THE AUTODIGESTION HYPOTHESIS AND RECEPTOR CLEAVAGE IN DIABETES AND HYPERTENSION.

One of the key features of cardiovascular complications, such as hypertension or diabetes, is that they often appear at the same time in the same individual together with other forms of co-morbidities. While clinically a recognized phenomenon, no molecular mechanism for such co-morbidities has received universal acceptance. We propose a new hypothesis that provides a molecular basis for co-morbidities in hypertension due to unchecked proteolytic activity and receptor destruction. Testing of the hypothesis in the spontaneously hypertensive rat reveals an unchecked matrix metalloproteinase and serine protease activity in plasma and on several cardiovascular and parenchymal cells. The elevated proteolytic activity causes extracellular cleavage of multiple receptor types, such that cleavage of one receptor type leads to loss of the function carried out by this receptor. Proteolytic cleavage of the extracellular domain of the ß(2) adrenergic receptor in arteries and arterioles causes vasoconstriction and elevation of the central blood pressure while cleavage of the extracellular domain of the insulin receptor leads to insulin resistance and lack of transmembrane glucose transport. A diverse set of cell dysfunctions in the spontaneously hypertensive rat are accompanied by cleavage of the membrane receptors that are involved in these functions. Chronic inhibition of the unchecked protease activity in the spontaneously hypertensive rat serves to restore the extracellular receptor density and alleviates the corresponding cell dysfunctions. The mild unchecked proteolytic activity in the spontaneously hypertensive rat points towards a chronic autodigestion process as a contributor to the end organ injury encountered in this rat strain. The presence of various soluble receptors, which consist of extracellular fragments of membrane receptors, in the plasma of hypertensive and diabetic patients suggest that the autodigestion process may also be present in man.

Keratinocyte growth factor promotes alveolar epithelial cell DNA repair after H2O2 exposure.

Alveolar epithelial cell (AEC) injury and repair are important in the pathogenesis of oxidant-induced lung damage. Keratinocyte growth factor (KGF) prevents lung damage and mortality in animals exposed to various forms of oxidant stress, but the protective mechanisms are not yet established. Because DNA strand break (DNA-SB) formation is one of the earliest cellular changes that occurs after cells are exposed to an oxidant stress, we determined whether KGF reduces H2O2-induced pulmonary toxicity by attenuating AEC DNA damage. KGF (10-100 ng/ml) decreased H2O2 (0.05-0.5 mM)-induced DNA-SB formation in cultured A549 and rat alveolar type II cells measured by an alkaline unwinding, ethidium bromide fluorometric technique. The protective effects of KGF were independent of alterations in catalase, glutathione (GSH), or the expression of bcl-2 and bax, two protooncogenes known to regulate oxidant-induced apoptosis. Actinomycin D and cycloheximide abrogated protective effects of KGF. Furthermore, protection by KGF was completely blocked by 1) genistein, a tyrosine kinase inhibitor; 2) staurosporine and calphostin C, protein kinase C (PKC) inhibitors; and 3) aphidicolin, butylphenyl dGTP, and 2',3'-dideoxythymidine 5'-triphosphate, inhibitors of DNA polymerase. We conclude that KGF attenuates H2O2-induced DNA-SB formation in cultured AECs by mechanisms that involve tyrosine kinase, PKC, and DNA polymerases. These data suggest that the ability of KGF to protect against oxidant-induced lung injury is partly due to enhanced AEC DNA repair.

Teaching receptive naming of Chinese characters to children with autism by incorporating echolalia.

The facilitative effect of incorporating echolalia on teaching receptive naming of Chinese characters to children with autism was assessed. In Experiment 1, echoing the requested character name prior to the receptive naming task facilitated matching a character to its name. In addition, task performance was consistently maintained only when echolalia preceded the receptive manual response. Positive results from generalization tests suggested that learned responses occurred across various novel conditions. In Experiment 2, we examined the relation between task difficulty and speed of acquisition. All 3 participants achieved 100% correct responding in training, but learning less discriminable characters took more trials than learning more discriminable characters. These results provide support for incorporating echolalia as an educational tool within language instruction for some children with autism.

Nicotinamide as a rapid-acting inhibitor of renal brush-border phosphate transport.

Administration of nicotinamide to rats produces specific dose-dependent inhibition of Na+-dependent phosphate transport across the renal brush-border membrane (BBM) and an increase in urinary excretion of phosphate. The intracellular mechanism of action of nicotinamide is not well established. As a step in this direction, the present studies determined whether nicotinamide was a rapid- or slow-acting regulator of the BBM phosphate transport system. Nicotinamide (0.5 g/kg) inhibited Na+-dependent BBM phosphate transport under conditions when de novo protein synthesis was inhibited by cycloheximide (1.0 mg/kg). Furthermore, the degree of inhibition was not different from that achieved by nicotinamide alone, suggesting that the action of nicotinamide does not require de novo protein synthesis. Studies on the time course of the onset of nicotinamide action revealed inhibition of BBM phosphate transport within 1 h after injection of nicotinamide, even in rats pretreated with cycloheximide. The rapid response to nicotinamide and its independence of de novo protein synthesis characterize nicotinamide as a rapid-acting regulator of the Na+-dependent phosphate transport system in renal BBM.

Nicotinamide and the regulation of renal phosphate transport.

The specific inhibitory action of nicotinamide on renal Pi transport does not require de novo protein synthesis and can be detected within 1 hr, at least in low Pi diet rats. These properties characterize nicotinamide as a rapidly acting regulator of the Pi transport system in the renal BBM (Kempson and Dousa, 1986). The studies with LLC-PK 1 cells strongly suggest that the action of nicotinamide in rats is due to a direct effect on the cells of the proximal tubule. Further studies on the mechanism of action of nicotinamide may lead to an understanding of the intracellular mechanisms that mediate the action of rapidly acting physiological regulators of BBM transport of Pi.

Cycloheximide blocks nicotinamide action on phosphate excretion in thyroparathyroidectomized rats.

Nicotinamide causes marked inhibition of phosphate (Pi) reabsorption in the renal proximal tubule and this can be detected both as a specific decrease in Na+-dependent Pi uptake by isolated brush border membrane (BBM) vesicles and as a marked increase in urinary Pi excretion. In the present study, thyroparathyroidectomized (TPTX) rats were adapted to low-Pi diet and injected with cycloheximide (CHX), an inhibitor of protein synthesis, prior to nicotinamide treatment. Compared to rats that received nicotinamide alone, the pretreatment with CHX did not alter the inhibitory action of nicotinamide on BBM uptake of Pi. However, CHX completely blocked the phosphaturic response. We conclude that, at least in TPTX rats adapted to low-Pi diet, nicotinamide inhibits Pi reabsorption not only in the proximal convoluted tubule but also in other nephron segments such as the pars recta or distal sites. Nicotinamide action on these additional sites is dependent on protein synthesis, in contrast to its action in the proximal convoluted tubule.

Colchicine blocks the action of parathyroid hormone but not nicotinamide on renal phosphate transport.

Nicotinamide, like parathyroid hormone, is a rapidly acting specific inhibitor of Na+-dependent transport of phosphate (Pi) across the brush-border membrane of the proximal tubule of the mammalian kidney. Pretreatment of rats with colchicine (0.7 mg/kg body weight) for 1 h led to a significantly diminished phosphaturic response to parathyroid hormone (synthetic 1-34 fragment, 4 micrograms/kg). In contrast, the same dose of colchicine had no effect on the renal response to nicotinamide (1.0 g/kg), measured both as the change in urinary Pi excretion and as Na+-dependent Pi uptake by isolated brush-border membrane vesicles. These data suggest indirectly that the intracellular mechanism that mediates the inhibitory effects of nicotinamide on renal Pi transport does not require intact microtubules.