EB2000 SYMPOSIUM REPORT
Lung redox homeostasis: emerging concepts

Marilyn P. Merker1, Bruce R. Pitt2, Augustine M. Choi3, Paul M. Hassoun4, Christopher A. Dawson1, and Aron B. Fisher5

2 Department of Pharmacology, University of Pittsburgh School of Medicine, Pittsburgh 15261; 5 Institute for Environmental Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104; 4 Pulmonary and Critical Care Division, Department of Medicine, New England Medical Center and Tufts University School of Medicine, Boston, Massachusetts 02111; 3 Department of Medicine, Yale University School of Medicine, New Haven, Connecticut 06520; and 1 Departments of Anesthesiology, Pharmacology/Toxicology, and Physiology, Medical College of Wisconsin and Zablocki Veterans Affairs Medical Center, Milwaukee, Wisconsin 53295


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This symposium was organized to present some aspects of current research pertaining to lung redox function. Focuses of the symposium were on roles of pulmonary endothelial NADPH oxidase, xanthine oxidase (XO)/xanthine dehydrogenase (XDH), heme oxygenase (HO), transplasma membrane electron transport (TPMET), and the zinc binding protein metallothionein (MT) in the propagation and/or protection of the lung or other organs from oxidative injury. The presentations were chosen to reflect the roles of both intracellular (metallothionein, XO/XDH, and HO) and plasma membrane (NADPH oxidase, XO/XDH, and unidentified TPMET) redox proteins in these processes. Although the lung endothelium was the predominant cell type under consideration, at least some of the proposed mechanisms operate in or affect other cell types and organs as well.

endothelium; oxidation-reduction; oxidative stress


    INTRODUCTION
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INTRODUCTION
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THIS SYMPOSIUM WAS ORGANIZED to present some aspects of current research pertaining to lung redox function. Focuses of the symposium were on the roles of pulmonary endothelial NADPH oxidase, xanthine oxidase (XO)/xanthine dehydrogenase (XDH), heme oxygenase (HO), transplasma membrane electron transport (TPMET), and the zinc binding protein metallothionein (MT) in the propagation and/or protection of the lung or other organs from oxidative injury.


    EFFECT OF NITRIC OXIDE ON METAL ION HOMEOSTASIS IN PULMONARY ENDOTHELIAL CELLS1
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The profound effects of nitric oxide (NO) on cellular metabolism are in part related to its affinity for heme and nonheme iron, including targets such as the Fe-S clusters of aconitase/iron response element binding protein, hemoproteins such as catalase or cyclooxygenase 1, and heme oxygenase (HO)-1 (8, 24). After iron, zinc is the major intracellular metal. Indeed, 1-10% of the genome of species from invertebrates to humans are zinc proteins, including transcription factors, enzymes, ion channels, and structural proteins. Zinc is redox inert, but by binding to cysteine, it creates functionally important protein folds protecting the target molecule from oxidation. Such biophysical effects contribute to the role of zinc in gene expression, DNA synthesis, enzymatic catalysis, hormonal storage, neurotransmission, immunology, and cell injury.

Metallothionein (MT) is an intracellular cysteine-rich (30 mol/100 ml) metal binding protein and a critical component of zinc homeostasis. It serves a unique role, linking changes in free intracellular zinc to altered redox status of cells. In this regard, in vitro data show that NO can S-nitrosylate MT and that NO can increase labile zinc in aortic endothelial cells. Dr. Pitt summarized recent progress from his laboratory demonstrating that S-nitrosylation of MT links NO to zinc homeostasis in pulmonary endothelial cells.

To directly study the interaction between MT and NO in live cells, a new fusion protein consisting of MT sandwiched between two mutant green fluorescent proteins (GFPs) was prepared (21). In vitro studies with this chimera (FRET-MT) demonstrated that fluorescent resonance energy transfer (FRET) can be used to follow conformational changes indicative of metal release from MT. Imaging experiments with live pulmonary endothelial cells showed that agents that increase cytoplasmic Ca2+ (the Ca2+ ionophore A-23187, carbachol, and bradykinin) act via endogenously generated NO to rapidly and persistently release metal from MT, an effect that can be mimicked by NO donors such as S-nitrosoglutathione or exogenous NO gas.

Additional microspectrofluorometric studies with the zinc-sensitive fluorophore Zinquin revealed that exposure of pulmonary endothelial cells to the NO donor S-nitrosocysteine resulted in a rapid increase in free zinc that was mimicked by increasing extracellular zinc (50 µM) or by the zinc ionophore pyrithione (21). The NO- and zinc-induced changes were sensitive to the zinc chelator N,N,N',N'-tetrakis(2-pyridylmethyl)ethylenediamine (TPEN), further demonstrating that Zinquin was reporting zinc.

Exposure of pulmonary endothelial cells to the NO donor S-nitroso-N-penicillamine or virus-mediated direct gene transfer of inducible nitric oxide synthase (iNOS) reduced the sensitivity of these cells to lipopolysaccharide (LPS)-induced apoptosis (6). This NO-induced resistance is associated with the inhibition of LPS-induced activation of caspase-3, an element in numerous apoptotic pathways and itself a potential zinc-inhibitable protease. Preliminary experiments indicating reversal of the NO-induced resistance by simultaneous exposure of the cells to the zinc chelator TPEN suggest the possibility that the well-known antiapoptotic effects of zinc (perhaps via caspase-3 activation) play a role in the NO-mediated resistance to LPS toxicity in pulmonary endothelial cells in culture.

Future studies will require more quantitative measurements of labile zinc and new fluorophores with isobestic spectral properties and higher affinities for free zinc than Zinquin. In addition to MT, other components of intracellular zinc homeostasis, including members of the zinc transport protein gene family, need to be investigated in pulmonary endothelial cells for a fuller understanding of the role of zinc in endothelial cell function in health and disease.


    REDOX ACTIVITY OF THE PULMONARY ENDOTHELIAL SURFACE2
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TPMET systems effect reduction of extracellular electron acceptors via transport of electrons from intracellular donors. TPMET systems exist in pulmonary endothelial cells (4, 5, 14-17). However, compared with other cell types in which the roles of TPMET consistent with the physiological function of those cells have been identified, the physiological role and mechanisms of pulmonary endothelial TPMET systems are less well understood. In this symposium, the concept that pulmonary endothelial TPMET influences the redox status of systemic arterial blood constituents via regeneration of plasma lipoprotein antioxidants was explored. It is envisioned that TPMET-mediated reduction of bloodborne phenolic lipoprotein antioxidants (e.g., coenzyme Q10) has the potential to regenerate active hydroquinone antioxidants from oxidized, or spent, quinone forms (9).

To evaluate the capability of pulmonary endothelium to carry out TPMET-mediated reduction of extracellular electron acceptors, a capillary- and plasma membrane-impermeant thiazine electron acceptor, toluidine blue O polyacrylamide polymer (TBOP), was synthesized (5). TBOP was reduced by endothelial cells both in culture and in the perfused lung. All of the TBOP was recovered in the extracellular medium or lung perfusate, indicating that neither the oxidized nor reduced forms of TBOP entered cells, and various control studies appeared to rule out release of a TBOP reducing agent from the cells or lung into the medium. The observations indicate that endothelial cells have the capability of altering the redox status of a least some bloodborne redox active substances that are confined to the blood.

The fact that thiazine reductases are commonly also quinone reductases led to speculation that natural endothelial TPMET electron acceptors might include spent quinoid antioxidants. This speculation was bolstered by the observation that when endothelial cells were incubated with certain quinones, such as duroquinone, the reduced hydroquinone form appeared in the extracellular medium. Although the study did not reveal whether the reduction occurred at the cell surface, it did demonstrate that the endothelium can modify the redox composition of the extracellular medium. To evaluate the possibility that TPMET might have contributed to the appearance of the hydroquinones in the medium, quinone reduction by endothelial cell plasma membrane preparations was studied. Luminally accessible endothelial plasma membrane proteins were labeled in the perfused lung by single-pass bolus injection of the cell membrane-impermeant amine reactive reagent sulfosuccinimidyl-6-(biotinamido)hexanoate (sulfo-NHS-LC-biotin) (10). To separate the plasma membrane proteins labeled with biotin from other cell proteins, the lungs were homogenized, and the biotin-labeled proteins in the lung homogenate were captured on avidin-coated beads. When the beads, now coated with the cell surface proteins, were mixed with the quinone form of coenzyme Q10 and the electron donor NAD(P)H, the beads mediated a diphenyleneiodonium-sensitive reduction of quinone.

These studies demonstrate that some isolated endothelial cell surface plasma membrane proteins are capable of mediating quinone reduction, consistent with the hypothesis that pulmonary endothelial TPMET may regenerate antioxidant hydroquinones from spent, oxidized quinones present in the extracellular medium. This redox activity of the endothelial surface is also likely to be involved in modifying the redox status of other bloodborne substances such as redox active metals, toxins, and antibiotics.


    EMERGING ROLE OF CARBON MONOXIDE IN LUNG BIOLOGY AND PATHOLOGY3
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HO catalyzes the rate-limiting step in the degradation of heme to yield equimolar quantities of biliverdin IXa, carbon monoxide (CO), and iron (7). Three isoforms of HO exist: HO-1 is the inducible isoform, whereas HO-2 and HO-3 are constitutively expressed (7). Heme, the major substrate of HO-1, as well as heavy metals, cytokines, endotoxin, and various agents that induce oxidative stress all induce HO-1 expression (7). The diversity of agents that induce HO-1 has led to the speculation that it may play a vital role in cellular homeostasis. Recent analyses of HO-1-null mice and a HO-1-deficient human have strengthened the emerging paradigm that HO-1 is indeed an important molecule in host defense against oxidant stress, but the mechanism(s) by which HO-1 provides protection is poorly understood. Based on the observations that endogenous induction of HO-1 provides protection against oxidative stress (7, 19), the hypothesis that the gaseous molecule CO, a major by-product of heme catalysis by HO, mediates the protection was pursued.

Animals exposed to a low concentration of CO (50-500 parts/million) exhibited a marked tolerance to lethal hyperoxia in vivo; survival was associated with significant attenuation of hyperoxia-induced lung injury (decrease in volume of pleural effusion, protein accumulation in the airways, and neutrophil influx into the airways) (20). In rats exposed to hyperoxia in the presence of a low concentration of CO, histological examination showed that the lungs were devoid of airway and parenchymal inflammation, fibrin deposition, and pulmonary edema. Furthermore, in rats in which endogenous HO enzyme activity was inhibited with the HO inhibitor tin protoporphyrin, exogenous CO protected against hyperoxia-induced lung injury. Low concentrations of CO also had potent anti-inflammatory effects in vivo and in vitro, including inhibition of expression of LPS-induced proinflammatory cytokines, including tumor necrosis factor-alpha , interleukin (IL)-1beta , and macrophage inflammatory protein-1beta , and augmentation of LPS-induced expression of the anti-inflammatory cytokine IL-10 (18). These anti-inflammatory effects of CO were mediated via a mitogen-activated protein kinase pathway and not a guanylyl cyclase-cGMP- or nitric oxide-dependent pathway. These data suggest that CO may play an important protective role in other oxidant-induced tissue injury and inflammatory states.


    REGULATION OF XANTHINE OXIDASE AND ROLE IN OXIDATIVE LUNG INJURY4
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Through its ability to generate reactive oxygen species (ROS), XO/XDH plays a significant role in the pathogenesis of various organ diseases including acute lung injury. As a result of stimulation by endotoxin and inflammatory cytokines, iNOS also participates in tissue injury through high and sustained release of NO. The products of XO and iNOS, superoxide and NO, respectively, interact to form peroxynitrite, a highly toxic oxidant capable of oxidizing biological molecules and nitrating protein tyrosine residues. Recent evidence demonstrating the presence of nitrated tyrosine residues in patients with acute respiratory distress syndrome suggests that peroxynitrite may indeed be an important oxidant in human acute lung injury. Hypoxia-induced upregulation of XO/XDH mRNA has been observed in pulmonary artery endothelial cells (PAECs) (13), and lung XO/XDH activity and gene expression increase in response to hypoxia, endotoxin, and IL-1beta treatment in an animal model of lung injury (12). Pharmacological inhibition of XO/XDH prevents the development of pulmonary edema after these treatments, further supporting a role for this enzyme in the pathogenesis of acute lung injury (12). New evidence was presented showing that lung iNOS is also upregulated by the combination of hypoxia, endotoxin, and IL-1beta , consistent with the interaction of XO/XDH and iNOS products in this model of lung injury.

Evidence was also presented that at least part of the unexplained antioxidant activity of estrogen may occur via regulation of XO/XDH. Estradiol (10 µM for 24 h) significantly inhibited XO/XDH activity in normoxic and hypoxic PAECs. A 5- to 7-day exposure to physiological concentrations of estradiol also decreased XO and XDH activities and protein expression. The estrogen receptor (ER) type beta  (ER-beta ) was upregulated after exposure of PAECs to hypoxia for 24 h. To investigate the mechanism of estrogen-mediated effects on XO/XDH, the levels of ERs in the cells were enhanced by transfection with ER-alpha and ER-beta , each tagged with the expression vector pEGFP-C2. Under normoxic conditions, cells expressing high levels of ER-alpha expression had decreased XO/XDH activity compared with that in control cells transfected with GFP alone, and XO/XDH activity in these cells did not increase in response to hypoxia. Taken together, these results suggest that the antioxidant activity of estrogen may be effected via inhibition of XO/XDH expression. It was speculated that the upregulation of ER-beta in hypoxia may represent a counterregulatory mechanism in response to the upregulation of XO in hypoxia.


    ISCHEMIA-MEDIATED SIGNALING THROUGH ROS GENERATION BY FLOW-ADAPTED ENDOTHELIUM5
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It was proposed that cessation of flow is detected by shear-sensitive elements in the pulmonary endothelium and translated into intracellular signals that serve to promote vasodilatation via NO release and tissue remodeling through activation of transcription factors (1, 22, 25). These responses require adequate oxygenation of pulmonary tissue, which is provided by continued ventilation during ischemia. Initiation of the signaling cascade results from rapid membrane depolarization followed by increased production of ROS (1, 3, 23). Using fluorescence microscopy with ROS-sensitive fluorophores in isolated rat and mouse lungs, Dr. Fisher presented evidence of endothelial generation of ROS in ischemia that begins within 1-2 min of flow cessation (11). ROS generation is markedly reduced by inhibitors of membrane-associated NADPH oxidase and is abolished by knockout of gp91phox, a major NADPH oxidase component (2).

Immunofluorescence studies by Dr. Fisher and his colleagues demonstrated the presence of all four major protein components of NADPH oxidase in rat and mouse pulmonary endothelia. The ischemia response system was reconstituted in vitro with bovine PAECs that had been conditioned to flow (shear stress of 1-2 dyn/cm2) for 2 days in an artificial capillary system. Cessation of flow in this in vitro system led to ROS generation, activation of nuclear factor-kappa B and activator protein-1, increased [3H]thymidine incorporation into DNA, and cell proliferation as indicated by cell cycle analysis. These responses were not seen in control (non-flow-adapted) cells.

These studies indicated participation of endothelial NADPH oxidase and perhaps other ROS-generating pathways in the physiological response to altered pulmonary perfusion, leading to a cell signaling cascade. These events could also lead to oxidative lung injury depending on the balance between ROS generation and antioxidant defenses.

In summary, the symposium presentations reflect growing insight into the roles of intracellular (MT, XO/XDH, and HO) and plasma membrane (NADPH oxidase, XO/XDH, and unidentified TPMET) proteins in lung redox homeostasis. The focus was on the lung endothelium, but at least some of the proposed mechanisms no doubt operate in other cell types and organs as well. In addition, the redox activities present on the luminal pulmonary endothelial surface, in conjunction with the large pulmonary endothelial surface area to which the venous blood is exposed before entering the systemic arteries, suggest a possible impact of pulmonary endothelial redox functions on other organs as well.


    FOOTNOTES

Address for reprint requests and other correspondence: M. Merker, VA Medical Center, Research Service 151, 5000 W. National Ave., Milwaukee, WI 53295 (E-mail: mmerker{at}mcw.edu).

2  Presented by Marilyn P. Merker.

3  Presented by Augustine M. Choi.

4  Presented by Paul M. Hassoun.

5  Presented by Aron B. Fisher.

1  Presented by Bruce R. Pitt.


    REFERENCES
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ABSTRACT
INTRODUCTION
EFFECT OF NITRIC OXIDE...
REDOX ACTIVITY OF THE...
EMERGING ROLE OF CARBON...
REGULATION OF XANTHINE OXIDASE...
ISCHEMIA-MEDIATED SIGNALING...
REFERENCES

1.   Al-Mehdi, AB, Shuman H, and Fisher AB. Intracellular generation of reactive oxygen species during nonhypoxic lung ischemia. Am J Physiol Lung Cell Mol Physiol 272: L294-L300, 1997[Abstract/Free Full Text].

2.   Al-Mehdi, AB, Zhao G, Dodia C, Tozawa K, Costa K, Muzykantov V, Ross C, Blecha F, Dinauer M, and Fisher AB. Endothelial NADPH oxidase as the source of oxidants in lungs exposed to ischemia or high K+. Circ Res 83: 730-737, 1998[Abstract/Free Full Text].

3.   Al-Mehdi, AB, Zhao G, and Fisher AB. ATP-independent membrane depolarization with ischemia in the oxygen-ventilated isolated rat lung. Am J Respir Cell Mol Biol 18: 653-661, 1998[Abstract/Free Full Text].

4.   Bongard, RD, Krenz GS, Linehan JH, Roerig DL, Merker MP, Widell JL, and Dawson CA. Reduction and accumulation of methylene blue by the lung. J Appl Physiol 77: 1480-1491, 1994[Abstract/Free Full Text].

5.   Bongard, RD, Merker MP, Shundo R, Okamoto Y, Roerig DL, Linehan JH, and Dawson CA. Reduction of thiazine dyes by bovine pulmonary arterial endothelial cells in culture. Am J Physiol Lung Cell Mol Physiol 269: L78-L84, 1995[Abstract/Free Full Text].

6.   Ceneviva, GD, Tzeng E, Hoyt DG, Yee E, Gallagher A, Engelhardt JF, Kim YM, Billiar TR, Watkins SA, and Pitt BR. Nitric oxide inhibits lipopolysaccharide-induced apoptosis in pulmonary artery endothelial cells. Am J Physiol Lung Cell Mol Physiol 275: L717-L728, 1998[Abstract/Free Full Text].

7.   Choi, AM, and Alam J. Heme oxygenase-1: regulation, function, implication of a novel stress-inducible protein in oxidant injury. Am J Respir Cell Mol Biol 15: 9-19, 1996[Abstract].

8.   Davidge, ST, Pitt BR, McLaughlin MK, Roberts JM, and Johnson BA. Biphasic stimulation of prostacyclin by endogenous nitric oxide (NO) in endothelial cells transfected with inducible NO synthase. Gen Pharmacol 33: 383-387, 1999[Medline].

9.  Dawson CA, Audi SH, Bongard RD, Okamoto Y, Olson LE, and Merker MP. Transport and reaction at endothelial plasmalemma. Distinguishing intra- from extra-cellular events. Ann Biomed Eng. In press.

10.   De La Fuente, E, Dawson CA, Nelin LD, Bongard RD, McAuliffe TL, and Merker MP. Biotinylation of membrane proteins accessible via the pulmonary vasculature in normal and hyperoxic rats. Am J Physiol Lung Cell Mol Physiol 272: L461-L470, 1997[Abstract/Free Full Text].

11.   Fisher, AB, Al-Mehdi AB, and Muzykantov V. Activation of endothelial NADPH oxidase as the source of a reactive oxygen species in lung ischemia. Chest 116: 25S-26S, 1999[Free Full Text].

12.   Hassoun, PM, Yu FS, Cote CG, Zulueta JJ, Sawhney R, Skinner KA, Skinner HB, Parks DA, and Lanzillo JJ. Upregulation of xanthine oxidase by lipopolysaccharide, interleukin-1, and hypoxia. Role in acute lung injury. Am J Respir Crit Care Med 158: 299-305, 1998[Abstract/Free Full Text].

13.   Hassoun, PM, Yu FS, Zulueta JJ, White AC, and Lanzillo JJ. Effect of nitric oxide and cell redox status on the regulation of endothelial cell xanthine dehydrogenase. Am J Physiol Lung Cell Mol Physiol 268: L809-L817, 1995[Abstract/Free Full Text].

14.   Merker, MP, Bongard RD, Linehan JH, Okamoto Y, Vyprachticky D, Brantmeier BM, Roerig DL, and Dawson CA. Pulmonary endothelial thiazine uptake: separation of cell surface reduction from intracellular reoxidation. Am J Physiol Lung Cell Mol Physiol 272: L673-L680, 1997[Abstract/Free Full Text].

15.   Merker, MP, Olson LE, Bongard RD, Patel MK, Linehan JH, and Dawson CA. Ascorbate-mediated transplasma membrane electron transport in pulmonary arterial endothelial cells. Am J Physiol Lung Cell Mol Physiol 274: L685-L693, 1998[Abstract/Free Full Text].

16.   Olson, LE, Merker MP, Bongard RD, Brantmeier BM, Audi SH, Linehan JH, and Dawson CA. Kinetics of plasma membrane electron transport in pulmonary endothelial cell column. Ann Biomed Eng 26: 117-127, 1998[ISI][Medline].

17.   Olson, LE, Merker MP, Patel MK, Bongard RD, Daum JM, Johns RA, and Dawson CA. Cyanide increases reduction but decreases sequestration of methylene blue by endothelial cells. Ann Biomed Eng 28: 85-93, 2000[ISI][Medline].

18.   Otterbein, L, Bach FH, Alam J, Soares MP, Lu HT, Wysk M, Davis RJ, and Flavell RA. Carbon monoxide mediates anti-inflammatory effects via the p38 mitogen activated protein kinase pathway. Nat Med 6: 422-428, 2000[ISI][Medline].

19.   Otterbein, LE, Kolls JK, Mantell LL, Cook JL, Alam J, and Choi AM. Exogenous administration of heme oxygenase-1 by gene transfer provides protection against hyperoxia-induced lung injury. J Clin Invest 103: 1047-1054, 1999[Abstract/Free Full Text].

20.   Otterbein, LE, Mantell LL, and Choi AM. Carbon monoxide provides protection against hyperoxic lung injury. Am J Physiol Lung Cell Mol Physiol 276: L688-L694, 1999[Abstract/Free Full Text].

21.   Pearce, LL, Wasserloos K, St. Croix CM, Gandley RE, Levitan ES, and Pitt BR. Metallothionein, nitric oxide and zinc homeostasis in vascular endothelial cells. J Nutr 130, Suppl: 1467S-1470S, 2000[Abstract/Free Full Text].

22.   Tozawa, K, Al-Mehdi AB, and Muzykantov V. In situ imaging of intracellular calcium with ischemia in lung subpleural microvascular endothelial cells. Antioxidants Redox Signal 1: 145-153, 1999[Medline].

23.   Wei, Z, Costa K, Al-Mehdi AB, Dodia C, Muzykantov V, and Fisher AB. Simulated ischemia in flow-adapted endothelial cells leads to generation of reactive oxygen species and cell signaling. Circ Res 85: 682-689, 1999[Abstract/Free Full Text].

24.   Yee, EL, Pitt BR, Billiar TR, and Kim YM. Effect of nitric oxide on heme metabolism in pulmonary artery endothelial cells. Am J Physiol Lung Cell Mol Physiol 271: L512-L518, 1996[Abstract/Free Full Text].

25.   Zhao, G, Al-Mehdi AB, and Fisher AB. Anoxia-reoxygenation versus ischemia in isolated rat lungs. Am J Physiol Lung Cell Mol Physiol 273: L1112-L1117, 1997[Abstract/Free Full Text].


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