Immunology and Inflammation Center for Excellence, North Shore-Long Island Jewish Research Institute, and Department of Medicine, Long Island Jewish Medical Center, New Hyde Park, New York 11040
Submitted 8 April 2003 ; accepted in final form 14 June 2003
![]() |
ABSTRACT |
---|
![]() ![]() ![]() ![]() ![]() ![]() |
---|
human immunodeficiency virus-associated nephropathy; focal glomerulosclerosis; opiate
Classic lesions of focal glomerulosclerosis (FGS) are usually initiated with mesangial cell hyperplasia and hypertrophy of glomerular epithelial cells (GECs) (36), whereas patients with HIV-associated nephropathy often have a variant type of FGS, i.e., collapsing glomerulopathy, which manifests in the form of GEC hyperplasia (6). Nevertheless, in the course of the disease, the classic and variant forms show loss of mesangial and epithelial cells (18). We asked whether morphine, a metabolite of heroin, might be contributing to this peculiar form of epithelial cell injury.
An altered balance between forces promoting survival and those promoting death usually determines the fate of a cell. Loss of glomerular cells has been suggested to be an underlying mechanism for the development of glomerulosclerosis (21, 39, 40). Opiate addiction has been implicated in the progression of renal lesions, and research has demonstrated that opiate addicts develop FGS. There is no clear evidence that opiates have a role in the development of renal lesions. Nevertheless, in in vitro studies, morphine has been shown to induce the apoptosis of fibroblasts, mesangial cells, and macrophages (44, 45, 47). In the present study, we evaluated the direct effect of morphine on the growth of cultured GECs.
Morphine has been demonstrated to stimulate the production of superoxide by macrophages and mesangial cells (41, 46). We recently reported that morphine also promotes macrophage heme oxygenase (HO) activity (34). HO-1 expression is considered a biological marker of oxidative stress (29). Microsomal HO is the rate-limiting enzyme for heme degradation in mammals (50). HO cleaves heme into biliverdin and releases free iron and carbon monoxide. Two isoforms have been identified showing differences in regulation and localization (11, 42, 50).
In the present study, we examined the effect of morphine on GEC proliferation and apoptosis. In addition, we evaluated the role of oxidative stress in morphine-induced modulation of GEC growth. We also examined the role of HO activity in morphine-induced GEC growth.
![]() |
MATERIALS AND METHODS |
---|
![]() ![]() ![]() ![]() ![]() ![]() |
---|
Proximal renal tubular epithelial cell culture. Rat proximal renal tubular epithelial cells (NRK 52 E) were obtained from American Type Culture Collection (Rockville, MD). Cells were grown in Dulbecco's modified Eagle's medium (GIBCO) containing 2% penicillin-streptomycin, 1% HEPES, 1.5 g of NaHCO3, 2 mM L-glutamine, 1 mM sodium pyruvate, and 10% fetal calf serum.
Proliferation studies. Equal numbers of RGECs were plated in 24-well plates and grown to semiconfluence, washed in PBS, and incubated in serum-free RPMI 1640 medium containing 0.5% bovine serum albumin and 1% insulin, transferrin, and selenium solution (GIBCO) for 72 h to arrest growth. Subsequently, cells were washed and reincubated in medium containing vehicle (control) or variable concentrations of morphine (10-20-10-6 M) for 48 h. At the end of the incubation period, cells were trypsinized and counted in a hemocytometer. Four series of experiments were carried out, each in triplicate.
Thiazolyl blue assay. Equal numbers of RGECs were plated in 96-well plates and grown to semiconfluence followed by growth arrest (see Proliferation studies). Subsequently, cells were washed and reincubated in medium containing vehicle (control) or 10-18-10-6 M morphine for 48 h. At the end of the scheduled incubation period, control and morphine-treated cells were treated with 10 µl of 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide [thiazolyl blue (MTT), 5 mg/ml; Sigma, St. Louis, MO] and incubated for 4 h at 37°C in the incubator. After 4 h, medium and MTT were aspirated from the wells, and the formazan crystals were dissolved in 100 µl of 0.04 N HCl in isopropanol. The absorbance was recorded in an ELISA reader at 550 nm, with 620 nm as the reference wavelength. The wells that contained only medium and 10 µl of MTT were used as the blank for the plate reader. Four series of experiments were carried out.
To determine whether there is any species-specific difference, equal numbers of growth-arrested HGECs were incubated in medium containing vehicle (control) or 10-20-10-6 M morphine for 48 h. At the end of the incubation period, cells were trypsinized and counted in a hemocytometer. Four sets of experiments were carried out, each set in triplicate.
To determine the role of HO activity, equal numbers of growth-arrested RGECs were incubated in medium containing vehicle, hemin, or zinc protoporphyrin (ZnP) for 16 h and reincubated in medium containing buffer alone or 10-14 M morphine for 48 h. Subsequently, cells were trypsinized and counted using a hemocytometer.
Apoptosis studies. For morphological evaluation of GECs, cells were stained with H-33342 (Molecular Probes, Portland, OR) and propidium iodide (Sigma). H-33342 stains the nuclei of live cells and identifies apoptotic cells by increased fluorescence. Double staining by these two agents provides the percentage of live, apoptotic, and necrotic cells (45). Cells were prepared under control and experimental conditions. At the end of the incubation period, cells were treated with H-33342 (1.0 µg/ml) for 7 min at 37°C. Subsequently, propidium iodide (1.0 µg/ml final concentration) was added to each well. Cells were incubated with the dyes for 10 min on ice, protected from light, and then examined under ultraviolet light. The percentage of live, apoptotic, and necrosed cells was recorded in eight random fields by two observers unaware of the experimental conditions.
To confirm the effect of morphine on RGEC apoptosis, RGECs treated under control and experimental conditions were assayed by the TdT-mediated dUTP nick end labeling method (kit supplied by Roche Applied Science, Indianapolis, IN) (28).
DNA fragmentation assay: gel electrophoresis. Gel electrophoresis is a simple method that is specific for isolation and confirmation of DNA fragments from apoptotic cells (23). Because this method only picks up DNA fragments, loading of samples that do not contain DNA fragments will not be visualized. Equal numbers (108 cells/petri dish) of RGECs were prepared under control and experimental conditions. At the end of the incubation period, cells were centrifuged at 1,600 g for 10 min at room temperature, and the pellets were resuspended in DNA lysis buffer (1% NP-40 in 20 mM EDTA and 50 mM Tris · HCl, pH 7.5, 10 µl/106 cells). After centrifugation, the supernatant was collected, and the extraction was repeated. SDS in a final concentration of 1% was added to the supernatants before the samples were treated with RNase A (5 µg/µl final concentration) at 56°C and digested with proteinase K (Promega, Madison, WI) for 2 h at 37°C. After addition of 0.5 volume of 10 M ammonium acetate, the DNA was precipitated with 2.5 volumes of ethanol, dissolved in gel loading buffer, and separated by electrophoresis on 1.6% agarose gels.
To evaluate the role of HO activity, equal numbers of RGECs were incubated in medium containing vehicle, hemin, or ZnP for 16 h, reincubated in medium containing buffer alone or 10-6 M morphine for 16 h, and assayed for apoptosis. Three sets of experiments were carried out.
Superoxide assay. Equal numbers of RGECs were plated in 100-mm petri dishes and grown to subconfluence. The cells were washed twice with normal saline and incubated in serum- and phenol red-free medium containing buffer or 10-14-10-6 M morphine at 37°C for 2 h. Supernatants were collected at 0, 30, 45, 60, and 120 min into precooled microcentrifuge test tubes, and a superoxide assay was carried out. Briefly, 50 µl of each supernatant were pipetted into a 96-well plate, kept on ice, and mixed with 100 µl of cytochrome c (160 µM final concentration; ICN Biomedicals, Costa Mesa, CA) diluted with Hanks' balanced salt solution (GIBCO). Incubation was carried out at 37°C for 45, 90, and 150 min, and optical density was read at 550 nm (28). Results are expressed in arbitrary units, and experiments were repeated four times, each in triplicate.
Measurement of HO enzyme activity. HO activity was measured by the bilirubin generation method (34). Briefly, RGECs grown to confluence (in tissue flasks) were incubated in medium containing buffer or 10-14-10-4 M morphine for 16 h. At the end of the incubation period, cells were washed, scraped, and centrifuged (1,000 g for 10 min at 4°C). The cell pellet was suspended in MgCl2 (2 mM)-phosphate (100 mM) buffer (pH 7.4) and sonicated on ice before centrifugation at 18,800 g for 10 min at 4°C. The supernatant was added to the reaction mixture (400 µl) containing rat liver cytosol (2 mg), hemin (20 µM), glucose-6-phosphate (2 mM), glucose-6-phosphate dehydrogenase (0.2 U), and NADPH (0.8 mM) for 1 hat 37°C in the dark. The formed bilirubin was extracted with chloroform, and the change in optical density between 464 and 530 nm was measured (extinction coefficient, 40 mM-1 · cm-1 for bilirubin). HO activity is expressed as picomoles of bilirubin formed per microgram of GEC protein per 60 min.
Protein extraction and Western blot analysis. RGECs were treated under control and experimental conditions as indicated. At the end of the incubation period, the cells were washed three times with PBS, scraped in a modified RIPA buffer (1x PBS, 1% NP-40, 0.5% sodium deoxycholate, 1 mM sodium orthovanadate, 0.1% SDS, 10 µl of protease inhibitor cocktail/ml of buffer, and 100 µg of PMSF/ml of buffer), and transferred with a syringe fitted with a 21-gauge needle to a microcentrifuge tube. The cell lysates were centrifuged at 15,000 g for 30 min at 4°C. The supernatant was analyzed for total protein content. Twenty micrograms of protein were heated at 100°C for 10 min, loaded, and separated on a 12% polyacrylamide gel under nonreducing conditions. The proteins were electrotransferred to a nitrocellulose membrane in transfer buffer containing 48 mM Tris · HCl, 39 mM glycine, 0.037% SDS, and 20% methanol at 4°C overnight. Nonspecific binding to the membrane was blocked for 1 h at room temperature with blocking buffer (0.5% bovine serum albumin in PBS with 0.1% Tween 20). The membrane was then incubated for 16 h at 4°C with rabbit polyclonal anti-HO-2 (1:5,000 dilution; Stressgen, Victoria, BC, Canada) in blocking buffer and then incubated for 1 h at room temperature with the secondary antibody in blocking buffer. Signals were visualized by an enhanced chemiluminescence detection kit (Pierce) after exposure to X-ray film (Eastman Kodak, Rochester, NY).
Statistical analysis. For comparison of mean values between groups, an unpaired t-test was used. To compare values between multiple groups, analysis of variance was applied, and a Newman-Keuls multiple range test was used to calculate a P value. Values are means ± SE, except where otherwise indicated. Statistical significance was defined as P < 0.05.
![]() |
RESULTS |
---|
![]() ![]() ![]() ![]() ![]() ![]() |
---|
|
To evaluate whether this effect of morphine is species specific, we repeated the experiment using HGECs. Morphine exhibited a bimodal effect similar to the effect on RGECs (Fig. 1B). It stimulated HGEC proliferation at lower concentrations but suppressed HGEC proliferation at higher concentrations.
To confirm the effect of morphine on GECs, equal numbers of growth-arrested RGECs were treated with vehicle (control) or 10-18-10-6 M morphine for 48 h and then subjected to MTT assay. As shown in Fig. 2A, 10-18-10-12 M morphine promoted GEC proliferation; however, 10-8-10-6 M morphine suppressed GEC growth.
|
To determine whether morphine has similar effects on proximal tubular cells, equal numbers of growth-arrested cultured proximal tubular cells were incubated in medium containing buffer (control) or 10-14-10-4 M morphine for 72 h. At the end of the incubation period, cells were trypsinized and counted. As shown in Table 1, at higher concentrations, morphine suppressed the growth of tubular cells.
|
Apoptosis studies. To evaluate the mechanism of morphine-induced growth suppression, equal numbers of RGECs were incubated in medium containing buffer or 10-6 M morphine for 16 h. Subsequently, cells were assayed for apoptosis using H-33342. Morphine promoted GEC apoptosis: 2.1 ± 0.5 and 19.8 ± 1.8 apoptosed cells/field in control and morphine-treated cells, respectively (P < 0.001). Representative micrographs are shown in Fig. 2B. Apoptosed cells show condensed nuclei with bright fluorescence. Similar results were obtained by the TdT-mediated dUTP nick end labeling assay (data not shown).
To confirm the effect of morphine on GEC apoptosis, equal numbers of RGECs were incubated in medium containing buffer or 10-8-10-6 M morphine for 16 h. Subsequently, cells were harvested, and DNA was extracted and subjected to electrophoresis. As shown in Fig. 2C, morphine-treated cells showed multiple integers of 180 bp in a ladder pattern.
Role of oxidative stress. To determine the role of oxidative stress, we evaluated the effect of antioxidants on morphine-induced GEC apoptosis. Equal numbers of RGECs were incubated in medium containing buffer, diphenyleneiodonium iodide (10 µM), ascorbic acid (100 µM), or N-acetyl cysteine (50 µM) with or without 10-8 M morphine for 24 h. Subsequently, cells were assayed for apoptosis. As shown in Fig. 3A, diphenyleneiodonium iodide, ascorbic acid, and N-acetyl cysteine inhibited morphine-induced GEC apoptosis.
|
To confirm the effect of oxidative stress in morphine-induced GEC injury, we evaluated the effect of free radical scavengers. Equal numbers of RGECs were incubated in medium containing buffer (control), SOD (50 µM), catalase (2,000 U/ml), or dimethylthiourea (10 µM) with or without 10-8 M morphine for 24 h. Subsequently, cells were assayed for apoptosis. As shown in Fig. 3B, SOD and catalase partially inhibited the effect of morphine.
To further confirm the role of oxidative stress, we evaluated the effect of morphine on superoxide production by GECs. Equal numbers of RGECs were incubated in serum-free medium containing buffer or 10-14, 10-12, 10-8, and 10-6 M morphine for 2 h. Aliquots of supernatants were collected at 15, 30, 45, 60, and 120 min. Subsequently, superoxide concentration was measured. Morphine stimulated GEC production of superoxide at 45-120 min. The effect of morphine on production of superoxide at 60 min is shown in Fig. 3C.
To determine the effect of morphine on GEC HO activity, equal numbers of GECs were incubated in medium containing buffer or 10-14-10-6 M morphine for 16 h. Subsequently, cells were harvested, and HO activity was measured. As shown in Fig. 4A, morphine stimulated HO activity at lower concentrations; however, 10-6 M morphine suppressed HO activity.
|
To evaluate whether morphine-induced alteration of HO-2 induction might have also contributed to HO activity, equal numbers of RGECs were incubated in medium containing buffer or 10-20-10-6 M morphine for 16 h. Subsequently, cells were harvested, protein was extracted, and Western blots were prepared and probed for HO-2. To confirm equal protein loading, blots were stripped and reprobed for -actin. As shown Fig. 4B, morphine did not modulate GEC expression of HO-2.
To determine the role of HO activity in morphine-induced RGEC proliferation, equal numbers of growth-arrested RGECs were incubated in medium containing vehicle, hemin (5 µM), or ZnP (50 µM) for 16 h and then reincubated in medium containing buffer alone or 10-14 M morphine for 48 h, and cells were counted. As shown in Fig. 4C, morphine promoted GEC growth. Hemin, an inducer of HO activity, decreased GEC proliferation, whereas ZnP, an inhibitor of HO activity, increased GEC proliferation. Hemin also attenuated morphine-induced GEC proliferation. On the other hand, ZnP accentuated the mitogenic effect of morphine on GECs.
To confirm the role of HO-1 induction in GEC proliferation, we evaluated the effect of curcumin (a known inducer of HO-1) on HIV transactivator (Tat)-induced GEC proliferation (7, 10). Equal numbers of growth-arrested GECs were incubated in medium containing buffer (control), curcumin (15 µM), Tat (2 ng/ml), or curcumin + Tat for 48 h and then subjected to MTT assay. As shown in Table 2, Tat promoted GEC proliferation. However, curcumin attenuated GEC proliferation under basal and Tat-stimulated states.
|
To determine the effect of HO activity on morphine-induced RGEC apoptosis, equal numbers of RGECs were incubated in medium containing vehicle, hemin (5 µM), or ZnP (50 µM) for 16 h and then reincubated in medium containing buffer alone or 10-6 M morphine for 16 h. Subsequently, cells were evaluated for apoptosis. As shown in Fig. 4D, morphine promoted GEC apoptosis. Hemin promoted GEC apoptosis under basal and morphine-stimulated states. However, ZnP attenuated morphine-induced GEC apoptosis.
![]() |
DISCUSSION |
---|
![]() ![]() ![]() ![]() ![]() ![]() |
---|
Superoxide has been demonstrated to stimulate MAP kinases in smooth muscle cells (1). Similarly, in rat neuronal cells, MAP kinase is stimulated by superoxide (24). In renal tubular cells, reactive oxygen species activate p44 MAP kinase as well as p38 MAP kinase (20). In the present study, at lower concentrations, morphine stimulated a moderate amount of superoxide production. However, at higher concentrations, morphine promoted a greater amount of superoxide production. It appears that, at lower concentrations (low-dose morphine-induced), superoxide stimulates GEC proliferation, perhaps through the activation of p44 MAP kinase, whereas, at higher concentrations (high-dose morphine-induced), superoxide promotes apoptosis via p38 MAP kinase activation. However, this hypothesis needs to be tested in future studies.
HO-2 is a constitutive enzyme that is localized primarily in vasculature, brain, and testis (22, 31, 43). HO-3 exhibits 90% homology to HO-2, but it lacks significant catalytic activity and only functions as a heme-regulatory protein (31). In the present study, morphine did not modulate GEC expression of HO-2. Thus it appears that morphine-induced alteration in GEC HO activity may be representing the status of HO-1 induction. These findings are consistent with those of other investigators (22).
HO-1 is an inducible form previously known as heat shock protein-32 (25). It is an integral part of the antioxidant response element of cells. It is upregulated by a variety of factors, including hypoxia, hyperoxia, heat shock, cytokines, heavy metals, H2O2, ultraviolet irradiation, and its substrate heme (4, 9, 26, 27, 32, 52). Because heme synthesis and degradation are essential for cytochromes and other heme-containing enzymes such as catalase and nitric oxide synthase, HO-1 is expressed in many cells. Moreover, heme is prooxidant and induces cytotoxicity (5). Thus expression of HO-1 after oxidative stress may be a protective response. Furthermore, the products of heme cleavage (bilirubin and biliverdin) may act as antioxidants (3, 33). Many investigators have used preinduction of HO-1 to prevent cellular injury in various models of inflammation (4, 19, 48). In the present study, morphine showed a bimodal effect on HO activity in GECs. HO activity was stimulated by morphine at lower concentrations and suppressed by morphine at higher concentrations. At lower concentrations, morphine also promoted GEC proliferation. Is there any relation between morphine-induced GEC proliferation and elevated HO activity? To evaluate this aspect, we examined the effect of an inhibitor of HO activity on morphine-induced GEC proliferation. ZnP, an inhibitor of HO activity, promoted GEC proliferation under basal and morphine-stimulated conditions. Thus it appears that, at lower concentrations, morphine-induced HO activity may be a negative-feedback phenomenon to contain the morphine-induced GEC proliferation.
Oxidative stress induced by generation of free radicals (e.g., superoxide and H2O2) is a major inciting mechanism of renal injury, leading to a cascade of events resulting in renal cell damage followed by renal cell proliferation, fibrosis, and, ultimately, glomerulosclerosis (13, 37). In in vitro studies, H2O2, at various concentrations, induced mouse mesangial cell apoptosis (49). However, the role of reactive oxygen species in the development of GEC proliferation and apoptosis has not been investigated previously. The present study clearly demonstrates the role of oxidative stress in the growth of GECs. Morphine showed a bimodal effect on GEC growth. At lower concentrations, morphine stimulated GEC proliferation, whereas, at higher concentrations, it promoted GEC apoptosis. However, both of the effects of morphine were inhibited by antioxidants.
Morphine promoted GEC apoptosis at higher concentrations. However, at higher concentrations, morphine suppressed HO activity. Because hemin, an inducer of HO activity, promoted GEC apoptosis under basal as well as morphine-stimulated conditions, it appears that morphine-induced suppression of HO activity may have been an attempt to contain the proapoptotic effect of morphine.
We conclude that morphine has a bimodal effect on GEC growth. This effect of morphine is mediated through oxidative stress. HO activity modulates GEC growth under basal and morphine-stimulated conditions.
![]() |
DISCLOSURES |
---|
![]() |
ACKNOWLEDGMENTS |
---|
![]() |
FOOTNOTES |
---|
The costs of publication of this article were defrayed in part by the payment of page charges. The article must therefore be hereby marked "advertisement" in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
![]() |
REFERENCES |
---|
![]() ![]() ![]() ![]() ![]() ![]() |
---|
|
HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
Visit Other APS Journals Online |