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Erschienen in: Diabetologia 8/2003

01.08.2003 | Article

Erk 1,2 phosphorylates p27Kip1: Functional evidence for a role in high glucose-induced hypertrophy of mesangial cells

verfasst von: Dr. G. Wolf, R. Reinking, G. Zahner, R. A. K. Stahl, S. J. Shankland

Erschienen in: Diabetologia | Ausgabe 8/2003

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Abstract

Aims/hypothesis

Mesangial cell hypertrophy is one of the earliest morphological abnormalities of diabetic nephropathy. We have previously shown that high glucose induces p27Kip1 by a post-transcriptional mechanism and that mesangial cell hypertrophy depends on G1-phase arrest mediated by this CDK-inhibitor. However, it remains poorly understood how high glucose stimulates p27Kip1 expression in mesangial cells.

Methods

Mesangial cells were isolated from p27Kip1 +/+ and –/– mice and characterized by light microscopy and immunohistochemistry. It was tested by Western blotting and autoradiography whether high glucose medium activates Erk 1,2 and whether this activation phosphorylates p27Kip1. The three consensus phosphorylation sites of p27Kip1 were mutated and these constructs were expressed in p27Kip1 –/– mesangial cells. Hypertrophy was assessed by different methods.

Results

High glucose stimulates phosphorylation of MAP kinases Erk 1,2 in p27Kip1 +/+ and –/– mesangial cells. Activation of Erk 1,2 leads to phosphorylation of p27Kip1 in vitro and in vivo. Mutations of serine10 or threonine187 still supported high glucose-induced hypertrophy. In contrast, a mutation of serine178 converted the hypertrophic response into a proliferative phenotype. Mutation of serine178 leads to the attenuated expression of p27Kip1 protein in the presence of high glucose.

Conclusions/interpretation

Our study shows that high glucose stimulates Erk 1,2 that phosphorylate p27Kip1 at serine178 increasing its expression. This is an important molecular mechanism of high glucose-induced hypertrophy of mesangial cells.
Literatur
1.
Zurück zum Zitat Bak M, Thomsen K, Christiansen T, Flyvbjerg A (2000) Renal enlargement precedes renal hyperfiltration in early experimental diabetes in rats. J Am Soc Nephrol 11:1287–1292PubMed Bak M, Thomsen K, Christiansen T, Flyvbjerg A (2000) Renal enlargement precedes renal hyperfiltration in early experimental diabetes in rats. J Am Soc Nephrol 11:1287–1292PubMed
2.
Zurück zum Zitat Drummond K, Mauer M (2002) The early natural history of nephropathy in type 1 diabetes. II. Early renal structural changes in type 1 diabetes. Diabetes 51:1580–1587PubMed Drummond K, Mauer M (2002) The early natural history of nephropathy in type 1 diabetes. II. Early renal structural changes in type 1 diabetes. Diabetes 51:1580–1587PubMed
3.
Zurück zum Zitat Baumgartl HJ, Sigl G, Banholzer P, Halsbeck M, Standl E (1998) On the prognosis of IDDM patients with larger kidneys. Nephrol Dial Transplant 13:630–634CrossRefPubMed Baumgartl HJ, Sigl G, Banholzer P, Halsbeck M, Standl E (1998) On the prognosis of IDDM patients with larger kidneys. Nephrol Dial Transplant 13:630–634CrossRefPubMed
4.
Zurück zum Zitat Fogo A, Ichikawa I (1991) Evidence for a pathogenic linkage between glomerular hypertrophy and sclerosis. Am J Kidney Dis 17:666–669PubMed Fogo A, Ichikawa I (1991) Evidence for a pathogenic linkage between glomerular hypertrophy and sclerosis. Am J Kidney Dis 17:666–669PubMed
5.
Zurück zum Zitat Wolf G, Ziyadeh FN (1999) Molecular mechanisms of diabetic renal hypertrophy. Kidney Int 56:393–405CrossRefPubMed Wolf G, Ziyadeh FN (1999) Molecular mechanisms of diabetic renal hypertrophy. Kidney Int 56:393–405CrossRefPubMed
6.
Zurück zum Zitat Wolf G, Sharma K, Chen Y, Ericksen M, Ziyadeh FN (1992) High glucose-induced proliferation in mesangial cells is reversed by autocrine TGF-β. Kidney Int 42:647–656PubMed Wolf G, Sharma K, Chen Y, Ericksen M, Ziyadeh FN (1992) High glucose-induced proliferation in mesangial cells is reversed by autocrine TGF-β. Kidney Int 42:647–656PubMed
7.
Zurück zum Zitat Huang HC, Preisig PA (2000). G1 kinases and transforming growth factor-β signaling are associated with a growth pattern switch in diabetes-induced renal growth. Kidney Int 58:162–172CrossRefPubMed Huang HC, Preisig PA (2000). G1 kinases and transforming growth factor-β signaling are associated with a growth pattern switch in diabetes-induced renal growth. Kidney Int 58:162–172CrossRefPubMed
8.
Zurück zum Zitat Cosio FG (1995) Effects of high glucose concentrations on human mesangial cell proliferation. J Am Soc Nephrol 5:1600–1609PubMed Cosio FG (1995) Effects of high glucose concentrations on human mesangial cell proliferation. J Am Soc Nephrol 5:1600–1609PubMed
9.
Zurück zum Zitat Kuan CJ, Al-Douahji M, Shankland SJ (1998) The cyclin kinase inhibitor p21WAF1,CIP1 is increased in experimental diabetic nephropathy: potential role in glomerular hypertrophy. J Am Soc Nephrol 9:986–993PubMed Kuan CJ, Al-Douahji M, Shankland SJ (1998) The cyclin kinase inhibitor p21WAF1,CIP1 is increased in experimental diabetic nephropathy: potential role in glomerular hypertrophy. J Am Soc Nephrol 9:986–993PubMed
10.
Zurück zum Zitat Wolf G, Schroeder R, Ziyadeh FN, Thaiss F, Zahner G, Stahl RAK (1997) High glucose stimulates expression of p27Kip1 in cultured mouse mesangial cells: relationship to hypertrophy. Am J Physiol 273:348–356 Wolf G, Schroeder R, Ziyadeh FN, Thaiss F, Zahner G, Stahl RAK (1997) High glucose stimulates expression of p27Kip1 in cultured mouse mesangial cells: relationship to hypertrophy. Am J Physiol 273:348–356
11.
Zurück zum Zitat Wolf G, Schroeder R, Thaiss F, Ziyadeh FN, Helmchen U, Stahl RAK (1998) Glomerular expression of p27Kip1 in diabetic db/db mouse: role of hyperglycemia. Kidney Int 53:869–879CrossRefPubMed Wolf G, Schroeder R, Thaiss F, Ziyadeh FN, Helmchen U, Stahl RAK (1998) Glomerular expression of p27Kip1 in diabetic db/db mouse: role of hyperglycemia. Kidney Int 53:869–879CrossRefPubMed
12.
Zurück zum Zitat Wolf G, Schroeder R, Zahner G, Stahl, RAK, Shankland SJ (2001) High glucose-induced hypertrophy of mesangial cells requires p27Kip1, an inhibitor of cyclin-dependent kinases. Am J Pathol 158:1091–1100PubMed Wolf G, Schroeder R, Zahner G, Stahl, RAK, Shankland SJ (2001) High glucose-induced hypertrophy of mesangial cells requires p27Kip1, an inhibitor of cyclin-dependent kinases. Am J Pathol 158:1091–1100PubMed
13.
Zurück zum Zitat Wolf G, Haberstroh U, Neilson EG (1992) Angiotensin II stimulates the proliferation and biosynthesis of type I collagen in cultured murine mesangial cells. Am J Pathol 140:95–107PubMed Wolf G, Haberstroh U, Neilson EG (1992) Angiotensin II stimulates the proliferation and biosynthesis of type I collagen in cultured murine mesangial cells. Am J Pathol 140:95–107PubMed
14.
Zurück zum Zitat Ernest S, Bello-Reus E (1996) Xenobiotic transport differences in mouse mesangial cell clones mdr1 and mdr3. Am J Physiol 270 (Cell Physiol 39):C910–C919PubMed Ernest S, Bello-Reus E (1996) Xenobiotic transport differences in mouse mesangial cell clones mdr1 and mdr3. Am J Physiol 270 (Cell Physiol 39):C910–C919PubMed
15.
Zurück zum Zitat Isono M, Iglesias-de la Cruz MC, Chen S, Hong SW, Ziyadeh FN (2000) Extracellular signal-regulated kinase mediates stimulation of TGF-β1 and matrix by high glucose in mesangial cells. J Am Soc Nephrol 11:2222–2230PubMed Isono M, Iglesias-de la Cruz MC, Chen S, Hong SW, Ziyadeh FN (2000) Extracellular signal-regulated kinase mediates stimulation of TGF-β1 and matrix by high glucose in mesangial cells. J Am Soc Nephrol 11:2222–2230PubMed
16.
Zurück zum Zitat Awazu M, Ishikura K, Hida M, Hoshiya M (1999) Mechanisms of mitogen-activated protein kinase activation in experimental diabetes. J Am Soc Nephrol 10:738–745PubMed Awazu M, Ishikura K, Hida M, Hoshiya M (1999) Mechanisms of mitogen-activated protein kinase activation in experimental diabetes. J Am Soc Nephrol 10:738–745PubMed
17.
Zurück zum Zitat Müller D, Thieke K, Bürgin A, Dickmanns A, Eilers M (2000) Cyclin E-mediated elimination of p27 requires its interaction with the nuclear pore-associated protein mNPAP60. EMBO J 1119:2168–2180CrossRef Müller D, Thieke K, Bürgin A, Dickmanns A, Eilers M (2000) Cyclin E-mediated elimination of p27 requires its interaction with the nuclear pore-associated protein mNPAP60. EMBO J 1119:2168–2180CrossRef
18.
Zurück zum Zitat Boyle WJ, van der Geer P, Hunter T (1991) Phosphopeptide mapping and phosphoamino acid analysis by two-dimensional separation on thin-layer cellulose plates. Methods Enzymol 201:110–149PubMed Boyle WJ, van der Geer P, Hunter T (1991) Phosphopeptide mapping and phosphoamino acid analysis by two-dimensional separation on thin-layer cellulose plates. Methods Enzymol 201:110–149PubMed
19.
Zurück zum Zitat Hannken T, Schroeder R, Zahner G, Stahl RAK, Wolf G (2000) Reactive oxygen species stimulate p44/42 MAP kinase and induce p27Kip1: role in angiotensin II-mediated hypertrophy of proximal tubular cells. J Am Soc Nephrol 11:1387–1397PubMed Hannken T, Schroeder R, Zahner G, Stahl RAK, Wolf G (2000) Reactive oxygen species stimulate p44/42 MAP kinase and induce p27Kip1: role in angiotensin II-mediated hypertrophy of proximal tubular cells. J Am Soc Nephrol 11:1387–1397PubMed
20.
Zurück zum Zitat Wolf G, Wenzel U, Ziyadeh, FN, Stahl RAK (1999) ACE-inhibitor treatment reduces glomerular p16INK4 and p27Kip1 expression in diabetic BBdp rats. Diabetologia 42:1425–1432CrossRefPubMed Wolf G, Wenzel U, Ziyadeh, FN, Stahl RAK (1999) ACE-inhibitor treatment reduces glomerular p16INK4 and p27Kip1 expression in diabetic BBdp rats. Diabetologia 42:1425–1432CrossRefPubMed
21.
Zurück zum Zitat Al-Douahji M, Brugarolas J, Brown PA, Stehman-Breen CO, Alpers CE, Shankland SJ (1999) The cyclin kinase inhibitor p21WAF/CIP1 is required for glomerular hypertrophy in experimental diabetic hypertrophy. Kidney Int 56:1691–1699CrossRefPubMed Al-Douahji M, Brugarolas J, Brown PA, Stehman-Breen CO, Alpers CE, Shankland SJ (1999) The cyclin kinase inhibitor p21WAF/CIP1 is required for glomerular hypertrophy in experimental diabetic hypertrophy. Kidney Int 56:1691–1699CrossRefPubMed
22.
Zurück zum Zitat Awazu M, Omori S, Ishikura K, Hida M, Fujita H (2003) The lack of cyclin kinase inhibitor p27Kip1 ameliorates progression of diabetic nephropathy. J Am Soc Nephrol 14:699–708PubMed Awazu M, Omori S, Ishikura K, Hida M, Fujita H (2003) The lack of cyclin kinase inhibitor p27Kip1 ameliorates progression of diabetic nephropathy. J Am Soc Nephrol 14:699–708PubMed
23.
Zurück zum Zitat Alessandrini A, Chiaur DS, Pagano M (1997) Regulation of the cyclin-dependent kinase inhibitor p27 by degradation and phosphorylation. Leukemia 11:342–345PubMed Alessandrini A, Chiaur DS, Pagano M (1997) Regulation of the cyclin-dependent kinase inhibitor p27 by degradation and phosphorylation. Leukemia 11:342–345PubMed
24.
Zurück zum Zitat Wilkinson MG, Millar JBA (2000) Control of the eukaryotic cell cycle by MAP kinase signaling pathways. FASEB J 14:2147–2157PubMed Wilkinson MG, Millar JBA (2000) Control of the eukaryotic cell cycle by MAP kinase signaling pathways. FASEB J 14:2147–2157PubMed
25.
Zurück zum Zitat Tian W, Zhang Z, Cohen DM (2000) MAPK signaling and the kidney. Am J Physiol Renal Physiol 279:F593–F604PubMed Tian W, Zhang Z, Cohen DM (2000) MAPK signaling and the kidney. Am J Physiol Renal Physiol 279:F593–F604PubMed
26.
Zurück zum Zitat Ingram AJ, Ly H, Thai K, Kang MJ, Scholey JW (1999) Mesangial cell signaling cascades in response to mechanical strain and glucose. Kidney Int 56:1721–1728CrossRefPubMed Ingram AJ, Ly H, Thai K, Kang MJ, Scholey JW (1999) Mesangial cell signaling cascades in response to mechanical strain and glucose. Kidney Int 56:1721–1728CrossRefPubMed
27.
Zurück zum Zitat Brownlee M (2001) Biochemistry and molecular cell biology of diabetic complications. Nature 414:813–820 Brownlee M (2001) Biochemistry and molecular cell biology of diabetic complications. Nature 414:813–820
28.
Zurück zum Zitat Nishikawa T, Edelstein D, Du XL et al. (2000) Normalizing mitochondrial superoxide production blocks three pathways of hyperglycaemic damage. Nature 404:787–790PubMed Nishikawa T, Edelstein D, Du XL et al. (2000) Normalizing mitochondrial superoxide production blocks three pathways of hyperglycaemic damage. Nature 404:787–790PubMed
29.
Zurück zum Zitat Jacobs D, Glossip D, Xing H, Muslin AJ, Kornfeld K (1999) Multiple docking sites on substrate proteins form a modular system that mediates recognition by ERK MAP kinase. Genes Dev 13:163–175CrossRefPubMed Jacobs D, Glossip D, Xing H, Muslin AJ, Kornfeld K (1999) Multiple docking sites on substrate proteins form a modular system that mediates recognition by ERK MAP kinase. Genes Dev 13:163–175CrossRefPubMed
30.
Zurück zum Zitat Pagano M, Tam SW, Theodoras AM et al. (1995) Role of the ubiquitin-proteasome pathway in regulating abundance of the cyclin-dependent kinase inhibitor p27. Science 269:682–685PubMed Pagano M, Tam SW, Theodoras AM et al. (1995) Role of the ubiquitin-proteasome pathway in regulating abundance of the cyclin-dependent kinase inhibitor p27. Science 269:682–685PubMed
31.
Zurück zum Zitat Sheaff RJ, Groudine M, Gordon M, Roberts JM, Clurman BE (1997) Cyclin E-CDK2 is a regulator of p27Kip1. Genes Dev 11:1464–1478PubMed Sheaff RJ, Groudine M, Gordon M, Roberts JM, Clurman BE (1997) Cyclin E-CDK2 is a regulator of p27Kip1. Genes Dev 11:1464–1478PubMed
32.
Zurück zum Zitat Vlach J, Hennecke S, Amati B (1997) Phosphorylation-dependent degradation of the cyclin-dependent kinase inhibitor p27Kip1. EMBO J 16:5334–5344CrossRefPubMed Vlach J, Hennecke S, Amati B (1997) Phosphorylation-dependent degradation of the cyclin-dependent kinase inhibitor p27Kip1. EMBO J 16:5334–5344CrossRefPubMed
33.
Zurück zum Zitat Tsvetkov LM, Yeh KH, Lee SJ, Sun H, Zhang H (1999) p27Kip1 ubiquitination and degradation is regulated by the SCFSkp2 complex through phosphorylated Thr187 in p27. Curr Biol 9:661–664CrossRefPubMed Tsvetkov LM, Yeh KH, Lee SJ, Sun H, Zhang H (1999) p27Kip1 ubiquitination and degradation is regulated by the SCFSkp2 complex through phosphorylated Thr187 in p27. Curr Biol 9:661–664CrossRefPubMed
34.
Zurück zum Zitat Nakayama K, Nagahama H, Minamishima YA et al. (2000) Targeted disruption of Skp2 results in accumulation of cyclin E and p27Kip1, polyploidy and centrosome overduplication. EMBO J 19:2069–2081CrossRefPubMed Nakayama K, Nagahama H, Minamishima YA et al. (2000) Targeted disruption of Skp2 results in accumulation of cyclin E and p27Kip1, polyploidy and centrosome overduplication. EMBO J 19:2069–2081CrossRefPubMed
35.
Zurück zum Zitat Spruck C, Strohmaier H, Watson M et al. (2001) A CDK-independent function of Cks1: targeting of SCFSkp2 to the CDK inhibitor p27Kip1. Mol Cell 7:639–650PubMed Spruck C, Strohmaier H, Watson M et al. (2001) A CDK-independent function of Cks1: targeting of SCFSkp2 to the CDK inhibitor p27Kip1. Mol Cell 7:639–650PubMed
36.
Zurück zum Zitat Hara T, Kamura T, Nakayama K, Oshikawa K, Hatakeyama S, Nakayama KI (2001) Degradation of p27Kip1 at the G0-G1 transition mediated by a Skp2-independent ubiquitination pathway. J Biol Chem 276:48937–48943CrossRefPubMed Hara T, Kamura T, Nakayama K, Oshikawa K, Hatakeyama S, Nakayama KI (2001) Degradation of p27Kip1 at the G0-G1 transition mediated by a Skp2-independent ubiquitination pathway. J Biol Chem 276:48937–48943CrossRefPubMed
37.
Zurück zum Zitat Shirane M, Harumiya Y, Ishida N et al. (1999) Down-regulation of p27Kip1 by two mechanisms, ubiquitin-mediated degradation and proteolytic processing. J Biol Chem 274:13886–13893CrossRefPubMed Shirane M, Harumiya Y, Ishida N et al. (1999) Down-regulation of p27Kip1 by two mechanisms, ubiquitin-mediated degradation and proteolytic processing. J Biol Chem 274:13886–13893CrossRefPubMed
38.
Zurück zum Zitat Malek NP, Sundberg H, McGrew S, Nakayama K, Kyriakidis TR, Roberts JM (2001) A mouse knock-in model exposes sequential proteolytic pathways that regulate p27Kip1 in G1 and S phase. Nature 413:323–327CrossRefPubMed Malek NP, Sundberg H, McGrew S, Nakayama K, Kyriakidis TR, Roberts JM (2001) A mouse knock-in model exposes sequential proteolytic pathways that regulate p27Kip1 in G1 and S phase. Nature 413:323–327CrossRefPubMed
39.
Zurück zum Zitat Kawada M, Yamagoe S, Murakami Y, Suzuki K, Mizuno S, Uehara Y (1997) Induction of p27Kip1 degradation and anchorage independence by Ras through the MAP kinase signaling pathway. Oncogene 15:629–637PubMed Kawada M, Yamagoe S, Murakami Y, Suzuki K, Mizuno S, Uehara Y (1997) Induction of p27Kip1 degradation and anchorage independence by Ras through the MAP kinase signaling pathway. Oncogene 15:629–637PubMed
40.
Zurück zum Zitat Delmas C, Manenti S, Boudjelal A, Peyssonnaux C, Eychène A, Darbon JM (2001) The p42/p44 mitogen-activated protein kinase activation triggers p27Kip1 degradation independently of CDK2/cyclin E in NIH 3T3 cells. J Biol Chem 276:34958–34965CrossRefPubMed Delmas C, Manenti S, Boudjelal A, Peyssonnaux C, Eychène A, Darbon JM (2001) The p42/p44 mitogen-activated protein kinase activation triggers p27Kip1 degradation independently of CDK2/cyclin E in NIH 3T3 cells. J Biol Chem 276:34958–34965CrossRefPubMed
41.
Zurück zum Zitat Cheng M, Sexl V, Sherr CJ, Roussel MF (1998) Assembly of cyclin D-dependent kinase and titration of p27Kip1 regulated by mitogen-activated protein kinases kinase (MEK1). Proc Natl Acad Sci USA 95:1091–1096CrossRefPubMed Cheng M, Sexl V, Sherr CJ, Roussel MF (1998) Assembly of cyclin D-dependent kinase and titration of p27Kip1 regulated by mitogen-activated protein kinases kinase (MEK1). Proc Natl Acad Sci USA 95:1091–1096CrossRefPubMed
42.
Zurück zum Zitat Pumiglia KM, Decker SJ (1997) Cell cycle arrest mediated by the MEK/mitogen-activated protein kinase pathway. Proc Natl Acad Sci USA 94:448–452CrossRefPubMed Pumiglia KM, Decker SJ (1997) Cell cycle arrest mediated by the MEK/mitogen-activated protein kinase pathway. Proc Natl Acad Sci USA 94:448–452CrossRefPubMed
43.
Zurück zum Zitat Ishida N, Kitagawa M, Hatakeyama S, Nakayama KI (2000) Phosphorylation at serine 10, a major phosphorylation site of p27Kip1, increases its protein stability. J Biol Chem 275:25146–25154PubMed Ishida N, Kitagawa M, Hatakeyama S, Nakayama KI (2000) Phosphorylation at serine 10, a major phosphorylation site of p27Kip1, increases its protein stability. J Biol Chem 275:25146–25154PubMed
44.
Zurück zum Zitat Ishida N, Hara T, Kamura T, Yoshida M, Nakayama K, Nakayama KI (2002) Phosphorylation of p27Kip1 on serine 10 is required for its binding to CRM1 and nuclear export. J Biol Chem 277:14355–14358CrossRefPubMed Ishida N, Hara T, Kamura T, Yoshida M, Nakayama K, Nakayama KI (2002) Phosphorylation of p27Kip1 on serine 10 is required for its binding to CRM1 and nuclear export. J Biol Chem 277:14355–14358CrossRefPubMed
45.
Zurück zum Zitat Rodier G, Montagnoli A, Di Marcotullio L et al. (2001) p27 cytoplasmic localization is regulated by phosphorylation on Ser10 and is not a prerequisite for its proteolysis. EMBO J 20:6672–6682CrossRefPubMed Rodier G, Montagnoli A, Di Marcotullio L et al. (2001) p27 cytoplasmic localization is regulated by phosphorylation on Ser10 and is not a prerequisite for its proteolysis. EMBO J 20:6672–6682CrossRefPubMed
46.
Zurück zum Zitat Monkawa T, Hiromura K, Wolf G, Shankland SJ (2002) The hypertrophic effect of transforming growth factor-β is reduced in the absence of cyclin-dependent kinase-inhibitors p21 and p27. J Am Soc Nephrol 13:1172–1178PubMed Monkawa T, Hiromura K, Wolf G, Shankland SJ (2002) The hypertrophic effect of transforming growth factor-β is reduced in the absence of cyclin-dependent kinase-inhibitors p21 and p27. J Am Soc Nephrol 13:1172–1178PubMed
Metadaten
Titel
Erk 1,2 phosphorylates p27Kip1: Functional evidence for a role in high glucose-induced hypertrophy of mesangial cells
verfasst von
Dr. G. Wolf
R. Reinking
G. Zahner
R. A. K. Stahl
S. J. Shankland
Publikationsdatum
01.08.2003
Verlag
Springer-Verlag
Erschienen in
Diabetologia / Ausgabe 8/2003
Print ISSN: 0012-186X
Elektronische ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-003-1163-z

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