Role of Metallothioneins in Copper Transport in Patients with Menkes Syndrome
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ANNALS OF CLINICAL AND LABORATORY SCIENCE, Vol. 8, No. 4 Copyright © 1978, Institute for Clinical Science Role of Metallothioneins in Copper Transport in Patients with Menkes Syndrome ADOLFO D. GARNICA, M.D., W. Y. CHAN, Ph.D.* and OWEN M. RENNERT, M.D.* Division of Genetics, Department of Pediatrics, University o f Florida College of Medicine, Gainesville, FL 32610 and Department o f Pediatrics, Health Science Center, University of Oklahoma, Oklahoma City, OK 73190 ABSTRACT Fibroblasts from infants with Menkes kinky hair syndrome, which accumu late excessive quantities of copper, are thought to represent a disorder of copper storage or transport. Because of this abnormality, it was thought that they might provide a useful system for investigation of the presumed storage or transport protein metallothionein. Data are presented which are consist ent with defective copper efflux from the mutant cells. Because of the more specific role of metallothionein in cadmium detoxification, studies of cad mium metabolism were undertaken which demonstrated abnormal cadmium retention and metallothionein induction in the mutant cells. The association, therefore, of a defect of cadmium metabolism and storage with an abnormality of copper efflux provides evidence implicating metallothionein in copper transport for fibroblasts. Introduction tute significant components. Metallothio nein synthesis in response to metal loading The metallothioneins are zinc, copper in animals implicates them in heavy metal and cadmium-binding intracellular pro detoxification and/or essential trace metal teins of low molecular weight, which con m etabolism .5, 10, 21, 28,30 M etallothionein tain 30 to 35 percent cysteine and 6 to 11 synthesis occurs in response to toxic metal percent metal bound to cysteinyl side challenge. However, the liver content of chains by mercaptide bonds. They occur in zinc, an essential trace metal, has been multiple tissues in some species, in forms reported to be an important determinant of of varying amino acid composition, de the concentration of metallothionein-type spite which their biological function has not proteins.1,5,11,31 been established.20,22 In human liver, zinc The function of metallothionein in in is the principal metal constituent, al tracellular copper transport was suggested though copper and cadmium also consti by the identification and isolation of a 302 0091-7370/78/0700-0302 $01.20 © Institute for Clinical Science, Inc. ROLE OF METALLOTHIONEINS IN PATIENTS WITH MENKES SYNDROME 3 0 3 cytosol protein of an estimated 10,000 Amersham/Searle. 64 Cu and 109 Cd were molecular weight which apparently is counted in a gamma counter.* Metal involved in intestinal copper absorp analysis was performed with an atomic tion.9, 10,36,37 A copper-binding cytosol pro absorption spectrophotometerf equip tein of molecular weight 11,000, the same ped with graphite furnace. Protein was estimated size as metallothionein, has determined by the method of Lowry been implicated in the cellular uptake of et a l.23 copper.36,37 On the basis of similarities be tween this protein fraction and the metal- C o p p e r -D o s e R e s p o n s e lothioneins, a role has been postulated for metallothionein in intracellular copper Copper sulfate was added to confluent transport.9,10,37 fibroblast cultures to achieve copper con Copper is potentially toxic to all forms centrations of a 2 to 40 ju.g per ml. The of life, especially those having no capac cultures were incubated for 48 hours at ity to limit its uptake. In such instances, 37° C, trypsinized and homogenized, and susceptibility to copper toxicity, of the supernatant copper and protein necessity, becomes a function of cellular measured. excretory efficiency. The viability of cul tured fibroblasts, despite their permea C a d m iu m C o n t e n t bility to copper, thus implies the function of efficient homeostatic mechanisms, and Cadmium chloride was added to basal the accumulation of excessive amounts of culture medium to achieve cadmium copper by skin fibroblasts from individu concentrations of 0.1 to 1.1 meg per ml. als with Menkes kinky hair syndrome Confluent fibroblast cultures were incu might represent a failure of such mecha bated for 48 hours at 37°C in medium of nisms.6,13,14,16 This report reviews studies increasing cadmium concentration, then attempting to clarify the molecular basis harvested, homogenized and the super of this abnormality and the role of metal natant protein and cadmium determined. lothionein in its pathogenesis. A decrease in copper efflux from Menkes syndrome C a d m iu m a n d C o p p e r U p t a k e fibroblasts is recorded, along with an aberrant response to cadmium challenge, Precisely 17 ju.Ci o f64Cu were added to which implies an inborn defect in copper confluent cultures in 10 ml of medium, and cadmium metabolism. These obser the Cu++ concentration of which was ad vations support the intracellular detoxifi justed to 9 /xg per ml with CuS04. Cad cation and transport functions postulated mium, if present, was added to a concen for metallothionein.5,1 u21,32,35 tration of 0.09 fig per ml. The cultures were incubated at 37° C for one to 10 hours, harvested, homogenized, the pro Materials and Methods tein content of the lysate determined and Skin fibroblast cultures were explanted the 64Cu counted. 109 Cd uptake by cul from three infants w'ith Menkes kinky tured fibroblasts were examined at 37°C. hair syndrome. Two additional mutant Four nCi of109 Cd were added to the cul cultures and control cultures were ob ture medium and the Cd++ concentration tained from the Human Genetic Cell Re adjusted to 0.56 ng per ml with CdCl2. pository and the American Type Culture Collection. 64Cu was obtained from the * Packard Model S210. New England Nuclear and 109Cd from t Perkin-Elmer Model 306. 304 GARNICA, CHAN AND RENNERT C o ppe r E f f l u x concentrations of 10 through 15 meg per ml, the copper content of both cultures in Cultures were pulse-labeled with 16.7 creased above the baseline levels, while ju.Ci of 64Cu at 37°C for 20 hours, then that of the Menkes syndrome cells re transferred to non-radioactive medium. mained greater than the normal (P < Cultures were harvested and analyzed for 64 Cu and protein one to 10 hours after the 0.04). At medium concentrations equal to or above 20 meg per ml, the copper con medium change. tent of the normal cells was not signifi Statistical differences were examined cantly different from that of the mutant for significance using a t-test for paired cells. data. These observations suggest that copper Results uptake by the mutant fibroblasts is at least equal to that of normal fibroblasts. F ib r o b l a st C o p p e r a n d C adm ium Furthermore, they imply that the copper C o n t e n t regulatory mechanisms in normal fibro Cultured Menkes syndrome fibroblasts blasts function effectively up to a medium are morphologically normal but have a copper concentration of approximately 15 diminished tolerance to copper.4 The in meg per ml, while those of Menkes syn creased sensitivity of these cells to cop drome fibroblasts are abnormal at all con- per toxicity is associated with increased concentrations. An inconsistency in the intracellular copper content.13,16 In basal general relationship between medium cop culture medium (copper concentration per concentration and fibroblast copper 48.70 ± 20.0 ng per ml) the copper con content involving both cell lines is appa tent of normal cells was 108 ng per mg rent at a medium concentration of 1 meg cell protein, while that of the mutant fi per ml, which most plausibly may be ex broblasts was 310 ng per mg (table I). As plained in terms of a ten-fold error in di the copper concentration of the medium lution, since the values at one and 10 meg was gradually increased, the copper con per ml are essentially the same for both tent of neither cell culture increased sig cultures. nificantly until the medium copper con As the cadmium concentration of the centration exceeded 6 meg per ml. At culture medium was increased from basal T A B L E I Copper and Cadmium Content of Cultured Skin Fibroblasts Medium (Cu++) Copper Content*+ Medium (Cd++) Cadmium Content *§ meg p e r ml MS* (n=7) N orm al (n=4) m eg p e r ml MS (n-5) Normal (n=4) + + 0 3 1 0 + 6411 1 0 8 ± 2 1 0 2 3 . 6 6.4 1 ! 2 3 . 5 93 + 1 6 0 5 + 1 8 9 2 2 2 + 74 0 . 1 1 9 2 4 4 1 8 0 ± 8 4 + + 4 2 5 3 + 4 6 1 0 6 + 2 0 0 . 3 8 6 6 3 9 2 2 4 1 4 9 + + 6 2 6 4 ± 5 0 1 5 4 + 37 0 . 5 1 1 6 5 2 1 6 6 2 0 2 0 7 1 0 6 3 7 + 2 2 9 2 5 9 + 94 0 . 7 1 0 7 3 + 3 6 3 7 6 5 ± 93 + + 15 8 0 4 + 1 1 1 4 5 2 + 1 3 3 0 . 9 1 4 3 4 1 5 7 8 0 1 1 1 3 + 2 0 9 7 5 + 3 3 1 1 0 8 0 + 1 5 1 1 . 1 1 0 1 8 + 2 2 8 6 5 5 1 2 3 25 1 1 3 9 + 1 9 5 1 9 1 3 + 6 0 8 30 1 3 6 7 + 332 1 5 5 3 + 383 35 2 1 5 0 + 1 0 1 2 2 0 8 6 + 5 1 6 40 2 2 2 2 + 4 1 8 2 4 7 5 + 7 2 0 *Units expressed as ng metal per mg cell protein.