Involvement of the Na+/H+ exchanger in membrane phosphatidylserine exposure during human platelet activation.

Platelet membrane phosphatidylserine (PS) exposure that regulates the production of thrombin represents an important link between platelet activation and the coagulation cascade. Here, we have evaluated the involvement of the Na+/H+ exchanger (NHE) in this process in human platelets. PS exposure induced in human platelets by thrombin, TRAP, collagen or TRAP+ collagen was abolished in a Na+ -free medium. Inhibition of the Na+/H+ exchanger (NHE) by 5-(N-Ethyl-N-Isopropyl) Amiloride (EIPA) reduced significantly PS exposure, whereas monensin or nigericin, which mimic or cause activation of NHE, respectively, reproduced the agonist effect. These data suggest a role for Na+ influx through NHE activation in the mechanism of PS exposure. This newly identified pathway does not discount a role for Ca2+, whose cytosolic concentration varies together with that of Na+ after agonist stimulation. Ca2+ deprivation from the incubation medium only attenuated PS exposure induced by thrombin, measured from the uptake of FM1-43 (a marker of phospholipid scrambling independent of external Ca2+). Surprisingly, removal of external Ca2+ partially reduced FM1-43 uptake induced by A23187, known as a Ca2+ ionophore. The residual effect can be attributed to an increase in [Na+]i mediated by the ionophore due to a lack of its specificity. Finally, phosphatidylinositol 4,5-bisphosphate (PIP2), previously reported as a target for Ca2+ in the induction of phospholipid scrambling, was involved in PS exposure through a regulation of NHE activity. All these results would indicate that the mechanism that results in PS exposure uses redundant pathways inextricably linked to the physio-pathological requirements of this process.

Signaling pathways involved in glucocorticoid-induced apoptosis of thymocytes.

This review synthesizes recent insights on the signaling pathways triggered by glucocorticoids during apoptosis of thymocytes. Thymocyte apoptosis is a complex process, which is involved in thymic selection. Even if the main partners are identified, there still remain dark zones on the whole pathway and notably on the crosstalk between each signaling cascade. Glucocorticoids trigger thymocyte apoptosis by enhancing cyclin-dependent kinase 2 activity, downregulating the expression of antiapoptotic Bcl-2 proteins, and upregulating that of proapoptotic Bcl-2 proteins. These events result in mitochondrial alterations and subsequent caspase activation. Proteasome intervenes at various levels of the signaling cascades--for instance, degrading the glucocorticoid receptor or caspase inhibitory proteins. Changes in intracellular K+ and Ca2+ concentrations are involved in caspase and endonulease activation. All these effects are dependent on macromolecular synthesis. The only known non-genomic effect of glucocorticoids is an early production of sphingolipids (ceramide and sphingosine), which are involved in caspase activation independent of mitochondrial alterations. Externalization of phosphatidylserine, a process mediating phagocytosis of dying thymocytes, depends on pathways that diverge from those leading to nuclear apoptosis.

Sphingosine contributes to glucocorticoid-induced apoptosis of thymocytes independently of the mitochondrial pathway.

During the selection process in the thymus, most thymocytes are eliminated by apoptosis through signaling via TCR or glucocorticoids. The involvement of ceramide (Cer) and sphingosine (SP), important apoptotic mediators, remains poorly defined in glucocorticoid-induced apoptosis. We report that, in mouse thymocytes, apoptosis triggered by 10(-6) M dexamethasone (DX) was preceded by a caspase-dependent Cer and SP generation, together with activation of acidic and neutral ceramidases. Apoptosis was drastically reduced by blocking either sphingolipid production (by acid sphingomyelinase inhibitor) or SP production (by ceramidase inhibitors), but not by inhibition of de novo Cer synthesis. Thus, SP generated through acid sphingomyelinase and ceramidase activity would contribute to the apoptotic effect of DX. Consistent with this hypothesis, SP addition or inhibition of SP kinase induced thymocyte apoptosis. DX induced a proteasome-dependent loss of mitochondrial membrane potential (Deltapsim) and caspase-8, -3, and -9 processing. Apoptosis was abolished by inhibition of Deltapsim loss or caspase-8 or -3, but not caspase-9. Deltapsim loss was independent of SP production and caspase-8, -3, and -9 activation. However, inhibition of SP production reduced caspase-8 and -3, but not caspase-9 processing. Proteasome inhibition impaired activation of the three caspases, whereas inhibition of Deltapsim loss solely blocked caspase-9 activation. These data indicate that DX-induced apoptosis is mediated in part by SP, which contributes, together with proteasome activity, to caspase-8-3 processing independently of mitochondria, and in part by the proteasome/mitochondria pathway, although independently of caspase-9 activation.

Involvement of sodium in early phosphatidylserine exposure and phospholipid scrambling induced by P2X7 purinoceptor activation in thymocytes.

Extracellular ATP (ATP(ec)), a possible effector in thymocyte selection, induces thymocyte death via purinoceptor activation. We show that ATP(ec) induced cell death by apoptosis, rather than lysis, and early phosphatidylserine (PS) exposure and phospholipid scrambling in a limited thymocyte population (35-40%). PS externalization resulted from the activation of the cationic channel P2X7 (formerly P2Z) receptor and was triggered in all thymocyte subsets although to different proportions in each one. Phospholipid movement was dependent on ATP(ec)-induced Ca(2+) and/or Na(+) influx. At physiological external Na(+) concentration, without external Ca(2+), PS was exposed in all ATP(ec)-responsive cells. In contrast, without external Na(+), physiological external Ca(2+) concentration promoted a submaximal response. Altogether these data show that Na(+) influx plays a major role in the rapid PS exposure induced by P2X7 receptor activation in thymocytes.

Extracellular ATP induces phosphatidylserine externalization earlier than nuclear apoptotic events in thymocytes.

The present study shows for the first time that ATP(ec) induces a very early PS exposure in thymocytes and that this process can be induced in the absence of Ca(2+) influx and caspase activation.

Involvement of sphingosine in dexamethasone-induced thymocyte apoptosis.

It is generally accepted that ceramide plays an essential role in apoptosis. In this study we suggest that in thymocytes, dexamethasone-induced apoptosis is mediated by sphingosine rather than ceramide, through the activation of an aSMase and a cerase in a caspase-dependent manner.

Effect of cyclical intravenous pamidronate therapy in children with osteogenesis imperfecta. Open-label study in seven patients.

OBJECTIVES: To evaluate the efficacy of pamidronate in protecting against fractures, increasing bone mineral density (BMD), and decreasing bone remodeling marker levels in children with osteogenesis imperFecta. PATIENTS AND METHODS: Seven children (two girls and five boys; mean age, 8.5 years) were given cyclical intravenous pamidronate (Aredia) for 1 to 7 years, with a mean cycle duration of 6 months and a mean dose of 1.86 mg/kg/cycle. Four patients had type III and three type IV disease according to the Sillence classification scheme. RESULTS: A trend toward a decrease in the fracture rate as compared to the pretreatment period was found, but the difference was not significant in this small sample (P = 0.09). Lumbar spine BMD showed a significant annual increase (+26.7%, P = 0.03) far greater than the expected mean annual increase related to growth. No significant decreases in bone remodeling markers were noted. CONCLUSION: Pamidronate seems useful in the treatment of osteogenesis imperfecta in children, since it increases BMD and reduces the fracture rate, in keeping with the findings from the larger series studied by Glorieux. Pamidronate is a symptomatic, noncurative treatment that does not correct the genetic abnormalities responsible for the histological bone alterations.