The Expression and Regulation of Hyaluronan Synthases and Their Role in Glycosaminoglycan Synthesis

Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine 955

______

JONAS BRINCK

ACTA UNIVERSITATIS UPSALIENSIS UPPSALA 2000 Dissertation for the Degree of Doctor of Philosophy (Faculty of Medicine) in Medical Biochemistry presented at Uppsala University in 2000

ABSTRACT

Brinck, J. 2000. The Expression and Regulation of Hyaluronan Synthases and Their Role in Glycosaminoglycan Synthesis. Acta Universitatis Upsaliensis. Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine 955. 63 pp. Uppsala. ISBN 91-554-4806-2. The glycosaminoglycan hyaluronan is an essential component of the extracellular matrix in all higher organisms, affecting cellular processes such as migration, proliferation and differentiation. Hyaluronan is synthesized by a plasma membrane bound hyaluronan synthase (HAS) which exists in three genetic isoforms. This thesis focuses on the understanding of the hyaluronan biosynthesis by studies on the expression and regulation of the HAS proteins. In order to characterize the structural and functional properties of the HAS isoforms we developed a method to solubilize HAS protein(s) while retaining enzymatic activity. The partially purified HAS protein is, most likely, not asscociated covalently with other components. Cells transfected with cDNAs for HAS1, HAS2 and HAS3 were studied and all three HAS isozymes were able to synthesize high molecular weight hyaluronan chains in intact cells. The regulation of the hyaluronan chain length involves cell specific elements as well as external stimulatory factors. HAS3 transfected cells with high hyaluronan production exhibit reduced migration capacity and reduced amounts of a cell surface hyaluronan receptor molecule (CD44) compared to wild-type cells. The three HAS isoforms were studied and shown to be differentially expressed and regulated in response to external stimuli. Platelet derived growth factor (PDGF-BB) and transforming growth factor (TGF-ß1) are important regulators of HAS at both the transcriptional and translational level. The HAS2 isoform is the isoform most susceptible to external regulation. The role of the UDP-glucose dehydrogenase in mammalian glycosaminoglycan biosynthesis was assessed. The enzyme is essential for hyaluronan, heparan sulfate and chondroitin sulfate biosynthesis, but does not exert a rate-limiting effect. Key words: hyaluronan, glycosaminoglycans, CD44, growth factors, UDP-glucose dehydrogenase.

Jonas Brinck, Department of Medical Biochemistry and Microbiology, Biomedical Centre, Box 582, SE-751 23 Uppsala, Sweden

ISSN 0282-7476 ISBN 91-554-4806-2 Printed in Sweden by Lindbergs Grafiska, Uppsala 2000

2 non scholae sed vitae discimus Seneca († 65)

3 This thesis is based on the following papers, which are referred to in the text by their Roman numerals:

I Asplund, T., Brinck, J*., Suzuki, M., Briskin, M. and Heldin, P. (1998) Characterization of hyaluronan synthase from a human glioma cell line. Biochim Biophys Acta. 1380:377- 388 * The two first authors contributed equally to the work.

II Brinck, J. and Heldin, P. (1999) Expression of recombinant hyaluronan synthase (HAS) isoforms in CHO cells reduces cell migration and cell surface CD44. Exp Cell Res. 252:342-351

III Jacobson, A., Brinck, J., Briskin, M., Spicer, A. and Heldin, P. (2000) Expression of human hyaluronan synthases in response to external stimuli. Biochem J. 348:29-35

IV Brinck, J., Roman, E*., Heldin, P. and Kusche-Gullberg, M. (2000) The role of UDP- glucose dehydrogenase in mammalian glycosaminoglycan biosynthesis. Manuscript. * The two first authors contributed equally to the work

Published manuscripts have been reprinted with permission from the respective journals.

4 TABLE OF CONTENTS

BACKGROUND………………………………………………………………… 9 1 The extracellular matrix – the social context of the cells…………………………….…. 9 2 Glycosaminoglycans……………………………………………………………….…… 9 2.1 Hyaluronan (HA)………………………………………………………….…… 10 2.1.1 Structure and properties…………………………………………………10 2.1.2 Tissue distribution……………………………………………….….… 10 2.1.3 Functions…………………………………………………………….… 11 2.2 Sulfated glycosaminoglycans……………………………………………………11 2.2.1 Structures and properties…………………………………………….… 11 2.2.2 Functions……………………………………………………………… 12 3 HA binding proteins…………………………………………………………………… 13 3.1 Link module containing proteins………………………………………………. 13 3.1.1 Hyalectans………………………………………………………………14 3.1.2 CD44……………………………………………………………………14 3.1.2.1 Structure and ligand binding…………………………………… 14 3.1.2.2 CD44 and HA in cell migration…………………………………16 3.1.3 LYVE-1………………………………………………………………… 17

3.2 BX7B containing proteins…………………………………………………….… 17 3.3 Novel HA binding proteins…………………………………………………..… 18 4 Biosynthesis of glycosaminoglycans………………………………………………….…18 4.1 UDP-sugars…………………………………………………………………… 19 4.1.1 Synthesis of UDP-sugar pools……………………………………….…19 4.1.2 Regulatory role………………………………………………………… 21 4.2 Biosynthesis of HA………………………………………………………………22 4.2.1 Hyaluronan synthase (HAS) gene family……………………………… 22 4.2.2 HAS protein………………………………………………………….… 23 4.2.2.1 Enzyme properties…………………………………………..… 23 4.2.2.2 Kinetics…………………………………………………..…… 25 4.2.3 Regulation of HA biosynthesis………………………………………… 26 4.2.3.1 Turnover of HAS protein……………………………………… 26 4.2.3.2 Effects of growth factors……………………………………… 27 4.2.3.3 Involvement of protein kinases…………………………..…… 28 4.2.4 Biosynthetic directionality……………………………………………… 28

5 4.3 Biosynthesis of sulfated glycosaminoglycans…………………………….…… 29 4.3.1 Linkage region………………………………………………………… 30 4.3.2 Polymerization and modification……………………………….……… 30 5 Degradation of HA………………………………………………………………………31 5.1 Tissue turnover………………………………………………………….……… 31 5.2 Hyaluronidases………………………………………………………….……… 31 PRESENT INVESTIGATION…………………………………………..……… 33 6 Aims of the study…………………………………………………………….………… 33 7 HAS enzyme can be solubilized in an active form (Paper I)………………….………… 34 7.1 Solubilization and purification………………………………………..………… 34 7.2 Antibodies towards HAS protein……………………………………….……… 35 8 Is HA synthesized from the reducing end? (Paper I)…………………………….………35 9 Expression of HAS affects cell behavior (Paper II)……………………………..……… 37 9.1 Synthesis and accumulation of HA……………………………………..……… 37 9.2 HA chain length………………………………………………………………… 38 9.3 Cell migration…………………………………………………………..……… 39 10 HAS isoforms show specificity in gene regulation (Paper III)………………………… 39 10.1 Effects of culture conditions…………………………………………..……… 39 10.2 Effects of external stimuli………………………………………………………40 11 The role of UDP-glucose dehydrogenase in mammalian glycosaminoglycan biosynthesis (Paper IV) ……………………………………………………….……… 40 12 Conclusions…………………………………………………………………………… 42 13 Future perspectives……………………………………………………………….…… 43 ACKNOWLEDGEMENTS…………………………………………………….… 45 REFERENCES………………………………………………………….…….… 46

6 Abbreviations aa amino acids CHO Chinese hamster ovary (cells) CS chondroitin sulfate DS dermatan sulfate EGF epidermal growth factor GAG glycosaminoglycan Gal D-galactose GalNAc N-acetyl D-galactosamine Glc D-glucose GlcA D-glucuronic acid GlcNAc N-acetyl D-glucosamine GPI glycosylphospatidylinositol HA hyaluronan HAS hyaluronan synthase HS heparan sulfate IdoA L-iduronic acid KS keratan sulfate PDGF platelet derived growth factor PMA phorbol 12-myristate 13-acetate TGF transforming growth factor TSG-6 protein product of tumor necrosis factor-stimulated gene-6 UDP uridine 5'-diphosphate xlHAS-rs Xenapus laevis hyaluronan synthase related sequence Xyl D-xylose

7 8 BACKGROUND

1 The extracellular matrix – the social context of the cells It is a well-known fact that the human body is composed of different kinds of cells carrying out the specialized functions for which they have been designed. Cells with similiar or complementary functions assemble into tissues and organs that constitute functional entities and make the biological organism Homo sapiens “work”. One difference between the human body and single cell organisms such as bacteria is the fact that the individual cells in the body exist in a self-created social environment, in contrast to the bacteria where the cell wall constitutes the barrier towards the exterior world. The biological name for this social habitat is the extracellular matrix. The cells synthesize the components of the extracellular matrix to fit their needs, which means that structure and function of the matrix is almost as specialized and unique as the cells themselves. It is the extracellular matrix that gives the tissues their tensile strength or elasticity, and serves as a scaffold for cell adhesion and cell movement. The components of the matrix also help to transmit signals that regulate cellular functions and are able to enhance or diminish these signals. The extracellular matrix consists of a wide variety of protein and sugar molecules entangled in a complex network that is constantly turned over. Among these are the linear carbohydrate polymers, glycosaminoglycans, with essential functions both in the matrix and attached to the surfaces of cells. It is of great importance to understand their metabolism since imbalances or disorders in this system eventually will lead to disease. The main topic of this thesis is to give new insights to the synthesis and regulation of the glycosaminoglycan hyaluronan.

2 Glycosaminoglycans The members of the glycosaminoglycan (GAG) family are essential components in all higher organisms and are found both on the surfaces of cells and in the extracellular matrix. GAGs are unbranched carbohydrate polymers consisting of repeating disaccharide units that can be subject to extensive modifications, thereby rendering highly diverse polysaccharide chains. The individiual members of the GAG family are defined according to their disaccharide structure and modifications.

9 2.1 Hyaluronan (HA) 2.1.1 Structure and properties The GAG hyaluronan (HA)(reviewed in (106)) was first isolated from the vitreous body of the eye by Meyer and Palmer in the 1930’s (123). HA consists of repeating disaccharide units of [GlcAß1-

3GlcNAcß1-4]n, where n can be up to twentyfive-thousand. The contour length of an HA chain of 6 Mr 4 x 10 is 10 µm (44). The HA chain is polymerized by a plasma membrane bound enzyme and is not subjected to any type of covalent modification during its synthesis. Nuclear magnetic resonance studies of the shape of the HA chain by Scott (165) have shown the existence of internal hydrogen bounds that stabilize the chain in a stiffened helical conformation. HA chains have the capacity to self-aggregate in aqueous solutions which can be visualized in electron microscopy of rotary-shadowed preparations of HA (166). The aggregation of two anti-parallel HA molecules is promoted by hydrogen bonds between the acetoamido group on one chain and the carboxylate on the other (167). Preparations of high molecular weight HA in concentrations of 5-10 mg/ml are therefore viscous.

Figure 1. An HA pericellular matrix excluding fixed red blood cells from the plasma membrane of a Chinese hamster ovary cell.

2.1.2 Tissue distribution HA is synthesized by almost all members of the animal kingdom as well as by certain bacteria and algae viruses (106)(26). HA is found mainly in the extracellular space where it accumulates, but the polymer can also be bound to the cell surface or be located intracellularly around in the nucleus and in the lysosomes (153)(36)(108). The largest storage of HA in the human body is in the skin, constituting about 50 % of the total HA supply (152).

10 Table 1 HA concentrations in various human organs and fluids

Organ or fluid Concentration (µg/g) aqueous humour 0.3-2.2 brain 35-115 dermis 200 plasma (serum) 0.01-0.1 synovial fluid 1400-3600 thoracic lymph 8.5-18 umbilical cord 4100 urine 0.1-0.3 vitreous body 140-340 Data taken from (48).

2.1.3 Function High molecular weight HA have been ascribed an essential structural role in the extracellular matrix of the connective tissue where the polymers create a mesh-like structure (106)(166). The viscous hydrated HA gel provides resistance to compressive forces and acts as a biological lubricant. During embryonic development the deposite of HA creates a cell free area by expansion of the extracellular space which facilitates cell migration (202). Besides being a structural element, HA has been reported to be involved in several specific processes such as lympocyte extravasation (32), cancer metastasis (171) and angiogenesis (158) probably through interactions with HA binding proteins. Since the HA polymer itself does not exhibit any structural diversity, its function is in part due to the chain length. The inductive role of HA in angiogenesis could be ascribed to HA oligosaccharides (4-25 disaccharides)(221) whereas high molecular weight HA exerted an inhibitory effect (43). HA fragments have also been reported to evoke an inflammatory response in macrophages (121)(80).

2.2 Sulfated glycosaminoglycans 2.2.1 Structure and properties The sulfated GAGs can be subdivided into three groups based on the disaccharide composition: heparan sulfate (HS)/heparin, chondroitin sulfate (CS)/dermatan sulfate (DS) and keratan sulfate (KS) (Table 2)(96). During their synthesis in the Golgi, the chains are heavily modified by

11 deacetylation, C5-epimerization, N- and O-sulfations generating a high degree of diversity (see section 4.3). The chain lengths vary between 5-70 kDa.

Table 2 The structure of the sulfated GAGs GAG disaccharide unit modifications heparan sulfate (HS)/ [GlcA/IdoAß/α1-4GlcNAcα1-4] N-deacetylation, N-sulfation heparin C5-epimerization of GlcA C2-sulfation on GlcA/IdoA C3,C6-sulfation on GlcNAc chondroitin sulfate (CS)/ [GlcA/IdoAß/α1-3GalNAcß1-4] C5-epimerization of GlcA dermatan sulfate (DS) C2-sulfation on GlcA/IdoA C4,C6-sulfation on GlcNAc keratan sulfate (KS) [Galß1-4GlcNAcß1-3] C6-sulfation on Gal/GlcNAc

The sulfated GAG chains appear as proteolglycans, i.e. covalently linked to proteins, where the protein core can be of a different nature: transmembrane, glycosylphosphatidylinositol (GPI)- anchored or soluble. A proteoglycan can have several GAG chains of different types attached to it as exemplified by aggrecan, which consists of a 200 kDa protein core and about 130 CS and KS 6 chains, with a total Mr of about 3 x 10 (66). The expression pattern of proteoglycans is specific; heparin is synthesized only by connective tissue mast cells in the form of the proteoglycan serglycin whereas HS is found on several types of proteoglycans on virtually all cells in the body (96). The structural diversity of the GAG chains is also precisely regulated as shown by recent studies with monoclonal antibodies directed against structurally different epitopes of HS (212)(90). Different structures of the kidney and muscle basal lamina were investigated and shown to contain a subset of different HS species.

2.2.2 Functions The proteoglycan superfamily consists of over 30 members with a wide variety of biological functions (82). They play an important role in the extracellular matrix organization, influence cell growth and tissue maturation, and participate in the regulation of matrix turn-over by the binding and inactivation of protease inhibitors. Proteoglycans act also as biological sieves by being structural components in the glomerular basal laminae. Many of the specific functions of the proteoglycans are due to the highly modified diverse saccharide sequences of the GAG chains. For example, the anticoagulant activity of heparin has

12 been known for a long time (77). A unique pentameric structure present only in a fraction of the total heparin has the capacity to interact with antithrombin-III, thus forming a potent inhibitor of thrombin and thereby blood coagulation (12). Furthermore, proteoglycans are important modulators of growth factor activities (159). The binding of growth factors to the GAGs protect ligands from proteolytic degradation and GAGs have therefore been suggested to act as a growth factor storage facility. HS has been shown to be required for binding of basic fibroblast growth factor to its receptor and the growth factor mediated effects (228)(149).

3 HA binding proteins HA is unique in the GAG family by lacking covalent linkages to proteins thus not being able to form proteoglycans. The only exception to this rule is the ester linkage between the C-terminal aspartic acid of the heavy chains of pre-α-trypsin inhibitor/inter-α-trypsin inhibitor and the C6- hydroxyl group of an internal GlcNAc residue in the HA chain (234), although the functional role of this linkage is not clear. The fact that HA can form several specific interactions with proteins, serves as indirect evidence that HA is more than a structural component of the extracellular matrix. These HA binding proteins are mainly found extracellularly, but can also be bound to the cell surface or be located intracellularly. New HA binding proteins are currently under characterization and the list is likely to get longer. Below is some of the best characterized HA binding proteins presented, subdivided according to their HA binding motif.

3.1 Link module containing proteins The Link module, about 100 amino acids (aa), is the structural HA binding motif shared by the Link module superfamily, which comprise extracellular matrix molecules (link protein, hyaluronectin, versican, aggrecan, neurocan, brevican, TSG-6) and the cell surface receptors (CD44 and LYVE-1) (25).The three-dimensional structure of the human TSG-6 Link module, expressed in Escherichia coli, has been resolved by nuclear magnetic resonance spectroscopy (100). It comprises two α- helices and two triple-stranded anti-parallel ß-sheets arranged around a large hydrophobic core, identical to the fold of the C-type lectin domain. The recombinant expressed Link module of TSG-6 has the capacity to bind HA (100), compared to CD44 which requires additional 60 aa of the receptor in order to acquire the correct fold and HA binding capacity (6). The Link module of TSG- 6 can also bind CS at a position which is overlapping with the HA binding surface (136).

13 3.1.1 Hyalectans The hyalectans are a family of proteoglycans interacting with HA and lectins and have currently four members: versican, aggrecan, neurocan and brevican (83). They share a common tridomain structure consisting of an N-terminus that binds HA, a central domain that carries GAG chains and a C- terminal that binds to lectins (82). Versican is the largest member of the hyalectan family with the core protein of 265-370 kDa which is modified by 10-30 CS/DS chains. Versican binds HA with a Kd of about 4 nM (109) but can also bind simple monosaccharide sugars as well as HS and heparin (209). The versican gene can be upregulated by a variety of growth factors such as platelet derived growth factor (PDGF), epidermal growth factor (EGF) and tumor necrosis factor (TNF) (195). Versican has been implicated in regulation of neural crest cell migration by exerting a barrier role for the axonal outgrowth (103). Aggrecan consists of a core protein of about 220 kDa modified by CS and KS chains (up to 130). Aggrecan secreted by chondrocytes aggregates extracellularly but can also bind to the cell surface (94)(176). Aggrecan, link protein and HA forms a ternary complex (66) which, inside cartilage, occupies a large hydrodynamic volume making the tissue elastic to compressive forces. The affinity of the aggrecan link complex for HA is quite high (Kd≤1 nM). Neurocan (protein core 140 kDa) was first cloned from rat brain (150) and is synthesized by neurons, and probably astrocytes, in the brain (218). Neurocan binds neural adhesion molecules Ng-CAM and N-CAM with high affinity and can thereby inhibit their homophilic interactions and block neurite outgrowth (58)(51). Neurocan is developmentally regulated, and its interactions with its ligands may be confined to restricted areas and a relatively brief stage in development (126). Brevican is the smallest member of the hyalectans (protein core 100 kDa). The molecule can be synthesized in a soluble extracellular form or as a GPI-anchored protein (168), which localizes to the plasma membrane. This latter splice variant is deprived of its lectin binding domain, but still has the HA binding domain and sites for glycosylation. Brevican is one of the most abundant CS containing proteoglycans in the adult brain and its expression is highly specific (224). Brevican has been reported to inhibit neurite outgrowth in vitro thus maybe controlling infiltration of axons and dendrites in vivo (222).

3.1.2 CD44 3.1.2.1 Structure and ligand binding CD44 is the best characterized HA receptor to date and its structure and function have been covered in several excellent reviews (113)(95)(112). Besides HA, the CD44 receptor can bind a number of other extracellular matrix components such as collagen I (42), fibronectin (89), HS, CS and heparin (174). CD44 is widely expressed, and can be found on most hematopoetic cells,

14 keratinocytes, chondrocytes, many epithelial cell types and some endothelial and neural cells (112). The many functions attributed to the receptor include T-cell extravasation (32), myelopoeisis (129) and tumor migration (59)(237), although the mechanisms behind this are not always clear. CD44 is a type-1 transmembrane glycoprotein and the standard isoform (CD44H; originally found on hematopoetic cells (23)) consists of ~270 aa. The amino terminal part (~180 aa) of the extracellular domain is characterized as the conserved region and exhibits 85 % homology between mammalian species. This region harbors the Link module, five N-glycosylation sites and a BX7B motif (see section 3.2). The proximal part of the extracellular domain (non-conserved region) is characterized by alternative splicing of at least ten variant exons of the CD44 gene which allows insertion of extra aa (87)(200)(237). The alternative splicing occurs only in particular cell types and under certain conditions and is therefore considered to be precisely regulated. This proximal region also contains O-glycosylation sites and sites for attachment of GAG chains. The CD44 protein, including the splice variants, have been shown to be decorated with KS, HS and CS chains (14)(72)(188). The transmembrane domain (21 aa) is 100 % conserved between mammalian species. The cytoplasmic domain (~72 aa) seems to be able to interact with several intracellular proteins such as ankyrin (91) and the ERM-protein family (ezrin, radixin and moesin) (206)(160) thus potentially creating a linkage between the receptor and the actin cytoskeleton. The cytoplasmic domain can also be phosphorylated at several tyrosine and serine residues but only two serine residues are phosphorylated in vivo (130). CD44 is the principle cell surface receptor for HA (1) by binding of HA to the Link module

(100)(4); the contribution of the BX7B motif (225) to HA binding is probably minor (112). The smallest HA molecule that can bind to CD44 is a hexasaccharide to decasaccharide (210)(2)(189). However, the existence of CD44 molecules on the cell surface does not automatically convey HA binding but depends on the ”activation state” of the cell (113)(95). Three CD44 activation states have been described: 1) CD44+ cells that bind HA constitutively, 2) CD44+ cells that can be induced (by monoclonal antibodies or cytokines) to bind HA and 3) CD44+ cells that do not bind HA at all. A lot of work has been put in to clarify what regulates the binding of HA to CD44. N- glycosylation of CD44 seems to inhibit HA binding, since active HA binding cells have less N- glycosylation than non-binding cells and treatment of these non-binding cells with N-glycosylation inhibitors rendered them active (64)(92). O-glycosylation of CD44 has also been reported to have a negative effect on HA binding in some cases (24) but not in all (235). Modification of the receptor by sulfation leads to increased HA binding (118). The transmembrane and intracellular domain of CD44 contribute to HA binding. Evidence that the transmembrane domain is involved in dimerization of the receptor by disulfide bonding (116) and palmitoylation (11) has been presented, and a correlation between ligand binding capacity and dimerization has been shown (173). The cytoplasmic part of CD44 is important for ligand

15 binding, since cells expressing this truncated form failed to bind HA if they were not first exposed to CD44-specific antibodies (111). The cytoplasmic part is also involved in heterogeneous localization and polarization of receptors on the cell surface in pre-B cells and epithelial cells (131)(216). Taken together, this strengthens the role of receptor-clustering as a positive factor for HA binding. Phosphorylation of the intracellular domain of CD44 does however not seem to promote or reglulate ligand binding (138)(208).

3.1.2.2 CD44 and HA in cell migration Cell migration and cell locomotion involves a series of complex interactions between cytoskeleton, cell surface receptors and matrix components (105)(170). Several examples from the field of embryonic development implicate HA and CD44 as positive elements in cell migration. The migration of cells into the developing chick embryo cornea and heart coincided temporally and spatially with the synthesis of HA and the migration decreased as the hyaluronidase activity in the tissues increased (204)(135). During the development of the soft palate, Spicer and co-workers have shown with studies of HAS knock-out mice that the cells of the cranio-facial mesenchyme are dependent on HA for migration and normal organization of the tissue (178). The embryonic development of the cardiac septum and valves were also dependent on HA as shown in HAS2 knock-out mice (16); when the cardiac valve cells were cut out and grown on collagen gels they could not migrate unless they were rescued with HAS2 expression or addition of exogenous HA. In another study, Thomas et al. (194) showed that melanoma cells enhanced their migration rates on HA coated dishes after transfection with CD44 compared to non-transfected cells, while antibodies against the receptor inhibited migration. Phosphorylation of the intracellular serine residues of CD44 is important for the CD44 mediated migratory effect, since melanoma cells expressing phosphorylation mutants of CD44 were not able to migrate (138). Attempts to explain the mechanism of the CD44 – HA interaction in cell migration have been made. The deposit of HA in the extracellular matrix leads to an overall expansion of the tissue (202)(122), thereby creating hydrated routes that facilitates cell migration according to Toole (202). For example, HA indirectly promoted glioblastoma cell migration in 3-dimensional fibrin gels by modulation of the fibrin fiber architecture thus increasing the pore sizes in the gels (65). In such a model, CD44 could be the link between the cell’s actin cytoskeleton and the scaffold that the HA- gel provide. The mechanism of migration might also comprise a turnover of the extracellular components and cell surface receptors (105). Fibroblasts, macrophages and chondrocytes have the capacity to internalize and degrade HA by a CD44 mediated endocytosis (22)(81), although the amount of HA degraded by the cells of mesenchymal origin seems to be limited (71). Knudson and Knudson (97) have presented an hypothesis where the assembly of HA containing pericellular matrices around cells (first visualized by Claris and Fraser (18)) prevent

16 them from forming necessary interactions for cell migration with a decreased migration rate as an effect. In vitro these matrices consist either of newly synthesized HA chains, still attached to the HAS protein (69), or of exogeneously added HA which is bound to HA receptors (CD44)(99)(98). The matrix formation can be promoted by HA binding proteoglycans, which also increase their density and stability (70). Experimental evidence supporting this hypothesis has been presented (140)(141) where neural crest cell migration was inhibited by HA matrix promoting chondroitin sulfate proteoglycans (i.e. aggrecan).

3.1.3 LYVE-1 LYVE-1 is a type-1 transmembrane protein and a new member of the Link module superfamily being a homologue of the CD44 receptor with an overall similarity to CD44 of 41 % (7). Of the nine key amino acids that have been shown to be important in HA binding to CD44 (137)(4), only three are conserved in LYVE-1 (7). The receptor is almost exclusively expressed in lymph vessels where it co-localizes with HA on the luminal side. LYVE-1 is not, unlike CD44, expressed in blood vessels. Since the major part of the HA turnover and clearance takes place via the lymphatic system (see section 5.1) the receptor could be an important regulator of these events.

3.2 BX7B containing proteins α The -helical peptide sequence BX7B, where B is a basic aa and X is any non-negatively charged aa, have been shown to bind HA (226)(225). At least three proteins (RHAMM, IHABP and CD34) have such a functional HA binding motif, although it exists in several other proteins, including members of the Link module superfamily. It is not known if the BX7B sequence can confer HA binding capacity in these contexts. RHAMM (acronym for Receptor for Hyaluronan-Mediated Motility) was first characterized by Turley in 1992 from a 3T3 cDNA expression library (63) and contains two adjacent BX7B motifs which contribute equally to HA binding. The 52 kDa RHAMM protein proved to be similar to two of the proteins (52 kDa and 58 kDa) previously reported to be members of the Hyaluronan Receptor Complex (HARC) involved in ras-transformed cell locomotion (207). However, the cDNA clone isolated (63) was not of full length and additional exons, including splice variants, have been described (14 exons in total)(40)(217) coding for a protein of 70-73 kDa. The RHAMM receptor was first reported to be cell surface associated/extracellular (63) but recent studies revealed that it also exists in the cytoplasm and in the nucleus (233)(39). RHAMM has been implicated as a regulator of several important cell functions. Overexpression of the RHAMMv4 (splice variant 4) in murine fibroblasts is transforming and causes spontaneous metastases in the lung (60). RHAMM has been postulated to act down-stream of Ras on the MAP kinase - ERK (extracellular-regulated kinase) signaling pathway (233). There is also a correlation

17 between RHAMM overexpression and overexpression of MAP kinase, which could serve as a prognostic indicator of breast carcinoma progression (217). In 1998 Hofmann et al. (76) identified IHABP (acronym for Intracellular Hyaluronic Acid Binding Protein) which has over 90 % similarity to the RHAMM protein and which shares the HA binding BX7B motifs found in RHAMM. Fieber et al. (45) could later show that RHAMM is a N- truncated form of IHABP and that the full length RHAMM/IHABP gene encodes 18 exons in total. IHABP is expressed as a 95 kDa intracellular protein in a wide variety of tissues. The function of IHABP remains to be elucidated but the intracellular localization gives potentially new biological roles for HA. The physiological role of RHAMM is under evaluation in the light of the new data about IHABP (75).

3.3 Novel HA binding proteins The liver is important for HA turnover by the uptake and degradation of the HA in liver endothelial cells (see section 5). The putative receptor(s) responsible for receptor-mediated endocytosis of HA on these cells have been described but not cloned (107)(120)(227)(236). The receptor reported by McCourt et al. (120) is possibly a part of a protein complex of three (related) proteins (two 170- 180 kDa and one 270 kDa proteins) and shows functional similarities to the scavenger receptor family. Polyclonal antisera towards the 270 kDa protein blocked HA binding and degradation in liver endothelial cells. The receptor reported by Zhou et al. (236) indicate a 300 kDa protein complex as the functional unit for the receptor. Complete cloning and sequencing remains to be done for both of these receptors to determine if they are related and to elucidate the molecular basis of their HA binding. Recently, three putative HA binding proteins have been identified on cDNA level by search in an expressed sequence tag (EST) database (205). Based on the original tissues from which these cDNAs were derived, namely white fat, bone marrow and osteoblast, they have received the names WF-HABP, BM-HABP and OE-HABP, respectively. The functional roles of these molecules as HA binding proteins remain to be assessed.

4 Biosynthesis of glycosaminoglycans The biosynthesis of the members of the GAG family is done by partly unique pathways and involve interactions between enzymes in different subcellular compartments. In a first common step, high energy nucleotide sugar donors are synthesized in the cytoplasm. These UDP-sugars can be directly utilized by the plasma membrane bound hyaluronan synthases (HAS) for HA polymerization. The sulfated GAGs are synthesized on a protein core as proteoglycans in the Golgi and the UDP-sugars must therefore first be transported into the Golgi compartments by an

18 antiporter system. The Golgi biosynthetic machinery include chain polymerization and various modifications which, in concert, generate unique chain structures.

4.1 UDP-sugars 4.1.1 Synthesis of UDP-sugar pools The main part of the cell’s glycosylation reactions occur in the Golgi apparatus, which includes N- and O-glycosylation of proteins and lipids, synthesis of ceramide linked oligosaccharides and glycophospholipid anchors and the polymerization of GAG chains (214). A common feature for these reactions is the transfer of monosaccharide units to proteins/lipids from high-energy nucleotide sugar donors, UDP-sugars, by the action of specific glycosyltransferases. The biosynthetic pathways for UDP-sugar have been studied and are now established (50). Practically all of them occur in the cytoplasm of the cell and include unique pathways and interconversion of UDP-sugars from other pathways (Figure 2). The starting material is often the cytoplasmatic glucose pool, but monosaccharide units salvaged from lysosomal degradation of glycoproteins and GAGs (117) can also act as precursors. Rome and Hill (157) have shown that hexosamines in the lysosomes can be reutilized by over 50 % after being transported back into the cytoplasm by specific transporters. Thus the transporters may give an important contribution to the UDP-sugar synthesis in the cell.

Gal Glc

Gal-1-P Glc-6-P Fru-6-P

UDP-Gal UDP-Glc Glc-1-P GlcN-6-P GlcN

UDP-GlcA GlcNAc-6-P

UDP-Xylose GlcNAc-1-P

GalNAc UDP-GalNAc-1-P UDP-GalNAc UDP-GlcNAc

Figure 2. Schematic view of UDP-sugar biosynthesis. Adapted from (50).

19 The cellular concentrations of UDP-sugars have been estimated by Phelps and co-workers in bovine corneal epithelium, endothelium (62) and stroma (61), and in sheep cartilage (55) (Table 3). It must be emphasized that these are estimates of the total cellular pools and do not specify anything about concentrations in various subcompartments. The turnover of these UDP-sugar pools is rapid. Studying freshly isolated chondrosarcoma cells in culture Sweeney et al. (187) could show the half- life of UDP-Glc/Gal and UDP-GlcA was 12 min and for UDP-Glc/GalNAc was 50 min. The cellular UDP-sugars pools seem also to be exchangeable since the ratios of UDP-Glc/UDP-Gal and UDP-GlcNAc/UDP-GalNAc (62)(187) are similar to the free equilibrium ratios reported for the corresponding C4-epimerases (56).

Table 3 Cellular concentrations of UDP-sugars in cornea tissues and nasal cartilage

Cellular concentration (µM) UDP-sugar epithelium endothelium stroma cartilage UDP-Gal 115 28 85 24 UDP-GalNAc 138 82 95 UDP-Glc 279 87 364 73 UDP-GlcA 28 UDP-GlcNAc 368 172 211 UDP-Xyl 85 9 72 7 Data taken from (62)(61)(55).

The UDP-glucose dehydrogenase (UDPGDH) (reviewed in (139)) is a key enzyme in GAG precursor biosynthesis. The enzyme converts UDP-Glc to UDP-GlcA, by the oxidation of C6 hydroxyl group with concomitant reduction of NAD+ to NADH. GlcA and its C5-epimer, IdoA, constitutes every other residue in HA, HS/heparin and CS/DS. Also, the only way to synthesize UDP-Xyl, necessary in the linkage region of GAGs (see section 4.3), is by decarboxylation of UDP-GlcA. This reaction occurs both in the ER/early Golgi and in the cytoplasm (215)(93). The UDP-GlcA is also needed as substrate in the glucuronidation of bile salts and detoxification of xenobiotics in the liver ER (88). The functional unit of UDPGDH is a cytoplasmic complex of six subunits, “trimers of dimers” (139). The Km-values for the UDPGDH from various vertebrate tissues are 90-150 µM for NAD+ and 10-50 µM for UDP-glucose (55)(9). Kinetic studies in corneal stroma and epithelium show that UDP-Xyl can act as an allosteric inhibitor for UDPGDH (55)(132).

20 To be utilized for the biosynthesis of the sulfated GAGs in the Golgi, UDP-sugars synthesized in the cytoplasma have to overcome their subcellular mislocation. The transport into the Golgi is mediated through a group of hydrophobic transmembrane proteins and has been extensively studied by Hirschberg (reviewed in (74)(73)). The proteins are antiporters, meaning that for each nucleotide sugar transported into the Golgi, the corresponding nucleoside monophosphate must be transported back to the cytoplasm. Each nucleotide sugar has its specific transporter and there is little, if any, non-specificity in the system. The transport does not require ATP but is thought to be driven by the down-concentration for the nucleoside monophosphate being transported out from the lumen into the cytosplasm. Studies on reconstituted antiporters in proteoliposomes have revealed useful information regarding transport kinetics (127)(128). The Km-values for the UDP-Gal, UDP-Xyl and UDP-GlcA transporters were determined to be between 2-5 µM which was very close to the Km-values for intact Golgi vesicles. Preloading the proteoliposomes with UMP, a putative antiporter for the nucleotide sugars, increased the nucleotide sugar transport by 2-3-fold. Thus the antiporters have the potential to concentrate the nucleotide sugars between 50- to 100-fold relative to the incubation medium (73).

4.1.2 Regulatory role The question of whether UDP-sugars exert any regulatory effect on mammalian GAG biosynthesis is important, but there are few definite answers up to date. Balduini et al. (5) could show a decrease CS synthesis in cornea when UDP-Xyl was added in vitro. They concluded that the level of regulation was at the UDPGDH enzyme, presumably due to the negative allosteric effect of UDP- Xyl. The turn-over of the UDP-sugars is rapid as reported by Mason and co-workers (187). After stimulation of chondrosarcoma cells with serum or insulin the [35S]sulfate and [3H]leucin incorporation into macromolecules increased 2-3-fold although the UDP-sugar pool sizes remained constant. In another study (230), articular explant cultures could increase their UDP-GlcA pool upon stimulation with serum concomitantly with increased production of GAGs. Thus the increased demand for UDP-sugars in cells can be met by an increased fluctuation of the pools or by an expansion of the pool size. They concluded that the UDP-sugars pools are unlikely to become rate- limiting in GAG biosynthesis (187). A Madin-Darby canine kidney (MDCK) cell line, 98 % deficient in UDP-Gal transport into the Golgi lumen, had marked reduced galactosylation of glycoproteins and glycosphingolipids (13) and reduced amounts of KS (the only GAG containing Gal in the polymer) (201). However, the biosynthesis of HS and CS in these cells was not affected although Gal is needed in the linkage region between the core protein and the GAG polymer (201). The authors speculated that the Km- values for the glycosyltransferases involved in the transfer of Gal in the linkage region are lower

21 than that of the transferases involved in polymerization of KS, thereby explaining the different effects on KS and HS/CS, although they could not rule out the possibility of subcompartementation of the two processes.

Several reports, including studies of Km-values of the nucleotide antiporters in proteolysomes, have suggested that the rate-limiting step of the Golgi located posttranslational modifications (e.g. glycosylation) is the transport of UDP-sugars into the Golgi by the antiporter system and not the glycosyltransferase activities (73).

4.2 Biosynthesis of HA 4.2.1 Hyaluronan synthase (HAS) gene family In 1992 van de Rijn and co-workers identified a gene responsible for HA production in group A Streptococcus (33)(211). It soon became clear that the synthase was part of a hyaluronan synthase (HAS) operon consisting of three members and that all encapsulated Group A Streptococci possessed this operon (20). The gene was characterized (31)(35) and received the acronym hasA. The hasB gene was characterized as a UDPGDH (34), the enzyme that converts UDP-Glc to UDP- GlcA. The hasC gene encodes a UDP-glucose pyrophosphorylase responsible for the production of UDP-Glc from glucose 1-phosphate and UTP (19). The vertebrate HAS proteins belong to a gene family with four members (180). The first three isoforms termed HAS1, HAS2 and HAS3 were cloned from human and mouse origins in a short period of time between 1996 and 1998 (85)(172)(219)(177)(182). The fourth member, termed HAS-related sequence (xlHAS-rs), was identified in Xenopus leavis (African green frog) with no mammalian orthologue found so far (180). The first HAS gene was actually submitted to the gene bank already in 1983 (164) but under the name DG42 (Differentially expressed at Gastrulation), a protein found to be predominantly expressed during X. laevis gastrulation. The function of the protein was at that point in time unknown. Later, a controversy about its catalytic properties arose (213) which now has been resolved (see section 4.2.2.1). The four members of the vertebrate gene family have probably arisen from a common ancestral gene (180) after three gene duplications with subsequent divergence. Data that support this hypothesis are common intron-exon boundaries and high sequence similarities between different orthologues (Figure 3). The HAS gene family seems to have developed early in evolution since the three first HAS genes are located on three separate autosomes (183). The tight coupling between the HAS protein and the precursor producing enzymes seen in bacteria is not seen in the vertebrates; the UDPGDH gene is located on a separate chromosome from the HAS genes (179). The identification of a HAS gene in 1997 in the Paramecium bursaria Chlorella virus (PBCV-1) genome (30) was a big surprise. When infecting chlorella-like green algae, a HAS enzyme is translated from the open reading frame A98R. The origin of the viral HAS gene is still an

22 enigma. The enzyme shows about 30 % similarity on aa level with both vertebrate and bacterial HAS with a slight predominance for the vertebrate protein. However, the viral genome also carries two genes for HA precursors synthesis; a UDPGDH and a glutamine:fructose-6-phosphate amidotransferase for synthesizing UDP-GlcA and glucosamine, respectively (104), which show a higher degree of homology with their prokaryotic counterparts than their vertebrate ones (26). However, the three genes do not function as an operon in the algae as they do in bacteria (30).

Amino acid sequence similarity (%)

xl HAS-rs xl HAS-rs HAS1 HAS2 HAS3 xl HAS-rs 47 44 44 HAS1 HAS1 46 53 ancestral 52 HAS gene HAS2 HAS2 46 41 67 HAS3 44 53 58 HAS3 DNA sequence similarity (%)

Figure 3. The evolution of the vertebrate HAS gene family and the sequence similarities between its members. Data taken from (180).

The Gram-negative bacteria Pasteurella multocida is able to synthesize an HA capsule. Utilizing transposon insertional mutagenesis a new type of HAS enzyme was cloned in the bacterial strain by DeAngelis (29). This enzyme does not show any major resemblance to the other HAS genes, deviating by size, predicted membrane topology and polymerization mechanism. DeAngelis has suggested a classification of the HAS enzymes based on these characteristics (26). As of now, all the HAS proteins cloned including vertebrate, prokaryotic and viral HAS belong to class I, with the P. multocida HAS as the only member of class II.

4.2.2 HAS protein 4.2.2.1 Enzyme properties The structure and topology of the HAS protein is to a large extent unknown. Philipson and Schwartz could, with rigid experimental data, show that the vertebrate enzyme co-purified with the plasma membrane fraction of mouse oligodendroglioma cells when fractionated by centrifugation

23 (142). Previously, Dorfmann and co-workers had shown that the bacterial HAS resides in the membrane in group A Streptococci (119). The size of the vertebrate HAS proteins is about 65 kDa, deduced from their aa sequences. In a review of the HAS enzymes (220) a seven transmembrane or membrane associated domain topology of the enzyme was suggested based on hydrophobicity plots of the aa sequence (Figure 4); only a very small portion of the polypeptide chain is exposed to the outer surface in this model. The structure has partly been supported by experimental data putting both the N- and C- terminus in the cytosol (178). A basic aa cluster in the C-terminal part of the enzyme has been proposed to participate in the regulation of the shedding of the negatively charged HA chain from the cell surface. The large intracellular loop has motifs that are highly homologous between different HAS members (180)(26) indicating this as the catalytic domain. Recently, site-directed mutagenesis of HAS1 revealed potential sites for ß1-3GlcA and ß1-4GlcNAc transferase activities in the central loop (229). The suggested topology is shared by both the prokaryotic and eukaryotic members of the class I HAS family (220) with the difference that the prokaryotic proteins are shorter by a lack of two C-terminal membrane spanning domains. This leaves only the P. multocida HAS (class II) with a different structure (30) which probably only has two transmembrane domains or is soluble (26).

Extracellular matrix

NH2 COOH

Cytoplasm

Figure 4. Suggested topology of the HAS enzyme (class I). Adapted from (220). Star and circles show positions of aa important in ß1-3GlcA and ß1-4GlcNAc transferase activities, respectively. Box depicts basic aa cluster suggested to be involved in shedding of the HA chain from cell surface.

The long lasting enigma about the enzymatic activity of the DG42 protein, now termed Xenopus laevis HAS1, seems to be resolved. In 1996 Semino et al. (169) claimed that DG42 synthesizes

24 chitin oligomers [GlcNAcß1-4GlcNAc]n n=4-5, while Meyer and Kreil (124) showed HA polymerization; the dispute was commented on by Ajit Varki (213)). Kimata and co-workers have recently shown that both activities reside in the purified enzyme when assayed in vitro (229). The structure and topology of the HAS enzyme has been studied in greater detail in the bacterial system. Weigel and co-workers have suggested that the HAS protein forms a pore in the plasma membrane through which the polymer can be translocated concomitantly with chain elongation (199)(197). The association of about 16 cardiolipin molecules, which induced enzyme activity in vitro, seems to assist in the formation of a pore like structure. Other lipids have been shown to enhance enzymatic activity, while others completely abolish it. (197). Less is known about the vertebrate HAS enzymes and their lipid dependence and association. Several laboratories, including ours, have solubilized HAS protein from different cell lines with sustained activity using (preferably) digitonin as detergent (Paper I)(133). Kimata and co-workers have recently shown that the detergent CHAPS was able to restore activity and kinetics of solubilized HAS protein to that of the membrane bound enzyme (229). To synthesize HA the following enzymatic activities are needed: ß1-3GlcA transferase, ß1- 4GlcNAc transferase and HA translocation (through the membrane). Does the HAS protein display all of these activities by itself or is it aided by an accessory component? Three reports give rigid evidence supporting the one polypeptide hypothesis. Weigel and co-workers (199) could show that the size of the functional Streptococcal HAS complex expressed in E. coli was the same as the HAS protein itself in irradiation studies, thereby excluding additional proteins. DeAngelis (28) transformed the yeast strain Saccharomyces cerevisiae with the cDNA for Xenopus laevis HAS1 which gave the yeast the capacity to synthesize HA polymers in vitro. Wild-type yeast lacks the ability to synthesize any GAGs due to lack of UDP-GlcA in the cells. The yeast cell should therefore completely lack the machinery for GAG synthesis but the HAS polypeptide gives it that capacity. Kimata and co-workers (229) managed to purify mouse HAS1 to homogeniety and showed that it could synthesize HA in vitro.

4.2.2.2 Kinetics The enzyme kinetics of synthases of both prokaryotic (198) and eukaryotic (86) origin have been studied with regard to their substrates UDP-GlcA and UDP-GlcNAc. The data are summarized in Table 4. The UDP-GlcNAc utilization of recombinant Streptococcus pyogenes (spHAS) and Streptococcus equisimilis (seHAS) expressed in E. coli were studied and shown to be sigmoidal for spHAS in a Michaelis-Menten plot. The indicated cooperativity for UDP-GlcNAc was seen both for membrane fractions of spHAS (198) and for the solubilized form in the presence of cardiolipin (197). The utilization of the UDP-GlcA was non-cooperative for both the bacterial strains. Stoolmiller and Dorfman have also reported a non-hyperbolic plot for UDP-GlcNAc

25 utilization by Streptococcus (185). The enzyme kinetics displayed by spHAS may reflect an evolutionary adaptation to ensure that cell growth is not imparied by the production of the HA capsule (198). The three vertebrate HAS proteins were assessed in a similar manner to the bacterial forms

(86). The enzymes displayed similar Km- and Vmax-values and showed no sign of cooperativity for either substrate.

Table 4 Enzyme kinetics of prokaryotic and eukaryotic HAS enzymes

† †† Km for UDP-GlcA Km for UDP-GlcNAc HA polymerization rate Source (µM) (µM) (monosaccharide/min) spHAS 27 125 seHAS 51 30 HAS1 53 501 1256 HAS2 33 331 1014 HAS3 35 223 174 Data taken from (198)(86). Membrane fractions of recombinant Streptococcal and mouse HAS proteins were used to determine Km-values. † Concentration of UDP-GlcNAc was 500 µM †† Concentration of UDP-GlcA was 100 µM for bacterial HAS and 200 µM for mouse HAS

4.2.3 Regulation of HA biosynthesis The HA biosynthesis can be regulated on different levels. As described in section 4.1.2 the access to UDP-sugars can potentially constitute a regulatory mechanism for GAG synthesis. Several studies have also been conducted on the growth factor stimulation of HA synthesis and the involvement of protein kinases.

4.2.3.1 Turnover of the HAS protein The turnover of the HAS proteins have only been studied indirectly and the results are contradictory. Calabro and Hascall (15) studied HA and CS synthesis in chondrosarcoma cells during brefaldin A treatment. Brefaldin A is a fungal metabolite that interferes with vesicular transport causing disassembly of the Golgi complex and could thus indirectly interfere with the delivery of the newly synthesized HAS proteins to the cell membrane. However, the HA synthesis remained remarkably constant for a period of 8 hours (15). Bansal and Mason (8) came to different conclusions using the same cell line when they added cycloheximide, an eukaryotic protein

26 synthesis inhibitor, to the cultured cells. They could see a 50 % reduction in HA production after less than 2 hours treatment. Other studies have also indicated a more rapid turnover of HAS protein using cycloheximide (68). An explanation to the contradictory results of HAS protein turnover could be that different HAS isozymes are influenced by the cell type that they are expressed in, by the cell culture conditions and/or that the HAS isoforms exhibit different turnover rates. Itano et al. (86) have shown that the three enzymes deviated from each other in terms of their catalytical stability in vitro, HAS1 having the narrowest window of activity (1 hour) while the HAS2 (4 hours) and HAS3 (8 hours) windows were broader.

4.2.3.2 Effects of growth factors Platelet derived growth factor (PDGF) is a growth factor with broad specificity which stimulates proliferation in connective-tissue cells (67). The transforming growth factor (TGF) is a family of growth factors acting on a broad range of cells exhibiting stimulatory and inhibitory effects in a cell specific manner (143). Heldin and co-workers (68) demonstrated that PDGF-BB stimulation of human mesothelial cells led to increased production of HA and that antibodies towards PDGF-BB partly inhibited this increase (3). The authors showed that mesothelioma cells, the transformed counterpart of mesothelial cells, could generate stimulatory signals for HA production. Mesothelioma cells do not produce HA by themselves; rather they secrete factors that stimulate HA synthesis in fibroblasts and mesothelial cells (3). Furthermore, inhibition of the de novo protein synthesis with cycloheximide diminished the effect of PDGF in mesothelial cells, suggesting that PDGF controls the HA synthesis at the transcriptional level (68). In another study, PDGF-BB and TGF-ß1 were shown to stimulate HA synthesis in human foreskin fibroblasts (186). These signals were also dependent on protein synthesis since cycloheximide inhibited in part the stimulatory effects. Schor and collegues have been studying HA production in skin fibroblasts in relation to growth substratum and growth factors. These studies revealed that fetal and adult fibroblasts upregulate their HA synthesis when cultured on a collagen substratum compared to plastic dishes, and that TGF-ß1 stimulated HA synthesis in confluent fetal cells growing on plastic substratum, but inhibited HA synthesis when cells were growing on collagen (38). In 3-dimensional collagen gels fetal fibroblast HA synthesis was unaffected by PDGF, epidermal growth factor (EGF) and fibroblast growth factor (FGF), but was inhibited by TGF-ß1. Adult fibroblast HA synthesis was stimulated by the same factors, but was unaffected by TGF-ß1 (37). More recently, the promotor sequence of mouse HAS1 have been cloned and partly analyzed (223). Using the Internet Transfac program several potential regulatory cis-elements have

27 been identified, such as AP-2, CREB, MyoD, SRY and Sox-5, which in future might help to predict and determine the importance of various growth stimuli for HA production.

4.2.3.3 Involvement of protein kinases Several reports have indicated that protein kinases are involved in the stimulatory signals leading to increased HA production, including direct phosphorylation of the HAS protein (125)(146). After the cloning and characterization of the HAS enzyme family (220) caution is advised about the conclusions drawn in these former reports. Studies by Heldin and co-workers revealed that the stimulatory effect of PDGF on HA biosynthesis in mesothelial cells and fibroblasts was partly dependent on protein kinase C and partly dependent on de novo protein synthesis. Interestingly, the phorbol ester PMA, an activator of protein kinase C, stimulated HAS proteins through a pathway which was not dependent on de novo synthesis (68)(186). Treatment of mesothelial cells with phosphotyrosine phosphatase inhibitors have also been shown to stimulate HA production (68)(134). Stimulation of mesothelial cells from rabbit pericardial cavity with EGF and insulin-like growth factor (IGF) gave a cooperative enhancement of HA biosynthesis, which could be suppressed by a tyrosine kinase inhibitor (78). This result suggested that the inhibitory effect was on the tyrosine kinase activity of the cytoplasmic domains of the IGF-I and EGF receptors, rather than a direct influence on the HAS protein. Similar results with IGF-I were also seen in peritubular rat testis cells (193). The HA production in pericardial mesothelial cells could be stimulated by prostaglandin E2 through a cAMP-mediated signal, which could also be seen when the intracellular level of cAMP was raised by addition of synthetic analogues or stimulators of cAMP production to the cell culture media (79). They could also show that the signal transduction pathway from cAMP was to protein kinase A and not protein kinase C in these cells. Salustri and co-workers have shown that the cumulus cells increase their HA synthesis during the expansion of the cumulus oophorus in the mammalian preovulatory follicle (163) in response to follicle stimulating hormone (FSH) and a soluble oocyte factor(s) (162). FSH has been shown to increase the intracellular cAMP levels, which correlated with the net increase of HA production in mouse cumulus cells, while tyrosine kinase inhibitors suppressed the effect of FSH partially (196). The HA synthesis was abolished after treatment with RNA synthesis inhibitors, indicating that the induction of HA production is primarily controlled at the transcriptional level.

4.2.4 Biosynthetic directionality A question that still remains unclear is the biosynthetic directionality of the HAS enzyme, i.e. whether monosaccharides are added to the reducing end or the non-reducing end of the growing HA polymer. In nature the predominant biosynthetic directionality for carbohydrate polymers

28 seems to be at the non-reducing end, exemplified by the sulfated GAGs (96), but elongation in the reducing end has also been reported (polymerization of dextran (155)). The existence of two classes of HAS enzymes, probably with different evolutionary origin (see section 4.2.1), makes it possible that the different classes exhibit different polymerization mechanisms. Several attempts using different approaches have been made to clarify the polymerization directionality of class I Has but conclusive results are still lacking. However, the polymerization directionality of class II Has (Pasturella multocida) has been determined. Stoolmiller and Dorfman in 1969 showed experimental data that HAS protein from Streptococcus polymerized the HA chain at the non-reducing end (185). The study was based on an in vitro pulse experiment with UDP-[14C]GlcA alone, with subsequent digestion of the labeled HA chain with Streptococcal hyaluronidase. The hyaluronidase digests ß1-4 linkages in the HA chain by an eliminase reaction rendering predominantly unsaturated disaccharides (∆di-HA), and a smaller portion of saturated disaccharides (di-HA), which are formed from the non-reducing terminal disaccharide of the HA chain. The majority (88 %) of the radioactivity was found in di-HA after the pulse experiment, indicating chain growth in the non-reducing end. Prehm obtained the opposite result in 1983 when assaying differentiated teratocarcinoma cells by pulse-chase experiments (144). HA polymerization was done with a pulse of UDP- [14C]GlcA and UDP-GlcNAc followed by a chase with unlabeled UDP-GlcA. The pulse-chase labeled HA was then degraded from the non-reducing end with exo-enzymes (ß-glucuronidase and ß-N-acetylglucosaminidase). Prehm concluded that HA synthesis occurs at the reducing end since the [14C]GlcA residues were cleaved off the HA chains directly in the presence of the digestive enzymes; if the HA chain had been polymerized from the non-reducing end there would have been a time lag before a drop in radioactivity could have been seen. DeAngelis has studied the unique Pasturella multocida HAS expressed in the yeast S. cerevisiae in terms of its polymerization directionality (27). The system has the advantage of being devoid of nascent HA chains, since yeast cells are not able to synthesize UDP-GlcA. This means that all HA produced in the in vitro HA polymerization assay is synthesized de novo. Under these experimental conditions, DeAngelis was able to show addition of a monosaccharide unit to a HA tetrasaccharide which could be cleaved off with exoglucosidases from the non-reducing end. This was also the first time that a HA primer, other than UDP-GlcA or UDP-GlcNAc, could be used in HA biosynthesis. In summary, rigid evidence that the P. multocida HAS elongates HA from the non-reducing end was provided.

4.3 Biosynthesis of sulfated glycosaminoglycans The three groups of sulfated GAGs, HS/heparin, CS/DS and KS, are synthesized as proteoglycans in the Golgi. A linkage region, connecting the protein core with the GAG chain, initializes the chain

29 polymerization before the chain is further polymerized and modified by an elaborate biosynthetic machinery.

4.3.1 Linkage region The linkage region, connecting HS/heparin and CS/DS chains to a serine residue on the protein core, consists of the tetrasaccharide GlcAß1-3Galß1-3Galß1-4Xylß1-Serine (156) and is initiated by a unique transferase adding Xyl from a UDP-Xyl donor. The addition of a α-GlcNAc and ß- GalNAc residue after the terminal GlcA residue of the linkage region constitutes the bifurcation of HS/heparin and CS/DS biosynthesis, respectively. The aa sequence in the vicinity of the serine residue partly influences the nature of the GAG chain that is going to be synthesized; repetitive serine-glycine residues together with an acidic aa cluster and a hydrophobic patch promotes HS polymerization (232)(231). The linkage region in KS is different from the tetrasaccharide described above. KS chains can either be linked to an asparagine or a serine/threonine thus resembeling the linkage of N- and O-linked glycans, respectively (57).

4.3.2 Polymerization and modification The heparin synthesis is the best studied and understood and is referred to as the default modification (161). It begins with alternating transfer of GlcA and GlcNAc from corresponding UDP-sugars to the linkage region, followed by the action of the first modification enzyme N- deacetylase/N-sulfotransferase (NDST) that replaces the N-bound acetyl group on the GlcNAc residue with a sulfate group. The subsequent enzymatic modifications are partly coupled to the action of the NDST enzyme and therefore cannot take place before N-sulfation has occured. The C5-epimerase converts GlcA to IdoA which promotes the 2-O-sulfation of the IdoA residue, although GlcA residues can be modified in the same way. The last step in the chain synthesis is the 6-O-sulfation and selective 3-O-sulfation on GlcNAc residues. The default modification results in a highly sulfated polymer with a typical disaccharide structure -IdoA(2-OSO3)-GlcNSO3(6-OSO3)-; this disaccharide constitutes about 80 % of the disaccharides in heparin. HS is structurally more diverse than heparin because the HS chains escape the default modification pathway for reasons that are not fully understood. Only about 10 % of the disaccharides in HS are default modified (161). Four different NDST isozymes have now been cloned and seem to contribute to the different N-sulfation patterns seen in HS and heparin. Transfection of NDST-2, an isozyme predominantly expressed in heparin-producing mast cells, into HS producing cells increased their N-sulfation (17), which was not the case when more widely distributed NDST-1 was overexpressed (84). Several isoforms of the 2-O-, 3-O and 6-O-

30 sulfotransferases exhibiting different substrate specificities in vitro have been cloned, that could contribute to generation of specific sulfation patterns in vivo (115). The polymerization of CS/DS and KS is less well understood (96). The GalNAc residues remain acetylated in CS/DS chains rendering the chains less structurally diverse than HS. KS can undergo modifications through selective 6-O-sulfation on both Gal and GlcNAc residues which are non-randomly distributed along the chain.

5 Degradation of HA 5.1 Tissue turnover HA is constantly being turned over in the body. In a series of experiments performed by Laurent and Fraser (108)(49)(46) it has been estimated that about one third of the total HA content (11-17 g for a 70 kg man) is degraded per day. The degradation takes place both locally in the tissue and in central organs such as the liver, kidney, spleen and bone marrow. The local tissue turnover rate of 3 HA has been estimated to t1/2=12 hours in the skin studying injected [ H]HA (151). The HA that escapes degradation locally is transported via the lymph to the lymph nodes (191) where 50-90 % of the HA is degraded (47). The blood receives HA from lymph nodes (10-100 mg/day), where it disappears within minutes (t1/2= 2-6 min). The liver takes up about 90 % of the HA that reaches the blood by a receptor mediated process (41). The receptor(s) have been studied functionally and biochemically by several groups and their cloning seems to be at hand (120)(236).

5.2 Hyaluronidases The HA that is taken up by the cells is degraded inside the lysosomes by hyaluronidases and the exoenzymes ß-glucuronidase and ß-N-acetylglucosaminidase (108). The hyaluronidases are a diverse group of enzymes isolated from different origins such as vertebrates, leeches and bacteria, and the enzymes exhibit different kinds of activities (102). The vertebrate enzymes are endo-ß-N- acetyl-D-hexosaminidases that degrade HA (and CS to a lesser extent) yielding tetrasaccharides and hexasaccharides as final products. Up to now six paralogue human hyaluronidase genes have been identified (21)(184) which are arranged in two tightly linked triplets on chromosomes 3p21.3 (genes HYAL1, HYAL2, HYAL3) and 7q31.3 (genes HYAL4, SPAM1, HYALP1) and codes for the proteins Hyal-1, Hyal-2, Hyal-3 and Hyal-4, PH-20 respectively; SPAM1 is a pseudogene with no protein product. HYAL1, HYAL2 and HYALP1 are widely expressed, whereas HYAL3 and HYAL4 are differentially expressed in bone marrow and testis, and placenta and skeletal muscle, respectively. The genes for human hyaluronidases are mapped to loci which have been described as candidate tumor suppressor loci (101).

31 It is not known if the functional implications of the hyaluronidases are restricted to HA degradation in the lysosomes due to the fact that the enzymes are only active in acidic pH (52); the role of hyaluronidases remains largely to be elucidated. An exception is PH-20, a 64 kDa GPI-anchored hyaluronidase acting at neutral pH, found in the sperm membrane (102). The protein enables the sperm to penetrate the cumulus cell layer surrounding the egg during the fertilization process (114). Hyaluronidases have been implicated in tumorigenesis. Frost et al. (54) showed that head and neck squamous cell carcinomas had inactivated their HYAL1 gene by aberrant splicing of pre- mRNA, which rendered the cells devoid of hyaluronidase activity. Additional pieces of information suggesting a broader function of the hyaluronidases in HA metabolism have been presented. The presence of Hyal-1 in human plasma and urine (10)(53) and the novel specificity of Hyal-2, hydrolysing HA to 20 kDa fragments (50-60 disaccharide units) instead of tetrasachharides (110), opens up the field for further investigations.

32 PRESENT INVESTIGATION

6 Aims of the study At the start of this study the knowledge about the molecular mechanisms that regulate HA biosynthesis was limited. Purification of proteins involved in HA polymerization as well as studying the expression and regulation HAS proteins were general topics of interest. We were also interested in investigating the effects of HA overproduction for cell function and cell behavior. The specific aims of the thesis were to study:

• if HA is synthesized by a functional multi-protein complex. Are there proteins associated with the HAS protein that might assist in the HA polymerization process or regulation of it? If yes, is it possible to co-purify these accessory proteins from solubilized lysates of HA producing cells? For these studies, we wanted to develop immunoprecipitating antibodies towards the HAS protein(s). • the polymerization directionality of HA synthesis. Is HA polymerized in the same way as the sulfated GAGs, where monosaccharides are added to the non-reducing end of the polymer or does it have a unique way of polymerization from the reducing end? • the overexpression of HAS proteins. Do the HAS isozymes synthesize the same product and are they equally efficient in HA polymerization? What are the consequences of HA overproduction for cell function? • if the HAS isoforms are differentially expressed and regulated. Which signals and growth factors are involved in upregulation of the HAS genes? Are there signals that can down-regulate HAS gene and protein expression and thereby decrease HA production? • the role of UDPGDH in GAG biosynthesis. How is the GAG production affected in cells overexpressing the UDPGDH and/or HAS enzymes? Is UDPGDH a regulatory or rate-limiting enzyme in mammalian GAG biosynthesis?

33 7 HAS enzyme in glioma cells can be solubilized in an active form (Paper I) The knowledge about the enzyme(s) involved in HA biosynthesis was limited when this project was initiated; none of the HAS isozymes were purified to homogeneity or cloned due to the difficulties to study membrane associated proteins. We were interested in purifying the HAS protein and identifying possible accessory proteins involved in the HA polymerization process or regulation of it. During the progress of the project, our research group was involved in the characterization of the cloned HAS1 gene (172), which made it possible for us to develop peptide antibodies against the C- terminal part of the protein.

7.1 Solubilization and purification The glioma cell line U-118 MG produces large amounts of HA and was therefore a potentially useful source to try to purify and characterize HA polymerizing protein(s). It was important to have maximal enzymatic activity at the start of the solubilization and purification process, since the method available to monitor the HAS protein was a functional in vitro assay. We discovered that when glioma cells were pretreated with the phorbol ester PMA in combination with testicular hyaluronidase prior to cell harvesting, the in vitro enzymatic activity was increased 23-fold. A battery of different detergents was tested for their ability to solubilize HAS activity. Only digitonin extracted an appreciable amount of the enzymatic activity (26 % of non-solubilized protein), compared to other detergents such as CHAPS, Triton X-100 and Thesit (2-6 %). We concluded that the HAS protein, despite its intimate association with the plasma membrane, can be solubilized in active form. The enzymatically active HAS protein was submitted to gel chromatography on a Superdex- 200 column. The eluted fractions from the column were tested for protein content, HA synthase activity and immunoblotting. The fractions eluted just after the the void volume (about 600 kDa) contained the highest HA synthase activity and also exhibited the strongest bands in Western blotting. These bands were around 66 kDa, under both reducing and non-reducing conditions. A 12-fold purification measured in specific enzymatic activity was achieved after the chromatography. In summary, we could show that the active HAS enzyme was eluted in the high molecular weight fractions from a Superdex-200 column, suggesting that the HAS protein(s) forms a complex with other components. Gel electrophoreses and immunoblotting indicate that such a complex, if it exists, is not brought together with covalent disulfide bonds, but probably weaker ionic interactions. In the literature, several reports have indicated that HA is polymerized by a single polypeptide chain with no additional components (199)(147)(229)(see section 4.2.2). An explanation to our result from the chromatography, where the HAS protein is eluted in the 600 kDa

34 fraction, is that partly synthesized HA chains are still connected to the HAS proteins during the purification process thereby increasing the apparent size of the eluted proteins. The cell preparations used for solubilization have a high HA content (about 2 mg/mg protein) which supports this explanation (Marianne Svarvare, unpublished observations).

7.2 Antibodies towards HAS proteins The cloning of HAS1 (172) and HAS2 (177) led us to develop peptide antibodies towards different epitopes of HAS in our laboratory. The GVR-antibody was produced against the C-terminal portion of HAS1 (peptide sequence GVRRLCRRRTGGYRVQV) and the TIY-antibody against the C- terminal portion of HAS2 (peptide sequence TIYKESKKPFSESKQT). The specificity of the antibodies was tested against protein preparations from recombinant expressed HAS (Paper I) or from cell lines with specific HAS mRNA expression and high HA production (Paper III). This approch was complicated by the finding that some cell lines have low HA production but a more pronounced mRNA expression of HAS genes (Jonas Brinck, unpublished observations) and the difficulty to find native HAS null cells. In paper I, the GVR-antibody was used in immunoblotting of the HAS protein in glioma cells, a cell line which later showed to express mainly HAS2 (Paper III). The explanation for this could be two-fold. First, the specificity of polyclonal peptide antibodies is not absolute and there is a similarity of about 30 % between the HAS1 and HAS2 and HAS3 protein sequences at the epitope site of the GVR-antibody. Second, glioma cells may exhibit a low HAS1 expression that we did not detect with Northern blots (Paper III). To be able to identify and study a possible functional HAS protein complex we decided to develop immunoprecipitating antibodies against HAS using a GST (glutathione-S-transferase) fusion protein system. Four GST-HAS constructs were developed against conserved and unique parts of the intracellular domain of various HAS isoforms, expressed in a low protease active Escherichia coli strain (BL21) and the purified proteins were injected into rabbits for antisera production. Initial attempts to use these antibodies for immunoprecipitations of HAS proteins have been unsuccessful.

8 Is HA synthesized from the reducing end? (Paper I) The polymerization directionality of the HAS enzyme had been adressed before (185)(144)(145) resulting in contradictory conclusions. Therefore we addressed this question by further developing the pulse-chase experiments performed by Prehm (144). HAS containing glioma cell membranes were incubated in two different pulse-chase experiments (see Fig. 5). In the first approach (A), HA was polymerized during a pulse period in the presence of UDP-[14C]GlcA and UDP-GlcNAc, followed by a chase period where the UDP-

35 [14C]GlcA had been competed out by high concentration of unlabeled UDP-GlcA. In the second approach (B), HA was polymerized during a pulse period with UDP-GlcA and UDP-GlcNAc, followed by a chase with addition of UDP-[14C]GlcA. The unincorporated radioactivity was washed away before the samples were submitted to hydrolysis at the non-reducing end with ß-glucuronidase and ß-N-acetylglucosaminidase in dialysis bags. Results showed that the HA chains polymerized in approach A were immediately susceptible to hydrolysis, whereas the chains polymerized in approach B had a time lag between the start of the enzyme digestion and the drop in radioactivity. In conclusion, these results support the hypothesis that HA is polymerized at the reducing end.

Approach A Approach B synthesis synthesis

-R -R

degradation degradation

)

l 100

(

t 80

i 60

n i 40

r 20

30 60 90 Time (min)

Figure 5. Schematic picture of the pulse-chase experiments of HA polymerization and the result of hydrolysis of pulse-chased chains in dialysis bags. The -R indicates the reducing end of the chain and the black bars show the [14C]labeled parts under the assumption that synthesis occurs at the reducing end. Symbols in the lower panel: approach A, filled boxes; approach B, empty boxes; control with no exoenzymes, filled circles.

The pulse-chase experiments reported here and elsewhere (185)(144) have obvious limitations when it comes to the experimental set-up. At the starting point of the pulse-chase incubation the HAS membranes contain already initialized HA chains that will be elongated together with de novo

36 synthesised chains, which will create heterogenity in the synthesized HA species. The digestion of the pulse-chase labeled HA chains by exoglucosidases cannot be achieved completely giving substantial levels of non-degradable radioactivity. One explanation to these residual levels could be that the part of the HA chain closest to the HAS protein is less accessible for enzymatic degradation. In summary, rigid evidence to the question of polymerization directionality of HA is still lacking.

9 Expression of HAS affects cell behavior (Paper II) After the identification and cloning of HAS in 1996 (i.e. HAS1) the cloning of two other isoforms (HAS2, HAS3) was done during 1996-1997 by separate groups, thus revealing a potentially new possibility for the regulation of the HA biosynthesis. The aim of this project was to study the functional expression of the three HAS isoforms and the effects of overproduction of HA on cell behavior.

9.1 Synthesis and accumulation of HA The Chinese hamster ovary (CHO) cell line was chosen for HAS expression due to its relatively high genomic stability and high expression levels. Cells were transfected with cDNAs from human HAS1, mouse HAS2 and mouse HAS3, and stabile expressing clones were established. The sequence similarities between the mouse and human HAS orthologues is high, about 98 % (180), indicating a conserved mechanisms of action between the species; we concluded that we could compare the expression of the different cDNAs in the same system. Screening the clones for HA in the cell culture media displayed a difference in HA synthesizing capacity between the different HAS isoforms. The HAS3 transfected clones exhibited the highest HA synthesizing capacity (at maximum 1.2 µg/105 cells/24 hours) compared to 0.07 µg and 0.6 µg per 105 cells/24 hours for the most efficiently transfected HAS1 and HAS2 clones, respectively. The increase seen in the HAS3 clone corresponds to a 1000-fold increase in HA production compared to wild-type CHO cells. The HA content in the culture media of the transfected cells (up to 1.2 µg/105 cells/24 hours) is in the same range as in media of human mesothelial cells and glioma cells (Paper III). This indicates that the HA amounts produced are within the physiological range, although not for the CHO cell line. We also wanted to investigate if overexpression of HAS enzymes could lead to increased amounts of cell associated HA. A classical way of visualizing pericellular HA since the 1960’s has been the in vitro particle exclusion assay (18), where the cell surface associated HA can be seen as a halo between the cell membrane and excluded particles (e.g. erythrocytes). In our CHO cell model, we could show that whereas wild-type cells did not have the capacity to form HA matrices,

37 their transfected counterparts attained this ability. The HA synthesizing capacity needed to generate such matrices was about 1 µg of HA per 105 cells and 24 hours. This accumulation of HA around transfected cells could be confirmed by comparing cell associated [3H]HA amounts from low and high HA producing clones.

9.2 HA chain length The chain length of HA synthesized by HAS transfected CHO cells were studied both after in vitro and in vivo synthesis. The in vitro assay is based on HA polymerization by membrane preparations 14 incubated with UDP-[ C]GlcA,UDP-GlcNAc and MgCl2, while HA synthesized in intact cells in the presence of [3H]glucosamine mimics in vivo conditions. Results showed that only HAS2 6 produced high molecular weight HA (Mr >3.9 x 10 ) when assayed in vitro, compared to HAS1 6 6 (average Mr 0.12 x 10 ) and HAS3 (Mr 0.12-1 x 10 ). However, under in vivo conditions, all three 6 isozymes generated HA of high molecular weight (Mr >3.9 x 10 ). As a comparison, HA chains synthesized by mesothelial cells (cells with native expression of HAS1, HAS2 and HAS3; Paper III) were of high molecular weight both in vitro and in vivo. We also studied the HA chain length after solubilization of the HAS protein from glioma cells (Paper I) and after stimulation of mesothelial cells with various growth factors and other compounds (Paper III). Glioma cells, which predominantly express the HAS2 isoform, produced high molecular weight HA when assayed in vitro. Solubilization of the glioma membranes with digitonin prior to the assay rendered a more polydisperse product, but still HA polymers were still produced. Treatment of mesothelial cells with growth factors such as PDGF-BB and TGF-ß led to HA synthesis of high molecular weight in vivo. Interestingly, phorbol ester PMA pretreatment 6 6 induced synthesis of HA chains of polydisperse character (Mr 0.25 x 10 to over 3.9 x 10 ). The results show that all three HAS isoforms, whether recombinantly expressed in CHO cells or native in human mesothelial cells, have the capacity to synthesize high molecular weight HA in vivo. We also show that the HA chain length is dependent on the cell type where it is synthesized. Taken together with the result that the phorbol ester PMA can influence the chain size in mesothelial cells, interesting questions are raised about the molecular mechanims behind the regulation of HA chain length, which needs further investigation. The matter is important since the function of HA polymers is partly dependent on their size. Large HA polymers are important structural elements in the extracellular matrix (106) whereas short HA fragments can induce angiogenesis (221)(148) and inflammatory reponses (121)(80).

38 9.3 Cell migration The migration capacity of wild-type CHO cells and HAS3 transfectants exhibiting different HA synthesizing capacities were quantified using a Boyden chamber assay. The results revealed that the migration capacity was inversely correlated to the HA synthesizing capacity. When excessive amounts of exogenous HA was added to the migration assay, the migration was inhibited for cells producing low amounts of HA, but not for high producing cells. Another finding was that the amounts of cell surface CD44 (as detected by flow cytometry) decreased in high HA producing cells. For the HAS3 clone producing the highest amounts of HA, a 75 % decrease in migration rate and a 50 % reduction in cell surface CD44 was observed. When an antibody towards CD44, blocking the HA binding site, was included in the assays the migration was inhibited up to 50 %. In conclusion, our results suggests that the overproduction and accumulation of pericellular HA impairs normal cell function and reduces cell migration in HAS transfected cells. The concomitant down-regulation of CD44 molecules on the surface of these cells explains partly the reduction in their migratory ability. The total amount of CD44 does not seem to reduce significantly when visualized in Western blotting of total cell lysates (Jonas Brinck, unpublished observations), suggesting a receptor mediated endocytosis of the receptor; such a mechanism has been described in the literature (22). Knudson and Knudson (97) have presented the hypothesis where the establishment of a pericellular HA matrix would interfere with and disrupt normal cell migration. This model has to some extent been experimentally supported by Perris et al. (141), where HA binding proteoglycans that promote pericellular matrix formation was shown to inhibit migration in neural crest cells.

10 HAS isoforms show specificity in gene regulation (Paper III) Under pathological conditions such as chronic inflammation and carcinogenesis an upregulation of HA production is seen, which could be of importance for the pathological development of the disease state (190)(203). To understand the regulation of the HAS genes we therefore investigated the expression HAS genes in response to growth conditions and external stimuli.

10.1 Effects of culture conditions Subconfluent and confluent cultures of glioma cells, mesothelioma cells, mesothelial cells, skin fibroblasts and lung fibroblasts were tested for their ability to express the three HAS isoforms. The culture conditions affected the HAS expression levels by reducing all HAS genes when the cell density increased, indicating a cell-cell contact as a negative factor for HAS expression. Northern blots revealed that only mesothelial cells expressed all three HAS isoforms. The mRNA levels of HAS in the various cell cultures were well correlated with their HA production. Mesothelial cells

39 displayed the highest HA synthesizing capacity (approx. 18 ng HA per 103 cells after 24 hours of culture). Interestingly, mesothelioma cells had a different HAS mRNA expression pattern compared to mesothelial cells; mesothelioma cells expressed HAS3 isoform and synthesized only minute amounts of HA.

10.2 Effects of external stimuli Mesothelial cells were chosen for studying the differential expression of the HAS genes in response to external stimuli since they have native expression of all three isoforms. We stimulated mesothelial cells with the PDGF-BB and TGF-ß1, which are known to be important regulators of HA synthesis in cells of mesenchymal origin (68)(186). Stimulation of the cells with PDGF-BB increased the mRNA level of HAS2 to a peak at 6 hours whereas TGF-ß1 treatment attenuated it. The HAS2 mRNA increase observed after PDGF-BB stimulation was accompanied by increased protein levels and production of high molecular weight HA. The effects of growth factors on HAS1 and HAS3 mRNA expression levels were less pronounced as for HAS2. Treatment of the mesothelial cells with TGF-ß1 increased HAS1 isoform at both the mRNA and protein level whereas HAS3 isoform was not markedly affected by either PDGF-BB or TGF-ß1. Treatment of mesothelial cells with hydrocortisone (125 µg/ml) suppressed HAS2 mRNA expression considerably (about 80 % suppression compared to normal levels), whereas HAS1 and HAS3 mRNA levels only decreased marginally or not at all. The down-regulatory effect of hydrocortisone at HAS2 mRNA level was also seen at the protein level and on the production of HA. Approximately a 40 % decrease in HA production was observed after 6 hours of treatment with hydrocortisone compared to control treated cells. In conclusion, we have found that the three HAS genes are differentially regulated in different cell types in response to growth conditions and external stimuli. It seems that the growth factors mediate their major stimulatory effects through the HAS2 isoform, and therefore HAS2 could be the most important enzyme for HA production in the body. Such an hypothesis is in line with the fact that only HAS2 knock-out mice are embryonically lethal compared to HAS1 and HAS3 knock-outs (181)(16). In addition, the functional inhibition of HA production seen, after down-regulation of HAS2 caused by hydrocortisone treatment, could constitute a strategy for pharmacological treatment of disease in a future perspective.

11 The role of UDP-glucose dehydrogenase in mammalian glycosaminoglycan biosynthesis (Paper IV) The UDPGDH enzyme converts UDP-Glc to UDP-GlcA, which is an essential building block in mammalian GAG biosynthesis. The enzyme has been postulated to play a key regulatory role in the cell wall polysaccharide biosynthesis in plants (192)(154) and is indispensable for vertebrate

40 embryonic development (179)(181) by being the sole producer of UDP-GlcA. The aim of this study was to investigate the role of UDPGDH in mammalian GAG biosynthesis. We have created an experimental cell system where the rate of synthesis and consumption of UDP-GlcA can be modulated in human embryonic kidney (293T) cells by transient overexpression of UDPGDH and HAS3. The dehydrogenase and HA synthase activities were measured in vitro and were found to be over 400-fold greater in favor of the dehydrogenase activity in 293T cells; even after the cells were transfected with UDPGDH and/or HAS3 the overcapacity of the dehydrogenase enzyme persisted. The mRNA expression of UDPGDH was also investigated in CHO cells stably transfected with HAS3. The basal mRNA expression level of UDPGDH in wild- type cells was sufficient for HA production in HAS3 transfected cells exhibiting high HA production; the levels of mRNA in HAS3 expressing cells did not increase after transfection. The amounts of synthesized GAGs were determined after UDPGDH and/or HAS3 transfection. Overexpression of UDPGDH increased the production of CS about 1.5-fold, but did not affect the amount of synthesized HA and HS. HAS3 transfection on the other hand, led to a 20- fold increase of HA production. The overproduction of HA was in part at the expense of HS production which was reduced to 50 % compared to mock transfected cells (CS amounts were normal). Co-expression of UDPGDH with HAS3 did not rescue HS production back to normal levels or increase HA or CS production. The isolated HA, HS and CS chains from the UDPGDH and/or HAS3 transfected cells did not display any major structural changes, in terms of their chain lengths or their the degree of sulfation (HS and CS), compared to GAG chains from mock transfected cells. In conclusion, our findings indicate that the activity of UDPGDH is not rate limiting in mammalian GAG biosynthesis. The diverse effects seen on the HS and CS production in response to UDPGDH and HAS3 transfection could suggest that the biosynthetic machineries responsible for HS and CS synthesis are located in separate Golgi compartments, or that they have different affinities for the substrates (Km-values). Studies are currently underway to determine the concentrations and the fluctuations in the UDP-sugar pools, which will assist in the interpretation of the effects seen on HA, HS and CS production.

41 12 Conclusions • We have shown that the HAS protein(s) can be solubilized in active form. Results indicate that the partially purified HAS isozyme(s) is most likely not asscociated covalently with any accessory components that may be needed in the regulation of HA biosynthesis. • We have results supporting the hypothesis that HA is polymerized at the reducing end of the polymer thereby being unique in the polymerization directionality in the family of GAGs. • We have shown that all three HAS isoforms are able to synthesize high molecular weight HA in intact mammalian cells and that the regulation of the HA chain length involves cell specific elements as well as external stimulatory factors. • We have shown that overexpression of HAS in CHO cells leads to increased HA production and accumulation of pericellular HA and that these cells exhibit a reduced migration capacity and reduced amounts of cell surface CD44 molecules. • We have shown that the HAS1, HAS2 and HAS3 genes are differentially expressed and regulated in response to culture conditions and external stimuli. PDGF-BB and TGF-ß1 are important regulators of HAS at both transcriptional and translational level. • We have results indicating that UDPGDH is not a rate-limiting enzyme in mammalian GAG biosynthesis.

42 13 Future perspectives The sequencing of the whole human genome is soon complete (175), revealing the genetic code of man, whereas the work with discovering the function of many of these genes is still in its infancy. Although the three genes involved in the biosynthesis of HA were sequenced and cloned during the time period of this thesis study, the action and regulation of the HAS enzymes are still topics of scientific interest and many questions remain to be answered. The mechanism of how small HA fragments, found in extracellular matrix of various mammalian tissues under physiological and pathological conditions, are formed is still not resolved. Reports by us and others (Paper II, (180)(86)) indicating that HA can be synthesized as shorter chains can be an in vitro finding with little or no physiological relevance. Two main stand-points can be taken when trying to explain the origin of these fragments. The first conjecture is that HA is 6 always synthesized as full size polymers (Mr 5-10 x 10 ) in vivo. In such a model, the production of low molecular weight HA could instead be due to hyaluronidase activity. The fact that the human hyaluronidase gene family now comprise six paralogous genes corresponding to five different hyaluronidase proteins strengthens their role in HA metabolism (21)(184). Specific growth factors could thereby regulate hyaluronidase expression and promote or decrease the formation of HA oligosaccharides. However, before these enzymes (PH-20 excluded) can be ascribed an essential role in HA chain regulation rigid evidence for hyaluronidase activity in the extracellular matrix at physiological pH must first be provided. The second conjecture is that the regulation of the HA chain length is controled by the HAS molecule itself, or an accessory component, during the process of synthesis. Preliminary results by Spicer and co-workers show that a positive aa cluster in the C-terminal part of the HAS protein displays chain length regulation capacity by binding to the nascent intracellular part of the HA chain (178). More suggestive evidence, based on the fact that HA polymerization is regulated in a cell specific manner (Paper II)(180)(86), indicates that an additional component might be involved. The nature of this component, if it exists, remains to be elucidated. In several pathological conditions such as carcinogenesis and chronical inflammation elevated levels of HA can be detected. Is this increased production of HA a primary or secondary effect of the pathological condition and how are the other GAGs affected by the shift in HA synthesis? In paper IV we investigated the potentially regulatory role of UDP-sugars and UDPGDH for GAG biosynthesis. Our results indicate that the UDPGDH enzyme does not exert a rate-limiting effect on mammalian GAG biosynthesis. However, the HS production was markedly affected in cells overproducing HA, suggesting that shifts in UDP-sugar fluxes can influence their GAG production quantitatively. It will be of importance to investigate the susceptibility of GAG biosynthetic machineries to changes in UDP-sugar concentrations, since it could constitute a mechanism of regulation. The functional diversity of the three HAS isoforms in terms of their HA

43 coat forming capacity (86) could be an example of this kind of regulation. Also, the observed vulnerability of the HS production in HA overproducing cells could lead to an impairment in the affected cells’ growth factor signaling, which is known to be mediated through HS containing proteoglycans (159).

44 ACKNOWLEDGEMENTS

I wish to express my gratitude to:

Evi Heldin, my supervisor, for sharing her enthusiasm for science with me and teaching me to be a critical scientist.

Professors Ulf Lindahl and Torvard Laurent for guidance and encouragement in the field of science in general and glycosaminoglycans in particular.

Marion Kusche-Gullberg and Dorothe Spillman for generous supervision in the field of complex polysaccharides. All my co-authors and collaborators for their work and advice in the four papers presented in this thesis.

Marianne Svarvare for always being at hand with excellent technical advice and for teaching me all the practical things I thought I already knew but apparently did not.

Örjan Zetterqvist, my mentor in everything that has concerned teaching of the graduate students, for inspiring discussion and for entrusting me with part of the graduate student education. It has been very stimulating and challenging!

Annica, Johan and Mehdi for creating that day-to-day (year-to-year!) atmosphere that makes it possible to get through four years of pipetting and cell culture work. Don’t give up – your day will come soon! Special thanks to Maria for letting me borrow her brother’s “slagborrmaskin” and many, many other things. Also thanks to all the people in Ulf Lindahl’s group, and especially Elisabet, for partially adopting me (and “my” polysaccharide) into your group.

All the persons, past and present, at the department for creating a pleasant working atmosphere.

The people in Lena Claesson-Welsh’s group for letting me in on a few secrets in field of cell biology and for teaching me how to use your (expensive) equipment.

Anna for being at my side.

45 REFERENCES 1. Aruffo, A., Stamenkovic, I., Melnick, M., Underhill, C.B. and Seed, B. (1990) CD44 is the principal cell surface receptor for hyaluronate. Cell. 61:1303-1313. 2. Asplund, T. and Heldin, P. (1994) Hyaluronan receptors are expressed on human malignant mesothelioma cells but not on normal mesothelial cells. Cancer Res. 54:4516-4523. 3. Asplund, T., Versnel, M.A., Laurent, T.C. and Heldin, P. (1993) Human mesothelioma cells produce factors that stimulate the production of hyaluronan by mesothelial cells and fibroblasts. Cancer Res. 53:388-392. 4. Bajorath, J., Greenfield, B., Munro, S.B., Day, A.J. and Aruffo, A. (1998) Identification of CD44 residues important for hyaluronan binding and delineation of the binding site. J Biol Chem. 273:338-343. 5. Balduini, C., Brovelli, A. and Castellani, A.A. (1970) Biosynthesis of glycosaminoglycans in bovine cornea. The effect of uridine diphosphate xylose. Biochem J. 120:719-723. 6. Banerji, S., Day, A.J., Kahmann, J.D. and Jackson, D.G. (1998) Characterization of a functional hyaluronan-binding domain from the human CD44 molecule expressed in Escherichia coli. Protein Expr Purif. 14:371-381. 7. Banerji, S., Ni, J., Wang, S.X., Clasper, S., Su, J., Tammi, R., Jones, M. and Jackson, D.G. (1999) LYVE-1, a new homologue of the CD44 glycoprotein, is a lymph-specific receptor for hyaluronan. J Cell Biol. 144:789-801. 8. Bansal, M.K. and Mason, R.M. (1986) Evidence for rapid metabolic turnover of hyaluronate synthetase in Swarm rat chondrosarcoma chondrocytes. Biochem J. 236:515-519. 9. Bdolah, A. and Feingold, D.S. (1968) Uridine diphosphate-D-glucose dehydrogenase of hen oviduct. Biochim Biophys Acta. 159:176-178. 10. Bonner, W.M., Jr. and Cantey, E.Y. (1966) Colorimetric method for determination of serum hyaluronidase activity. Clin Chim Acta. 13:746-752. 11. Bourguignon, L.Y., Kalomiris, E.L. and Lokeshwar, V.B. (1991) Acylation of the lymphoma transmembrane glycoprotein, GP85, may be required for GP85-ankyrin interaction. J Biol Chem. 266:11761-11765. 12. Bourin, M.C. and Lindahl, U. (1993) Glycosaminoglycans and the regulation of blood coagulation. Biochem J. 289:313-330. 13. Brandli, A.W., Hansson, G.C., Rodriguez-Boulan, E. and Simons, K. (1988) A polarized epithelial cell mutant deficient in translocation of UDP-galactose into the Golgi complex. J Biol Chem. 263:16283-16290.

46 14. Brown, T.A., Bouchard, T., St. John, T., Wayner, E. and Carter, W.G. (1991) Human keratinocytes express a new CD44 core protein (CD44E) as a heparan-sulfate intrinsic membrane proteoglycan with additional exons. J Cell Biol. 113:207-221. 15. Calabro, A. and Hascall, V.C. (1994) Differential effects of brefeldin A on chondroitin sulfate and hyaluronan synthesis in rat chondrosarcoma cells. J Biol Chem. 269:22764-22770. 16. Camenisch, T.D., Spicer, A.P., Brehm-Gibson, T. and McDonald, J.A. (1999) Identification of a hyaluronan synthase2 as a critical source of hyaluronan during mammalian embryogenesis. Conference abstract in "International Conference on Molecular Interactions of Proteoglycans", Kanagawa, Japan. 17. Cheung, W.F., Eriksson, I., Kusche-Gullberg, M., Lindhal, U. and Kjellen, L. (1996) Expression of the mouse mastocytoma glucosaminyl N-deacetylase/ N-sulfotransferase in human kidney 293 cells results in increased N-sulfation of heparan sulfate. Biochemistry. 35:5250-5256. 18. Clarris, B.J. and Fraser, J.R. (1968) On the pericellular zone of some mammalian cells in vitro. Exp Cell Res. 49:181-193. 19. Crater, D.L., Dougherty, B.A. and van de Rijn, I. (1995) Molecular characterization of hasC from an operon required for hyaluronic acid synthesis in group A streptococci. Demonstration of UDP- glucose pyrophosphorylase activity. J Biol Chem. 270:28676- 28680. 20. Crater, D.L. and van de Rijn, I. (1995) Hyaluronic acid synthesis operon (has) expression in group A streptococci. J Biol Chem. 270:18452-18458. 21. Csoka, A.B., Scherer, S.W. and Stern, R. (1999) Expression analysis of six paralogous human hyaluronidase genes clustered on chromosomes 3p21 and 7q31. Genomics. 60:356- 361. 22. Culty, M., Nguyen, H.A. and Underhill, C.B. (1992) The hyaluronan receptor (CD44) participates in the uptake and degradation of hyaluronan. J Cell Biol. 116:1055-1062. 23. Dalchau, R., Kirkley, J. and Fabre, J.W. (1980) Monoclonal antibody to a human brain- granulocyte-T lymphocyte antigen probably homologous to the W 3/13 antigen of the rat. Eur J Immunol. 10:745-749. 24. Dasgupta, A., Takahashi, K., Cutler, M. and Tanabe, K.K. (1996) O-linked glycosylation modifies CD44 adhesion to hyaluronate in colon carcinoma cells. Biochem Biophys Res Commun. 227:110-117. 25. Day, A.J. and Parkar, A.A. (1998) The structure of the Link module: a hyaluronan binding domain. In "The Chemistry, Biology and Medical Applications of Hyaluronan and its Derivatives". Vol. 72. Laurent, T.C., editor. Portland Press, London. 141-147.

47 26. DeAngelis, P.L. (1999) Hyaluronan synthases: fascinating glycosyltransferases from vertebrates, bacterial pathogens, and algal viruses. Cell. Mol. Life Sci. 56:670-682. 27. DeAngelis, P.L. (1999) Molecular directionality of polysaccharide polymerization by the Pasteurella multocida hyaluronan synthase. J Biol Chem. 274:26557-26562. 28. DeAngelis, P.L. and Achyuthan, A.M. (1996) Yeast-derived recombinant DG42 protein of Xenopus can synthesize hyaluronan in vitro. J Biol Chem. 271:23657-23660. 29. DeAngelis, P.L., Jing, W., Drake, R.R. and Achyuthan, A.M. (1998) Identification and molecular cloning of a unique hyaluronan synthase from Pasturella multicoda. J Biol Chem. 273:8454-8458. 30. DeAngelis, P.L., Jing, W., Graves, M.V., Burbank, D.E. and Van Etten, J.L. (1997) Hyaluronan synthase of chlorella virus PBCV-1. Science. 278:1800-1803. 31. DeAngelis, P.L., Papaconstantinou, J. and Weigel, P.H. (1993) Molecular cloning, identification, and sequence of the hyaluronan synthase gene from group A Streptococcus pyogenes. J Biol Chem. 268:19181-19184. 32. DeGrendele, H.C., Estess, P. and Siegelman, M.H. (1997) Requirement for CD44 in activated T cell extravasation into an inflammatory site. Science. 278:672-675. 33. Dougherty, B.A. and van de Rijn, I. (1992) Molecular characterization of a locus required for hyaluronic acid capsule production in group A streptococci. J Exp Med. 175:1291-1299. 34. Dougherty, B.A. and van de Rijn, I. (1993) Molecular characterization of hasB from an operon required for hyaluronic acid synthesis in group A streptococci. Demonstration of UDP- glucose dehydrogenase activity. J Biol Chem. 268:7118-7124. 35. Dougherty, B.A. and van de Rijn, I. (1994) Molecular characterization of hasA from an operon required for hyaluronic acid synthesis in group A streptococci. J Biol Chem. 269:169- 175. 36. Eggli, P.S. and Graber, W. (1995) Association of hyaluronan with rat vascular endothelial and smooth muscle cells. J Histochem Cytochem. 43:689-697. 37. Ellis, I., Banyard, J. and Schor, S.L. (1997) Differential response of fetal and adult fibroblasts to cytokines: cell migration and hyaluronan synthesis. Development. 124:1593-1600. 38. Ellis, I.R. and Schor, S.L. (1996) Differential effects of TGF-beta1 on hyaluronan synthesis by fetal and adult skin fibroblasts: implications for cell migration and wound healing. Exp Cell Res. 228:326-333. 39. Entwistle, J., Hall, C.L. and Turley, E.A. (1996) HA receptors: regulators of signalling to the cytoskeleton. J Cell Biochem. 61:569-577.

48 40. Entwistle, J., Zhang, S., Yang, B., Wong, C., Li, Q., Hall, C.L., A, J., Mowat, M., Greenberg, A.H. and Turley, E.A. (1995) Characterization of the murine gene encoding the hyaluronan receptor RHAMM. Gene. 163:233-238. 41. Eriksson, S., Fraser, J.R., Laurent, T.C., Pertoft, H. and Smedsrod, B. (1983) Endothelial cells are a site of uptake and degradation of hyaluronic acid in the liver. Exp Cell Res. 144:223- 228. 42. Faassen, A.E., Schrager, J.A., Klein, D.J., Oegema, T.R., Couchman, J.R. and McCarthy, J.B. (1992) A cell surface chondroitin sulfate proteoglycan, immunologically related to CD44, is involved in type I collagen-mediated melanoma cell motility and invasion. J Cell Biol. 116:521-531. 43. Feinberg, R.N. and Beebe, D.C. (1983) Hyaluronate in vasculogenesis. Science. 220:1177- 1179. 44. Fessler, J.H. and Fessler, L.I. (1966) Electron microscopic visualization of the polysaccharide hyaluronic acid. Proc Natl Acad Sci U S A. 56:141-147. 45. Fieber, C., Plug, R., Sleeman, J., Dall, P., Ponta, H. and Hofmann, M. (1999) Characterisation of the murine gene encoding the intracellular hyaluronan receptor IHABP (RHAMM). Gene. 226:41-50. 46. Fraser, J.R., Appelgren, L.E. and Laurent, T.C. (1983) Tissue uptake of circulating hyaluronic acid. A whole body autoradiographic study. Cell Tissue Res. 233:285-293. 47. Fraser, J.R., Kimpton, W.G., Laurent, T.C., Cahill, R.N. and Vakakis, N. (1988) Uptake and degradation of hyaluronan in lymphatic tissue. Biochem J. 256:153-158. 48. Fraser, J.R., Laurent, T.C. and Laurent, U.B. (1997) Hyaluronan: its nature, distribution, functions and turnover. J Intern Med. 242:27-33. 49. Fraser, J.R., Laurent, T.C., Pertoft, H. and Baxter, E. (1981) Plasma clearance, tissue distribution and metabolism of hyaluronic acid injected intravenously in the rabbit. Biochem J. 200:415-424. 50. Freeze, H. (1999) Monosaccharide Metabolism. In "Essentials of Glycobiology". Varki, A., Cummings, R., Esko, J., Freeze, H., Hart, G. and Marth, J., editors. Coldspring Harbor Laboratory Press, New York. 69-84. 51. Friedlander, D.R., Milev, P., Karthikeyan, L., Margolis, R.K., Margolis, R.U. and Grumet, M. (1994) The neuronal chondroitin sulfate proteoglycan neurocan binds to the neural cell adhesion molecules Ng-CAM/L1/NILE and N-CAM, and inhibits neuronal adhesion and neurite outgrowth. J Cell Biol. 125:669-680. 52. Frost, G.I., Csoka, T. and Stern, R. (1996) The hyaluronidases: A Chemical, Biological and Clinical Overview. Trends in Glycoscience and Glycotechnology. 8:419-434.

49 53. Frost, G.I., Csoka, T.B., Wong, T. and Stern, R. (1997) Purification, cloning, and expression of human plasma hyaluronidase. Biochem Biophys Res Commun. 236:10-15. 54. Frost, G.I., Mohapatra, G., Wong, T.M., Csoka, A.B., Gray, J.W. and Stern, R. (2000) HYAL1LUCA-1, a candidate tumor suppressor gene on chromosome 3p21.3, is inactivated in head and neck squamous cell carcinomas by aberrant splicing of pre-mRNA. Oncogene. 19:870-877. 55. Gainey, P.A. and Phelps, C.F. (1972) Uridine diphosphate glucuronic acid production and utilization in various tissues actively synthesizing glycosaminoglycans. Biochem J. 128:215- 227. 56. Glaser, L. (1959) The Biosynthesis of N-Acetylgalactoseamine. J Biol Chem. 234:2801- 2805. 57. Greiling, H. (1994) Structure and biological functions of keratan sulfate proteoglycans. Exs. 70:101-122. 58. Grumet, M., Flaccus, A. and Margolis, R.U. (1993) Functional characterization of chondroitin sulfate proteoglycans of brain: interactions with neurons and neural cell adhesion molecules. J Cell Biol. 120:815-824. 59. Gunthert, U., Hofmann, M., Rudy, W., Reber, S., Zoller, M., Haussmann, I., Matzku, S., Wenzel, A., Ponta, H. and Herrlich, P. (1991) A new variant of glycoprotein CD44 confers metastatic potential to rat carcinoma cells. Cell. 65:13-24. 60. Hall, C.L., Yang, B., Yang, X., Zhang, S., Turley, M., Samuel, S., Lange, L.A., Wang, C., Curpen, G.D., Savani, R.C., Greenberg, A.H. and Turley, E.A. (1995) Overexpression of the hyaluronan receptor RHAMM is transforming and is also required for H-ras transformation. Cell. 82:19-28. 61. Handley, C.J. and Phelps, C.F. (1972) The biosynthesis in vitro of keratan sulphate in bovine cornea. Biochem J. 128:205-213. 62. Handley, C.J. and Phelps, C.F. (1972) The concentrations of sugar nucleotides in bovine corneal epithelium and endothelium. Biochem J. 127:911-912. 63. Hardwick, C., Hoare, K., Owens, R., Hohn, H.P., Hook, M., Moore, D., Cripps, V., Austen, L., Nance, D.M. and Turley, E.A. (1992) Molecular cloning of a novel hyaluronan receptor that mediates tumor cell motility. J Cell Biol. 117:1343-1350. 64. Hathcock, K.S., Hirano, H., Murakami, S. and Hodes, R.J. (1993) CD44 expression on activated B cells. Differential capacity for CD44-dependent binding to hyaluronic acid. J Immunol. 151:6712-6722. 65. Hayen, W., Goebeler, M., Kumar, S., Riessen, R. and Nehls, V. (1999) Hyaluronan stimulates tumor cell migration by modulating the fibrin fiber architecture. J Cell Sci. 112:2241-2251.

50 66. Heinegard, D. and Oldberg, A. (1989) Structure and biology of cartilage and bone matrix noncollagenous macromolecules. Faseb J. 3:2042-2051. 67. Heldin, C.H. and Westermark, B. (1999) Mechanism of action and in vivo role of platelet- derived growth factor. Physiol Rev. 79:1283-1316. 68. Heldin, P., Asplund, T., Ytterberg, D., Thelin, S. and Laurent, T.C. (1992) Characterization of the molecular mechanism involved in the activation of hyaluronan synthetase by platelet- derived growth factor in human mesothelial cells. Biochem J. 283:165-170. 69. Heldin, P. and Pertoft, H. (1993) Synthesis and assembly of the hyaluronan-containing coats around normal human mesothelial cells. Exp Cell Res. 208:422-429. 70. Heldin, P., Suzuki, M., Teder, P. and Pertoft, H. (1995) Chondroitin sulfate proteoglycan modulates the permeability of hyaluronan-containing coats around normal human mesothelial cells. J Cell Physiol. 165:54-61. 71. Heldin, P., Torres, M., Ytterberg, D. and Bergh, J. (1996) Differential synthesis and binding of hyaluronan by human breast cancer cell lines: Relationship to hormone receptor status. Oncology reports. 3:1011-1016. 72. Henke, C.A., Roongta, U., Mickelson, D.J., Knutson, J.R. and McCarthy, J.B. (1996) CD44- related chondroitin sulfate proteoglycan, a cell surface receptor implicated with tumor cell invasion, mediates endothelial cell migration on fibrinogen and invasion into a fibrin matrix. J Clin Invest. 97:2541-2552. 73. Hirschberg, C.B., Robbins, P.W. and Abeijon, C. (1998) Transporters of nucleotide sugars, ATP, and nucleotide sulfate in the endoplasmic reticulum and Golgi apparatus. Annu Rev Biochem. 67:49-69. 74. Hirschberg, C.B. and Snider, M.D. (1987) Topography of glycosylation in the rough endoplasmic reticulum and Golgi apparatus. Annu Rev Biochem. 56:63-87. 75. Hofmann, M., Assmann, V., Fieber, C., Sleeman, J.P., Moll, J., Ponta, H., Hart, I.R. and Herrlich, P. (1998) Problems with RHAMM: a new link between surface adhesion and oncogenesis? Cell. 95:591-593. 76. Hofmann, M., Fieber, C., Assmann, V., Gottlicher, M., Sleeman, J., Plug, R., Howells, N., von Stein, O., Ponta, H. and Herrlich, P. (1998) Identification of IHABP, a 95 kDa intracellular hyaluronate binding protein. J Cell Sci. 111:1673-1684. 77. Holmer, E., Lindahl, U., Backstrom, G., Thunberg, L., Sandberg, H., Soderstrom, G. and Anderson, L.O. (1980) Anticoagulant activities and effects on platelets of a heparin fragment with high affinity for antithrombin. Thromb Res. 18:861-869. 78. Honda, A., Noguchi, N., Takehara, H., Ohashi, Y., Asuwa, N. and Mori, Y. (1991) Cooperative enhancement of hyaluronic acid synthesis by combined use of IGF-I and EGF,

51 and inhibition by tyrosine kinase inhibitor genistein, in cultured mesothelial cells from rabbit pericardial cavity. J Cell Sci. 98:91-98. 79. Honda, A., Sekiguchi, Y. and Mori, Y. (1993) Prostaglandin E2 stimulates cyclic AMP- mediated hyaluronan synthesis in rabbit pericardial mesothelial cells. Biochem J. 292:497- 502. 80. Horton, M.R., McKee, C.M., Bao, C., Liao, F., Farber, J.M., Hodge-DuFour, J., Pure, E., Oliver, B.L., Wright, T.M. and Noble, P.W. (1998) Hyaluronan fragments synergize with interferon-gamma to induce the C-X-C chemokines mig and interferon-inducible protein-10 in mouse macrophages. J Biol Chem. 273:35088-35094. 81. Hua, Q., Knudson, C.B. and Knudson, W. (1993) Internalization of hyaluronan by chondrocytes occurs via receptor-mediated endocytosis. J Cell Sci. 106:365-375. 82. Iozzo, R.V. (1998) Matrix proteoglycans: from molecular design to cellular function. Annu Rev Biochem. 67:609-652. 83. Iozzo, R.V. and Murdoch, A.D. (1996) Proteoglycans of the extracellular environment: clues from the gene and protein side offer novel perspectives in molecular diversity and function. Faseb J. 10:598-614. 84. Ishihara, M., Guo, Y., Wei, Z., Yang, Z., Swiedler, S.J., Orellana, A. and Hirschberg, C.B. (1993) Regulation of biosynthesis of the basic fibroblast growth factor binding domains of heparan sulfate by heparan sulfate-N-deacetylase/N-sulfotransferase expression. J Biol Chem. 268:20091-20095. 85. Itano, N. and Kimata, K. (1996) Expression cloning and molecular characterization of HAS protein, a eukaryotic hyaluronan synthase. J Biol Chem. 271:9875-9878. 86. Itano, N., Sawai, T., Yoshida, M., Lenas, P., Yamada, Y., Imagawa, M., Shinomura, T., Hamaguchi, M., Yoshida, Y., Ohnuki, Y., Miyauchi, S., Spicer, A.P., McDonald, J.A. and Kimata, K. (1999) Three isoforms of mammalian hyaluronan synthases have distinct enzymatic properties. J Biol Chem. 274:25085-25092. 87. Jackson, D.G., Buckley, J. and Bell, J.I. (1992) Multiple variants of the human lymphocyte homing receptor CD44 generated by insertions at a single site in the extracellular domain. J Biol Chem. 267:4732-4739. 88. Jakoby, W.B. (1994) Detoxication: Conjugation and Hydrolysis. In "The Liver: Biology and Pathobiology". Arias, I.M., Boyer, J.L., Fausto, N., Jakoby, W.B., Schachter, D.A. and Shafritz, D.A., editors. Raven Press Ltd, New York. 429-440. 89. Jalkanen, S. and Jalkanen, M. (1992) Lymphocyte CD44 binds the COOH-terminal heparin- binding domain of fibronectin. J Cell Biol. 116:817-825.

52 90. Jenniskens, G.J., Oosterhof, A., Brandwijk, R., Veerkamp, J.H. and van Kuppevelt, T.H. (2000) Heparan sulfate heterogeneity in skeletal muscle basal lamina: demonstration by phage display-derived antibodies. J Neurosci. 20:4099-4111. 91. Kalomiris, E.L. and Bourguignon, L.Y. (1988) Mouse T lymphoma cells contain a transmembrane glycoprotein (GP85) that binds ankyrin. J Cell Biol. 106:319-327. 92. Katoh, S., Zheng, Z., Oritani, K., Shimozato, T. and Kincade, P.W. (1995) Glycosylation of CD44 negatively regulates its recognition of hyaluronan. J Exp Med. 182:419-429. 93. Kearns, A.E., Vertel, B.M. and Schwartz, N.B. (1993) Topography of glycosylation and UDP-xylose production. J Biol Chem. 268:11097-11104. 94. Kimura, J.H., Hardingham, T.E., Hascall, V.C. and Solursh, M. (1979) Biosynthesis of proteoglycans and their assembly into aggregates in cultures of chondrocytes from the Swarm rat chondrosarcoma. J Biol Chem. 254:2600-2609. 95. Kincade, P.W., Zheng, Z., Katoh, S. and Hanson, L. (1997) The importance of cellular environment to function of the CD44 matrix receptor. Curr Opin Cell Biol. 9:635-642. 96. Kjellen, L. and Lindahl, U. (1991) Proteoglycans: structures and interactions. Annu Rev Biochem. 60:443-475. 97. Knudson, C.B. and Knudson, W. (1993) Hyaluronan-binding proteins in development, tissue homeostasis, and disease. Faseb J. 7:1233-1241. 98. Knudson, W., Bartnik, E. and Knudson, C.B. (1993) Assembly of pericellular matrices by COS-7 cells transfected with CD44 lymphocyte-homing receptor genes. Proc Natl Acad Sci U S A. 90:4003-4007. 99. Knudson, W. and Knudson, C.B. (1991) Assembly of a chondrocyte-like pericellular matrix on non-chondrogenic cells. Role of the cell surface hyaluronan receptors in the assembly of a pericellular matrix. J Cell Sci. 99:227-235. 100. Kohda, D., Morton, C.J., Parkar, A.A., Hatanaka, H., Inagaki, F.M., Campbell, I.D. and Day, A.J. (1996) Solution structure of the link module: a hyaluronan-binding domain involved in extracellular matrix stability and cell migration. Cell. 86:767-775. 101. Kok, K., Osinga, J., Carritt, B., Davis, M.B., van der Hout, A.H., van der Veen, A.Y., Landsvater, R.M., de Leij, L.F., Berendsen, H.H., Postmus, P.E. and et al. (1987) Deletion of a DNA sequence at the chromosomal region 3p21 in all major types of lung cancer. Nature. 330:578-581. 102. Kreil, G. (1995) Hyaluronidases--a group of neglected enzymes. Protein Sci. 4:1666-1669. 103. Landolt, R.M., Vaughan, L., Winterhalter, K.H. and Zimmermann, D.R. (1995) Versican is selectively expressed in embryonic tissues that act as barriers to neural crest cell migration and axon outgrowth. Development. 121:2303-2312.

53 104. Landstein, D., Graves, M.V., Burbank, D.E., DeAngelis, P. and Van Etten, J.L. (1998) Chlorella virus PBCV-1 encodes functional glutamine: fructose-6-phosphate amidotransferase and UDP-glucose dehydrogenase enzymes. Virology. 250:388-396. 105. Lauffenburger, D.A. and Horwitz, A.F. (1996) Cell migration: a physically integrated molecular process. Cell. 84:359-369. 106. Laurent, T.C. and Fraser, J.R. (1992) Hyaluronan. Faseb J. 6:2397-2404. 107. Laurent, T.C., Fraser, J.R., Pertoft, H. and Smedsrod, B. (1986) Binding of hyaluronate and chondroitin sulphate to liver endothelial cells. Biochem J. 234:653-658. 108. Laurent, T.C. and Fraser, J.R.E. (1991) Catabolism of Hyaluronan. In "Degradation of Bioactive Substances: Physiology and Pathology". Henriksen, J.H., editor. CRC Press, Boca Raton. 249-265. 109. LeBaron, R.G., Zimmermann, D.R. and Ruoslahti, E. (1992) Hyaluronate binding properties of versican. J Biol Chem. 267:10003-10010. 110. Lepperdinger, G., Strobl, B. and Kreil, G. (1998) HYAL2, a human gene expressed in many cells, encodes a lysosomal hyaluronidase with a novel type of specificity. J Biol Chem. 273:22466-22470. 111. Lesley, J., He, Q., Miyake, K., Hamann, A., Hyman, R. and Kincade, P.W. (1992) Requirements for hyaluronic acid binding by CD44: a role for the cytoplasmic domain and activation by antibody. J Exp Med. 175:257-266. 112. Lesley, J. and Hyman, R. (1998) CD44 structure and function [In Process Citation]. Front Biosci. 3:D616-630. 113. Lesley, J., Hyman, R. and Kincade, P.W. (1993) CD44 and its interaction with extracellular matrix. Adv Immunol. 54:271-335. 114. Lin, Y., Mahan, K., Lathrop, W.F., Myles, D.G. and Primakoff, P. (1994) A hyaluronidase activity of the sperm plasma membrane protein PH-20 enables sperm to penetrate the cumulus cell layer surrounding the egg. J Cell Biol. 125:1157-1163. 115. Lindahl, U., Kusche-Gullberg, M. and Kjellen, L. (1998) Regulated diversity of heparan sulfate. J Biol Chem. 273:24979-24982. 116. Liu, D. and Sy, M.S. (1997) Phorbol myristate acetate stimulates the dimerization of CD44 involving a cysteine in the transmembrane domain. J Immunol. 159:2702-2711. 117. Lloyd, J.B. (1996) Metabolite efflux and influx across the lysosome membrane. Subcell Biochem. 27:361-386. 118. Maiti, A., Maki, G. and Johnson, P. (1998) TNF-alpha induction of CD44-mediated leukocyte adhesion by sulfation. Science. 282:941-943.

54 119. Markovitz, A., Cifonelli, J.A. and Dorfman, A. (1959) The biosynthesis of HA by group A Streptococcus. VI. Biosynthesis from uridine nucleotides in cell-free extracts. J Biol Chem. 234:2343-2350. 120. McCourt, P.A., Smedsrod, B.H., Melkko, J. and Johansson, S. (1999) Characterization of a hyaluronan receptor on rat sinusoidal liver endothelial cells and its functional relationship to scavenger receptors. Hepatology. 30:1276-1286. 121. McKee, C.M., Lowenstein, C.J., Horton, M.R., Wu, J., Bao, C., Chin, B.Y., Choi, A.M. and Noble, P.W. (1997) Hyaluronan fragments induce nitric-oxide synthase in murine macrophages through a nuclear factor kappaB-dependent mechanism. J Biol Chem. 272:8013-8018. 122. Meyer, F.A. (1983) Macromolecular basis of globular protein exclusion and of swelling pressure in loose connective tissue (umbilical cord). Biochim Biophys Acta. 755:388-399. 123. Meyer, K. and Palmer, J.W. (1934) The polysaccharide of the vitreous humor. J Biol Chem. 107:629-634. 124. Meyer, M.F. and Kreil, G. (1996) Cells expressing the DG42 gene from early Xenopus embryos synthesize hyaluronan. Proc Natl Acad Sci U S A. 93:4543-4547. 125. Mian, N. (1986) Characterization of a high-Mr plasma-membrane-bound protein and assessment of its role as a constituent of hyaluronate synthase complex. Biochem J. 237:343- 357. 126. Milev, P., Maurel, P., Haring, M., Margolis, R.K. and Margolis, R.U. (1996) TAG-1/axonin-1 is a high-affinity ligand of neurocan, phosphacan/protein-tyrosine phosphatase-zeta/beta, and N-CAM. J Biol Chem. 271:15716-15723. 127. Milla, M.E., Clairmont, C.A. and Hirschberg, C.B. (1992) Reconstitution into proteoliposomes and partial purification of the Golgi apparatus membrane UDP-galactose, UDP-xylose, and UDP-glucuronic acid transport activities. J Biol Chem. 267:103-107. 128. Milla, M.E. and Hirschberg, C.B. (1989) Reconstitution of Golgi vesicle CMP-sialic acid and adenosine 3'-phosphate 5'-phosphosulfate transport into proteoliposomes. Proc Natl Acad Sci U S A. 86:1786-1790. 129. Moll, J., Khaldoyanidi, S., Sleeman, J.P., Achtnich, M., Preuss, I., Ponta, H. and Herrlich, P. (1998) Two different functions for CD44 proteins in human myelopoiesis. J Clin Invest. 102:1024-1034. 130. Neame, S.J. and Isacke, C.M. (1992) Phosphorylation of CD44 in vivo requires both Ser323 and Ser325, but does not regulate membrane localization or cytoskeletal interaction in epithelial cells. Embo J. 11:4733-4738.

55 131. Neame, S.J. and Isacke, C.M. (1993) The cytoplasmic tail of CD44 is required for basolateral localization in epithelial MDCK cells but does not mediate association with the detergent- insoluble cytoskeleton of fibroblasts. J Cell Biol. 121:1299-1310. 132. Neufeld, E. and Hall, C. (1965) Inhibition of UDP-D-glucos dehydrogenase by UDP-D- xylose. Biochem Biophys Res Commun. 19:456-461. 133. Ng, K.F. and Schwartz, N.B. (1989) Solubilization and partial purification of hyaluronate synthetase from oligodendroglioma cells. J Biol Chem. 264:11776-11783. 134. Ohashi, Y., Honda, A., Iwai, T. and Mori, Y. (1988) Stimulatory effect of vanadate on hyaluronic acid synthesis in mesothelial cells from rabbit pericardium. Biochem Int. 16:293- 302. 135. Orkin, R.W. and Toole, B.P. (1978) Hyaluronidase activity and hyaluronate content of the developing chick embryo heart. Dev Biol. 66:308-320. 136. Parkar, A.A. and Day, A.J. (1997) Overlapping sites on the Link module of human TSG-6 mediate binding to hyaluronan and chrondroitin-4-sulphate. FEBS Lett. 410:413-417. 137. Peach, R.J., Hollenbaugh, D., Stamenkovic, I. and Aruffo, A. (1993) Identification of hyaluronic acid binding sites in the extracellular domain of CD44. J Cell Biol. 122:257-264. 138. Peck, D. and Isacke, C.M. (1996) CD44 phosphorylation regulates melanoma cell and fibroblast migration on, but not attachment to, a hyaluronan substratum. Curr Biol. 6:884-890. 139. Perozich, J., Leksana, A. and Hempel, J. (1995) UDP-glucose dehydrogenase. Structural characteristics. Adv Exp Med Biol. 372:79-84. 140. Perris, R. and Johansson, S. (1990) Inhibition of neural crest cell migration by aggregating chondroitin sulfate proteoglycans is mediated by their hyaluronan-binding region. Dev Biol. 137:1-12. 141. Perris, R., Perissinotto, D., Pettway, Z., Bronner-Fraser, M., Morgelin, M. and Kimata, K. (1996) Inhibitory effects of PG-H/aggrecan and PG-M/versican on avian neural crest cell migration. Faseb J. 10:293-301. 142. Philipson, L.H. and Schwartz, N.B. (1984) Subcellular localization of hyaluronate synthetase in oligodendroglioma cells. J Biol Chem. 259:5017-5023. 143. Piek, E., Heldin, C.H. and Ten Dijke, P. (1999) Specificity, diversity, and regulation in TGF- beta superfamily signaling. Faseb J. 13:2105-2124. 144. Prehm, P. (1983) Synthesis of hyaluronate in differentiated teratocarcinoma cells. Characterization of the synthase. Biochem J. 211:181-189. 145. Prehm, P. (1983) Synthesis of hyaluronate in differentiated teratocarcinoma cells. Mechanism of chain growth. Biochem J. 211:191-198.

56 146. Prehm, P. (1989) Identification and regulation of the eukaryotic hyaluronate synthase. In "The Biology of Hyaluronan". Vol. 143. Evered, D. and Whelan, J., editors. Wiley, Chichester. 21-31. 147. Pummill, P.E., Achyuthan, A.M. and DeAngelis, P.L. (1998) Enzymological characterization of recombinant xenopus DG42, a vertebrate hyaluronan synthase. J Biol Chem. 273:4976- 4981. 148. Rahmanian, M., Pertoft, H., Kanda, S., Christofferson, R., Claesson-Welsh, L. and Heldin, P. (1997) Hyaluronan oligosaccharides induce tube formation of a brain endothelial cell line in vitro. Exp Cell Res. 237:223-230. 149. Rapraeger, A.C., Krufka, A. and Olwin, B.B. (1991) Requirement of heparan sulfate for bFGF-mediated fibroblast growth and myoblast differentiation. Science. 252:1705-1708. 150. Rauch, U., Karthikeyan, L., Maurel, P., Margolis, R.U. and Margolis, R.K. (1992) Cloning and primary structure of neurocan, a developmentally regulated, aggregating chondroitin sulfate proteoglycan of brain. J Biol Chem. 267:19536-19547. 151. Reed, R.K., Laurent, U.B., Fraser, J.R. and Laurent, T.C. (1990) Removal rate of [3H]hyaluronan injected subcutaneously in rabbits. Am J Physiol. 259:H532-535. 152. Reed, R.K., Lilja, K. and Laurent, T.C. (1988) Hyaluronan in the rat with special reference to the skin. Acta Physiol Scand. 134:405-411. 153. Ripellino, J.A., Bailo, M., Margolis, R.U. and Margolis, R.K. (1988) Light and electron microscopic studies on the localization of hyaluronic acid in developing rat cerebellum. J Cell Biol. 106:845-855. 154. Robertson, D., Beech, I. and Bolwell, G.P. (1995) Regulation of the Enzymes of UDP-sugar Metabolism during Differentiation of French Bean. Phytochemistry. 39:21-28. 155. Robyt, J.F., Kimble, B.K. and Walseth, T.F. (1974) The mechanism of dextransucrase action. Direction of dextran biosynthesis. Arch Biochem Biophys. 165:634-640. 156. Roden, L., Koerner, T., Olson, C. and Schwartz, N.B. (1985) Mechanisms of chain initiation in the biosynthesis of connective tissue polysaccharides. Fed Proc. 44:373-380. 157. Rome, L.H. and Hill, D.F. (1986) Lysosomal degradation of glycoproteins and glycosaminoglycans. Efflux and recycling of sulphate and N-acetylhexosamines. Biochem J. 235:707-713. 158. Rooney, P., Kumar, S., Ponting, J. and Wang, M. (1995) The role of hyaluronan in tumour neovascularization (review). Int J Cancer. 60:632-636. 159. Ruoslahti, E. and Yamaguchi, Y. (1991) Proteoglycans as modulators of growth factor activities. Cell. 64:867-869. 160. Sainio, M., Zhao, F., Heiska, L., Turunen, O., den Bakker, M., Zwarthoff, E., Lutchman, M., Rouleau, G.A., Jaaskelainen, J., Vaheri, A. and Carpen, O. (1997) Neurofibromatosis

57 2 tumor suppressor protein colocalizes with ezrin and CD44 and associates with actin- containing cytoskeleton. J Cell Sci. 110:2249-2260. 161. Salmivirta, M., Lidholt, K. and Lindahl, U. (1996) Heparan sulfate: a piece of information. Faseb J. 10:1270-1279. 162. Salustri, A., Yanagishita, M. and Hascall, V.C. (1990) Mouse oocytes regulate hyaluronic acid synthesis and mucification by FSH-stimulated cumulus cells. Dev Biol. 138:26-32. 163. Salustri, A., Yanagishita, M., Underhill, C.B., Laurent, T.C. and Hascall, V.C. (1992) Localization and synthesis of hyaluronic acid in the cumulus cells and mural granulosa cells of the preovulatory follicle. Dev Biol. 151:541-551. 164. Sargent, T.D. and Dawid, I.B. (1983) Differential gene expression in the gastrula of Xenopus laevis. Science. 222:135-139. 165. Scott, J.E. (1989) Secondary structures in hyaluronan solutions: chemical and biological implications. In "The Biology of Hyaluronan". Vol. 143. Evered, D. and Whelan, J., editors. Wiley, Chichester. 6-20. 166. Scott, J.E., Cummings, C., Brass, A. and Chen, Y. (1991) Secondary and tertiary structures of hyaluronan in aqueous solution, investigated by rotary shadowing-electron microscopy and computer simulation. Hyaluronan is a very efficient network-forming polymer. Biochem J. 274:699-705. 167. Scott, J.E. and Heatley, F. (1999) Hyaluronan forms specific stable tertiary structures in aqueous solution: a 13C NMR study. Proc Natl Acad Sci U S A. 96:4850-4855. 168. Seidenbecher, C.I., Richter, K., Rauch, U., Fassler, R., Garner, C.C. and Gundelfinger, E.D. (1995) Brevican, a chondroitin sulfate proteoglycan of rat brain, occurs as secreted and cell surface glycosylphosphatidylinositol-anchored isoforms. J Biol Chem. 270:27206-27212. 169. Semino, C.E., Specht, C.A., Raimondi, A. and Robbins, P.W. (1996) Homologs of the Xenopus developmental gene DG42 are present in zebrafish and mouse and are involved in the synthesis of Nod-like chitin oligosaccharides during early embryogenesis. Proc Natl Acad Sci U S A. 93:4548-4553. 170. Sheetz, M.P., Felsenfeld, D.P. and Galbraith, C.G. (1998) Cell migration: regulation of force on extracellular-matrix-integrin complexes. Trends Cell Biol. 8:51-54. 171. Sherman, L., Sleeman, J., Herrlich, P. and Ponta, H. (1994) Hyaluronate receptors: key players in growth, differentiation, migration and tumor progression. Curr. Opin. Cell Biol. 6:726-733. 172. Shyjan, A.M., Heldin, P., Butcher, E.C., Yoshino, T. and Briskin, M.J. (1996) Functional cloning of the cDNA for a human hyaluronan synthase. J Biol Chem. 271:23395-23399.

58 173. Sleeman, J., Rudy, W., Hofmann, M., Moll, J., Herrlich, P. and Ponta, H. (1996) Regulated clustering of variant CD44 proteins increases their hyaluronate binding capacity. J Cell Biol. 135:1139-1150. 174. Sleeman, J.P., Kondo, K., Moll, J., Ponta, H. and Herrlich, P. (1997) Variant exons v6 and v7 together expand the repertoire of glycosaminoglycans bound by CD44. J Biol Chem. 272:31837-31844. 175. Smaglik, P. and Butler, D. (2000) Celera turns to public genome data to speed up endgame. Nature. 403:119. 176. Sommarin, Y. and Heinegard, D. (1983) Specific interaction between cartilage proteoglycans and hyaluronic acid at the chondrocyte cell surface. Biochem J. 214:777-784. 177. Spicer, A.P., Augustine, M.L. and McDonald, J.A. (1996) Molecular cloning and characterization of a putative mouse hyaluronan synthase. J Biol Chem. 271:23400-23406. 178. Spicer, A.P., Camenisch, T., Nguyen, T., Haudenschild, D. and McDonald, J. (1999) Hyaluronan biosynthesis and function in vertebrates. Conference abstract in "Glyco XV", Tokyo, Japan. 179. Spicer, A.P., Kaback, L.A., Smith, T.J. and Seldin, M.F. (1998) Molecular cloning and characterization of the human and mouse UDP- glucose dehydrogenase genes. J Biol Chem. 273:25117-25124. 180. Spicer, A.P. and McDonald, J.A. (1998) Characterization and molecular evolution of a vertebrate hyaluronan synthase gene family. J Biol Chem. 273:1923-1932. 181. Spicer, A.P. and Nguyen, T.K. (1999) Mammalian hyaluronan synthases: investigation of functional relationships in vivo. Biochem Soc Trans. 27:109-115. 182. Spicer, A.P., Olson, J.S. and McDonald, J.A. (1997) Molecular cloning and characterization of a cDNA encoding the third putative mammalian hyaluronan synthase. J Biol Chem. 272:8957-8961. 183. Spicer, A.P., Seldin, M.F., Olsen, A.S., Brown, N., Wells, D.E., Doggett, N.A., Itano, N., Kimata, K., Inazawa, J. and McDonald, J.A. (1997) Chromosomal localization of the human and mouse hyaluronan synthase genes. Genomics. 41:493-497. 184. Stern, R. and Csoka, A. (2000) Mammalian Hyaluronidases. Glycoforum Website "Science of Hyaluronan Today" . 185. Stoolmiller, A.C. and Dorfman, A. (1969) The biosynthesis of hyaluronic acid by Streptococcus. J Biol Chem. 244:236-246. 186. Suzuki, M., Asplund, T., Yamashita, H., Heldin, C.-H. and Heldin, P. (1995) Stimulation of hyaluronan biosynthesis by platelet-derived growth factor-BB and transforming growth factor-β1 involves activation of protein kinase C. Biochem J. 307:817-821.

59 187. Sweeney, C., Mackintosh, D. and Mason, R.M. (1993) UDP-sugar metabolism in Swarm rat chondrosarcoma chondrocytes. Biochem J. 290:563-570. 188. Takahashi, K., Stamenkovic, I., Cutler, M., Dasgupta, A. and Tanabe, K.K. (1996) Keratan sulfate modification of CD44 modulates adhesion to hyaluronate. J Biol Chem. 271:9490- 9496. 189. Tammi, R., MacCallum, D., Hascall, V.C., Pienimaki, J.P., Hyttinen, M. and Tammi, M. (1998) Hyaluronan bound to CD44 on keratinocytes is displaced by hyaluronan decasaccharides and not hexasaccharides. J Biol Chem. 273:28878-28888. 190. Teder, P., Nettelbladt, O. and Heldin, P. (1995) Characterization of the mechanism involved in bleomycin-induced increased hyaluronan production in rat lung. Am J Respir Cell Mol Biol. 12:181-189. 191. Tengblad, A., Laurent, U.B., Lilja, K., Cahill, R.N., Engstrom-Laurent, A., Fraser, J.R., Hansson, H.E. and Laurent, T.C. (1986) Concentration and relative molecular mass of hyaluronate in lymph and blood. Biochem J. 236:521-525. 192. Tenhaken, K. and Thulke, O. (1996) Cloning of an enzyme that synthesize a key nucleotide- sugar precursor of hemicellulose biosynthesis from soybean: UDP-glucose dehydrogenase. Plant Phys. 112:1127-1134. 193. Thiebot, B., Bichoualne, L., Langris, M., Bonnamy, P.J., Barbey, P., Carreau, S. and Bocquet, J. (1997) IGF-1 stimulates synthesis of undersulfated proteoglycans and of hyaluronic acid by peritubular cells from immature rat testis. Biochim Biophys Acta. 1358:127-141. 194. Thomas, L., Byers, H.R., Vink, J. and Stamenkovic, I. (1992) CD44H regulates tumor cell migration on hyaluronate-coated substrate. J Cell Biol. 118:971-977. 195. Tiedemann, K., Malmstrom, A. and Westergren-Thorsson, G. (1997) Cytokine regulation of proteoglycan production in fibroblasts: separate and synergistic effects. Matrix Biol. 15:469- 478. 196. Tirone, E., D'Alessandris, C., Hascall, V.C., Siracusa, G. and Salustri, A. (1997) Hyaluronan synthesis by mouse cumulus cells is regulated by interactions between follicle-stimulating hormone (or epidermal growth factor) and a soluble oocyte factor (or transforming growth factor beta1). J Biol Chem. 272:4787-4794. 197. Tlapak-Simmons, V., Baggenstoss, B.A., Clyne, T. and Weigel, P. (1999) Purification and lipid dependence of the recombinant hyaluronan synthases from Streptococcus pyogenes and streptococcus equisimilis. J Biol Chem. 274:4239-4245. 198. Tlapak-Simmons, V.L., Baggenstoss, B.A., Kumari, K., Heldermon, C. and Weigel, P.H. (1999) Kinetic characterization of the recombinant hyaluronan synthases from Streptococcus pyogenes and Streptococcus equisimilis. J Biol Chem. 274:4246-4253.

60 199. Tlapak-Simmons, V.L., Kempner, E.S., Baggenstoss, B.A. and Weigel, P.H. (1998) The active streptococcal hyaluronan synthases (HASs) contain a single HAS monomer and multiple cardiolipin molecules. J Biol Chem. 273:26100-26109. 200. Tolg, C., Hofmann, M., Herrlich, P. and Ponta, H. (1993) Splicing choice from ten variant exons establishes CD44 variability. Nucleic Acids Res. 21:1225-1229. 201. Toma, L., Pinhal, M.A., Dietrich, C.P., Nader, H.B. and Hirschberg, C.B. (1996) Transport of UDP-galactose into the Golgi lumen regulates the biosynthesis of proteoglycans. J Biol Chem. 271:3897-3901. 202. Toole, B.P. (1982) Developmental role of hyaluronate. Connect Tissue Res. 10:93-100. 203. Toole, B.P., Biswas, C. and Gross, J. (1979) Hyaluronate and invasiveness of the rabbit V2 carcinoma. Proc Natl Acad Sci U S A. 76:6299-6303. 204. Toole, B.P. and Trelstad, R.L. (1971) Hyaluronate production and removal during corneal development in the chick. Dev Biol. 26:28-35. 205. Tsifrina, E., Ananyeva, N.M., Hastings, G. and Liau, G. (1999) Identification and characterization of three cDNAs that encode putative novel hyaluronan-binding proteins, including an endothelial cell-specific hyaluronan receptor. Am J Pathol. 155:1625-1633. 206. Tsukita, S., Oishi, K., Sato, N., Sagara, J. and Kawai, A. (1994) ERM family members as molecular linkers between the cell surface glycoprotein CD44 and actin-based cytoskeletons. J Cell Biol. 126:391-401. 207. Turley, E.A., Austen, L., Vandeligt, K. and Clary, C. (1991) Hyaluronan and a cell-associated hyaluronan binding protein regulate the locomotion of ras-transformed cells. J Cell Biol. 112:1041-1047. 208. Uff, C.R., Neame, S.J. and Isacke, C.M. (1995) Hyaluronan binding by CD44 is regulated by a phosphorylation-independent mechanism. Eur J Immunol. 25:1883-1887. 209. Ujita, M., Shinomura, T., Ito, K., Kitagawa, Y. and Kimata, K. (1994) Expression and binding activity of the carboxyl-terminal portion of the core protein of PG-M, a large chondroitin sulfate proteoglycan. J Biol Chem. 269:27603-27609. 210. Underhill, C.B., Chi-Rosso, G. and Toole, B.P. (1983) Effects of detergent solubilization on the hyaluronate-binding protein from membranes of simian virus 40-transformed 3T3 cells. J Biol Chem. 258:8086-8091. 211. van de Rijn, I. and Drake, R.R. (1992) Analysis of the streptococcal hyaluronic acid synthase complex using the photoaffinity probe 5-azido-UDP-glucuronic acid. J Biol Chem. 267:24302-24306. 212. van Kuppevelt, T.H., Dennissen, M.A., van Venrooij, W.J., Hoet, R.M. and Veerkamp, J.H. (1998) Generation and application of type-specific anti-heparan sulfate antibodies using

61 phage display technology. Further evidence for heparan sulfate heterogeneity in the kidney. J Biol Chem. 273:12960-12966. 213. Varki, A. (1996) Does DG42 synthesize hyaluronan or chitin?: A controversy about oligosaccharides in vertebrate development. Proc Natl Acad Sci U S A. 93:4523-4525. 214. Varki, A. (1998) Factors controlling the glycosylation potential of the Golgi apparatus. Trends Cell Biol. 8:34-40. 215. Vertel, B.M., Walters, L.M., Flay, N., Kearns, A.E. and Schwartz, N.B. (1993) Xylosylation is an endoplasmic reticulum to Golgi event. J Biol Chem. 268:11105-11112. 216. von Andrian, U.H., Hasslen, S.R., Nelson, R.D., Erlandsen, S.L. and Butcher, E.C. (1995) A central role for microvillous receptor presentation in leukocyte adhesion under flow. Cell. 82:989-999. 217. Wang, C., Entwistle, J., Hou, G., Li, Q. and Turley, E.A. (1996) The characterization of a human RHAMM cDNA: conservation of the hyaluronan-binding domains. Gene. 174:299- 306. 218. Watanabe, E., Aono, S., Matsui, F., Yamada, Y., Naruse, I. and Oohira, A. (1995) Distribution of a brain-specific proteoglycan, neurocan, and the corresponding mRNA during the formation of barrels in the rat somatosensory cortex. Eur J Neurosci. 7:547-554. 219. Watanabe, K. and Yamaguchi, Y. (1996) Molecular identification of a putative human hyaluronan synthase. J Biol Chem. 271:22945-22948. 220. Weigel, P.H., Hascall, V.C. and Tammi, M. (1997) Hyaluronan synthases. J Biol Chem. 272:13997-14000. 221. West, D.C., Hampson, I.N., Arnold, F. and Kumar, S. (1985) Angiogenesis induced by degradation products of hyaluronic acid. Science. 228:1324-1326. 222. Yamada, H., Fredette, B., Shitara, K., Hagihara, K., Miura, R., Ranscht, B., Stallcup, W.B. and Yamaguchi, Y. (1997) The brain chondroitin sulfate proteoglycan brevican associates with astrocytes ensheathing cerebellar glomeruli and inhibits neurite outgrowth from granule neurons. J Neurosci. 17:7784-7795. 223. Yamada, Y., Itano, N., Zako, M., Yoshida, M., Lenas, P., Niimi, A., Ueda, M. and Kimata, K. (1998) The gene structure and promoter sequence of mouse hyaluronan synthase 1. Biochem J. 330:1223-1227. 224. Yamaguchi, Y. (1996) Brevican: a major proteoglycan in adult brain. Perspect Dev Neurobiol. 3:307-317. 225. Yang, B., Yang, B.L., Savani, R.C. and Turley, E.A. (1994) Identification of a common hyaluronan binding motif in the hyaluronan binding proteins RHAMM, CD44 and link protein. Embo J. 13:286-296.

62 226. Yang, B., Zhang, L. and Turley, E.A. (1993) Identification of two hyaluronan-binding domains in the hyaluronan receptor RHAMM. J Biol Chem. 268:8617-8623. 227. Yannariello-Brown, J., Frost, S.J. and Weigel, P.H. (1992) Identification of the Ca(2+)- independent endocytic hyaluronan receptor in rat liver sinusoidal endothelial cells using a photoaffinity cross-linking reagent. J Biol Chem. 267:20451-20456. 228. Yayon, A., Klagsbrun, M., Esko, J.D., Leder, P. and Ornitz, D.M. (1991) Cell surface, heparin-like molecules are required for binding of basic fibroblast growth factor to its high affinity receptor. Cell. 64:841-848. 229. Yoshida, M., Itano, N., Yamada, Y. and Kimata, K. (2000) In vitro synthesis of hyaluronan by a single protein derived from mouse HAS1 gene and characterization of amino acid residues essential for the activity. J Biol Chem. 275:497-506. 230. Ysart, G.E. and Mason, R.M. (1994) Serum factors, growth factors and UDP-sugar metabolism in bovine articular cartilage chondrocytes. Biochem J. 303:713-721. 231. Zhang, L., David, G. and Esko, J.D. (1995) Repetitive Ser-Gly sequences enhance heparan sulfate assembly in proteoglycans. J Biol Chem. 270:27127-27135. 232. Zhang, L. and Esko, J.D. (1994) Amino acid determinants that drive heparan sulfate assembly in a proteoglycan. J Biol Chem. 269:19295-19299. 233. Zhang, S., Chang, M.C., Zylka, D., Turley, S., Harrison, R. and Turley, E.A. (1998) The hyaluronan receptor RHAMM regulates extracellular-regulated kinase. J Biol Chem. 273:11342-11348. 234. Zhao, M., Yoneda, M., Ohashi, Y., Kurono, S., Iwata, H., Ohnuki, Y. and Kimata, K. (1995) Evidence for the covalent binding of SHAP, heavy chains of inter-alpha-trypsin inhibitor, to hyaluronan. J Biol Chem. 270:26657-26663. 235. Zheng, Z., Cummings, R.D., Pummill, P.E. and Kincade, P.W. (1997) Growth as a solid tumor or reduced glucose concentrations in culture reversibly induce CD44-mediated hyaluronan recognition by Chinese hamster ovary cells. J Clin Invest. 100:1217-1229. 236. Zhou, B., Oka, J.A., Singh, A. and Weigel, P.H. (1999) Purification and subunit characterization of the rat liver endocytic hyaluronan receptor. J Biol Chem. 274:33831- 33834. 237. Zoller, M. (1995) CD44: physiological expression of distinct isoforms as evidence for organ- specific metastasis formation. J Mol Med. 73:425-438.