Involvement of caspases and transmembrane metalloproteases in sulphur mustard-induced microvesication in adult human skin in organ culture: directions for therapy.

While skin is a major target for sulphur mustard (HD), a therapy to limit HD-induced vesication is currently not available. Since it is supposed that apoptotic cell death and proteolytic digestion of extracellular matrix proteins by metalloproteases are initiating factors for blister formation, we have explored whether inhibition of these processes could prevent HD-induced epidermal-dermal separation using adult human skin in organ culture. Involvement of the caspase and the metalloprotease families was confirmed by the observation that their respective broad spectrum inhibitors, Z-VAD-fmk and GM6001, each suppressed HD-induced microvesication. The lowest effective concentrations were 10 and 100microM, respectively. Using specific inhibitors for caspase-8 (> or =10microM) and caspase-9 (> or =10microM) we learned that HD-induced apoptosis is initiated by the death receptor pathway as well as by the mitochondrial pathway. Remarkably, blocking caspase-8 activity resulted in morphologically better conserved cells than blocking caspase-9 activity. We zoomed in on the role of metalloproteases in HD-induced microvesication by testing the effects of two inhibitors: dec-RVKR-cmk and TAPI-2. Dec-RVKR-cmk is an inhibitor of furin, which activates transmembrane enzymes of the 'a disintegrin and metalloproteinase' (ADAM)-family as well as the membrane-type metalloproteases (MTx-MMP). TAPI-2 specifically inhibits TNFalpha-converting enzyme (TACE/ADAM17), which is involved in pericellular proteolysis. Both inhibitors prevented microvesication at concentrations of > or =500 and > or =20microM, respectively. This confirms that ADAMs and MT-MMPs play a role in HD-induced epidermal-dermal separation, with a particular role for TACE/ADAM17. Since TACE is involved not only in degradation of cell-matrix adhesion structures, but also in ectodomain shedding of ligands for epidermal growth factor receptor (EGFR) and in release of TNFalpha, these results imply TACE-mediated pathways as a new concept in HD toxicity. In conclusion, transmembrane metalloproteases probably form a main target for treatment of blisters in HD casualties. The observation that microvesication in the ex vivo human skin model still could be prevented when the metalloprotease inhibitor GM6001 was applied up to 8h after exposure to HD opens perspectives for non-urgent cure of HD casualties.

Proteomic assessment of sulfur mustard-induced protein adducts and other protein modifications in human epidermal keratinocytes.

Although some toxicological mechanisms of sulfur mustard (HD) have been uncovered, new knowledge will allow for advanced insight in the pathways that lead towards epidermal-dermal separation in skin. In the present investigation, we aimed to survey events that occur at the protein level in human epidermal keratinocytes (HEK) during 24 h after exposure to HD. By using radiolabeled (14)C-HD, it was found that proteins in cultured HEK are significant targets for alkylation by HD. HD-adducted proteins were visualized by two-dimensional gel electrophoresis and analyzed by mass spectrometry. Several type I and II cytokeratins, actin, stratifin (14-3-3sigma) and galectin-7 were identified. These proteins are involved in the maintenance of the cellular cytoskeleton. Their alkylation may cause changes in the cellular architecture and, in direct line with that, be determinative for the onset of vesication. Furthermore, differential proteomic analysis was applied to search for novel features of the cellular response to HD. Partial breakdown of type I cytokeratins K14, K16 and K17 as well as the emergence of new charge variants of the proteins heat shock protein 27 and ribosomal protein P0 were observed. Studies with caspase inhibitors showed that caspase-6 is probably responsible for the breakdown of type I cytokeratins in HEK. The significance of the results is discussed in terms of toxicological relevance and possible clues for therapeutic intervention.