Studies on regulation of IGF (insulin-like growth factor)-binding protein (IGFBP) 4 proteolysis by pregnancy-associated plasma protein-A (PAPP-A) in cells treated with phorbol ester

Can pregnancy-associated plasma protein-A be a marker for the assessment of atherosclerosis risk in patients with chronic plaque psoriasis?

Introduction

Psoriasis is an immune-mediated chronic inflammatory dermatosis. Several studies have shown that patients with psoriasis have a much greater risk of cardiovascular diseases than the normal population. The chronic inflammation observed in psoriasis is thought to have a role in the development of atherosclerosis and vascular endothelial injury.

Aim

To examine serum pregnancy-associated plasma protein-A (PAPP-A) levels, which has been regarded as a marker of early stage atherosclerosis in patients with psoriasis that do not have concurrent conventional cardiovascular risk markers.

Material and methods

Forty-one patients diagnosed with a chronic plaque type of psoriasis and 42 equally matched healthy volunteers were included in this study. The PAPP-A levels were compared between patient and control groups and the association between PAPP-A levels and disease duration and severity were evaluated in the patient group.

Results

Statistically, serum PAPP-A levels were significantly higher in the psoriasis group than in the control group (p = 0.015). Serum PAPP-A levels were found to be positively correlated with severity (p = 0.036, r = 0.329) and duration (p = 0.014, r = 0.269) of the disease.

Conclusions

As a marker of early stage atherosclerosis, PAPP-A levels were elevated in the psoriasis group and were correlated with disease duration and severity. This elevation reveals the presence of atherosclerosis in patients with psoriasis. Further studies are needed to confirm the use of PAPP-A as an available and inexpensive screening test and cardiovascular risk assessment for all centers.

Human annulus cells regulate PAPP-A and IGFBP-4 expression, and thereby insulin-like growth factor bioavailability, in response to proinflammatory cytokine exposure in vitro

Pregnancy-associated plasma protein-A (PAPP-A) is a metalloproteinase which cleaves IGF binding protein (BP)-4 in the extracellular matrix, making IGF available to nearby cells. We have shown that PAPP-A is present in the human intervertebral disc, and is significantly upregulated in more degenerated discs where increased proinflammatory cytokine levels are present. We hypothesized that increased proinflammatory cytokines present in the degenerating disc might be related to PAPP-A expression. Experiments exposed human annulus cells to IL-1-β or TNF-α to test this hypothesis. Treated cells showed significantly increased PAPP-A in conditioned media versus controls (p < 0.001). PAPP-A production following exposure to IL-1β was significantly greater in cells derived from more degenerated versus healthier discs (p = 0.05). PAPP-A gene expression (microarray analysis) was significantly upregulated in IL-1β- or TNF-α-exposed cells (p = 0.01-0.004). Quantitative RT-PCR confirmed significant upregulation of IGFBP-4 in IL-1β- or TNF-α-exposed cells. Data have potential relevance to future cell-based biologic therapies for disc degeneration.

Immunolocalization and biochemical evidence of pregnancy-associated plasma protein A in the intervertebral disc

STUDY DESIGN

Studies were approved by the authors' Human Subjects Institutional Review Board and Institutional Animal Care and Use Committee. Anulus tissue was used in studies of the immunocytochemical localization of pregnancy-associated plasma protein A (PAPP-A) in disc tissue from the sand rat and from human disc surgical specimens and specimens from control donors. Cultured human disc cells were also tested for production of PAPP-A.

OBJECTIVES

(1) To determine the immunohistochemical localization of PAPP-A in human and sand rat discs; (2) To test for gene expression of PAPP-A in the human disc in vivo and in vitro production by cultured cells; and (3) To test for expression of insulin-like growth factor binding proteins (IGFBP)-2, -4, and -5 in vivo and in vitro by human disc cells.

SUMMARY OF BACKGROUND DATA

PAPP-A is a metalloproteinase expressed by several cell types, including fibroblasts, osteoblasts, and smooth muscle cells. PAPP-A has an extremely important role because it cleaves IGFBP-2, -4, and -5 in the extracellular matrix, thereby increasing the bioavailability of IGF to nearby cells. METHODS.: Specimens of human disc tissue and lumbar discs from sand rats were assessed for immunocytochemical localization of PAPP-A, and the percentage of positive cells determined. Human disc cells in three-dimensional culture were assessed for production of PAPP-A using an enzyme linked immunosorbent assay. Molecular gene expression studies were carried out using microarray analysis.

RESULTS

Positive cytoplasmic immunolocalization of PAPP-A was present in the majority of cells of the human and sand rat outer anulus (OA). In the human outer anulus, the percentage of cells positive for PAPP-A localization did not differ in Grades I-II discs vs. Grades III-V discs (OA: 77.4% +/- 10.5 vs. 75.1% +/- 7.4 [mean +/- SEM] respectively). In the inner anulus, however, the percentage of cells positive for PAPP-A localization in more degenerate discs was significantly greater than the percentage in healthier discs (60.7% +/- 10.1 vs. 15.6 +/- 5.4, P = 0.024). % positive cells in the inner anulus correlated significantly with disc grade (r = 0.579; P = 0.01). Over a 5-day three-dimensional culture period, human anulus cells produced and secreted abundant PAPP-A into the culture media. Molecular studies confirmed the expression of IGFBP-2, -4, and -5 both in vivo and in vitro.

CONCLUSIONS

Data provide important new insights into disc cell expression of PAPP-A at the translational level. The presence of a significantly greater proportion of cells positive for PAPP-A in the inner anulus of more degenerate Grade III-V discs compared with healthier Grade I-II discs supports our previous observation of increased gene expression of PAPP-A in more degenerated discs. Biochemical data shown here documented production of PAPP-A by disc cells in vitro. Production of PAPP-A by disc cells is important since PAPP-A cleaves IGF-binding proteins, and makes IGF-I, a potent mitogen and antiapoptotic agent, available to cells. Future studies are indicated to further investigate PAPP-A and IGF-BP function in the disc.

Pregnancy-associated plasma protein-a is involved in matrix mineralization of human adult mesenchymal stem cells and angiogenesis in the chick chorioallontoic membrane

Pregnancy-associated plasma protein A (PAPP-A) is an IGF binding protein 4 protease that can function to increase local IGF-I bioavailability. Aside from its assumed role during pregnancy, in vitro and in vivo studies have indicated roles for PAPP-A in IGF-I-mediated wound healing, vascular repair, and bone formation. Because bone morphogenetic protein 2 (BMP-2) is known to up-regulate Igf-I gene expression, we hypothesized that PAPP-A may be involved in BMP-2 mechanisms in bone formation. To test this hypothesis, we quantified gene expression of Papp-A in response to BMP-2 treatment and runt-related transcription factor 2, Osterix, and Igf-I in response to PAPP-A protein treatment in human adult mesenchymal stem cells. Our results demonstrate that BMP-2 directly up-regulated Papp-A gene and protein expression. Purified PAPP-A protein directly up-regulated runt-related transcription factor 2 and Igf-I gene expression but not Osterix. When added in combination with recombinant human BMP-2, PAPP-A increased matrix mineralization in the absence of dexamethasone. PAPP-A further demonstrated an angiogenic effect in the chick chorioallontoic membrane, which implicates a critical developmental role and possible therapeutic potential. Our findings suggest that PAPP-A functions in the formation of mineralized tissues through direct up-regulation of key genes. Furthermore, PAPP-A is involved in the formation of new blood vessels, which is essential for proper bone regeneration.

Pregnancy-associated plasma protein-A regulates myoblast proliferation and differentiation through an insulin-like growth factor-dependent mechanism

Pregnancy-associated plasma protein-A (PAPP-A), a member of the metalloproteinase superfamily, is an important regulator of mammalian growth and development. However, the role of PAPP-A and its mechanism of action in various cellular processes remain unknown. In this study, we have investigated the role of PAPP-A in skeletal myogenesis using C2C12 myoblasts. Recombinant PAPP-A was purified from the conditioned medium of HT1080 cells overexpressing PAPP-A. Treatment of C2C12 myoblasts with PAPP-A increased their proliferation in a dose- and time-dependent manner. Addition of exogenous PAPP-A also increased the myotube formation and the activity of creatine kinase in C2C12 cultures. Transient overexpression of the full-length PAPP-A-(1-1547), but not truncated protease-inactive N-terminal PAPP-A-(1-920) or C-terminal PAPP-A-(1100-1547), significantly enhanced the proliferation of C2C12 myoblasts. In vitro and in situ experiments demonstrated that PAPP-A cleaves insulin-like growth factor-binding protein (IGFBP)-2, but not IGFBP-3, in the conditioned medium of C2C12 myoblasts. Overexpression of PAPP-A led to degradation of the IGFBP-2 produced by C2C12 myoblasts and increased free IGF-I concentrations without affecting total IGF-I concentrations. Addition of protease-resistant IGFBP-4 completely abolished the PAPP-A-induced proliferation of C2C12 myoblasts. Our results demonstrate that 1) PAPP-A increases the proliferation and differentiation of myoblasts, 2) the stimulatory effect of PAPP-A on myogenesis is governed by its proteolytic activity, and 3) PAPP-A promotes skeletal myogenesis by increasing the amount of free IGFs via specific degradation of IGFBP-2 produced by myoblasts.

Pregnancy-associated plasma protein-A proteolytic activity in rat vertebral cell cultures: Stimulation by dexamethasone-a potential mechanism for glucocorticoid regulation of osteoprogenitor proliferation and differentiation

Glucocorticoids (GCs) at physiological concentrations stimulate osteoprogenitor proliferation and differentiation in rat bone cell populations, and this is mediated in part by an increased response to insulin-like growth factors (IGFs). Since IGF binding proteins (IGFBPs) modulate IGF actions, we evaluated whether the increased IGF responsiveness might be associated with decreased inhibitory IGFBP-4 peptide levels. Rat vertebral cells were cultured for up to 20 days with or without dexamethasone (Dex). Cell layer proteins were extracted at day 6, 8, 14, and 20, conditioned media (CM) collected at day 8, 14, and 20, and total RNA isolated at day 14 and 20 of culture. Western blotting showed that cell layer IGFBP-4 levels were lower, while IGFBP-4 protease activity in CM was higher, in Dex-treated cultures. Addition of pregnancy-associated plasma protein-A (PAPP-A) antibody to CM abrogated IGFBP-4 proteolysis. PAPP-A mRNA levels were the same in control and Dex-treated cultures as evaluated by RT-PCR. Our data demonstrate that activity of the IGFBP-4 protease, PAPP-A, in rat bone cell cultures is increased by Dex via post-transcriptional mechanisms. Since IGFBP-4 mRNA levels in Dex-treated cultures were the same as in controls at day 8, slightly lower than in controls at day 14, and higher than in controls at day 20 as shown previously, the decreased IGFBP-4 peptide levels in Dex-treated cultures likely result from increased IGFBP-4 proteolysis by the elevated PAPP-A enzymatic activity. Our findings underscore a novel mechanism whereby GCs increase IGF responses in rat bone cells via PAPP-A-induced IGFBP-4 proteolysis.