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Hazardous Substances DB
*DEXAMETHASONE
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*Joint Disorders
*Rheumatoid Arthritis
*Steroids
The Journal of Immunology, 2001, 167: 469-474.
Copyright © 2001 by The American Association of Immunologists

Microsomal Prostaglandin E Synthase Is Regulated by Proinflammatory Cytokines and Glucocorticoids in Primary Rheumatoid Synovial Cells1

Dirk O. Stichtenoth*, Staffan Thorén{ddagger}, Huimin Bian*, Marc Peters-Golden{dagger}, Per-Johan Jakobsson{ddagger} and Leslie J. Crofford2,*

Divisions of * Rheumatology and {dagger} Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI 48109; and {ddagger} Division of Chemistry II, Karolinska Institutet, MBB, Stockholm, Sweden


    Abstract
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
The selective induction of PGE2 synthesis in inflammation suggests that a PGE synthase may be linked to an inducible pathway for PG synthesis. We examined the expression of the recently cloned inducible microsomal PGE synthase (mPGES) in synoviocytes from patients with rheumatoid arthritis, its modulation by cytokines and dexamethasone, and its linkage to the inducible cyclooxygenase-2. Northern blot analysis showed that IL-1{beta} or TNF-{alpha} treatment induces mPGES mRNA from very low levels at baseline to maximum levels at 24 h. IL-1{beta}-induced mPGES mRNA was inhibited by dexamethasone in a dose-dependent fashion. Western blot analysis demonstrated that mPGES protein was induced by IL-1{beta}, and maximum expression was sustained for up to 72 h. There was a coordinated up-regulation of cyclooxygenase-2 protein, although peak expression was earlier. Differential Western blot analysis of the microsomal and the cytosolic fractions revealed that the induced expression of mPGES protein was limited to the microsomal fraction. The detected mPGES protein was catalytically functional as indicated by a 3-fold increase of PGES activity in synoviocytes following treatment with IL-1{beta}; this increased synthase activity was limited to the microsomal fraction. In summary, these data demonstrate an induction of mPGES in rheumatoid synoviocytes by proinflammatory cytokines. This novel pathway may be a target for therapeutic intervention for patients with arthritis.


    Introduction
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Inflammation of synovial tissues of patients with arthritis is due, at least in part, to enhanced production of PGs (1). PGs are synthesized by an enzyme cascade initiated by the release of arachidonic acid by a phospholipase. It has become apparent over the last several years that there are distinct pathways by which PGs are formed. Constitutively produced PGs mediating homeostatic functions and PGs produced immediately following cellular activation are synthesized via enzymes expressed under basal conditions, including cytosolic phospholipase A2 (PLA2)3 and cyclooxygenase (COX)-1 (2). In contrast, induction of high level PG production in a time- and tissue-specific manner occurs via a set of synthetic enzymes whose expression is tightly regulated by pathologic and physiologic stimuli. In inflammatory arthritis, there is a marked increase in soluble PLA2 in the joint fluid providing transcellular arachidonic acid for eicosanoid biosynthesis (3, 4). Cytosolic PLA2 levels are also increased by treatment of cultured synovial cells with IL-1 (5, 6). We and others have shown the dramatic increase in levels of the inducible COX isoform, COX-2, in response to proinflammatory cytokines in synovial tissues and cells of patients with arthritis (6, 7, 8, 9). The dominant role for COX-2 in producing proinflammatory PGs associated with arthritis was confirmed in clinical trials demonstrating equal efficacy of specific COX-2 inhibitors and nonsteroidal anti-inflammatory drugs that block activity of both COX isoforms (2).

Among the stable PGs produced in rheumatoid synovia, PGE2 plays an important role. Injection of PGE2 recapitulates the cardinal signs of inflammation via vasodilation with plasma extravasation and sensitization of nociceptors (10). Furthermore, PGE2 stimulates production of matrix metalloproteinases (11) and angiogenesis (12) and inhibits apoptosis of T lymphocytes (13). PGE2 is specifically implicated in the symptoms of arthritis because neutralizing Abs against PGE2 are able to inhibit acute and chronic inflammation in the rat adjuvant arthritis model (14). Previous data point to a selective induction of PGE2 synthesis in inflammation (15, 16, 17, 18), suggesting that a PGE synthase (PGES) may be linked to the inducible pathway for PG synthesis.

Until recently, the ability to study regulation of terminal synthase enzymes was hampered by the fact that the PGES enzyme(s) had not been purified. However, two forms of the terminal synthase involved in production of PGE2 were recently cloned and characterized (19, 20, 21, 22). Similar to the more proximal PG synthetic enzymes, one isoform is constitutively expressed and unresponsive to proinflammatory stimuli, whereas the other isoform is inducible. The constitutive PGES is expressed in the cytosol (cPGES) under basal conditions in a wide variety of mammalian cell lines and rat tissues (21). Expression is generally unaltered by stimulation with bacterial LPS.

The inducible PGES is localized to the microsomal compartment and hence termed mPGES (19, 22). The enzyme was identified as a member of the membrane-associated proteins involved in eicosanoid and glutathione metabolism family of enzymes originally called microsomal glutathione S-transferase 1-like 1 (23). The same sequence was also identified as a gene induced by p53 (24). Jakobsson et al. characterized this enzyme as a human PGES that was dependent on glutathione for its activity and, more important, inducible by IL-1{beta} in human cells (19, 25). Subsequently, Murakami et al. reported that induced PGES activity previously identified in LPS-stimulated rat macrophages actually originated from this enzyme (22). Rat mPGES exhibited a high degree of sequence homology to the human mPGES, and a mouse homologue was also cloned (22). Thorén and Jakobsson described coordinate regulation of mPGES and COX-2 in a human lung cancer cell line (25). Using cotransfection experiments, functional coupling between constitutive cPGES and COX-1 and inducible mPGES and COX-2 has also been demonstrated (21, 22).

The concept of a regulated PG production pathway including both COX-2 and PGES has important implications for understanding inflammation in arthritis. mPGES has not previously been studied in any clinically relevant primary cell type, including synovial cells. We hypothesized that mPGES would be regulated coordinately with COX-2 by proinflammatory cytokines in synoviocytes isolated from patients with rheumatoid arthritis (RA). This pathway could lead to the marked increase in PGE2 observed in inflammatory arthritis.


    Materials and Methods
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Synoviocyte culture

Synovial tissue specimens were obtained from patients with RA at the time of total joint replacement surgery. Tissues were minced and digested for 4 h with 4 mg/ml collagenase (type I; Worthington Biochemical, Freehold, NJ) in DMEM at 37°C in 5% CO2. The dissociated cells were plated in 75-ml flasks containing DMEM supplemented with 10% human AB serum (BioWhittaker, Walkersville, MD), 10% FBS (Life Technologies, Rockville, MD), penicillin (100 U/ml), and streptomycin (100 µg/ml). When they reached 95% confluency, they were harvested with trypsin/EDTA (Life Technologies) and passed 1:3 into 175-ml flasks.

Cells were used between the third and seventh passage. After medium change to DMEM supplemented with 2% FBS, 1% glutamine, penicillin (100 U/ml), and streptomycin (100 µg/ml), cultures were treated as indicated in the figure legends using human recombinant IL-1{beta} and TNF-{alpha} (Genzyme, Cambridge, MA, or R&D Systems, Minneapolis, MN) or dexamethasone (Sigma, St. Louis, MO).

Determination of eicosanoid profile

Cells were labeled overnight with 3H-labeled arachidonic acid (AA) (1 µCi, sp. act. 76–100 µCi/mmol; DuPont/New England Nuclear, Boston, MA). Unincorporated label was removed by washing. Some cells were examined under unstimulated conditions. Some cells were treated with acetylsalicylic acid (ASA; aspirin) (1 mM) for 30 min to irreversibly inhibit constitutive COX-1, washed extensively to remove the ASA, then treated with IL-1{beta} (1 ng/ml) for 6 h to induce COX-2. All cells were then treated with the calcium ionophore A23187 (2.5 µM) 30 min before harvesting to stimulate activity of PLA2.

Radiolabeled AA and eicosanoid metabolites were extracted from the medium using a Sep-Pak cartridge (Waters, Milford, MA). Lipid extracts were subjected to reversed-phase HPLC as previously described (26). Radioactivity was determined online using a Radiomatic Flo-One Beta Detector (Packard, Downers Grove, IL). PG products were identified by comparison with the elution of known standards.

To determine whether PGE2 production was dependent on COX-2, synoviocytes were treated in the presence or absence of IL-1{beta} (1 ng/ml) or TNF-{alpha} (10 ng/ml) with or without aspirin (1 mM) or the selective COX-2 inhibitor NS-398 (3 µM) added simultaneously. Medium was collected after 16 h and analyzed for PGE2 by enzyme-linked immunoassay (Cayman Chemicals, Ann Arbor, MI). Cells were lysed, and total protein was determined by the Bradford method (Bio-Rad, Hercules, CA). PGE2 levels were normalized to protein concentration.

RNA preparation and analysis

Total RNA was prepared from synoviocytes using Tri-Reagent (Molecular Research Center, Cincinnatti, OH). For Northern blot analysis, 20 µg of total RNA was subjected to electrophoresis through a 1.5% agarose-4% formaldehyde gel and transferred onto a nylon membrane (Nytran; Schleicher & Schuell, Keene, NH). To generate a probe for mPGES, the human mPGES coding sequence of 792 bp (19) was amplified from the pT7T3D-Pac vector, purified, and 32P-labeled by the random prime method (Random Primed DNA Labeling Kit; Boehringer Mannheim, Mannheim, Germany). A probe for G3PDH was synthesized by random prime method from a cDNA fragment of human G3PDH generated by PCR using primers as described below. Membranes were hybridized in 50% formamide at 42°C for 24 h with 9 x 106 cpm/ml cDNA probe. Washing was performed twice for 15 min in 2x SSC, 0.1% SDS at room temperature and twice for 15 min in 0.1x SSC, 0.1% SDS at 65°C. The membranes were exposed to Kodak XAR film for 48 h at -80°C (Kodak, Rochester, NY).

The cDNA was prepared by reverse transcription of 5 µg total RNA in 50 µl containing 50 mM Tris-HCl (pH 8.3), 40 mM KCl, 6 mM MgCl2, 1 mM DTT, 0.4 mM dNTPs, 2 µM random hexamer primers (Life Technologies), 0.1 U/µl RNase inhibitor (Life Technologies), and 8 U/µl Moloney murine leukemia virus reverse transcriptase (Life Technologies). Reaction mixtures were incubated at 22°C for 10 min, at 42°C for 30 min, and at 95°C for 5 min. Complementary DNA was diluted 10-fold and used for PCR.

The PCR was performed in 50 µl containing 5 µl cDNA, 10 mM Tris-HCl (pH 8.3), 50 mM KCl, 100 µM dNTPs, 0.05 U/µl Taq polymerase (Life Technologies), and MgCl2 in appropriate concentrations (1 mM for mPGES and prostacylin synthase (PGIS), 2 mM for COX-2 and G3PDH, and 2.5 mM for cPGES). The oligonucleotide primers used were as follows: for mPGES, sense 5'-ATGCCTGCCCACAGCCTG-3', and antisense, 5'-TCACAGGTGGCGGGCCGC-3'; for cPGES, sense, 5'-ATGCAGCCTGCTTCTGCA-3', and antisense 5'-TTACTCCAGATCTGGCAT-3'; for COX-2, sense, 5'-TTCAAATGAGATTGTGGGAAAATTGCT-3', and antisense, 5'-AGATCATCTCTGCCTGAGTATCTT-3'; for PGIS, sense, 5'-GGAGCAAATGGCTGGAGAGTTAC-3', and antisense, 5'-ATCCGTCAGGGTTCAGGAATCG-3'; and for G3PDH, sense, 5'-CCACCCATGGCAAATTCCATGGCA-3', and antisense, 5'-TCTAGACGGCAGGTCAGGTCCACC-3'. Cycling conditions were as follows: denaturing at 94°C for 2 min; annealing at 70°C (mPGES and PGIS), 65°C (COX-2), 60°C (G3PDH), or 50°C (cPGES) for 1 min; extension at 72°C for 1 min; 25 cycles for G3PDH and 30 cycles for mPGES, COX-2, cPGES, and PGIS. All PCR conditions were adjusted to assure that product formation was on the linear portion of a cycle curve.

Immunoblot analysis

Synoviocytes were trypsinized, pelleted, washed in ice-cold phosphate-buffered saline, and resuspended in lysis buffer (10 mM HEPES (pH 7.9) at 4°C, 10 mM KCl, 0.1 mM EDTA, 0.1 mM EGTA, 1 mM DTT, and protease inhibitors). Protein concentration of the lysates was determined using the Bradford method (Bio-Rad), and 40 µg of protein was separated by electrophoresis in a denaturing sodium dodecyl sulfate polyacrylamide gel and transferred to a nylon membrane (Polyvinylidene Difluoride-Plus; Micron Separations, Westborough, MA). Rabbit polyclonal antiserum against human PGES and PGES electrophoresis standard were prepared as described previously (19).

For immunoblot anaysis of cytosolic and microsomal fractions, frozen cell pellets were resuspended in 1.0 ml homogenization buffer consisting of 0.1 M potassium phosphate buffer (pH 7.4), 1x Complete Protease Inhibitor mixture (Boehringer Mannheim), and 0.25 M sucrose. Cells were sonicated three times for 20 s and subjected to differential centrifugation at 1,000 x g for 10 min, 10,000 x g for 15 min, and 170,000 x g for 1 h at 4°C. The cytosolic fractions were centrifuged once more at 170,000 x g. Fractions were resuspended in 100 µl homogenization buffer, and protein concentrations were determined (Bio-Rad). Electrophoresis and immunoblotting were performed as previously described (25).

PGES activity assay

To determine PGES activity in whole cells, primary RA synoviocytes were cultured in six-well plates in complete medium. After they reached confluence, cells were washed with 2 ml PBS, and the medium was changed to DMEM supplemented with 2% FBS and 1 mM ASA to inhibit enzymatic activity of endogenous COXs. Cells were treated with IL-1{beta} for 24 or 72 h, washed with 2 ml PBS, and medium was exchanged. In some experiments, cells were pelleted and frozen in liquid N2 for fractionation.

For analysis of PGES activity in intact synoviocytes, plates were placed on ice and 7.05 µg PGH2 (Cayman Chemicals) was added. The reaction was stopped by adding 100 µl of 400 mM FeCl2-4 mM citric acid at the times indicated in the figure legends. Incubation of cells with acetone for 5 min served as negative control. Measurement of PGE2 was performed by enzyme-linked immunoassay (Cayman Chemicals).

Evaluation of PGES activity in microsomal fractions was performed as previously described (25). In these experiments, PGE2 was measured by reversed-phase HPLC with UV detection.


    Results
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Preferential induction of PGE2 by IL-1{beta} in primary synoviocytes

Under basal conditions, RA synoviocytes produced low levels of PGs from endogenous AA released by treatment with calcium ionophore, mostly PGI2 (Fig. 1Go). To determine changes in the profile of stable PGs after induction of COX-2, we treated synoviocytes with aspirin (1 mM) to inhibit constitutive COX-1. Aspirin was removed, and cells were treated for 6 h with IL-1{beta}, which we have previously shown to be sufficient to induce COX-2 protein (9). Levels of PGI2 were increased, but there was a proportionally greater induction of PGE2 (Fig. 1Go).



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FIGURE 1. Production of stable PGs in RA synoviocytes measured by HPLC. Unstimulated synoviocytes in which COX activity is due to COX-1 ({blacksquare}) were exposed to the calcium ionophore A23187 (2.5 µM). These cells synthesize low levels of PGs, particularly PGI2, as measured by 6-keto PGF1{alpha} (6-keto). After pretreatment with ASA (1 mM) to inhibit COX-1 and treatment with IL-1{beta} (1 ng/ml) for 6 h to induced COX-2 (), all PGs were more abundant. The data are from four separate labeling experiments using cell lines from two different patients with RA. The fold increase in PGE2 is greater than that of other PGs in all cell lines (p < 0.05 by paired Student t test).

 
To confirm that substrate was from a COX-2-dependent pathway, we incubated synoviocytes with either aspirin (1 mM), which inhibits both COX-1 and COX-2, or NS-398 (3 µM), a specific COX-2 inhibitor, during a 16-h incubation with IL-1{beta} or TNF-{alpha}. These experiments were performed three times using cells from three different RA patients. Complete inhibition of PGE2 in conditioned medium was seen in the aspirin- and NS-398-treated cells, demonstrating that substrate for PGE2 production was generated by a COX-2-dependent pathway.

mPGES mRNA expression is induced by pro-inflammatory cytokines

A specific increase in PGE2 could be explained by induction of a specific PGE synthase. To evaluate that possibility, we examined expression of the inducible mPGES. Treatment with IL-1{beta} led to a marked increase of mPGES mRNA from very low levels at baseline to maximum levels at 24 h, as shown by Northern blot analysis (Fig. 2AGo). Levels were increased by 4 h after treatment with IL-1{beta}, and high level mRNA expression was sustained for up to 72 h after treatment. TNF-{alpha} treatment for 24 h also resulted in an enhanced mPGES mRNA signal, but to a lesser degree than with IL-1{beta} (Fig. 2BGo).



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FIGURE 2. Northern blot demonstrating that mPGES mRNA is induced by treatment with IL-1{beta} and TNF-{alpha}. A, RA synoviocytes were treated with IL-1{beta} (1 ng/ml) for varying times. There is little if any mPGES mRNA present at baseline, but increased transcript is detectable by 4 h and continues to increase up to 24 h. Expression is sustained at high levels to 72 h. The experiment was performed three times using cells from different RA patients and yielding similar results. B, Two different RA synoviocyte lines demonstrate increased mPGES mRNA after stimulation with IL-1{beta} (1 ng/ml) or TNF-{alpha} (10 ng/ml) for 24 h. The lower panel shows the 28S rRNA band on the ethidium bromide-stained gel.

 
mPGES, but not cPGES, mRNA is regulated similarly to COX-2 by IL-1{beta} and dexamethasone

As previously documented, COX-2 mRNA levels were up-regulated by IL-1{beta} (Fig. 3Go). IL-1{beta}-induced COX-2 and mPGES transcripts, and mRNA was inhibited by dexamethasone in a dose-dependent fashion. cPGES is expressed under basal conditions, and expression is not altered by IL-1{beta} or glucocorticoids. PGIS expression is also constitutive and unaffected by either treatment. Expression of G3PDH is shown for comparison.



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FIGURE 3. Coordinate regulation of mPGES and COX-2 by IL-1{beta} and dexamethasone. Total RNA was extracted from RA synoviocytes at baseline or after treatment with IL-1{beta} (1 ng/ml) with or without increasing concentrations of dexamethasone (Dex) for 24 h. RT-PCR was performed for COX-2 (30 cycles), mPGES (30 cycles), cPGES (30 cycles), PGIS (30 cycles), or G3PDH (25 cycles). COX-2 and mPGES mRNA, but not cPGES or PGIS, are increased by IL-1{beta}. Dexamethasone inhibits the stimulated increase of COX-2 and mPGES in a dose-dependent manner. This experiment was performed three times using cells from different RA patients. Representative results are shown.

 
Cytokine effects on mPGES and COX-2 protein expression

mPGES and COX-2 protein expression followed the same pattern as shown above for mRNA (Fig. 4Go). There was an expected sharp increase in COX-2 protein after IL-1{beta} treatment. Peak expression of COX-2 was more rapid than for mPGES, and levels were beginning to decline by 24 h after treatment (Fig. 4Go).



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FIGURE 4. mPGES protein is increased after treatment with IL-1{beta}. Synoviocytes were treated with IL-1{beta} (1 ng/ml) for varying times. mPGES and COX-2 protein expression increased after treatment with IL-1{beta}. Peak COX-2 expression occurred by 4–8 h and begins to decline by 24 h; maximum expression of mPGES was at 24 h and sustained to 72 h. Similar results were obtained using synoviocytes from three patients with RA.

 
To determine the localization of mPGES, differential Western blot analysis for the microsomal and the cytosolic fractions was performed. Induced expression of mPGES protein was limited to the microsomal fraction (Fig. 5Go).



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FIGURE 5. The inducible PGES is localized to the microsomal fraction. Cytosolic and microsomal fractions of synoviocytes from three different patients treated for 24 or 72 h with IL-1{beta} (1 ng/ml) were isolated. Immunoblotting was performed using anti-PGES antiserum. Positive control lanes were bacterially expressed PGES containing 1 µg total protein, whereas other lanes contained 5 µg protein. C, Cytosolic fraction; M, microsomal fraction.

 
IL-1{beta} induces mPGES activity

The increase of mPGES protein was associated with a 3-fold increase of PGES activity in intact primary synovioctyes (Fig. 6Go), thus indicating that the detected mPGES protein is a catalytically functional PGES enzyme. Synovial cells were cultured in the presence of aspirin to achieve irreversible inhibition of both constitutive COX-1 and any COX-2 induced by IL-1{beta}. Aspirin acetylation of COX prevents the entry of AA to the catalytic site of the enzyme. Because endogenous PGH2 synthesis is blocked, we measure PGES activity by conversion of exogenous PGH2 to PGE2. Nonenzymatic degradation of PGH2 to PGE2 is minimal in our experimental conditions, as shown in the control wells without cells. In accordance with localization of mPGES protein to the microsomes, we observed a time-dependent increase in PGES activity in microsomal fractions of IL-1{beta}-treated synoviocytes (Fig. 7Go).



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FIGURE 6. Stimulation of synoviocytes with IL-1{beta} increases PGES activity. PGES activity assay was performed by adding exogenous PGH2 (10 µM) to wells without cells (to assay for nonenzymatic degradation of substrate), untreated synoviocytes, or synoviocytes treated with IL-1{beta} for 24 h. Reactions proceeded on ice over 5 min. PGE2 was assayed by enzyme-linked immunoassay. Only cells treated with IL-1{beta} demonstrated significant PGES activity. The data represent three experiments using cells from different patients with RA. *, p < 0.01 comparing 0 and 5 min by Students t test. C denotes samples incubated for 5 min in acetone without addition of PGH2.

 


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FIGURE 7. IL-1{beta}-stimulated PGES activity is localized to the microsomal fraction. Microsomal fractions were isolated from untreated RA synoviocytes or synoviocytes treated for 24 or 72 h with IL-1{beta} (1 ng/ml). Samples with increasing protein concentrations were incubated for 1 min on ice with PGH2 (11.3 µM) in a buffer containing 2.5 mM reduced glutathione. PGE2 product was detected by reversed-phase HPLC.

 

    Discussion
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
This manuscript is the first to describe expression and regulation of mPGES in primary rheumatoid synovial cells. This system is relevant for understanding pathogenic mechanisms and potential therapeutic targets in RA. There is abundant data to implicate PGE2 as a mediator of inflammation in arthritis (1). In addition, PGE2 affects tissue remodeling in the setting of chronic inflammation and has important effects on cells that mediate immune and inflammatory processes. Our data provide further support for the hypothesis that expression of the inducible enzymes of the PGE2 production pathway in vivo is mediated by proinflammatory cytokines in the milieu of the arthritic joint.

Similar to the COX enzymes, it appears that the PGES enzymes function as a pair of isoforms (21, 22). The experiments presented here demonstrate that the mPGES is the inducible isoform responsible for specific up-regulation of PGE2 in response to inflammatory stimuli in synovial tissues. In addition to increased mRNA and protein expression, we show that endogenous PGES activity is increased in intact cells after treatment with IL-1{beta}. Although both cPGES and mPGES mRNA are present in synoviocytes, only mPGES expression is regulated. Induction of PGES activity by IL-1{beta} suggests the mPGES is responsible. The observation that PGES activity is increased in the microsomal fraction further implicates mPGES rather than cPGES as mediating increased PGE2 production. Moreover, we demonstrated that mPGES expression occurs in a pattern generally similar to COX-2 with expression increased by proinflammatory cytokines and blocked by corticosteroids. These observations suggest a functional linkage between COX-2 and mPGES. This idea is supported by the finding that specific COX-2 inhibitors reduce production of PGE2 more than other stable PGs (27). Finally, our results provide an additional target by which glucocorticoids exert anti-inflammatory effects, because dexamethasone completely suppressed the induction of mPGES by IL-1{beta}.

Although COX-2 and mPGES expression vary similarly in response to the same stimuli, there are differences in the specific timing for induction. In keeping with the differences in the time course of COX-2 and mPGES expression after stimulation with IL-1{beta}, the promoter of the mPGES gene lacks many of the elements usually associated with cytokine-inducible genes (20). Examination of a 651-bp promoter region revealed the presence of GC boxes, barbie boxes, and an aryl hydrocarbon regulatory element but the mPGES promoter lacked a TATAA box and other known transcriptional elements. In addition to transcriptional stimulation by IL-1{beta}, promoter reporter constructs demonstrated enhanced transcription in response to 2,3,7,8-tetrachlorodibenzo-p-dioxin, known to stimulate transcription via aryl hydrocarbon regulatory elements. Transcription was inhibited by phenobarbital, presumably acting via the barbie boxes (20). COX-2 expression is regulated by posttranscriptional mechanisms (28, 29). The 3' region of mPGES lacks the AUUUA instability sequences found in the COX-2 gene, suggesting another possible difference in regulatory mechanisms of the two enzymes (20).

Similar to our findings, cytokine induction of mPGES in human A549 cells and rat macrophages was suppressed by dexamethasone (22, 25). Moreover, a functional linkage between mPGES and COX-2 was proven in transfected human embryonic kidney 293 cells, which stably expressed both enzymes. In those experiments, functional linkage could not be explained solely on the basis of subcellular localization because mPGES, COX-1, and COX-2 were all expressed in a perinuclear distribution. The basis for functional linkage remains unclear at the current time. However, mPGES is a member of a superfamily of enzymes involved in eicosanoid metabolism which includes 5-lipoxygenase-activating protein (FLAP). FLAP is involved in the transfer of AA to 5-lipoxygenase to achieve efficient leukotriene production (30). It is concievable that mPGES could facilitate interaction with COX-2 by similar mechanisms. It has been noted that transfection of FLAP into certain cell lines increases PGE2 synthesis and COX-2 expression (31).

Our findings have considerable clinical relevance for understanding and treating inflammatory arthritis. Although specific COX-2 inhibitors have decreased gastrointestinal toxicity compared with traditional nonsteroidal anti-inflammatory drugs, it is clear that there are adverse effects due to inhibition of COX-2 (2). For example, specific inhibition of COX-2 inhibits production of renal and systemic PGI2 (32, 33). Consistent with an important physiologic role for COX-2 in the kidney, specific COX-2 inhibition can lead to altered excretion of sodium, edema, and elevated blood pressure (34). In addition, specific inhibition of COX-2 alters the balance between platelet-derived thromboxane A2 and endothelial PGI2, leading to altered vascular tone and perhaps to an increased risk of thrombosis (35, 36). Thus, a more selective modulation of the prostanoid pathway is desirable. It is currently unclear how much of the inflammation in human arthritis is mediated by PGE2; indeed, mice with a targeted deletion of the prostacyclin receptor have reduced pain and inflammation (37). Nevertheless, these data suggest a novel pathway that may be a target for therapeutic intervention for patients with arthritis.


    Acknowledgments
 
We thank Robert W. McNish, Samardeep Gupta, and Sutang Guo for technical assistance in completing this work.


    Footnotes
 
1 This work was supported by the Michigan Chapter of the Arthritis Foundation, the University of Michigan Multipurpose Arthritis and Musculoskeletal Diseases Center (P60 AR20557), and the Swedish Medical Research Council (31X-12573). D.O.S. is the recipient of a Deutsche Forschungsgemeinschaft scholarship (176/1-1). Back

2 Address correspondence and reprint requests to Dr. Leslie J. Crofford, Division of Rheumatology, University of Michigan, Room 5510E, Medical Science Research Building I, 1150 West Medical Center Drive, Ann Arbor, MI 48109-0680. E-mail address: crofford{at}umich.edu Back

3 Abbreviations used in this paper: PLA2, phospholipase A2; COX, cyclooxygenase; PGES, PGE synthase; cPGES, cytosolic PGES; mPGES, inducible microsomal PGES; RA, rheumatoid arthritis; AA, arachidonic acid; ASA, acetylsalicyclic acid; PGIS, prostacyclin synthase; FLAP, 5-lipoxygenase-activating protein. Back

Received for publication December 28, 2000. Accepted for publication April 20, 2001.


    References
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 

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Transcriptional Regulation of the Membrane-associated Prostaglandin E2 Synthase Gene. ESSENTIAL ROLE OF THE TRANSCRIPTION FACTOR Egr-1
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A. N. McEvoy, E. A. Murphy, T. Ponnio, O. M. Conneely, B. Bresnihan, O. FitzGerald, and E. P. Murphy
Activation of Nuclear Orphan Receptor NURR1 Transcription by NF-{kappa}B and Cyclic Adenosine 5'-Monophosphate Response Element-Binding Protein in Rheumatoid Arthritis Synovial Tissue
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