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  • Giovanni Bussolati
    Affiliations
    Department of Biomedical Sciences and Human Oncology, University of Turin, 10126 Turin
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  • Marco Parenti
    Affiliations
    Department of Experimental and Environmental Medicine and Medical Biotechnologies, University of Milano-Bicocca, 20052 Monza, Italy
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  • Bice Chini
    Correspondence
    To whom correspondence should be addressed: CNR Institute of Neuroscience, Cellular and Molecular Pharmacology Section, Via Vanvitelli 32, 20129 Milan, Italy. Tel.: 39-02-5031 (ext. 6958); Fax: 39-02-7490574;
    Affiliations
    Consiglio Nazionale delle Ricerche (CNR) Institute of Neuroscience, Cellular and Molecular Pharmacology Section, 20129 Milan
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  • Author Footnotes
    * This study was supported by a Cofin grant year 2002 (Grant 2002055453) and a FIRB grant year 2001 (Grant RBAU01XWS4) from the Italian Ministry for University and Research (to M. P.) and a Special Projet Oncology, Compagnia di San Paolo/Fondazione Internazionale di Ricerca in Medicina Sperimentale (to G. B.). 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.
      In human myometrial cells, the promiscuous coupling of the oxytocin receptors (OTRs) to Gq and Gi leads to contraction. However, the activation of OTRs coupled to different G protein pathways can also trigger opposite cellular responses, e.g. OTR coupling to Gi inhibits, whereas its coupling to Gq stimulates, cell proliferation. Drug analogues capable of promoting a selective receptor-G protein coupling may be of great pharmacological and clinical importance because they may target only one specific signal transduction pathway. Here, we report that atosiban, an oxytocin derivative that acts as a competitive antagonist on OTR/Gq coupling, displays agonistic properties on OTR/Gi coupling, as shown by specific 35S-labeled guanosine 5′-3-O-(thio) trisphosphate ([35S]GTPγS) binding. Moreover, atosiban, by acting on a Gi-mediated pathway, inhibits cell growth of HEK293 and Madin-Darby canine kidney cells stably transfected with OTRs and of DU145 prostate cancer cells expressing endogenous OTRs. Notably, atosiban leads to persistent ERK1/2 activation and p21WAF1/CIP1 induction, the same signaling events leading to oxytocin-mediated cell growth inhibition via a Gi pathway. Finally, atosiban exposure did not cause OTR internalization and led to only a modest decrease (20%) in the number of high affinity cell membrane OTRs, two observations consistent with the finding that atosiban did not lead to any desensitization of the oxytocin-induced activation of the Gq-phospholipase C pathway. Taken together, these observations indicate that atosiban acts as a “biased agonist” of the human OTRs and thus belongs to the class of compounds capable of selectively discriminating only one among the multiple possible active conformations of a single G protein-coupled receptor, thereby leading to the selective activation of a unique intracellular signal cascade.
      Oxytocin, a nonapeptide secreted by the neurohypophysis, exerts its biological effects by binding to and activating the oxytocin receptor (OTR),
      The abbreviations used are: OT, oxytocin; OTR, oxytocin receptor; GPCR, G protein-coupled receptor; BSA, bovine serum albumin; InsP, inositol phosphate; GFP, green fluorescent protein; EGFP, enhanced GFP; GTPγS, guanosine 5′-3-O-(thio)trisphospate; PLC, phospholipase C; MAPK, mitogen activated kinase; ERK, extracellular signal-regulated kinase; PTx, pertussis toxin; MDCK, Madin-Darby canine kidney cells; PBS, phosphate-buffered saline.
      1The abbreviations used are: OT, oxytocin; OTR, oxytocin receptor; GPCR, G protein-coupled receptor; BSA, bovine serum albumin; InsP, inositol phosphate; GFP, green fluorescent protein; EGFP, enhanced GFP; GTPγS, guanosine 5′-3-O-(thio)trisphospate; PLC, phospholipase C; MAPK, mitogen activated kinase; ERK, extracellular signal-regulated kinase; PTx, pertussis toxin; MDCK, Madin-Darby canine kidney cells; PBS, phosphate-buffered saline.
      a membrane receptor belonging to the G protein-coupled receptor family (
      • Kimura T.
      • Tanizawa O.
      • Mori K.
      • Brownstein M.J.
      • Okayama H.
      ). As recently reviewed by Gimpl (
      • Gimpl G.
      • Fahrenholz F.
      ), OTRs were originally described in the uterus, mammary gland, and central nervous system. In the uterus, the level of OTR expression increases during pregnancy and peaks immediately before the onset of labor, when receptor activation promotes uterine contractility. The OTRs in the mammary gland are located on myoepithelial cells, where they stimulate contractility and promote milk ejection. In the central nervous system, where they modulate hippocampal synaptic plasticity during pregnancy (
      • Tomizawa K.
      • Iga N.
      • Lu Y.F.
      • Moriwaki A.
      • Matsushita M.
      • Li S.T.
      • Miyamoto O.
      • Itano T.
      • Matsui H.
      ), OTRs are involved in regulating a number of reproductive and non-reproductive behaviors.
      OTRs have more recently been detected in a vast number of tumor cells of various origin (breast and endometrial carcinomas, neuroblastomas, glioblastomas, Kaposi sarcomas, small-cell lung carcinomas), and their stimulation variably affects cell growth (
      • Bussolati G.
      • Cassoni P.
      ). Moreover, it has recently been suggested that OTRs are involved in the differentiation of cardiomyocytes (
      • Paquin J.
      • Danalache B.A.
      • Jankowski M.
      • McCann S.M.
      • Gutkowska J.
      ) and myoblasts (
      • Breton C.
      • Haenggeli C.
      • Barberis C.
      • Heitz F.
      • Bader C.R.
      • Bernheim L.
      • Tribollet E.
      ).
      Despite the biological relevance of OTR signaling, the identity of signaling pathways activated to accomplish these different functions has only been partially clarified. In particular, although human OTRs have been shown to associate to Gq, Gi, and, to a minor extent, to Gs (
      • Strakova Z.
      • Soloff M.S.
      ), only the signaling events induced by Gq activation have been extensively investigated and exploited to develop drugs already entered in the clinical use. In myometrial and breast myoepithelial cells, OTR coupling to Gq is responsible for phospholipase C (PLC) activation followed by inositol phosphate (InsP) and diacylglycerol production, increased intracellular calcium, and increased contractility (
      • Sanborn B.M.
      ). Accordingly, selective oxytocin analogues capable of blocking this pathway are employed in the treatment of preterm labor (
      • Thornton S.
      • Vatish M.
      • Slater D.
      ). The physiological role played by OTRs coupled to Gi in myometrial cells is far less clear, although it was shown some years ago to also lead to an increase of cell contractility (
      • Phaneuf S.
      • Europe-Finner G.N.
      • Varney M.
      • MacKenzie I.Z.
      • Watson S.P.
      • Lopez Bernal A.
      ). Recently, a specific role for OTR coupled to Gi has emerged in MDCK and HEK293 cells stably transfected with the human OTR, where OT inhibits cell growth in a pertussis toxin (PTx)-sensitive manner, thus suggesting a key role of OTR-Gi coupling in mediating an anti-proliferative effect (
      • Rimoldi V.
      • Reversi A.
      • Taverna E.
      • Rosa P.
      • Francolini M.
      • Cassoni P.
      • Parenti M.
      • Chini B.
      ).
      A review of our previous work indicated that atosiban, an OTR antagonist that is currently used in the treatment of preterm labor because of its ability to block the Gq/PLC/calcium signaling pathway in myometrial cells (
      • Akerlund M.
      • Stromberg P.
      • Hauksson A.
      • Andersen L.F.
      • Lyndrup J.
      • Trojnar J.
      • Melin P.
      ,
      • Manning M.
      • Miteva K.
      • Pancheva S.
      • Stoev S.
      • Wo N.C.
      • Chan W.Y.
      ,
      • Bossmar T.
      • Akerlund M.
      • Fantoni G.
      • Szamatowicz J.
      • Melin P.
      • Maggi M.
      ,
      • Phaneuf S.
      • Asboth G.
      • MacKenzie I.Z.
      • Melin P.
      • Lopez Bernal A.
      ), inhibits the proliferation of some cancer cells (
      • Cassoni P.
      • Sapino A.
      • Papotti M.
      • Bussolati G.
      ). As we have recently shown that the growth of MDCK and HEK293 cells is inhibited via Gi-coupled OTRs (
      • Rimoldi V.
      • Reversi A.
      • Taverna E.
      • Rosa P.
      • Francolini M.
      • Cassoni P.
      • Parenti M.
      • Chini B.
      ), we hypothesized that atosiban inhibited cell growth via a biased agonist mechanism by selectively promoting OTR coupling to Gi. Biased agonists have been defined as analogues displaying, at a single promiscuous GPCR, agonist properties at one coupling pathway and antagonist properties at another one (
      • Jarpe M.B.
      • Knall C.
      • Mitchell F.M.
      • Buhl A.M.
      • Duzic E.
      • Johnson G.L.
      ,
      • Kenakin T.
      ). To check the biased agonist properties of atosiban at the human OTR, we examined atosiban signaling in MDCK and HEK293 cell clones stably transfected with human OTRs, as well as in DU145 human prostate cancer cells endogenously expressing OTRs.

      EXPERIMENTAL PROCEDURES

      Peptides and Reagents—OT and Thr4Gly7OT were obtained from Sigma; atosiban ((mpa1,d-Tyr(et)2,Thr4, Orn8)OT) (
      • Akerlund M.
      • Stromberg P.
      • Hauksson A.
      • Andersen L.F.
      • Lyndrup J.
      • Trojnar J.
      • Melin P.
      ) was synthesized in the laboratory of Dr. M. Manning, Toledo, OH. The sources of the primary antibodies were as follows: polyclonal anti-p21 (catalogue number sc-397) and anti-caveolin-1 (catalogue number sc-894) from Santa Cruz Biotechnology Inc.; monoclonal anti-green fluorescent protein (GFP) (catalogue number M048–3 clone 1E4) from MBL International Corp.; polyclonal anti-β-tubulin (catalogue number T5293 clone 2–28-33) from Sigma; polyclonal anti-phospho p42/44 MAPK (catalogue number 9101) from Cell Signaling Technology. Peroxidase-conjugated secondary antibodies were from Pierce, and [35S]GTPγS (1250 Ci/mmol) was from PerkinElmer Life Sciences.
      Cell Culture—The human prostate carcinoma DU145 cell line was purchased from ATCC (Manassas, VA) and routinely cultured in RPMI 1640 medium (Invitrogen), supplemented with 10% fetal calf serum (Invitrogen), penicillin-streptomycin (Invitrogen), and Fungizone (Invitrogen), in a 5% CO2 humidified atmosphere, at 37 °C. Production, pharmacological characterization, and culture conditions of MDCK and HEK293 clones stably expressing the human OTR cDNA fused to EGFP have been described elsewhere (
      • Rimoldi V.
      • Reversi A.
      • Taverna E.
      • Rosa P.
      • Francolini M.
      • Cassoni P.
      • Parenti M.
      • Chini B.
      ,
      • Guzzi F.
      • Zanchetta D.
      • Cassoni P.
      • Guzzi V.
      • Francolini M.
      • Parenti M.
      • Chini B.
      ).
      Cell Growth Assay—Cells were seeded in 48-multiwell plates (10,000 cells/well) and allowed to adhere for 24–48 h. Peptides were then added to the culture medium at the specified concentrations for up to 72 h. DU145 and MDCK cells were then fixed in 2.5% (v/v) glutaraldehyde, stained with 0.1% (w/v) crystal violet in 20% (v/v) methanol, and solubilized in 10% (v/v) acetic acid prior to cell growth evaluation through measurement of absorbance at 590 nm in a microplate reader (Wallac Victor2, PerkinElmer Life Sciences). Cell growth of HEK293 was determined by a methanethiosulfonate-based assay (Promega CellTiter 96® AQueous one solution assay) according to the manufacturer's instructions. All treatments were performed in quadruplicate. Equal numbers of cells were assayed, and a linear correlation between absorbance and cell counts was established up to 1 × 105 cells. Statistical analysis was carried out by Student's t test.
      [35S]GTPγS Binding Studies—[35S]GTPγS binding studies were carried out on transiently transfected cells. HEK293 cells, plated in 10-cm dishes at a 50% confluence, were transfected with 30 μg of a pEGFP-N3 Clontech plasmid encoding human OTR·EGFP using calcium phosphate co-precipitation. Forty-eight h after transfection, cells were collected in PBS without Ca2+ and Mg2+ (PBS-), centrifuged, and resuspended in 50 mm Tris-HCl, pH 7.4, supplemented with 2 mm EDTA and a protease inhibitor mixture (Sigma). After cell rupture with a glass homogenizer and removal of nuclei by low speed centrifugation (800 × g), cell extracts were ultracentrifuged at 100,000 × g for 1 h. The resulting pellets were resuspended in 20 mm HEPES buffer, pH 7.4, containing 5 mm Mg2Cl and 100 mm NaCl, to a final concentration of 1–2 mg/ml and stored at -80 °C. When required, cells were exposed to PTx (Sigma) for 16 h at a final concentration of 150 ng/ml before harvesting. [35S]GTPγS binding studies were performed according to Wieland and Jakobs (
      • Wieland T.
      • Jakobs K.
      ). Briefly, 25 μg of membranes were incubated at 30 °C for 5 min in a final assay volume of 100 μl. The assay mixture consisted of 20 mm HEPES, pH 7.4, 5 mm Mg2Cl, 100 mm NaCl, and 0.1 μm GDP. [35S]GTPγS (1250 Ci/mmol) was used at 50 nCi/assay tube, giving a final assay concentration of 0.5 nm. Agonist- and antagonist-dependent binding of [35S]GTPγS was determined in the presence of 100 nm oxytocin or atosiban, whereas nonspecific binding was determined in the presence of 20 μm unlabeled GTPγS. The binding reaction was stopped by the addition of 900 μl of ice-cold washing buffer (20 mm HEPES, pH 7.4, 5 mm Mg2Cl) and filtration through Whatman GF/C filters followed by three quick washes with washing buffer. After air-drying filters and adding 5 ml of Ultima Gold™ XR scintillation fluid (PerkinElmer Life Sciences), the bound radioactivity was determined by liquid scintillation counting.
      Inositol Phosphate Determination—Inositol phosphate (InsP) accumulation was measured as described previously (
      • Kirk C.J.
      • Guillon G.
      • Balestre M.
      • Jard S.
      ,
      • Chini B.
      • Mouillac B.
      • Ala Y.
      • Balestre M.
      • Trumpp-Kallmeyer S.
      • Hoflack J.
      • Elands J.
      • Hibert M.
      • Manning M.
      • Jard S.
      • Barberis C.
      ). Briefly, cells grown in 6-well dishes were labeled for 24 h with myo-[2-3H]inositol at a final concentration of 2 μCi/ml in a serum- and inositol-free medium (Invitrogen). The cells were washed twice in Krebs buffer (146 mm NaCl, 4.2 mm KCl, 0.5 mm MgCl2, 1.0 mm CaCl2, 10 mm HEPES base, 1% (w/v) glucose, pH 7.4) and preincubated for 10 min at 37 °C in the same buffer supplemented with 10 mm LiCl. After incubation for 15 min in the absence (baseline) or presence of peptide at a final concentration 10-7m, the reaction was stopped with 5% (v/v) perchloric acid, and the [3H]InsPs were extracted and separated using a strong anionic exchange column (Dowex AG1X8, formate form, 200–400 mesh; Bio-Rad). The fraction containing the [3H]inositol mono-, bis-, and tris-phosphates was collected, and its radioactivity content was determined by liquid scintillation counting. This fraction is referred to as total InsP and expressed as DPM/well.
      cAMP Accumulation Assay—Cells grown in 10-cm Petri dishes for 48 h were washed twice with PBS- and incubated for 15 min at 37 °C in PBS- supplemented with 4 mm EDTA. After scraping with a rubber policeman, cells were centrifuged at low speed, and resulting pellets were resuspended at a density of 106 cells/90 μl in PBS- supplemented with 5.5 mm 3-isobutyl-1-methylxanthine. Cell suspensions (total volume of 90 μl) were equilibrated at 37 °C for 15 min and further incubated with peptides at a final concentration of 10-7m, or buffer (basal accumulation), for additional 10 min. cAMP accumulation was stopped by placing the tubes in liquid nitrogen and boiling for 5 min. The samples were then centrifuged for 8 min at 12,000 rpm in an Eppendorf minifuge, and the supernatants were immediately used to measure cAMP using a competitive binding assay (cyclic AMP [3H] assay kit, Amersham Biosciences) according to the manufacturer's instructions.
      Preparation of Cell Lysates and Western Blot Analysis—After 1 h of starvation in serum-free medium, cells were stimulated with OT or atosiban at the final concentration of 10-7m for the indicated periods of time. Cells were then washed once in ice-cold PBS- and lysed in 50 mm Tris-HCl, pH 6.8, containing 2% (w/v) SDS, preheated at 100 °C. After 4–5 cycles of freezing in dry ice and boiling for 2 min, aliquots of the lysates were assayed for protein content using the BCA protein assay reagent (Pierce). Cellular proteins (30 μg) were resolved by Laemmli SDS-PAGE system using 11% acrylamide (
      • Laemli U.K.
      ) and then blotted onto nitrocellulose membranes (Amersham Biosciences). Blots were incubated overnight at 4 °C in Tris-buffered saline (20 mm Tris-HCl, pH 7.4, 150 mm NaCl), containing 5% (w/v) skimmed milk. The membranes were then incubated for 2 h with primary antibodies diluted in Tris-buffered saline/milk and for 2 h with horseradish peroxidase-conjugated goat anti-mouse/rabbit IgG (Pierce). When phospho p42/44 MAPK antibody was used, blocking was performed in 5% (w/v) bovine serum albumin/0.2% (v/v) Tween 20 for 1 h at 37 °C,and incubation was performed overnight in Tris-buffered saline/bovine serum albumin at 4 °C. Proteins were detected using the SuperSignal® chemiluminescent substrate (Pierce). For quantification, unsaturated bands were acquired by means of an Arcus II Scanner (Agfa-Gevaert) and analyzed with the NIH Image program Version 1.61 (National Technical Information Service, Springfield, VA).
      Internalization Assays—Cells were washed twice in serum-free medium and left for 30 min to equilibrate at 37 °C. Peptides were then added at a final concentration of 10-7m. At fixed time intervals (0, 5, 15, 30, and 60 min), cells were processed for fluorescence microscopy or binding assays.
      For fluorescence microscopy, cells grown on glass coverslips placed in 6-well dishes were washed twice with 10 mm sodium phosphate buffer, pH 7.4, containing 150 mm NaCl and fixed for 20 min at room temperature with 4% (w/v) paraformaldehyde in PBS. Fixed cells were rinsed with LS buffer and mounted on glass slides with 90% (v/v) glycerol in PBS. Slides were observed under an MRC1024 Bio-Rad laser scanning confocal microscope.
      To determine cell surface binding, cells subcultured into 24-well dishes were washed twice with ice-cold binding buffer (146 mm NaCl, 4.2 mm KCl, 0.5 mm MgCl2, 1.0 mm CaCl2, 10 mm HEPES base, 1% (w/v) glucose, 0.018% (w/v) l-tyrosine, 1% (w/v) bovine serum albumin, pH 7.4) and placed on ice.[3H]OT at a final concentration of 4 nm was added to the wells with or without 10-7 m unlabeled OT in a final volume of 200 μl. After incubation at 4 °C for 2 h, a time required to reach the equilibrium, cells were washed three times with binding buffer to remove the unbound radioactivity and then solubilized with 0.5 N NaOH. The samples were transferred to scintillation vials and counted in a β counter after the addition of 3.5 ml of scintillation fluid. Specific surface binding at each time was calculated as percentage of specific binding at time 0.

      RESULTS

      Atosiban-induced Inhibition of MDCK and HEK29 Cells Expressing Human OTRs—To analyze the ability of atosiban to inhibit the growth of cells expressing the human OTR, we checked its effects on MDCK and HEK293 cells stably transfected with the human OTR fused to EGFP (
      • Rimoldi V.
      • Reversi A.
      • Taverna E.
      • Rosa P.
      • Francolini M.
      • Cassoni P.
      • Parenti M.
      • Chini B.
      ,
      • Guzzi F.
      • Zanchetta D.
      • Cassoni P.
      • Guzzi V.
      • Francolini M.
      • Parenti M.
      • Chini B.
      ). As shown in Fig. 1 (A and D), cell growth was significantly inhibited after 48 h of treatment with OT and atosiban. This effect was concentration-dependent with calculated IC50 values of 20.8 ± 0.2 nm in HEK293 cells and 15.4 ± 0.44 nm in MDCK cells (Fig. 1, B and E), very similar to those calculated for OT (5.76 ± 0.3 nm and 22.0 ± 4.3 nm in HEK293 and MDCK cells, respectively; 13, 18).
      A. Reversi, V. Rimoldi, and B. Chini, unpublished results.
      Saturation and competition binding experiments performed in HEK293 cells resulted in the following affinities: Kd = 4.9 ± 2.2 nm and Ki = 71.5 ± 21.2 nm for OT and atosiban, respectively (data not shown). Finally, as shown in Fig. 1 (C and F), OT and atosiban did not induce any change in cell growth in parental MDCK and HEK293 cells stably transfected with the pEGFP vector alone, thus indicating that their effects on cell growth could only be detected in cells expressing OTRs.
      Figure thumbnail gr1
      Fig. 1Atosiban and OT-induced effects on proliferation in MCDK and HEK293 cells stably expressing the human OTR. Cell growth was evaluated after a 48-h treatment with atosiban and OT at a final concentration of 10-7m on MDCK (A) and HEK293 (D) cells stably expressing the human wild-type (WT) OTR. MDCK cells were fixed and stained with crystal violet, and cell growth was evaluated by measuring the absorbance at 590 nm. Proliferation of HEK293 cells was determined by a methanethiosulfonate-based assay. All of the experiments were done in sextuplicate. B and E, concentration-response curves of atosiban-induced inhibition of cell proliferation in MDCK (B) and HEK293 (E) cells expressing the wild-type OTR. C and F, parental MDCK (C) and HEK293 (F) cells transfected with an empty pEGFP-N3 vector. The concentration-response curves are representative of two independent experiments each performed in triplicate. ***, p < 0.001; **, p < 0.01; *, p < 0.05 versus untreated cells grown for equal periods of time in the absence of the peptide (Student's t test).
      Signaling Pathways Involved in the Atosiban-mediated Inhibition of Cell Growth—As it is known that OTRs couple to Gq and Gi (
      • Strakova Z.
      • Soloff M.S.
      ) and that receptor coupling to Gi is responsible for the OT-induced inhibition of HEK293 cell growth (
      • Rimoldi V.
      • Reversi A.
      • Taverna E.
      • Rosa P.
      • Francolini M.
      • Cassoni P.
      • Parenti M.
      • Chini B.
      ), we investigated the signaling events leading to the atosiban-induced inhibition of cell growth, and particularly, whether Gi is involved. To determine whether atosiban could directly promote OTR coupling to heterotrimeric G proteins, we measured its ability to promote the binding of [35S]GTPγS, according to the paradigm that receptor activation promotes the GDP/GTP exchange on G protein α subunits. This assay utilizes [35S]GTPγS resistance to hydrolysis, its high affinity for the Gα subunits, and its relatively high specific activity to determine receptor-induced Gα activation (
      • Wieland T.
      • Jakobs K.
      ,
      • Harrison C.
      • Traynor J.R.
      ,
      • Milligan G.
      ). As shown in Fig. 2A, in HEK293 expressing the human OTR, OT and atosiban were both able to induce a percentage increase in [35S]GTPγS binding over basal of 23.84 ± 2.70 and 26.42 ± 4.10, respectively. In contrast, in parental, untransfected HEK293 cells, the two analogues did not induce any significant increase in [35S]GTPγS binding. These data indicate that atosiban is capable of promoting OTR coupling to G protein, thus displaying agonist properties toward the human OTR. In addition, in OTR-expressing cells pretreated with PTx, the capability of OT and atosiban to increase [35S]GTPγS binding was completely abolished, indicating a coupling to Gi-like proteins. The lack of any residual [35S]GTPγS binding even in membranes treated with OT indicates that, in our experimental conditions, OTR coupling to Gq did not significantly contribute to total [35S]GTPγS binding. We then checked the ability of atosiban to modulate proliferation of PTx-treated cells (Fig. 2B); under these conditions, the atosiban-induced inhibition of cell growth was completely abolished, thus indicating that a PTx-sensitive G protein of the Gi family mediates the inhibitory effect.
      Figure thumbnail gr2
      Fig. 2Signaling pathways involved in atosiban-induced growth inhibition of HEK293 cells expressing the recombinant human OTR.A, [35S]GTPγS binding assay. [35S]GTPγS binding performed as described under “Experimental Procedures” is expressed as the percentage of increase of specific binding measured in agonist-treated membranes with respect to membranes treated with vehicle (basal). Membranes were prepared from untransfected parental and OTR-expressing HEK293 cells untreated or pretreated for 16 h with PTx at a final concentration of 150 ng/ml. *, p < 0.05; **, p < 0.01, ***, p < 0.001 versus parental Hek293 cells (Student's t test). B, effect of PTx on atosiban-induced inhibition of cell growth. Atosiban-induced effects on cell growth were determined in cells pretreated or not with PTx. In cells treated with PTx, the atosiban-induced variations in cell number was determined with respect to control cells maintained in the presence of PTx for the complete duration of the experiment. C, MAPK activation by OT and atosiban. The cells were treated with 10-7m OT or atosiban for the indicated periods of time. Then cells were lysed, and 30 μg of proteins/lane were subjected to separation by SDS-PAGE (11% acrylamide), Western immunoblotting with polyclonal anti-phosphoERK1/ERK2 antibody, and chemiluminescence detection. A caveolin-1 (cav-1) antibody was used to check the quantities of protein loaded in the different lanes. After image acquisition, the band densities were quantitated using the NIH Image Program version 1.61. The results are expressed as -fold increase in phospho-ERK1/ERK2 over basal (Bas). The blot is representative of two independent experiments. D, dose-response curves of OT- and atosiban-induced accumulation of InsP. OTR coupling to Gq was assayed by measuring total InsP production induced by cell exposure for 15 min to increasing concentrations of OT or atosiban. Each point, performed in triplicate, represents the mean of total amount of InsPs produced (expressed in dpm/well). The data are representative of two independent experiments diverging for <20%. E, dose-response curves of OT-induced InsP accumulation in the absence and presence of different concentrations of atosiban. Total InsP production induced by OT (from 10-10 to 10-5m) was measured in the presence of a fixed concentration of atosiban (+ATO 10-8 to 10-5m). The amount of InsP produced at each point is expressed as the percentage of InsP produced at the maximal OT concentration (10-5m) in the absence of atosiban (-ATO) fixed at 100%. The data are representative of two independent experiments diverging for <20%. Each concentration was assayed in triplicate determinations; error bars were not included for the sake of clarity. F, agonist-induced cAMP production. The coupling of OTRs to Gs was assayed by measuring cAMP levels after stimulation with OT (10-7m), atosiban (10-7m), or forskolin (2 μm). The data are representative of two independent experiments diverging for <20%. **, p < 0.01 versus untreated cells (Student's t test).
      As we have shown that the OT-induced growth inhibition of MDCK and HEK293 cells is associated with a long-lasting activation of MAPK (
      • Rimoldi V.
      • Reversi A.
      • Taverna E.
      • Rosa P.
      • Francolini M.
      • Cassoni P.
      • Parenti M.
      • Chini B.
      ), we investigated whether atosiban can also induce MAPK phosphorylation. To this end, we applied atosiban for an increasing length of time and analyzed ERK1/2 activation by means of Western immunoblotting of cell lysates probed with phospho-specific anti-ERK1/2 antibody. As shown in Fig. 2C, atosiban induced a persistent increase in ERK1/2 phosphorylation, a pattern consistent with inhibition of cell growth, as demonstrated previously in HEK293 and MDCK cells (
      • Rimoldi V.
      • Reversi A.
      • Taverna E.
      • Rosa P.
      • Francolini M.
      • Cassoni P.
      • Parenti M.
      • Chini B.
      ).
      We then verified whether atosiban can promote OTR coupling to Gq by measuring the atosiban-induced accumulation of total InsPs; as shown in Fig. 2D, whereas OT caused a concentration-dependent enhancement in the production of InsPs, no effect was observed after atosiban treatment, even at very high concentrations, thus indicating that atosiban is completely devoid on any agonist properties on OTR/Gq coupling. In addition, we verified whether atosiban acted as an antagonist on the OTR/Gq/PLC signaling pathway. As shown in Fig. 2E, increasing concentrations of atosiban shifted to the right the dose-response curve of OT-induced InsP production, as expected for a competitive antagonist. This experiment also confirmed that atosiban does not behave as a partial agonist on the human OTR as, if this were the case, a very different family of curves, characterized by an increasingly higher level of basal InsP production and unchanged EC50 for OT, would have been obtained. Finally, the possibility that atosiban might act on OTRs coupled to Gs was excluded by the lack of any increase in cAMP induced by the drug as well as by OT (Fig. 2F).
      All together, these data indicate that atosiban is able to promote selective OTR coupling to Gi, whereas being devoid of any agonist activity upon OTR-Gq coupling, and inhibits cell growth through an intracellular cascade that involves a PTx-sensitive G protein and MAPK activation. The ability of atosiban to promote the selective activation of a Gi-mediated pathway while being, at the same time, a competitive antagonist of the OT-induced OTR/Gq coupling, supports the hypothesis that it acts as a biased agonist, i.e. by promoting and/or stabilizing an OTR conformational state(s) that “prefers” Gαi over Gq.
      Atosiban-induced Inhibition of DU145 Human Prostate Cancer Cell Growth—The human DU145 prostate cancer cell line expresses OTRs but not the endogenous OT ligand, and, in these cells, exposure to OT leads to a significant decrease in cell proliferation, already detectable after 48 h and peaking after 96 h (
      • Cassoni P.
      • Marrocco T.
      • Sapino A.
      • Allia E.
      • Bussolati G.
      ). Therefore, this cell line represents a suitable model for testing the ability of atosiban to affect the proliferation of cells endogenously expressing OTRs. When treated with 100 nm atosiban, DU145 cells responded with a significant decrease in proliferation, firstly observed after 48 h and reaching its maximum at 72 h (Fig. 3A). The extent of growth inhibition induced by atosiban was similar to that observed after treatment with equal concentrations of OT or the highly selective OTR agonist Thr4Gly7OT (Fig. 3B). The anti-proliferative effect of atosiban was concentration-dependent, with a calculated EC50 of 3.9 × 10-8m (Fig. 3C). Finally, no additive effect was observed upon combined exposure of cultures to OT and atosiban for 48 h (Fig. 3D).
      Figure thumbnail gr3
      Fig. 3Atosiban-induced effects on growth of DU145 human prostate cancer cells. Cell growth of DU145 cells was evaluated by means of a crystal violet-based assay. All experiments were done in sextuplicate. Statistical analysis was carried out by Student's t test. A, atosiban was added at a final concentration of 10-7m for 24, 48, and 72 and 96 h; ***, p < 0.001; **, p < 0.01; *, p < 0.05 versus untreated cells grown for equal periods of time in the absence of the peptide. B, OT, the highly specific OTR agonist Thr4Gly7OT, and atosiban were added at a final concentration of 10-7m for 48 h; the variations in cell number of Thr4Gly7OT- and atosiban-treated cells were not statistically different when compared with OT-treated cells. C, concentration-response curve of atosiban-induced inhibition of cell proliferation; the curve shown is representative of two independent experiments, each performed in triplicate determinations. D, the additivity of OT and atosiban effects were assayed in DU145 cells treated with a combination of the two peptides each at a final concentration of 10-7m. The decrease in cell number obtained treated with the combination was not significantly different from those of cells separately treated with OT or atosiban.
      Finally, we investigated whether atosiban stimulation of OTRs in DU145 cells leads to ERK1/2 phosphorylation. As shown in Fig. 4, both the highly selective OT analogue Thr4Gly7OT (
      • Elands J.
      • Barberis C.
      • Jard S.
      • Tribollet E.
      • Dreifuss J.
      • Bankowski K.
      • Manning M.
      • Sawyer W.H.
      ) and atosiban elicited a sustained ERK1/2 activation. Moreover, Western blot analysis showed that the levels of cell cycle inhibitor p21WAF1/CIP1 started to increase after 24 h of exposure and reached the maximum after 48 h, when the cell growth inhibition by Thr4Gly7OT and atosiban became measurable. These data suggest that the sustained MAPK activation observed after OTR stimulation by Thr4Gly7OT and atosiban inhibits the growth of DU145 cells by inducing the expression of p21WAF1/CIP1.
      Figure thumbnail gr4
      Fig. 4Time course of MAPK and p21WAF1/CIP1 activation in DU145 cells. DU145 cells were treated with the highly specific OTR agonist Thr4Gly7OT (A) or atosiban (B) for the indicated periods of time. The cells were lysed, and 30 μg of proteins were resolved by SDS-PAGE. MAPK activation was detected by Western blotting with anti-phospho-ERK1/ERK2 antibody, and p21WAF1/CIP1 induction was detected using a specific polyclonal antibody. Immunoblotting with a polyclonal anti-β-tubulin antibody was used to verify that equals amounts of proteins were loaded in all lanes. The blots are representative of two independent experiments.
      OT and Atosiban Induce Different OTR Desensitization and Internalization Patterns—GPCR signaling is generally down-regulated by agonist-induced internalization, a process that sequentially involves agonist binding to the receptor, and subsequent receptor phosphorylation, β-arrestin recruitment, and endocytosis. No data are yet available on the effects of biased agonists on GPCR internalization. To investigate whether atosiban can induce receptor internalization, we used MDCK and HEK293 cells stably transfected with OTR fused to EGFP to monitor receptor distribution by confocal microscopy. Thus, we examined the subcellular distribution of OTRs after incubation with 10-7m OT or atosiban for increasing lengths of time (Fig. 5, A and B). Before agonist exposure (time 0), confluent monolayers expressing OTRs were homogeneously fluorescent all around the cell edges. A punctate fluorescence (presumably associated with endocytotic vesicles) could be seen as early as 5 min after OT application and became more evident after 15 min. After 30 and 60 min, the fluorescent patches seemed to be mainly localized within intracellular compartments of both MDCK and HEK293 cells. In contrast, OTRs remained permanently localized at the cell surface even after 60 min of atosiban treatment, without any signs of endocytic vesicle formation.
      Figure thumbnail gr5
      Fig. 5Time course of agonist-induced OTR internalization. Subcellular localization of recombinant wild-type OTR fused to EGFP was visualized by laser scanning confocal microscopy in stably transfected MDCK and HEK293 cells grown on glass coverslips. In these experiments, OT and atosiban were added at time 0, at a final concentration of 10-7m, and cells were fixed after a further incubation at 37 °C for 5, 15, 30, and 60 min. The images show midsections of the cells. A, stable MDCK cells expressing OTR-GFP. Bas, basal. B, stable Hek293 cells expressing OTR-GFP. Comparable results were obtained with a final concentration of atosiban of 10-5m.
      We also estimated the number of cell surface OTRs by measuring the high affinity binding of [3H]OT to intact cells after different times of peptide exposure. As shown in Fig. 6A, OT treatment led to a progressive and almost complete (75%) loss of high affinity sites in HEK293 cells after only 15 min, whereas atosiban treatment induced the loss of only 20% specific high affinity binding sites even after 120 min.
      Figure thumbnail gr6
      Fig. 6Agonist-induced desensitization of OTR in HEK293 cells.A, time course of OTR internalization. HEK293 cells expressing the wild-type OTR were incubated in the presence of 10-7m OT or atosiban for the indicated times. Specific cell surface binding, determined at 4 °C using [3H]OT as a radioligand, is expressed as the percentage of [3H]OT specific binding at time 0. The curve is representative of two independent assays; the data are expressed as means + S.E. of triplicate determinations. B, agonist-induced desensitization of OTR. Desensitization was assayed by comparing the increase of total InsP in response to a 15-min OT application (final concentration of 10-7m) in basal (Bas) conditions and after a 60-min treatment with atosiban (final concentration of 10-7m). Total InsPs were measured after 60 min of atosiban treatment to exclude any change in basal InsP due to long-lasting atosiban application. The data are representative of two independent assays diverging for <20%. Each point represents the total amount of InsP and is expressed as dpm/well (means + S.E. of triplicate determinations).
      Finally, we investigated whether the surface OTRs remaining after prolonged atosiban exposure displayed any agonist-induced desensitization of the Gq/PLC signaling pathway by measuring the OT-induced accumulation of total InsP in the presence or absence of atosiban. As shown in Fig. 6B, a 60-min atosiban treatment did not affect the subsequent accumulation of total InsP induced by OT, thus indicating that atosiban did not induce any measurable desensitization of the canonical Gq/PLC pathway.

      DISCUSSION

      The results of this study show that atosiban, a peptidic compound used in the management of preterm labor because of its antagonistic activity on uterine contractility (
      • Thornton S.
      • Vatish M.
      • Slater D.
      ,
      • Akerlund M.
      • Stromberg P.
      • Hauksson A.
      • Andersen L.F.
      • Lyndrup J.
      • Trojnar J.
      • Melin P.
      ,
      • Coomarasamy A.
      • Knox E.M.
      • Gee H.
      • Khan K.S.
      ), can also inhibit cell growth by acting as a selective agonist of OTR/Gi coupling. This effect is indeed mediated by OTRs as it was only observed in MDCK and HEK293 cells stably transfected with human receptors but not in OTR-negative parental MDCK and HEK293 cells.
      Human OTRs promiscuously couple to Gq and Gi (
      • Strakova Z.
      • Soloff M.S.
      ) and can inhibit or stimulate cell growth depending on their differential coupling to G proteins, occurring inside or outside plasma membrane lipid rafts (
      • Rimoldi V.
      • Reversi A.
      • Taverna E.
      • Rosa P.
      • Francolini M.
      • Cassoni P.
      • Parenti M.
      • Chini B.
      ,
      • Guzzi F.
      • Zanchetta D.
      • Cassoni P.
      • Guzzi V.
      • Francolini M.
      • Parenti M.
      • Chini B.
      ). In particular, the OT-induced inhibition of cell growth is completely blocked by pretreatment with PTx, thus indicating the involvement of OTRs coupled to Gi-like proteins.
      Here, we show that atosiban inhibits cell growth via selective activation of OTR/Gi coupling, being completely blocked by pretreatment with PTx. In addition, as is true of OT (
      • Rimoldi V.
      • Reversi A.
      • Taverna E.
      • Rosa P.
      • Francolini M.
      • Cassoni P.
      • Parenti M.
      • Chini B.
      ) treatment, atosiban persistently induced MAPK phosphorylation and expression of the cell cycle inhibitor p21WAF1/CIP1. It is worth noting that atosiban, although behaving as agonist of OTR/Gi coupling, acts as a competitive antagonist of OTR/Gq coupling. The ability of displaying agonist-like properties toward a specific receptor-G protein coupling (Gi) and, simultaneously, acting as an antagonist at another receptor-G protein coupling (Gq) identifies atosiban as an analogue endowed with biased agonist properties.
      The term biased agonist was introduced in 1998 by Jarpe et al. (
      • Jarpe M.B.
      • Knall C.
      • Mitchell F.M.
      • Buhl A.M.
      • Duzic E.
      • Johnson G.L.
      ) to define the behavior of a substance P derivative, (d-Arg1,d-Phe5,d-Trp7,9,Leu11) substance P, a neurokinin-1 receptor antagonist that, in small-cell lung carcinoma, inhibits the Gq-mediated pathway and behaves as an agonist to activate the c-Jun N-terminal kinase. It was subsequently found that the latter effect is mediated by bombesin receptors, i.e. substance P activates bombesin receptor signaling through Gi and simultaneously blocks receptor coupling to Gq. Moreover, it was shown that substance P, via Gi, stimulates the MAPK pathway, leading to cell growth inhibition (
      • MacKinnon A.C.
      • Waters C.
      • Jodrell D.
      • Haslett C.
      • Sethi T.
      ). Another analogue characterized by a biased agonist activity is the bradykinin antagonist dimer CU201 that, in small-cell lung carcinoma and other cancer cell lines, blocks the Gq pathways and activates the G12–13 pathways, once again leading to apoptosis and inhibition of cell growth (
      • Chan D.C.
      • Gera L.
      • Stewart J.M.
      • Helfrich B.
      • Zhao T.L.
      • Feng W.Y.
      • Chan K.K.
      • Covey J.M.
      • Bunn Jr., P.A.
      ). Biased agonists can have enormous pharmacological and clinical importance because they can trigger, for each single receptor subtype, only the “appropriate” downstream signaling pathway, thus representing a novel class of highly selective compounds. The existence of biased agonists is consistent with a multistate model of receptor activation in which single ligands can promote specific receptor conformations capable of differentially activating distinct signaling partners. This phenomenon, termed “agonist-directed trafficking of receptor stimulus” by Kenakin (
      • Kenakin T.
      ,
      • Kenakin T.
      ), has recently gained further support by the finding that inverse agonists acting on β-adrenergic and vasopressin receptors can lead to ligand-selective receptor activation (
      • Azzi M.
      • Charest P.G.
      • Angers S.
      • Rousseau G.
      • Kohout T.
      • Bouvier M.
      • Pineyro G.
      ).
      Agonist-directed trafficking of receptor stimulus should not be confused with an “agonist strength-based mechanism.” In this case, a powerful agonist may produce a stimulus sufficient to simultaneously activate two intracellular pathways, whereas a weaker agonist may only stimulate the most sensitive one. As quoted from a recent review of Kenakin: “The most sound evidence for the demonstration of receptor-selective states with a ligand is either: (
      • Kimura T.
      • Tanizawa O.
      • Mori K.
      • Brownstein M.J.
      • Okayama H.
      ) thorough clear differences in efficacy (maximal response in which affinity is not an issue) or (
      • Gimpl G.
      • Fahrenholz F.
      ) actual reversal of relative potency in which there can be no question of differences as a result of a different strength of signal” (
      • Kenakin T.
      ). Here, comparing the potencies of OT and atosiban would be questionable because potency at Gq-coupled OTRs is evaluated as increased generation of InsPs, whereas potency at Gi-coupled OTRs is measured as degree of cell growth inhibition, an effect downstream of the proximal second messenger generation step. The evidence of stimulus trafficking comes, instead, from the very different efficacies of OT and atosiban in promoting OTR/Gq coupling, despite binding affinities differing by only 1 order of magnitude. Notably, atosiban was devoid of any agonist activity on OTR/Gq coupling when compared with the full agonist oxytocin, demonstrating the induction of ligand-selective receptor states. Furthermore, atosiban was confirmed to be a competitive antagonist on OTR/Gq coupling, indicating biased agonist properties.
      It is worth noting that a number of other peptidic antagonists have been found to interfere with cell proliferation in a complex and only partially understood manner, including the bradykinin B2 antagonist Hoe140 (
      • Drube S.
      • Liebmann C.
      ), the “dipeptoid” CCK-B/gastrin agents (
      • Bestervelt L.
      • Barr B.
      • Dethloff L.
      ), the neurotensin receptor antagonist SR48692 (
      • Moody T.W.
      • Chiles J.
      • Casibang M.
      • Moody E.
      • Chan D.
      • Davis T.P.
      ), the leukotriene B4 receptor antagonist LY293111 (
      • Tong W.G.
      • Ding X.Z.
      • Hennig R.
      • Witt R.C.
      • Standop J.
      • Pour P.M.
      • Adrian T.E.
      ), and the somatostatin receptor antagonist cSSTA (
      • Stirnweis J.
      • Boehmer F.D.
      • Liebmann C.
      ). It will be interesting to verify whether the complex effects on cell growth by these peptides may also be explained by a biased agonist action on their receptors. In this case, their classification as antagonists will need to be re-evaluated.
      Atosiban acts on a GPCR activated by OT, the small peptide from which it was originally derived. Since a vast number of peptidic analogues of oxytocin have been developed over the last 40 years (
      • Berde B.
      • Boissonnas R.A.
      ,
      • Manning M.
      • Sawyer W.H.
      ), it would be very interesting to evaluate the structural-functional relationships leading to biased agonist properties. The OTR has been subjected to molecular modeling by several groups (
      • Chini B.
      • Fanelli F.
      ), and recently, the atosiban-OTR interactions leading to putative high affinity binding have been investigated (
      • Slusarz M.J.
      • Slusarz R.
      • Kazmierkiewicz R.
      • Trojnar J.
      • Wisniewski K.
      • Ciarkowski J.
      ). A combined molecular modeling and site-directed mutagenesis study could greatly improve our understanding of the molecular basis underlying receptor activation as well as the specificity of receptor-G protein interaction. It will also be interesting to determine the amino acid residues of OT that are responsible for the induction of a selective coupling state of the receptor, as done for the human parathyroid hormone, where the regions responsible for the dual coupling to adenylyl cyclase and PLC have been mapped (
      • Takasu H.
      • Gardella T.J.
      • Luck M.D.
      • Potts Jr., J.T.
      • Bringhurst F.R.
      ).
      As atosiban acts as an agonist to promote Gi-mediated signaling, we investigated whether, like endogenous OT, it could induce agonist-induced receptor internalization (
      • Guzzi F.
      • Zanchetta D.
      • Cassoni P.
      • Guzzi V.
      • Francolini M.
      • Parenti M.
      • Chini B.
      ,
      • Oakley R.H.
      • Laporte S.A.
      • Holt J.A.
      • Barak L.S.
      • Caron M.G.
      ). On the basis of our confocal microscopy data, we can conclude that atosiban, at the concentrations used, does not induce any receptor internalization. Likewise, no desensitization of Gq/PLC signaling occurred. However, as atosiban treatment led to a small but significant 20% decrease in the number of high affinity binding sites, it is tempting to speculate that this OTR population may represent the agonist-activated OTRs coupled to Gi that undergo desensitization, a hypothesis that will require further investigation. It has been recently shown that recombinant human OTRs expressed in HEK293 cells undergo agonist-dependent phosphorylation by GRK2, an event that ultimately leads to receptor internalization (
      • Hasbi A.
      • Devost D.
      • Laporte S.A.
      • Zingg H.H.
      ), but it is still unclear whether receptor coupling to different G proteins affects the recruitment of the kinase and the subsequent events involved in receptor trafficking. To clarify this issue, atosiban could represent a very valuable tool.
      Finally, it is worth noting that atosiban inhibits cell growth not only in cell lines transfected with the human OTR but also in DU145 human prostate cancer cells endogenously expressing OTRs (this study) and mammary carcinoma cells (
      • Cassoni P.
      • Sapino A.
      • Papotti M.
      • Bussolati G.
      ); this occurs in the absence of Gq/PLC stimulation and thus represents a very specific downstream signaling event. Given that atosiban has already been approved as an antagonist for the treatment of preterm delivery, a pilot clinical trial of its use in the treatment of cancer cells expressing high human OTR levels warrants consideration.
      In conclusion, our data indicate that atosiban, a peptidic derivative of the posterior pituitary OT hormone, possesses biased agonist activity on the human OTRs and represents a very valuable tool for investigating the molecular basis of ligand-induced coupling specificity.

      Acknowledgments

      We thank Prof. M. Manning (Toledo, OH) and Prof. G. Milligan (Glasgow, UK) for critically reading the manuscript.

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