Upregulation of prolylcarboxypeptidase (PRCP) in lipopolysaccharide (LPS) treated endothelium promotes inflammation
© Ngo et al; licensee BioMed Central Ltd. 2009
Received: 09 September 2008
Accepted: 27 January 2009
Published: 27 January 2009
Prolylcarboxypeptidase (Prcp) gene, along with altered PRCP and kallikrein levels, have been implicated in inflammation pathogenesis. PRCP regulates angiotensin 1–7 (Ang 1–7) – and bradykinin (BK) – stimulated nitric oxide production in endothelial cells. The mechanism through which kallikrein expression is altered during infection is not fully understood. Investigations were performed to determine the association between PRCP and kallikrein levels as a function of the upregulation of PRCP expression and the link between PRCP and inflammation risk in lipopolysaccharide (LPS)-induced endothelium activation.
The Prcp transcript expression in LPS-induced human umbilical vein endothelial cells (HUVEC) activation was determined by RT-PCR for mRNA. PRCP-dependent kallikrein pathway was determined either by Enzyme Linked ImmunoSorbent Assay (ELISA) or by biochemical assay.
We report that PRCP is critical to the maintenance of the endothelial cells, and its upregulation contributes to the risk of developing inflammation. Significant elevation in kallikrein was seen on LPS-treated HUVECs. The conversion of PK to kallikrein was blocked by the inhibitor of PRCP, suggesting that PRCP might be a risk factor for inflammation.
The increased PRCP lead to a sustained production of bradykinin in endothelium following LPS treatment. This amplification may be an additional mechanism whereby PRCP promotes a sustained inflammatory response. A better appreciation of the role of PRCP in endothelium may contribute to a better understanding of inflammatory vascular disorders and to the development of a novel treatment.
Prolylcarboxypeptidase (PRCP) dysfunction is associated with adverse cardiovascular consequences such as inflammation and hypertension [1, 2]. Although the physiological role(s) of PRCP is still poorly understood, PRCP has been shown to be an active participant in processes such as cell permeability via the activation of prekallikrein (PK) and the melanogenic signaling pathway . PRCP-dependent plasma prekallikrein activation influences the permeability of the endothelium by liberating bradykinin (BK) from a protein precursor, high molecular weight kininogen (HK). BK- mediated bradykinin B 2 receptor activation leads to the release of nitric oxide and prostaglandins [4, 5]. In addition, PRCP metabolizes angiotensin II (Ang II) to angiotensin 1–7 (Ang 1–7) and angiotensin III (Ang III) to angiotensin 2–7 (Ang 2–7). Ang 1–7 -mediated Ang 1–7 receptor Mas activation causes the release of prostaglandins and nitric oxide. Thus, PRCP regulates Ang 1–7 – and BK – stimulated nitric oxide production in endothelial cells, highlighting PRCP's role as a regulatory protease rather than a digestive protease.
Kallikrein (activated prekallikrein) is implicated in many physiological and pathological processes including the blood coagulation, the initiation of the classical complement cascade pathway, as well as activating the alternative complement pathway [7, 8]. Kallikrein is also involved in induction of elastase release from neutrophils and conversion of prourokinase to urokinase to initiate fibrinolysis [9–12]. Kallikrein over-expression parallels endothelial lesion, tissue injury, and sepsis – underscoring the correlation between kallikrein alterations and inflammation [13–15]. The mechanism by which kallikrein expression is altered during infection is not fully understood; however, some possible mechanisms have been postulated by others [16–19].
Of interest, PK is markedly depressed immediately following intramural injection of exogenous bacterial components to Lewis rats or to normal human volunteers, an indicator of PK activation[20, 21]. The reduction in PK levels has been attributed to the activated factor XII(FXIIa) -induced plasma kallikrein-kinin system (KKS) activation via factor XII autoactivation[20, 21]. The autoactivation of factor XII is necessary step to make factor XII susceptible for cleavage by kallikrein to support activation of the KKS in plasma as described. Interestingly, activation of PK is not abolished in patients with factor XII deficiency, suggesting that PK is activated by an uncharacterized mechanism. Since PRCP (a PK activator) is also elevated during inflammation, we decided to develop an endothelium model of inflammation which would enable us to determine whether the upregulation of PRCP expression would cause an increase in the generation of kallikrein.
We document that the upregulation of PRCP in lipopolysaccharide (LPS) pretreated endothelial cells results in an increase kallikrein generation. The implication of this observation is that PRCP might be an independent risk factor for inflammation. Furthermore, the upregulation of PRCP expression might promote inflammation from an acute to a chronic state through Ang 1–7 – and BK – stimulated nitric oxide production. Inactivation of PRCP-dependent pathway becomes extremely important in clinical situations such as septic shock and systemic inflammation.
Agarose, ladder, 0.5 M EDTA, pH 8.0, ultra pure distilled water DNase, RNase free and dNTP were purchased from Gibco BRI (Invitrogen Life Technology, Carlsbad, CA). Prestained low molecular weight standards, nitrocellulose, and polyacrylamide were all purchased from Bio-Rad Corp (Richmond, CA). The bradykinin B2 receptor antagonist (HOE140, icatibant) was purchased from Peninsula Laboratories (San Carlos, CA). Markit BK kit was purchased from Dainippon Pharmaceutical (Osaka, Japan). H-D-Pro-Phe-Arg-p-nitroanilide (S2302) was purchased from Dia-Pharma (Franklin, OH).
Enzymes, proteins, and biochemicals
Ribonucleotides, deoxyribonucleotides, and restriction enzymes were purchased from Roche Applied Science (Indianapolis, IN). RNasin Plus Ribonuclease inhibitor, RNase-free DNase I, and RNAgents total RNA isolation system were obtained from Promega (Madison, WI). Oligonucleotide primers for PCR were synthesized at Gibco BRI (Carlsbad, CA). Platinum-polymerase and taq-polymerase were purchased from Roche Applied Science.
Single chain HK (MW = 120 kDa on reduced SDS-PAGE) with a specific activity of 13 U/mg in acetate buffer (4 mM sodium acetate-HCl and 0.15 M NaCl, pH 5.3) was purchased from DiaPharma Laboratories, Inc. (West Chester, Ohio). Prekallikrein (PK) with a specific activity of 27 U/mg was purchased from Enzyme Research Laboratories (South Bend, IN).
Culture of endothelial cells
Human umbilical vein endothelial cells (HUVEC) were purchased from Clonetics (San Diego, CA) and cultured according to the supplier's instructions. Cells displayed typical staining for the endothelial cell marker, von Willebrand factor (data not shown). Cellular morphology was typical for endothelial cells – monolayered 'cobblestone' morphology and the absence of contaminating fibroblasts. Cells were cultured on a 2 μg/well fibronectin substrate and passaged using 0.1% trypsin-0.02% ethylenediaminetetra-acetic acid (EDTA) followed by neutralizing trypsin. They were cultured in EGM medium purchased from Invitrogen Corp (Carlsbad, California) supplemented with 25 U/ml penicillin and 25 μg/ml streptomycin and 2% heat inactivated fetal calf serum purchased from Hyclone (Logan, UT). Cells at passage numbers one to five were used at confluence (>3.0 × 104/cm2) 24 h after seeding. Lipopolysaccharide (E. coli serotype 0111:B4) was diluted in culture medium, and added to cells to final concentrations of 1–1000 ng/ml for 1–24 h.
Lipopolysaccharide (LPS) – induced HUVEC activation
These experiments were performed to determine the sub-lethal dose of LPS that activates HUVECs. To determine LPS-induced cytotoxicity, HUVECs were incubated with various concentrations of LPS over time. At the end of stimulation, the lactate dehydrogenase (LDH) release was performed to test for the loss of plasma membrane integrity by using a LDH diagnostic kit as outlined in the manufacture's instructions. A hallmark of apoptosis is the onset of DNA fragmentation. Apoptotic cells were determined by terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL) assay under fluorescence microscopy. Cells on the slides were fixed in a solution containing 4% paraformaldehyde and 3% H2O2 for 10 min followed by washing with buffer containing 0.5% Triton X-100 at 4°C for 2 min. The slides were then incubated with TUNEL reactions at 37°C for 60 min and then in peroxidase (POD) at 37°C for 30 min. Finally, cells were stained with DAB (3,3'-diaminobenzidine-tetrahydrochloride) and studied microscopically.
Prekallikrein activation on LPS-stimulated endothelial cells
LPS (0.3 μg/ml) pretreated confluent monolayers of HUVEC at 4 × 104 cells density/well in microtiter plate cuvette wells were washed three times with HEPES-NaHCO3 buffer [137 mM NaCl, 3 mM KCl, 12 mM NaHCO3, 14.7 mM Hepes, 5.5 mM Dextrose and 0.1% gelatin, pH 7.4] containing 2 mM CaCl2, and 1 mM MgCl2 and blocked with 1% gelatin for 1 h at 37°C. After blocking, 20 nM HK in the same buffer was added to the monolayers for 60 min at 37°C. At the end of incubation, the cells were washed and then incubated with PK (20 nM) in HEPES- NaHCO3 buffer for 60 min at 37°C. Cells were washed and 0.8 mM H-D-Pro-Phe-Arg-p-nitroanilide (S2302) (Dia-Pharma, Franklin, OH) was added in the same buffer and substrate hydrolysis proceeded for 1 h at 37°C. The rate of paranitroanilide liberation from H-D-Pro-Phe-Arg-paranitroanilide (0.8 mM, S2302) by kallikrein was determined by the absorbance at 405 nm . Additional experiments were performed to determine if increasing concentration of Z-pro-prolinal (PRCP inhibitor) inhibited PK activation.
Measuring the generation of bradykinin by PRCP-dependent PK activation pathway on LPS-treated HUVECs
The generation of BK by PRCP-dependent pathway was monitored in order to assess the physiological and pathophysiological role of PRCP. In these experiments, HUVECs, LPS-treated HUVECs, or PRCP-siRNA transfected HUVECs pretreated with LPS were treated with 1 μM HOE140, and 100 μM lisinopril to block the metabolism of BK by bradykinin B2 receptors and angiotensin converting enzyme. After 5 minutes of incubation, cells were incubated with HEPES-NaHCO3 buffer containing 50 nM HK, 50 nM PK in the absence or presence of 1 μM HKH20 or Z-pro-prolinal. After 1 h of incubation, the supernatants of these reactions were collected and either immediately deproteinized with trichlororacetic acid or frozen at -80°C for further study. BK in the samples was determined using a commercial kit (Markit BK, Dainippon Pharmaceutical; Osaka, Japan), performed according to the supplier's instructions.
Permeability determination for the plasma KKS
In vitro cell permeability assay was performed according to the manufacturer's protocol (CHEMICON, Billerica, MA). Briefly, endothelial cells (1.0 × 106 cells/ml) were subcultured in the inserts of permeability chambers that were coated with collagen. Cells were incubated in the tissue culture incubator at 37°C until they well reached 100% confluency. Then, the endothelial cell monolayer were incubated with 300 nM HK, 300 nM PK, or the complex of HK and PK (300 nM each), 300 nM bradykinin, or 0.3 μg/ml LPS for 3 hours at 37°C in the tissue culture incubator. At the end of incubation, 150 μl of FITC-Dextran (1:30 dilution) was added to each insert for 5 min at room temperature, and then 100 μl of the solution in the lower chamber was transferred to a 96-well plate. The plate was read in a Perkinelmer (precisely) Envision 2103 Multimode Reader at excitation wavelength of 480 nm and emission wavelength of 530 nm and with the bandwidth of 10. Control inserts with cells plated were treated with HEPES carbonated buffer and used as a control.
Small interfering RNA
The 19-nt siRNA duplex (5'-GACUCCUCUGGUUGAUCAUTT-3') used were designed to recognize human PRCP transcript, and was synthesized at Integrated DNA Technologies. These unique nucleotide residues within the PRCP had no identity with known mammalian genes. Transfection of siRNA into HUVEC was carried out in a six-well plate using lipofectamine 2000 according to the manufacturer's instructions (Invitrogen, Carsbad, CA) and as described . Two microliters of lipofectamine 2000 were diluted in 50 μl of Opti-MEM, and the mixture was incubated for 5 min at room temperature. For each well, 2 μl of siRNA (20 μM) were diluted in 50 μl of Opti-MEM mixed and incubated for 25 min at room temperature. The siRNA was added to the lipofectamine 2000 solution and mixed. The transfection mixture was added to each well containing 5 × 104 endothelial cells in suspension and transfections were incubated for 48 h in the incubator at 37°C, 5% CO2. Then, PK activation was determined on PRCP-siRNA transfected HUVEC.
Gene expression studies
To define the inflammatory properties of HUVECs, a panel of nine biomarkers of activated endothelium participating in thrombophilia, fibrinolysis, endothelial viability, and inflammation was analyzed in LPS-treated HUVECs. Total RNA from untreated as well as LPS-treated HUVEC were isolated and the expression levels of the endothelial risk factors were analyzed by RT-PCR.
We further determined PRCP expression in LPS-induced endothelium activation. The objective of this investigation was to determine whether LPS mediates a concentration- and time-dependent increase in the rate of PRCP synthesis in LPS-treated endothelial cells. For analyses of PRCP, endothelial nitric oxide synthase (eNOS), von Willebrand factor (VWF), tissue plasminogen activator (tPA), plasminogen activator inhibitor 1 (PAI-1), bradykinin B1 receptor (BKB1R), bradykinin B2 receptor (BKB2R), intercellular adhesion molecule-1 (ICAM-1), and glyceraldehydes-3-phosphate dehydrogenase (GAPDH) genes expression levels, RNA was extracted from cell monolayers using Trizol (Invitrogen Corp., Carlsbad, CA) in accordance with the manufacturer's specifications. RNA was then treated with DNAse I (Ambion Inc., Austin, TX) to eliminate genomic DNA contamination. cDNA was derived from HUVEC exposed to LPS to give expression levels of the genes of interest using Super Script II or III RNase H-Reverse Transcriptase (Invitrogen Corp.).
Primer pairs used to analyze the expression of nine biomarkers of coagulation activation, fibrinolysis, endothelial injury, and inflammation.
Position On cDNA
Position on cDNA
PCR Product Length
Results are expressed as mean ± SEM, and data was analyzed using Student's t-test for significant difference. Statistical significance was defined as P < 0.05.
Characterizing endothelium model of inflammation
PRCP expression is up-regulated during inflammation [2, 3]. Emerging evidence suggests that lipopolysaccharide (LPS) activates the plasma kallikrein-kinin system in the choroid plexus . The mechanism by which kallikrein expression is altered during infection is not fully understood. In endothelium, PRCP converts prekallikrein (PK) to kallikrein . We decided to develop an endothelium model of inflammation, which would enable us to assess whether the upregulation of PRCP expression would cause an increase in kallikrein generation.
LPS-induced apoptosis of endothelial cells.
Ratio of apoptosis
4.0 ± 1.0
5.0 ± 2.0
8.0 ± 2.0
44 ± 3.0
To determine cell viability, the lactate dehydrogenase (LDH) release (Promega, Madison, WI) was measured. LDH release assay showed that the endothelium plasma membrane integrity was intact after the LPS (0.2 μg/ml) stimulation for 16 h. Cell viability assay along with phenotypic observation of apoptosis under microscopy suggested that 1 μg/ml LPS stimulated cells did not induce cell apoptosis.
von Willebrand factor (VWF) expression is up-regulated during endothelial cell activation. Since the concentration of LPS in plasma or blood of patients with sepsis is about 200 ng/ml, we treated HUVEC with LPS (0.2 μg/ml) at different times (1, 2, 3, 8, 16, and 24 h) to determine VWF upregulation. VWF transcript was significantly increased in LPS – treated HUVEC within 16 h suggesting the activation of HUVEC. Thus, the time point (16 h) and dosage (0.2 μg/ml) became the standard in subsequent experiments.
Total RNAs from untreated and LPS-treated endothelial cells were isolated and reverse transcribed.
RT-PCR products Intensity (arbitrary Unit)
LPS enhances prekallikrein activation on HUVEC
Previous investigations have suggested that the kallikrein-kinin system [KKS, the heteromeric dimer of HK and PK] of blood coagulation contributes to thrombogenicity of atherosclerotic plaque as well as angiogenesis in inflammation and cancer [27–29]. We analyzed the response of PRCP-dependent PK pathway in endothelial cells exposed to LPS by using combined molecular and biochemical approaches.
Bradykinin liberation on LPS-treated HUVEC
By utilizing siRNA, we determined that PRCP plays a functional role in PK activation and bradykinin generation. We analyzed BK generation on cells transfected with PRCP-siRNA for 48 hours. As shown in Figure 2, downregulation of PRCP in cells transfected with 100 nM siRNA targeting PRCP resulted in 40–50% reduction in BK generation. The inability of siRNA to block BK levels by 100% might be due to the poor transfection efficiency in HUVEC. These results suggest that PRCP may contribute to the risk of developing inflammation.
In vitro endothelial cell permeability
Prolylcarboxypeptidase (PRCP) activates prekallikrein (PK) to kallikrein leading to the generation of bradykinin (BK) from high molecular weight kininogen (HK). Prcp gene along with altered PRCP and kallikrein levels have been implicated in inflammation pathogenesis. PK is significantly depressed immediately following intramural injection of exogenous bacterial components to Lewis rats or to normal human volunteers suggesting the potential activation of PK to kallikrein by the activated factor XII [20, 21]. However, the activation of PK is not abolished in patients with factor XII deficiency, suggesting that PK is activated by an uncharacterized mechanism. The mechanism by which kallikrein expression is altered during infection is not fully understood.
The aim of the present study was to determine the association of PRCP and kallikrein levels as a function of the upregulation of PRCP expression and the link between PRCP and inflammation risk in lipopolysaccharide (LPS)-induced endothelium activation. The major finding of our current investigation was that the stimulation of endothelial cells by LPS resulted in a significant upregulation of PRCP mRNA expression. The activation of PK to kallikrein was also enhanced on LPS-treated HUVECs. The amount of BK generation was significantly higher on LPS-treated cells than on untreated cells. PRCP enhanced cell monolayer permeability through activation of plasma kallikrein-kinin system which generates BK. The down-regulation of PRCP by PRCP-siRNA markedly blocked both kallikrein and bradykinin (BK) generation on LPS-pretreated HUVECs. Thus, the present study extends the role of PRCP-dependent PK activation into inflammatory reactions.
Physiologically, BK is a cardioprotective peptide. However, uncontrolled BK – stimulated nitric oxide production could promote endothelial dysfunction. Experiments were performed to determine if PRCP-dependent PK activation would result in an increase in BK generation on LPS-treated HUVECs. BK generation was significantly higher on LPS-pretreated cells than on untreated cells indicating that PRCP modulates BK generation. The present findings suggest that the upregulation of PRCP can lead to an increase in BK generation in response to LPS-induced endothelial cell activation, and we therefore believe that PRCP might promote inflammatory response. PRCP inhibitors could represent a novel therapeutic possibility to reduce inflammation.
We observed elevated proinflammatory and endothelial dysfunction indices such as BKB1R, ICAM-1, and VWF expression in endothelium following LPS treatment. Tissue plasminogen activator inhibitor 1 (PAI-1) expression which counteracts tissue plasminogen activator (tPA) activity was also significantly increased in LPS-stimulated endothelium confirming the development of impaired fibrinolytic system and endothelium activation, a phenomenon found in patients with severe sepsis . Of interest, endothelium activation and thrombophilia were coincided with the PRCP expression levels in LPS-pretreated endothelium. Incubation of LPS-pretreated endothelium with PK alone resulted in no S2302 (kallikrein substrate) hydrolysis suggesting that the PK activation on LPS-treated HUVEC was not due to PK autoactivation. Our data suggested that there was a causal relationship between LPS-induced endothelium activation and PRCP-dependent PK over-activation.
It has been suggested that the root of vascular disease is due to the increased breakdown of nitric oxide and uncoupling of nitric oxide synthase, the two factors observed in hypertension due to having blunted endothelial vasorelaxation [35, 36]. Nonetheless, endothelial dysfunction may involve integrated multi-factorial agents/factors including ROS, angiotensin II, and aldosterone levels [37, 38]. PRCP is involved in inflammation pathophysiology, but the intracellular signalling leading to the up-regulation of PRCP is unknown. Therefore, it is likely that upregulation of PRCP expression during inflammatory state might be to sustain vasodilation and promote repair by enhancing liberation of nitric oxide and prostacyclin (PGI2), the two factors generated by the metabolites of PRCP.
The bradykinin B 1 receptor (BKB1R) expression was upregulated in LPS-induced endothelial cell activation. BKB1Rs are activated by des-Arg9-bradykinin, which is produced from BK by thrombin-activatable fibrinolysis inhibitor (TAFI), carboxypeptidase N and carboxypeptidase M[42, 43]. Regardless of the triggers of inflammation, BKB1R is induced only following inflammatory insult. This amplification may be an additional mechanism whereby PRCP promotes a sustained inflammatory response. Of note, PRCP has the ability to metabolize des-Arg9-bradykinin in in vitro study. Thus, PRCP might influence the balance of BKB2R and BKB1R signaling in endothelial cells by blocking BKB1 receptor-mediated effects. It will be of interest to determine if PRCP plays a pathophysiological role in modulating des-Arg9-bradykinin in infection and in other clinically relevant disease situations.
In conclusion, the data presented in this report supported the idea that PRCP contributed to the initiation of events associated with LPS-stimulated endothelial cells activation. Furthermore, the upregulation of PRCP expression was related to the intensity of kallikrein generation on endothelium (Figure 4). Further investigations must be performed to determine mechanistically how PRCP expression is upregulated in LPS-induced endothelium activation. However, our novel data underline the importance of PRCP in inflammation and in endothelial dysfunction, but its predictive value in inflammation needs to be further investigated.
This study was supported by American Heart Association 0330193N and NCRR/NIH P20RR021929 to SZ, and by American Society of Hematology to NM.
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