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2817.Full.Pdf Tissue damage in the amyloidoses: Transthyretin monomers and nonnative oligomers are the major cytotoxic species in tissue culture Nata` lia Reixach*, Songpon Deechongkit†‡, Xin Jiang†‡, Jeffery W. Kelly†‡, and Joel N. Buxbaum*§ *Division of Rheumatology Research, Department of Molecular and Experimental Medicine, †Department of Chemistry, and ‡The Skaggs Institute for Chemical Biology, The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, CA 92037 Communicated by Ernest Beutler, The Scripps Research Institute, La Jolla, CA, December 26, 2003 (received for review August 26, 2003) The transthyretin (TTR) amyloidoses are human diseases in which blastoma cell line IMR-32 through an apoptotic mechanism. We the misfolded TTR protein aggregates in tissues with subsequent also show that two compounds that inhibit TTR fibril formation visceral, peripheral, and autonomic nerve dysfunction. Recent in vitro, by stabilizing TTR tetramers, inhibit the TTR-induced reports have stressed the importance of oligomeric intermediates cytotoxicity. Thus, stabilization of the tetramer prevents the as major cytotoxic species in various forms of amyloidogenesis. We dissociation required to form the monomer and nonnative have examined the cytotoxic effects of several quaternary struc- oligomers associated with maximal cytotoxicity. tural states of wild-type and variant TTR proteins on cells of neural lineage. TTR amyloid fibrils and soluble aggregates >100 kDa were Materials and Methods not toxic. Incubation of TTR under the conditions of the cell assay Preparation of TTR. Four TTR variants were used for the studies and analysis by size-exclusion chromatography and SDS͞PAGE presented: WT TTR, the amyloidogenic mutant TTR with reveal that monomeric TTR or relatively small, rapidly formed Val30Met mutation (V30M TTR), and two engineered variants aggregates of a maximum size of six subunits were the major that do not tetramerize, referred to as monomeric WT (F87M͞ cytotoxic species. Small molecules that stabilize the native tet- L110M TTR, named WT M-TTR), and monomeric V30M rameric state were shown to prevent toxicity. The studies are (V30M͞F87M͞L110M TTR, designated V30M M-TTR) TTR. consistent with a model in which the misfolded TTR monomer The proteins were prepared and purified in an Escherichia coli rapidly aggregates to form transient low molecular mass assem- expression system as described elsewhere (10–12). The four blies (<100 kDa) that are highly cytotoxic in tissue culture. protein variants were purified by gel filtration on a Superdex 75 column (Amersham Biosciences) in 10 mM phosphate buffer he amyloidoses are human diseases, in which organ dysfunc- (sodium) pH 7.6͞100 mM KCl͞1 mM EDTA before each Ttion is a result of the deposition of proteins that are normally experiment to ensure that no aggregates were present in the soluble under physiologic conditions; they include Alzheimer’s starting material. Liquid chromatography-electrospray ioniza- disease (AD), Ig light chain amyloid, and amyloid A, among tion MS was used to confirm the molecular weight of the others (1, 2). Transthyretin (TTR), a transport protein synthe- proteins. sized primarily in liver, choroid plexus, and the retina, is one of the 23 human proteins known to be associated with local or V30M TTR Amyloid Fibril Preparation. Amyloid fibrils were obtained systemic amyloidosis (3–5). TTR is a homotetramer that carries incubating V30M TTR under mildly acidic conditions as de- retinol-binding protein loaded with retinol and thyroxine in the scribed elsewhere (13), with minor modifications. Briefly, V30M plasma and cerebrospinal fluid. Senile systemic amyloidosis is a TTR, 0.5 mg͞ml in 10 mM phosphate buffer, pH 7.6͞100 mM sporadic disorder resulting from the deposition of wild-type KCl͞1 mM EDTA was diluted with an equal volume of 200 mM TTR (WT TTR) fibrils in cardiac and other tissues. Familial acetate buffer, pH 4.8͞100 mM KCl͞1 mM EDTA, was mixed, amyloidotic polyneuropathy and cardiomyopathy are hereditary and was filtered through a 0.22-␮m membrane. Subsequent autosomal-dominant diseases, in which the deposited TTR fibrils manipulations were performed under sterile conditions. The are derived from one of 80 known amyloidogenic mutations, and TTR solution was incubated for 7 days at 37°C and the fibrils primarily affect the peripheral and autonomic nervous systems, were recovered by centrifugation at 14,000 ϫ g for 30 min at 4°C and heart, respectively. The TTR deposits are extracellular, with (90% of starting material). The aggregates were judged to be some variants exhibiting tissue-selective deposition (6). The fibrils by their Congo red-binding activity (14). The fibrils were mechanisms responsible for the tissue selectivity, damage, and diluted in Opti-MEM (cell medium) to the desired concentra- the pathway of deposition in vivo are unknown. Usually, depo- tions and tested under the cell assay conditions detailed below. sition occurs at a distance from the site of synthesis, although deposition in the choroid plexus has been reported (7). Cell Culture. The human neuroblastoma cell line IMR-32 (CCL- In vitro, the loss of TTR quaternary structure, i.e., disassembly 127; American Type Culture Collection), was grown in 75-cm2 of the native tetramer to its component monomers, is required flasks in Opti-MEM (Life Technologies), supplemented with 5% for aggregation and subsequent fibril formation (4, 8). Small FBS, 1 mM Hepes buffer͞2mML-glutamine͞100 units/ml molecules that fit in the thyroxine-binding pocket of TTR penicillin͞100 ␮g/ml streptomycin (complete cell media), and stabilize the native tetramer and prevent fibrillogenesis (9). A incubated at 37°C in a 5% CO2 atmosphere. The cells are therapeutic strategy based on the development and administra- tion of such compounds is a promising alternative to current treatment, i.e., replacement of the mutant TTR gene with wild Abbreviations: TTR, transthyretin; V30M TTR, TTR with Val30Met mutation; WT M-TTR, monomeric WT TTR; V30M M-TTR, monomeric V30M TTR; AD, Alzheimer’s disease; SEC, type by liver transplantation, and offers the potential of pro- size-exclusion chromatography; MTT, 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazo- phylaxis for asymptomatic gene carriers. lium bromide. In this article, we explore the use of a cell-based assay system §To whom correspondence should be addressed at: Division of Rheumatology Research, to evaluate the TTR quaternary structural requirements for Department of Molecular and Experimental Medicine, The Scripps Research Institute, cytotoxicity: TTR monomers and͞or nonnative oligomers 10550 North Torrey Pines Road, MEM-230, La Jolla, CA 92037. E-mail: [email protected]. BIOCHEMISTRY smaller than 100 kDa induce cytotoxicity in the human neuro- © 2004 by The National Academy of Sciences of the USA www.pnas.org͞cgi͞doi͞10.1073͞pnas.0400062101 PNAS ͉ March 2, 2004 ͉ vol. 101 ͉ no. 9 ͉ 2817–2822 Downloaded by guest on September 25, 2021 adherent and were replated every 2–3 days after treatment with (controls). After 40 h of incubation at 37°C, the cells were cell dissociation buffer (Life Technologies) and dilution at a 1:4 stained with Rhodamine 123 (Molecular Probes) and Hoechst to 1:6 ratio with complete cell media. 33342 (Alexis Biochemicals) for the visualization of mitochon- drial membrane potential and nuclear condensation, respec- Cell Assay. IMR-32 cells (2- to 3-day-old culture, up to 80% tively. Briefly, 1.8 ␮l per well of Rhodamine 123 solution (57 confluent) were plated into one-half-area 96-well plates in ␮g͞ml in water) was added and incubated for 30 min at 37°C. The complete cell media at a density of 6,000–10,000 cells per well, media was then replaced by 100 ␮l per well of prewarmed cell depending on the assay, and were incubated overnight at 37°Cin assay media and incubated at 37°C for 25 more minutes. Two ͞ a5%CO2 atmosphere. TTR preparations were buffer- microliters per well of Hoechst 33342 solution (1.5 mg ml in exchanged in Opti-MEM by using a Centriprep device (10-kDa water) was added, and the plates were spun at 200 ϫ g for 5 min pore size; Millipore). The TTR solutions were filter-sterilized, at room temperature. The medium was removed and replaced by and appropriate dilutions were prepared in Opti-MEM with fresh prewarmed cell assay media. The cells were visualized antibiotics, L-glutamine, and Hepes buffer (cell assay media). immediately with a Nikon TE300 fluorescent microscope The media from the cells was removed, and 100 ␮loftheTTR (excitation 510 nm and emission at 534 nm for Rhodamine 123; solutions was immediately added to each well. At least six wells excitation 402 nm and emission 462 nm for Hoechst 33342), and containing cells and six wells without cells received 100 ␮lof digital images captured with a Spot2 digital camera (Diagnostic media without TTR to serve as controls and blanks, respectively. Instruments). After addition of TTR solutions (or media), the plates were ͞ incubated at 37°Cina5%CO2 atmosphere until the cytotoxicity TTR Cross-Linking. Fifty microliters of TTR samples (0.44 mg ml) assays were performed. were incubated with 5 ␮l of glutaraldehyde (25% solution; Sigma) for 4 min at room temperature. The reaction was ␮ ͞ Cell Toxicity Assay. Twenty-five microliters per well of 3-[4,5- quenched by addition of 5 l of a 7% solution of NaBH4 (wt vol dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide (MTT) in 0.1 M NaOH), and the samples were analyzed by 5–15% (5 mg͞ml in PBS) were added to the wells (samples, blanks, acrylamide͞bisacrylamide gradient SDS͞PAGE after boiling for and controls), and the plates were incubated for 3–4hat37°C. 5 min in SDS reducing buffer (16). The protein bands were Then, 25 ␮l per well of lysis buffer (20% SDS in 1:1 N,NЈ- stained with Coomassie blue. dimethylformamide:water͞2% acetic acid͞2.5% HCl 1 M) was added, and the plates were incubated overnight at 37°Cto Size-Exclusion Chromatography (SEC).
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