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Departments of
*
Microbiology and Immunology and
Medicine, Virginia Commonwealth University, Richmond, VA 23298
| Abstract |
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germline transcripts. Although Bryo caused a delay
in the proliferative response of IL-4/CD40 ligand trimer-stimulated B
cells, CFSE studies revealed that the Bryo-mediated inhibition of class
switching to IgE occurred independently of the number of division
cycles. Notably, Bryo showed the same specific IgE inhibition in human
B cells. This study provides evidence for a unique mechanism regulating
IgE production possibly downstream of PKC by specifically modulating
I
germline transcription. | Introduction |
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,
,
II, and
;
the calcium-independent isoenzymes or novel PKC
,
,
',
,
, and µ; and the atypical isoenzymes
and i(
) (reviewed in
Ref. 2). Murine splenic B cells do not express PKC
(3) or PKC
(4). They express PKC
,
,
,
, and
at low levels and abundantly express PKC
(4). PKC isozymes are differentially expressed during B
cell differentiation; e.g., maturation to the plasma cell stage is
paralleled by an increase in PKC
and disappearance of the
isoform (3). PKC is activated by a number of exogenous
compounds including phorbol esters such as PMA (5).
Another class of PKC activators, structurally unrelated to phorbol
esters, is the bryostatins (6, 7). Both PMA and
bryostatin-1 (Bryo) activate the classic PKC and novel PKC
isozymes. Bryo is a macrocyclic lactone isolated from the marine bryozoan Bugula neritina (7). It activates and rapidly down-regulates PKC (8, 9, 10) and has shown potent antineoplastic properties both in vitro and in vivo (11). Bryo has been shown to induce differentiation in leukemia cells and exert antiproliferative properties in both normal and malignant hemopoietic cells (reviewed in Refs. 12 and 13).
IgE is thought to have evolved as a protective mechanism against parasites, but its production, especially in individuals from developed countries, is associated with allergic responses (14). Based on the direct involvement of IgE production in allergic conditions, several attempts are being made to modulate the synthesis of IgE. To this end, developing a better understanding of the mechanism specifically regulating the IgE isotype is crucial.
This study reports a novel effect of Bryo on in vitro murine and human IgE production models. Namely, IgE production is almost completely ablated, whereas the production of other Igs is either not affected or enhanced. Mechanistic studies indicate that germline transcription is impaired, suggesting that reduced switching to IgE is responsible for the effect observed. These findings provide insights into the potential role of PKC in the modulation of IgE production.
| Materials and Methods |
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CFSE (Molecular Probes, Eugene, OR) was prepared in DMSO at a concentration of 5 mM as a stock solution and kept at -20°C until used. Nonessential amino acids, 2-ME, sodium pyruvate, HEPES, and PMA were all purchased from Sigma Chemicals (St. Louis, MO). FBS was purchased from HyClone Laboratories (Logan, UT). Baculovirus supernatant containing recombinant murine IL-4 was a gift from Dr. W. Paul (National Institutes of Health, Bethesda, MD); recombinant murine IL-5 was purchased from R&D systems (Minneapolis, MN). Recombinant CD40 ligand trimer (CD40LT) and M15 (mouse IgG1 anti-leucine zipper mAb) were obtained from Immunex (Seattle, WA). Bryo was obtained from the National Cancer Institute (Bethesda, MD). Bryo was reconstituted from powder by preparing a 10-4 M stock in DMSO.
Animals and B cell isolation and cell culture
BALB/c mice were purchased from the National Cancer Institute-Frederick Cancer Research Center (Frederick, MD). All mice used in experiments were between 6 and 14 wk of age. BCL-6 -/-, BCL-6+/-, and wild-type controls were generously provided by Dr. A. Dent (Indiana University Medical School, Indianapolis, IN). Single-cell suspension of B lymphocytes isolated from disrupted spleens were negatively selected as described previously (15, 16). Briefly, anti-CD5, anti-CD8 (both from Dr. W. Paul), anti-Thy-1.1 (TiB99), and guinea pig complement (Life Technologies, Gaithersburg, MD) were used to kill T cells. Subsequently, the cells were layered on a discontinuous Percoll gradient, and resting B cells were collected from the 6670% interface. B cells were then plated at different cell concentrations in 96-well plates (Costar, Cambridge, MA) in a volume of 200 µl B cell medium (RPMI 1640 containing 2 mM L-glutamine, 1 mM sodium pyruvate, 0.1 mM nonessential amino acids, 10 mM HEPES buffer, 5 x 10-5 M 2-ME, 100 µg/ml streptomycin, 100 U/ml penicillin, and 10% FBS) and stimulated with 50,000 U/ml IL-4, 5 ng/ml IL-5, 0.1 µg/ml CD40LT, and 0.1 µg/ml M15 at 37°C in a 5% CO2 incubator. These activation conditions have been previously shown to be optimal for IgE production (17). In addition, cells were treated on day 0 or the day indicated with 100 nM Bryo. Cultures containing 1% DMSO were used as medium control.
To isolate PBL, blood obtained from donors was mixed with an equal volume of sterile PBS, then layered onto Ficoll-Paque (Amersham Pharmacia Biotech, Piscataway, NJ), and centrifuged. The cells at the interface were then collected, washed, and resuspended in RPMI 1640. The optimal concentration of PBL (2 x 106 cells/ml) were costimulated with 200 U/ml human rIL-4 (R&D systems) and 0.5 µg/ml anti-CD40 (BD PharMingen, San Jose, CA) in human B cell medium (RPMI 1640, 100 µg/ml streptomycin, 100 U/ml penicillin, and 10% FCS from HyClone Laboratories). These stimulation conditions were optimized for IgE production by Prof. Goulds laboratory (Kings College, London, U.K.). Cell cultures were performed in 96-well plates and were treated with increasing concentrations of Bryo or left untreated. Cells were incubated at 37°C in a 5% CO2 incubator. Supernatants were harvested 1012 days postculture, and Ig levels were assayed by ELISA.
ELISA
IgM, IgG1, and IgE levels were determined by ELISA as previously described (17). Because cells treated with PKC activators lived longer in cultures (data not shown), the absolute value of Ig levels increased with a longer culture period. Therefore, all supernatants were harvested on day 14, which was found to be the optimal time for supernatant collection. Supernatants were then analyzed for IgE as previously reported (17). Briefly, rat anti-mouse IgE mAbs B1E3 and R1E4 were used as the capture and biotinylated secondary Ab, respectively. IgG1 and IgM levels were determined using an unlabeled primary goat anti-mouse Ab at 5 µg/ml and detected using goat anti-mouse class-specific Ab coupled to alkaline phosphatase (Southern Biotechnology Associates, Birmingham, AL). All ELISA were performed in Costar high-binding ELISA plates.
For human IgE ELISA, mAbs 7.12 and 4.15 (American Type Culture Collection, Manassas, VA) were used as the capture Abs as previously described (18). Rabbit anti human-IgE/HRP (DAKO, Carpinteria, CA) was used as the detection Ab. IgM levels were assayed using unlabeled goat anti-human IgM polyclonal Ab at 2 µg/ml as the capture Ab and then detected by HRP-conjugated mouse anti-human IgM mAb (all from Southern Biotechnology) followed by the addition of TMB One Step Substrate (DAKO). The reaction was stopped with 0.18 M H2SO4 and read at wavelength 450 nm using a SPECTRAmax ELISA reader.
Proliferation assay
On day 2 postculture or the days indicated, B cells were pulsed using 1 µCi [3H]thymidine/well (ICN Biomedicals, Costa Mesa, CA) for 8 h. Cells were then harvested onto a Unifilter 96 plate (Packard Instrument, Meriden, CT) using a Filtermate 196 plate harvester (Packard), and the incorporation of [3H]thymidine into DNA was measured by reading the plate in a model B9902 TopCount (Packard).
ELISPOT
The protocol used to quantify IgE-producing cells is previously described (19). Briefly, ELISPOT Immulon 4 (Dynex, Chantilly, VA) plates were coated with B1E3 overnight then blocked with a solution of PBS with 5% FBS. Cells isolated on day 5 postculture were added to the plates, incubated for 5 h at 37°C in a 5% CO2 incubator, and then washed. Spots were detected using biotinylated R1E4, followed by streptavidin-AP and finally 5-bromo-4-chloro-3-indolyl phosphate substrate solution. The number of IgE secreting cells was quantified by counting the number of blue spots per well and multiplying by the dilution factor and was expressed as the number of Ab-forming cells (AFC) per million B cells.
RT-PCR
To determine I
transcript levels, B cells were stimulated as
described above. Total cellular RNA was prepared using TRIzol reagent
(Life Technologies) according to manufacturers recommended protocol.
RNA preparations were quantified by UV spectrophotometery. RT-PCR was
performed using the Gene Amp PCR kit (Applied Biosystems, Branchburg,
NJ), and the conditions described by Warren and Berton
(20). PCR products were detected using
[32P]dCTP (3000 Ci/mmol; ICN Biomedicals). A
10% polyacrylamide gel was used to analyze PCR products; the gel was
subsequently dried and exposed to a phosphor screen. Quantification of
I
and HGPRT (used as a housekeeping control gene) was performed
using a PhosphorImager 445SI (Molecular Dynamics, Sunnyvale, CA)
combined with ImageQuant software.
For detection of Iµ-C
postswitch hybrid transcripts, RNA was
isolated on day 4 postculture, reverse transcribed as described above,
and then amplified using the previously described primer set ImF and
CeR (21). PCR products were analyzed on 1.2% agarose and
stained with ethidium bromide (Sigma).
Real time PCR
Real time PCR was performed as previously described
(22). Briefly, RNA was isolated from the various
conditions on different days and reverse transcribed as described
above. Real time PCR was performed using the Taqman One-Step RT-PCR
Mastermix reagent kit and analyzed on a model 7700 ABI Prism Sequence
Detector (Applied Biosystems, Foster City, CA). I
transcripts were
amplified using the primer set IeHF (5'-TGGGCATGAATTAATGGTTACTAGAG-3')
and IeHR (3'-TGGCCAGACTGTTCTTATTCGAA-5') and detected by the Taqman
fluorescent probe IeHT (TCACAACGCCTGGGAGCCTGC).
Surface Ig determination
Surface IgE and IgG1 expression was analyzed by fluorescent
labeling. For IgE staining, cytophilic IgE was removed using the acid
stripping protocol. Briefly, cells were harvested, washed, and
resuspended in 1 ml acid stripping buffer, pH 4.0 (1.7 g/L sodium
acetate, 1.25 g/L NaCl, 0.1 g/L KCl, 1% newborn calf serum). After a
60-s incubation, 10 ml PBS/0.1 M HEPES were added to neutralize the
acidic solution followed by 25 ml Hanks medium (Hanks BSS, 5%
serum, 10 mM HEPES). To block nonspecific binding, cells were incubated
with 5 µg/ml anti-Fc
RII Ab (2.4G2). Stimulated unstained cells
were used to correct for autofluorescence. Direct labeling was
performed for surface IgE expression by incubating cells with either
FITC- or PE-conjugated anti-IgE (Southern Biotechnology) for 45 min
at 4°C. Cells stimulated with CD40LT alone, which are unable to
switch to IgE, were used as a control for nonspecific IgE binding. IgG1
expression was detected using an indirect labeling technique; a primary
biotinylated rat anti-mouse IgG1 was followed by FITC- or
PE-labeled avidin. Nonspecific controls were stained with
FITC/PE-avidin only. Immediately before analysis, propidium iodide (PI;
50 µg/ml in 0.1% sodium citrate, pH 7.4) was added to the cells to
aid in distinguishing dead cells. The viable cell population was gated
on forward and side scatter profile as well as
PI- population and analyzed on a FACScan (BD
Biosciences, San Jose, CA) using Cyclops software (Cytomation, Fort
Collins, CO).
CFSE staining and determination of cell division
Resting cells were labeled with CFSE as described previously (23, 24). Briefly, B cells were washed and resuspended at 107 cells/ml in PBS containing 0.1% BSA, CFSE was added to a final concentration of 10 µM, and cells were incubated for 10 min at 37°C in the dark. The cells were subsequently washed twice with PBS-BSA and resuspended into complete B cell medium. Labeled cells were then plated in 96-well plates at 2.5 x 103 cells/well; then stimulated with IL-4, CD40LT, and IL-5; and cultured at 37°C in a humid atmosphere containing 5% CO2. Activated B cells were then harvested at various time postculture, washed, and incubated with PE-labeled anti-IgE mAb (Southern Biotechnology) for 45 min. B cells double-stained with CFSE and PE-anti-IgE were then analyzed on FACScan (BD Biosciences).
| Results |
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As previously reported (25), IgE production in vitro
was consistently found to be sensitive to B cell dose. IgE levels
decreased substantially above 2.5 x 103
cells/well (Fig. 1
). Thus, varying B cell
doses were stimulated with CD40LT and cytokines in 96-well plates in
the presence or absence of Bryo. Interestingly, treatment with Bryo led
to a dramatic inhibition of IgE production as evidenced by ELISA (Fig. 1
A). Identical results were observed for BALB/c and C57BL/6
mice (data not shown). This inhibition was selective for the IgE
isotype; both IgM and IgG1 production were enhanced after treatment
with Bryo (Fig. 1
, B and C). This effect was not
unique to Bryo, given that PMA (the classic PKC activator) showed a
similar specific inhibition of IgE production (data not shown).
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To determine how long Bryo had to be present to observe the
inhibitory effect on IgE production, Bryo was added on different days
after culture initiation. As shown in Fig. 2
, Bryo had a maximal effect on IgE
production when added up to day 2 postculture. A modest inhibition by
Bryo could be achieved even 5 days after culture initiation. The cell
concentration depicted in Fig. 2
(1 x 103
cells/well) is representative of B cell doses ranging from 250 to
2.5 x 103 cells/well, where IgE levels are
not sensitive to cell density in culture wells.
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transcriptionProduction of IgE can be dissected into different critical steps starting with switching. The first step in switching involves transcription of the H chain Ig genes in their germline configuration. Subsequently, the active region is targeted for switch recombination and produces the mature transcript. Afterward, the cell goes through differentiation to ultimately produce IgE producing plasma cells (reviewed in Ref. 26).
To determine the level at which IgE inhibition is occurring, the
ability of murine B cells to differentiate in the presence of Bryo was
determined. To this end, B cells treated with Bryo were examined by
ELISPOT to determine whether reduction in IgE production correlated
with a reduced number of IgE Ab-forming cells (IgE AFC). Fig. 3
A shows that production of
IgE-forming cells, the terminal stage of B cell differentiation, is
greatly impaired after treatment with Bryo. These data indicate that
Bryo causes a decrease in the number of IgE AFC rather than a decrease
in IgE production per cell, suggesting a possible effect on class
switching.
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After class switching, the Iµ exon, its promoter, and its enhancer
are still present and active. Therefore, transcription is usually
initiated at the Iµ promoter and terminated 3' of the switched
CH gene. After processing, the resulting
transcript is composed of the Iµ exon spliced to the
CH exon. Thus, the detection of Iµ-C
transcripts by RT-PCR is generally accepted as an indicator of class
switching to IgE (28). As shown in Fig. 3
E,
hybrid Iµ-C
transcripts were inhibited in Bryo-treated cells
indicating that Bryo impairs class switching to the IgE isotype.
The inhibition was traced back to an early and essential step in IgE
switching, i.e., germline
transcription. RNA isolated
from B cells stimulated in the presence or absence of Bryo, was
screened for germline
transcripts (I
). Stimulation with CD40LT
and IL-4, as expected, activated I
transcription. In contrast,
treatment with Bryo consistently inhibited the appearance of I
transcripts (Fig. 3
C). The quantitative technique, real time
PCR, was used to confirm the hypothesis that Bryo inhibits germline
transcription. Fig. 3
D shows an analysis of these data
normalized for the levels of a housekeeping gene (mouse
-actin). The
data provide evidence that the germline transcription is dramatically
reduced on Bryo treatment, thereby inhibiting an early requisite for
IgE switching (Fig. 3
D).
Bryo-mediated IgE inhibition is independent of the delay in cell division
In addition to inhibiting switching to IgE, Bryo-reduced IL-4 and
CD40LT induced proliferation especially at earlier time points after
culture initiation (days 2 and 3) (Fig. 4
). However, by day 4, Bryo and control
cells exhibited similar proliferative responses.
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80% of the cells were positive for IgE in the
later divisions (divisions 69; Fig. 6
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Because the inhibition occurs at the level of the germline
transcription, we focused on putative transcription factors acting to
selectively repress I
. A recent report showed that BCL-6 could
repress only a subset of STAT6-dependent IL-4 responses. I
transcription was one of the selective targets for BCL-6-mediated
repression in vivo (31). The selective action of BCL-6
makes this transcriptional repressor a promising candidate acting
downstream from Bryo. To address this possibility, we examined IgE
production from B cells isolated from BCL-6-/-
animals. Resting B cells harvested from
BCL-6-/-, heterozygotes
(BCL-6+/-), and littermates were costimulated
with IL-4 and CD40LT in the presence and absence of Bryo and analyzed
for IgE production. Fig. 7
shows that IgE
inhibition occurs even in the absence of BCL-6, arguing against the
involvement of this transcription repressor in Bryo-mediated IgE
inhibition.
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Human PBL were stimulated with predetermined optimal
concentrations of human rIL-4 and anti-CD40 and were treated with
increasing concentration of Bryo. As shown in Fig. 8
, as little as 0.1 nM Bryo led to a 60%
inhibition of IgE production. Interestingly, when compared with their
murine counterpart (Fig. 8
, inset), human B cells were
10-fold more sensitive to Bryo-mediated IgE inhibition. This inhibition
appeared to be selective to the IgE isotype because IgM levels were not
affected at subnanomolar concentrations of Bryo and were consistently
induced at higher doses (Fig. 8
B). Similar results were
obtained using purified B cells (data not shown). Control IgG4 levels
were undetectable by ELISA, precluding the analysis of the effect of
Bryo on this isotype. Collectively, these data indicate that Bryo
actions are operative in both murine and human systems.
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| Discussion |
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In this study, treatment with Bryo showed a selective inhibition of IgE
production (Fig. 1
A). This inhibition was selective as both
IgM and IgG1 levels were enhanced by Bryo (Fig. 1
, B and
C). Similar results were obtained with PMA, a classic
activator of PKC (data not shown). Attempts to address the direct
involvement of the PKC pathway in this inhibition using selective PKC
inhibitors were unsuccessful. Both chelerethryn chloride and
bisindolylmaleimide (GF109203X) were toxic to B cells (data not shown)
consistent with the fact that PKC inhibitors are potent inducers of
apoptosis especially in hemopoietic cells (32). Given the
recent discovery of phorbol ester receptors that bind PMA or
1,2-diacylglycerol but lack kinase activity (reviewed in Ref.
33), it is possible that IgE inhibition is mediated by a
PKC-independent pathway.
Data from ELISA (Fig. 1
) and ELISPOT (Fig. 3
A) assays could
be interpreted to signify that B cells fail to terminally differentiate
to IgE-forming cells in the presence of Bryo. The fact that the time
course of Bryo inhibition was maximal up to day 2 postculture (Fig. 2
),
when the switching process starts, points to a major defect in
switching rather than maturation to IgE-secreting plasma cells. This is
further supported by flow cytometry analyses showing inhibition of sIgE
expression in Bryo-treated cells (Figs. 3
B and
6A) and a lack of postswitch transcription (Fig. 3
E). The inhibition was manifested at the level of germline
transcription, which is a critical step in switch recombination (Fig. 3
, C and D). However, an effect on other aspects
of differentiation cannot be excluded because Bryo continued to show
some degree of inhibition on IgE levels as late as day 5 postculture,
after switching had occurred (Fig. 2
).
In addition to its selective effect on IgE production, Bryo reduced the
proliferative response of murine B cells on days 2 and 3 postculture
(Fig. 4
). Because proliferation is intimately related to isotype
switching, one explanation for the results could be an insufficient
number of cell divisions. Isotype switching has been linked to cell
division by a number of reports, and B cells were found to require a
minimum number of divisions before switching to the various isotypes
(29). Three rounds of divisions are needed for switching
to IgG1 vs five divisions for switching to IgE (24). By
reducing proliferation, Bryo would provide a selective advantage for
IgG1 switching while failing to meet the required number of divisions
for IgE switching. This possibility appeared plausible based on the
finding that cell division regulated the levels of germline transcripts
(34), the step in which Bryo exerted its inhibitory
effect. CFSE labeling, however, refuted this hypothesis and provided
evidence that proliferation was only delayed in Bryo-treated cells
(Fig. 5
). Despite the delay, cells treated with Bryo are not at a
disadvantage for IgE switching because they remain viable for a longer
period of time in culture than do untreated cells (data not shown).
Nevertheless, Bryo inhibited switching to IgE at all cell division
cycles (Fig. 6
). Interestingly, in our system the threshold division
number for switching to IgE is lower than values previously reported
(Ref. 24 ; Fig. 6
). This apparent discrepancy may be
explained by the use of a higher concentration of rIL-4 (50,000 U/ml)
in our experiments. This is consistent with data from Hodgkin et al.
(24) in which the number of divisions preceding isotype
switching to IgG1 decreased with increasing IL-4 concentration.
After ensuring that the delay in proliferation did not represent the
mechanism by which Bryo regulates switch recombination, the germline
promoter regulation was examined. This promoter provides a site
where both negative and positive signals integrate and where Bryo might
be exerting its selective inhibitory effect. Optimal activation of this
promoter is achieved by cooperative synergy between several
transcription factors (35). In response to IL-4
stimulation, STAT6 binds to its target DNA (36). CD40
signaling activates NF-
B (37), which then interacts
with both STAT6 and RNA polymerase to drive transcription from the I
promoter (38, 39). This multicomponent complex is believed
to be coordinated by a B cell-specific factor, B cell-specific
activator protein (40). Bryo could be interfering with any
of the cis-controlling elements that regulate I
transcription, particularly STAT6 and NF-
B. Because these two
transcription factors are also important for IgG1 production and the
latter is enhanced by Bryo, this possibility seems unlikely.
Specific negative signals acting on this promoter include high mobility
protein (HMG-I(Y)) and the transcription repressor BCL-6. HMG-I(Y)
binds to the transcription initiation site, thereby inhibiting
transcription (41, 42), whereas BCL-6 inhibits
transcription by competing with STAT6 for its binding site
(31). As shown in Fig. 7
, BCL-6-/-
B cells were as susceptible as wild-type cells to Bryo-mediated
inhibition of IgE production, suggesting that the inhibition of IgE
switching by Bryo is not mediated though BCL-6.
HMG-1(Y) is another important negative regulator of IgE production.
HMG-I(Y) belongs to a family of nonhistone high mobility group protein
that bind to the minor groove of dAT clusters (43, 44, 45). In
response to IL-4 downstream of insulin receptor substrate-1 signaling,
HMG-I(Y) is serine phosphorylated (41, 46).
Phosphorylation of HMG-I(Y) results in an attenuation of binding to its
target DNA, thus allowing transcription to resume (41).
HMG-I proteins can be phosphorylated by serine/threonine kinases such
as cdc2 kinase (47, 48) and casein kinase II
(49), and recently HMG-I has been shown to be a substrate
of PKC. PKC-catalyzed phosphorylation of HMG-I showed a stronger
decrease in the DNA-binding affinity of this protein than did other
kinases (50). Although phosphorylation of HMG-I(Y) by PKC
in response to IL-4 signaling is yet to be established, the fact that
HMG-I(Y) has not been identified in other Ig germline promoters and
could depend on PKC activity to alleviate its negative effect makes
this regulator a strong candidate for mediating the effect of Bryo. In
this model, Bryo-induced alteration in PKC activity would inhibit the
derepression of germline
transcription specifically. We are
currently performing experiments to test the validity of this
model.
Although the exact mechanism of inhibition at the level of the germline
transcription is yet to be determined, this study identifies a
unique mechanism for regulating IgE switching and suggests for the
first time the possible involvement of the PKC pathway in IgE
regulation. An evolving understanding of selective IgE regulation, as
this study provides, may assist in designing new therapeutic approaches
for the treatment of Allergy.
| Acknowledgments |
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| Footnotes |
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2 Address correspondence and reprint requests to Dr. Daniel H. Conrad, Box 980678, Medical College of Virginia Station, Richmond, VA 23298. E-mail address: dconrad{at}hsc.vcu.edu ![]()
3 Abbreviations used in this paper: PKC, protein kinase C; Bryo, bryostatin-1; CD40LT, CD40 ligand trimer; AFC, Ab-forming cells; HMGI(Y), high mobility protein; PI, propidium iodide. ![]()
Received for publication December 21, 2000. Accepted for publication August 23, 2001.
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Y. J. Oh, J. H. Youn, Y. Ji, S. E. Lee, K. J. Lim, J. E. Choi, and J.-S. Shin HMGB1 Is Phosphorylated by Classical Protein Kinase C and Is Secreted by a Calcium-Dependent Mechanism J. Immunol., May 1, 2009; 182(9): 5800 - 5809. [Abstract] [Full Text] [PDF] |
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