Abnormal body iron distribution and erythropoiesis in a novel mouse model with inducible gain of iron regulatory protein (IRP)-1 function.

Disorders of iron metabolism account for some of the most common human diseases. Cellular iron homeostasis is maintained by iron regulatory proteins (IRP)-1 and 2 through their binding to cis-regulatory iron-responsive elements (IREs) in target mRNAs. Mouse models with IRP deficiency have yielded valuable insights into iron biology, but the physiological consequences of gain of IRP function in mammalian organisms have remained unexplored. Here, we report the generation of a mouse line allowing conditional expression of a constitutively active IRP1 mutant (IRP1) using Cre/Lox technology. Systemic activation of the IRP1 transgene from the Rosa26 locus yields viable animals with gain of IRE-binding activity in all the organs analyzed. IRP1 activation alters the expression of IRP target genes and is accompanied by iron loading in the same organs. Furthermore, mice display macrocytic erythropenia with decreased hematocrit and hemoglobin levels as well as impaired erythroid differentiation. Thus, inappropriately high IRP1 activity causes disturbed body iron distribution and erythropoiesis. This new mouse model further highlights the importance of appropriate IRP regulation in central organs of iron metabolism. Moreover, it opens novel avenues to study diseases associated with abnormally high IRP1 activity, such as Parkinson's disease or Friedreich's ataxia.

Irresistible IRES. Attracting the translation machinery to internal ribosome entry sites.

Studies on the control of eukaryotic translation initiation by a cap-independent recruitment of the 40S ribosomal subunit to internal messenger RNA sequences called internal ribosome entry sites (IRESs) have shown that these sequence elements are present in a growing list of viral and cellular RNAs. Here we discuss their prevalence, mechanisms whereby they may function and their uses in regulating gene expression.

p53 directs conformational change and translation initiation blockade of human fibroblast growth factor 2 mRNA.

Tumour suppressor p53 has been shown to inhibit fibroblast growth factor 2 expression post-transcriptionally in cultured cells. Here we have investigated the mechanism responsible for this post-transcriptional blockade. Deletion mutagenesis of the FGF-2 mRNA leader revealed the requirement of at least four RNA cis-acting elements to mediate the inhibitory effect of p53 in SK-Hep-1 transfected cells, suggesting the involvement of RNA secondary or tertiary structures. Recombinant wild-type, but not Ala(143) mutant p53, was able to specifically repress FGF-2 mRNA translation in rabbit reticulocyte lysate, in a dose dependent manner. Sucrose gradient experiments showed that p53 blocks translation initiation by preventing 80S ribosome formation on an mRNA bearing the FGF-2 mRNA leader sequence. Interaction of wild-type and mutant p53 with different RNAs showed no significant correlation between p53 RNA binding activity and its translational inhibiting effect. However, by checking the accessibility of the FGF-2 mRNA leader to complementary oligonucleotide probes, we showed that the binding to RNA of wild-type, but not mutant p53, induced RNA conformational changes that might be responsible for the translational blockade. This strongly suggests that p53 represses FGF-2 mRNA translation by a direct mechanism involving its nucleic acid unwinding-annealing activity.

Tumour suppressor p53 inhibits human fibroblast growth factor 2 expression by a post-transcriptional mechanism.

Fibroblast growth factor-2 (FGF-2) is a powerful mitogen and angiogenic factor whose expression is strongly regulated at the translational level. The constitutive upregulation of FGF-2 isoforms in transformed cells prompted us to investigate the post-transcriptional effects of a tumour suppressor, p53, on FGF-2 expression. We show here in human primary skin fibroblasts that the cell density-dependent variation of FGF-2 mRNA translatability was inversely correlated with endogenous p53 expression. Transient cell transfection revealed an inhibitory effect of wild-type p53 on the expression of chimeric FGF--CAT proteins. RNAse mapping experiments ruled out any effect of p53 on FGF--CAT mRNA accumulation, suggesting a translational inhibition. This inhibition was mediated by the FGF-2 mRNA leader, but not by vascular endothelial growth factor or platelet derived growth factor mRNA leaders. Neither p53-like protein p73, nor p21/waf had any inhibitory activity. Furthermore a set of hot spot mutants of p53 bearing mutations in the DNA binding domain had no post-transcriptional inhibitory effect. In contrast a p53 mutant of the transactivating domain was still able to block FGF--CAT expression, indicating that the post-transcriptional activity of p53 described here was independent of the trans-activation of target genes. Such data reveal a novel mechanism by which p53 efficiently blocks the expression of a major proliferating, anti-apoptotic and angiogenic gene.

Hepatocellular hypoxia-induced vascular endothelial growth factor expression and angiogenesis in experimental biliary cirrhosis.

We tested the potential role of vascular endothelial growth factor (VEGF) and of fibroblast growth factor-2 (FGF-2) in the angiogenesis associated with experimental liver fibrogenesis induced by common bile duct ligation in Sprague-Dawley rats. In normal rats, VEGF and FGF-2 immunoreactivities were restricted to less than 3% of hepatocytes. One week after bile duct ligation, hypoxia was demonstrated by the immunodetection of pimonidazole adducts unevenly distributed throughout the lobule. After 2 weeks, hypoxia and VEGF expression were detected in >95% of hepatocytes and coexisted with an increase in periportal vascular endothelial cell proliferation, as ascertained by Ki67 immunolabeling. Subsequently, at 3 weeks the density of von Willebrand-labeled vascular section in fibrotic areas significantly increased. Semiquantitative reverse transcription polymerase chain reaction showed that VEGF(120) and VEGF(164) transcripts, that correspond to secreted isoforms, increased within 2 weeks, while VEGF(188) transcripts remained unchanged. FGF-2 mainly consisting of a 22-kd isoform, according to Western blot, was identified by immunohistochemistry in 49% and 100% of hepatocytes at 3 and 7 weeks, respectively. Our data provide evidence that in biliary-type liver fibrogenesis, angiogenesis is stimulated primarily by VEGF in response to hepatocellular hypoxia while FGF-2 likely contributes to the maintenance of angiogenesis at later stages.

Cell transformation results in the loss of the density-dependent translational regulation of the expression of fibroblast growth factor 2 isoforms.

Alternative initiation of translation at three CUG and one AUG start codons leads to the synthesis of four isoforms of fibroblast growth factor 2 (FGF-2) that have distinct intracellular localizations and affect the cell phenotype differently. We show here that the expression of FGF-2 CUG-initiated isoforms decreases in a cell-density-dependent manner in normal human skin fibroblasts (HSFs) concomitantly with the FGF-2 mRNA level. In contrast, CUG-initiated FGF-2 expression is constitutive in SK-HEP-1 cells and in HSFs transformed with SV40 large T antigen. Cell transfection using a plasmid containing the FGF-2 mRNA leader fused to chloramphenicol acetyl transferase demonstrated that up-regulation of the CUG codons depends on cis-elements located in this leader. Furthermore, UV cross-linking experiments revealed a correlation between CUG codons utilization and the binding of several proteins to the mRNA leader. On the basis of the presence of an internal ribosome entry site (IRES) in the FGF-2 mRNA, we used bicistronic vectors to transfect normal and transformed cells. The density-dependent regulation in normal HSFs was cap-dependent, whereas the constitutive CUG-initiated FGF-2 expression in transformed cells occurred essentially by an IRES-dependent mechanism. Unexpectedly, the use of the AUG start codon occurred exclusively by internal entry, which suggests the presence of a second independent IRES in the FGF-2 mRNA that would be constitutive. A study of the eIF-4E levels and of the 4E-BP1 phosphorylation state at increasing cell densities showed a decrease of the eIF-4E level, concomitant with 4E-BP1 dephosphorylation in normal cells but not in transformed cells. These data point out a complex mechanism for the regulation of FGF-2 isoforms expression involving both the cap-dependent and the cap-independent initiation of translation and favor a positive role of CUG-initiated FGF-2 in cellular proliferation and transformation.

Translation of CUG- but not AUG-initiated forms of human fibroblast growth factor 2 is activated in transformed and stressed cells.

Four isoforms of the human fibroblast growth factor 2 (FGF-2), with different intracellular localizations and distinct effects on cell phenotype, result from alternative initiations of translation at three CUG and one AUG start codons. We showed here by Western immunoblotting and immunoprecipitation that the CUG-initiated forms of FGF-2 were synthesized in transformed cells, whereas "normal" cells almost exclusively produced the AUG-initiated form. CUG-initiated FGF-2 was induced in primary skin fibroblasts in response to heat shock and oxidative stress. In transformed cells and in stressed fibroblasts, CUG expression was dependent on cis-elements within the 5' region of FGF-2 mRNA and was not correlated to mRNA level, indicating a translational regulation. UV cross-linking experiments revealed that CUG expression was linked to the binding of several cellular proteins to FGF-2 mRNA 5' region. Since translation of FGF-2 mRNA was previously shown to occur by internal ribosome entry, a nonclassical mechanism already described for picornaviruses, the cross-linking patterns of FGF-2 and picornavirus mRNAs were compared. Comigration of several proteins, including a p60, was observed. However, this p60 was shown to be different from the p57/PTB internal entry factor, suggesting a specificity towards FGF-2 mRNA. We report here a process of translational activation of the FGF-2 CUG-initiated forms in direct relation with trans-acting factors specific to transformed and stressed cells. These data favor a critical role of CUG-initiated FGF-2 in cell transformation and in the stress response.

Inhibition of fibroblast growth factor 2 expression by antisense RNA induced a loss of the transformed phenotype in a human hepatoma cell line.

Fibroblast growth factor 2 (FGF-2 or basic FGF) is associated with the cell-transformed phenotype. To clarify the function of FGF-2 in the malignancy of tumor cells, we designed experiments to express antisense RNA in a hepatoma cell line. Using FGF-2 mRNA, alternative initiations of translation at one AUG and three CUG start codons led to the synthesis of four isoforms. SK-Hep1 cells, which naturally produce the four FGF-2 proteins, were stably transfected with expression vectors that generate antisense RNAs targeted against different sites of human FGF-2 mRNA. A variable decrease of all of the isoforms of FGF-2 synthesis was observed compared with the control: the strongest inhibition was obtained with the smaller antisense targeted against AUG codon. Our results clearly demonstrated that inhibition of FGF-2 expression led to a loss of anchorage independence in soft agar. This effect was not reversed by adding exogenous FGF-2, indicating that an intracrine process of FGF-2 probably is involved in the phenotypic changes of SK-Hep1 cells. Furthermore, the inhibition of FGF-2 synthesis was correlated with a loss of tumorigenicity in nude mice. These results clearly argue for a key role of endogenous FGF-2 in transformation and tumorigenesis of the hepatoma cell line used in this study.

Prevention of transfusion-associated HIV transmission in Kinshasa, Zaire: HIV screening is not enough.

The purpose of this study was to develop a strategy to reduce transfusion-related HIV transmission which went beyond the limits of routine HIV screening of blood donors. Current blood transfusion practices were assessed in 1044 patients for whom staff physicians had requested a transfusion between 5 September and 19 October, 1988. Children under 5 years of age with malaria, and pregnant women with acute anaemia requiring blood transfusion were the two highest risk groups. Many of the transfusions were given without an obvious medical indication; 22.7% (214 out of 955) of the recipients were transfused without prior laboratory tests [haemoglobin (Hb) or haematocrit (Hct)], 7.2% with Hb greater than 6g/100ml or Hct greater than 25% and 16.6% without clinical signs of severe anaemia (pulse less than 100/min without shortness of breath). The data of this study were used to organize a workshop for all the physicians responsible for blood transfusions in Kinshasa and two nearby health zones. A consensus statement on the indications for blood transfusion was developed. Subsequently, transfusion centres adopted this consensus statement instead of previous guidelines.

Human immunodeficiency virus infection among employees in an African hospital.

To define the prevalence and course of human immunodeficiency virus (HIV) infection, we examined prospectively a cohort of 2002 adult hospital workers in Kinshasa, Zaire. From 1984 to 1986 the prevalence of HIV infection increased from 6.4 percent to 8.7 percent. Over the two years there was a cumulative incidence of new HIV infection of 3.2 percent. The prevalence was higher among women (16.9 percent) and men (9.3 percent) under the age of 30 than among women (9.0 percent) and men (6.2 percent) over 30. Prevalence rates were similar among physicians (5.6 percent), laboratory workers (2.9 percent), and clerical workers (7.9 percent), but they were higher among female nurses (11.4 percent) and manual workers (11.8 percent). Despite marked differences in the intensity of nosocomial exposure, female nurses had similar infection rates on the female internal medicine ward (9.9 percent), in pediatrics (10.8 percent), and in the delivery room (10.7 percent). The attributable risk of HIV infection from a transfusion was 5.9 percent. Neither medical injections nor scarification was a risk factor for HIV infection. Of the 101 seropositive asymptomatic employees in the 1984 survey, 16 percent had AIDS-related complex, 3 percent had AIDS, and 12 percent had died of AIDS by 1986. Previous studies have revealed a seroprevalence of 8.4 percent among women attending an antenatal clinic near the hospital in 1984 and 1986, and of 5.8 percent (in 1984) and 6.5 percent (in 1986) among men donating blood at the hospital's blood bank. We conclude that there is a continuing high prevalence of HIV infection among hospital workers in Kinshasa, Zaire, which appears to be representative of that in the community and not nosocomial.

Epidemiology of HIV infection in Africa.

HIV infection in Africa is primarily acquired through heterosexual activity, accounting for up to 80% of cases. Prostitutes and sexually promiscuous individuals are at particularly high risk of acquiring infection via this route. In the general population, women between the ages of 18 and 30 years are at increased risk of transmission. The role of cofactors, particularly concurrent sexually transmitted diseases (STDs), appears to facilitate heterosexual spread. These groups represent opportunities for targeted prevention programs aimed at education, increased condom use, prompt treatment of STDs, and reduction in the number of sexual partners. HIV infection acquired via blood transfusion may account for up to 10% of new cases of HIV infection. Children with malaria and nutritionally induced anemias are at special risk of acquiring infection by this route. Early treatment of malaria, surveillance for and treatment of malnutrition, adoption of rigorous criteria for blood transfusion, and implementation of machine-independent, low cost HIV screening programs in transfusion centers will help prevent these infections. As the epidemiology of HIV infection becomes better understood, other opportunities for technologically appropriate, cost-effective interventions will become available and will facilitate African HIV control and prevention programs.