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Departments of 1 Internal Medicine and 2 Pediatrics, University of Michigan Medical Center, Ann Arbor, Michigan 48109
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ABSTRACT |
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We evaluated intracellular pathways responsible for the activation of the small GTP-binding protein Rho p21 in rat pancreatic acini. Intact acini were incubated with or without CCK and carbachol, and Triton X-100-soluble and crude microsomes were used for Western immunoblotting. When a RhoA-specific antibody was used, a single band at the location of 21 kDa was detected. CCK (10 pM-10 nM) and carbachol (0.1-100 µM) dose dependently increased the amount of immunodetectable RhoA with a peak increase occurring at 3 min. High-affinity CCK-A-receptor agonists JMV-180 and CCK-OPE (1-1,000 nM) did not increase the intensities of the RhoA band, suggesting that stimulation of RhoA is mediated by the low-affinity CCK-A receptor. Although an increase in RhoA did not require the presence of extracellular Ca2+, the intracellular Ca2+ chelator 1,2-bis(2-aminophenoxy)ethane-N,N,N',N'-tetraacetic acid-AM abolished the appearance of the RhoA band in response to CCK and carbachol. The Gq protein inhibitor G protein antagonist-2A (10 µM) and the phospholipase C (PLC) inhibitor U-73122 (10 µM) markedly reduced RhoA bands in response to CCK. The protein kinase C (PKC) activator phorbol ester (10-1,000 nM) dose dependently increased the intensities of the RhoA band, which were inhibited by the PKC inhibitor K-252a (1 µM). The pp60c-src inhibitor herbimycin A (6 µM) inhibited the RhoA band in response to CCK, whereas the calmodulin inhibitor W-7 (100 µM) and the phosphoinositide 3-kinase inhibitor wortmannin (6 µM) had no effect. RhoA was immunoprecipitated with Src, suggesting association of RhoA with Src. Increases in mass of this complex were observed with CCK stimulation. In permeabilized acini, the Rho inhibitor Clostridium botulinum C3 exoenzyme dose dependently inhibited amylase secretion evoked by a Ca2+ concentration with an IC50 of C3 exoenzyme at 1 ng/ml. We concluded that the small GTP-binding protein RhoA p21 exists in pancreatic acini and appears to be involved in the mediation of pancreatic enzyme secretion evoked by CCK and carbachol. RhoA pathways are involved in the activation of PKC and Src cascades via Gq protein and PLC.
cholecystokinin; pancreas
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INTRODUCTION |
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THERE ARE MANY SMALL monomeric GTP-binding proteins (molecular mass, 20-30 kDa) that show clear sequence homology to the proteins encoded by the Ras oncogenes, and some 50 distinct mammalian proteins of this type have been characterized as members of the Ras superfamily (2, 8, 17). Several different subfamilies have been defined based on their primary sources (Ras family, Rab family, Rho family, and others). These small GTP-binding proteins play a pivotal role in the regulation of cell functions. In general, the Ras family is involved in cell growth, cell proliferation, and differentiation (8), whereas the Rab family regulates intracellular vesicular transport during exocytosis and endocytosis (2), and the Rho family modulates the cytoskeletal systems (16).
Although several lines of evidence indicate that Ras, Rab3A, and Rab3D are involved in stimulus-secretion coupling of pancreatic acinar cells (10, 23, 24), the existence and functional role of the Rho proteins have not yet been ascertained in this cell type. Because the microtubular-microfilamentous systems participate in mediating pancreatic exocytosis (19), it is likely that the Rho protein might be involved during pancreatic enzyme secretion. Therefore, we attempted to identify and characterize the functional role(s) of Rho in rat pancreatic acini. Our results showed that the small GTP-binding protein RhoA p21 exists and appears to mediate pancreatic enzyme secretion evoked by cholecystokinin (CCK) and carbachol. The activation of RhoA involves the sequential stimulation of protein kinase C (PKC) and Src kinase cascades via the Gq protein and phospholipase C (PLC) pathway.
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METHODS |
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Materials. Chemicals were purchased from the following sources. CCK-8, carbachol, creatinine phosphatase, creatinine phosphokinase, ATP, 12-O-tetradecanoylphorbol 13-acetate (TPA), and wortmannin were from Sigma Chemical (St. Louis, MO). K-252a, W-7, and 1,2-bis(2-aminophenoxy)ethane-N,N,N',N'-tetraacetic acid-AM (BAPTA-AM) were from Calbiochem (La Jolla, CA). Clostridium botulinum C3 exoenzyme, U-73122, G protein antagonist-2A (GP antagonist-2A), and herbimycin A were from Biomol (Plymouth Meeting, PA). Anti-RhoA mouse monoclonal antibody 26C4 and anti-RhoB rabbit polyclonal antibody 119 were from Santa Cruz Biotechnology (Santa Cruz, CA). Anti-Src (pp60c-src) mouse monoclonal antibody was from Upstate Biotechnology (Lake Placid, NY). Protein G-Sepharose was from Pharmacia Biotech (Uppsala, Sweden). Streptolysin O (SLO) was from GIBCO BRL (Grand Island, NY). JMV-180 and CCK-OPE were from Research Plus (Bayonne, NJ).
Isolation of pancreatic acinar cells. Isolated rat pancreatic acini were prepared by collagenase digestion with pancreas obtained from male Sprague-Dawley rats (33). Acini obtained were suspended in a physiological salt solution (PSS). The PSS contained 0.1% bovine serum albumin, 0.1 mg/ml soybean trypsin inhibitor, and (in mM) 137 NaCl, 4.7 KCl, 0.56 MgCl2, 1.28 CaCl2, 1 NaH2PO4, 10 N-2-hydroxyethylpiperazine-N'-2-ethanesulfonic acid (HEPES), 5.5 D-glucose, and 2 L-glutamine with Eagle's minimum essential amino acid neutralized with NaOH. The PSS was adjusted to pH 7.4 and equilibrated with 100% O2. Isolated acini were preincubated for 40 min at 37°C in 40 ml of PSS, washed twice, and resuspended in 40 ml of fresh PSS.
Preparation of SLO-permeabilized pancreatic acinar
cells and measurement of amylase secretion.
Permeabilized pancreatic acinar cells were prepared as described
previously (31). Dispersed pancreatic acini suspended with the fresh
PSS were washed twice and resuspended with 40 ml of cytosol buffer. The
cytosol buffer (pH 7.2 at 37°C) contained 0.2% bovine serum
albumin, 1 mM ATP, 1 mM creatine phosphate, 50 µg/ml creatine
phosphokinase, and (in mM) 20 NaCl, 0.5 MgSO4, 100 KCl, 0.2 NaH2PO4,
0.8 Na2HPO4, 10 HEPES, and 10 glucose. One hundred nanomolar
free-Ca2+ solution
was prepared with
Ca2+-Mg2+-ethylene
glycol-bis(
-aminoethyl
ether)-N,N,N',N'-tetraacetic acid (EGTA) buffer (in mM: 2.55 CaSO4, 1.64 MgSO4, and 5 EGTA). Solutions with
different Ca2+ concentrations
([Ca2+]; 100 pM to 2 µM) were prepared by altering concentrations of both
CaSO4 and
MgSO4 in the cytosol buffer, which
contained 5 mM EGTA. Aliquots of SLO (1 U/ml) were added to a 40-ml
cell suspension that was suspended in 100 nM
Ca2+ cytosol buffer, incubated for
20 min, and gassed with 100% O2. After centrifugation (50 g), cells
were washed twice, resuspended with a 20-ml fresh and SLO-free cytosol
buffer (100 nM Ca2+), and
incubated in the presence or absence of various concentrations of C3
exoenzyme for 30 min at 37°C. After centrifugation and removal of
C3 exoenzyme, aliquots of the acinar cell suspension (2 ml each × 10 samples) were then incubated with buffers containing various
[Ca2+] gassed with
100% O2 for 30 min at 37°C.
The incubation was terminated by centrifugation (10,000 rpm) for 50 s
at 4°C in a microcentrifuge. The amylase that released into the
supernatant (1 ml of PSS × 2 in 10 groups) and that remained in
the pellet (1 ml of Triton X-100 × 2 in 10 groups) in each
microcentrifuge was assayed by using procion yellow starch as a
substrate. Amylase secretion was expressed as the percentage of the
total content in each sample.
Immunoprecipitation. Acinar cells (2 × 106) in 1 ml of PSS were
incubated with reagents for the indicated periods. The incubation was
stopped with 1 ml of chilled 8 mM HEPES buffer (pH 7.4) containing (in
mM) 1 sodium orthovanadate, 0.5 Na2HPO4,
109.5 NaCl, 4.7 KCl, and 1.13 MgCl2. The suspension was
immediately centrifuged (10,000 rpm) for 15 s at 4°C. The
supernatant was discarded, and the resultant pellet was resuspended in
chilled lysis buffer (pH 7.4) containing (in mM) 25
-glycerophosphate, 0.2 sodium orthovanadate, 1 phenylmethylsulfonyl fluoride, 5 EDTA, 1 dithiothreitol, 150 NaCl, and 50 tris(hydroxymethyl)aminomethane (Tris), 25 sodium fluoride and 0.2%
Triton X-100, 10 mg/ml leupeptin, and 0.05 trypsin inhibitor units
(TIU)/ml aprotinin. Each suspension was sonicated,
vortexed for 30 s, and centrifuged (10,000 rpm) for 10 min at 4°C.
The supernatant (crude microsomal fractions) was diluted with lysis
buffer to 1 mg/ml. Protein was determined by the method of Bradford
(3). Five hundred microliters of crude microsomes (0.5 mg protein) were
incubated with anti-Src monoclonal antibody (4 µg/ml) or
anti-RhoA monoclonal antibody (1 µg/ml) overnight at
4°C and with 50 ml of protein G-Sepharose for 2 h
at 4°C. The immunoprecipitates were washed three times with 100 mM Tris buffer, pH 7.5, containing 150 mM NaCl and 1.5 ml/l
Tween 20 and then analyzed by SDS-PAGE and Western blotting.
Western immunoblotting. Acinar cells
(2 × 106) in 0.5 ml of PSS
were incubated with reagents as described previously (34). The
incubation was stopped with 1 ml of chilled 8 mM HEPES buffer (pH 7.4)
containing (in mM) 1 sodium orthovanadate, 0.5 Na2HPO4, 109.5 NaCl, 4.7 KCl, and 1.13 MgCl2. The suspension was
immediately centrifuged (10,000 rpm) for 15 s at 4°C. The
supernatant was discarded, and the resultant pellet was resuspended in
150 µl of lysis solution (pH 7.4) containing (in mM) 66.7
-glycerophosphate, 1 sodium orthovanadate, 1 phenylmethylsulfonyl
fluoride, 1.5 EGTA, 1 dithiothreitol, 1% Triton X-100, 10 mg/ml
leupeptin, and 0.05 TIU/ml aprotinin. Each suspension was sonicated,
vortexed for 30 s at 4°C, and centrifuged at 10,000 rpm for 10 min.
The supernatant (25 µl, ~80 µg protein), which contained crude
microsomes, was mixed with 2.5 ml of 100%
-mercaptoethanol and 12.5 µl of Laemmli buffer (pH 7.8), containing 62.5 mM Tris base, 2.3%
SDS, 7.5% glycerol, and 0.1% bromphenol blue. Protein was determined
by the method of Bradford (3). The solution was heated at 95°C for
5 min and separated by SDS-PAGE on 15% polyacrylamide gels and
electrophoretically transferred to nitrocellulose membrane (Bio-Rad,
Hercules, CA) for 1 h at 100 V at 4°C. Immunoblotting was performed
with a mouse monoclonal RhoA antibody or a rabbit polyclonal RhoB
antibody (1 µg/ml). The membrane was then incubated with
peroxidase-conjugated goat anti-mouse IgG or anti-rabbit IgG (1:3,000
dilution). The blots were developed and visualized with a
chemiluminescent horseradish peroxidase substrate (enhanced chemiluminescence, Amersham, Arlington Heights, IL).
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RESULTS |
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CCK-8 and carbachol but not high-affinity
CCK-A-receptor agonists increased the density of the immunodetectable
RhoA band. When we applied the RhoA (26C4) mouse
monoclonal IgG, a single band at the location of 21 kDa was detected in
unstimulated rat pancreatic acinar cells (Fig.
1). Treatment of pancreatic acini with
CCK-8 (10 pM to 10 nM) for 20 min resulted in a quantitative increase
in the intensities of the RhoA p21 in the Triton X-100-soluble and
crude microsomal fractions (10,000 rpm supernatant of the cell
sonicates; Fig. 1A). Similarly,
carbachol (0.1-100 µM) also increased the immunodetectable RhoA
bands in a dose-dependent manner (Fig.
1B). On the other hand, the
high-affinity CCK-A agonists JMV-180 and CCK-OPE (1-1,000 nM) did
not increase the intensities of the RhoA band over basal (Fig. 1,
C and
D). Densitometry data from the
scanned gels are summarized in Fig. 2.
These results indicate that stimulation of the
M3 muscarinic receptor as well as
the low- (but not high-) affinity CCK-A receptor resulted in a
quantitative increase in RhoA in crude microsomes. CCK-8 at 1, 10, and
100 pM increased the density of the RhoA band with a peak increase
occurring at 3 min, which was sustained up to 20-30 min (Fig.
3). Note that all immunoblotting or
immunoprecipitation data presented in Figs. 1-9 were performed
with the same experimental conditions (e.g., exposure time and amounts
of protein). Each figure was prepared from data conducted on the same
series of experiments.
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RhoB could not be detected in pancreatic
acini. To determine whether other members of the
subfamily of Rho proteins are present in rat pancreatic acini, we
performed Western immunoblotting using RhoB and RhoA antibodies. It
should be noted that the RhoA monoclonal antibody does not cross-react
with RhoC, RhoG, Rac1, Rac2, or Cdc42Hs proteins, whereas the RhoB
polyclonal antibody has no cross-reactivity with RhoA, RhoC, or other
members of the Ras gene superfamily (tested by Santa Cruz
Biotechnology). In contrast to RhoA, no RhoB bands were detected in
unstimulated and CCK-stimulated pancreatic crude microsomes (Fig.
4).
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Stimulation of RhoA was independent of extracellular
[Ca2+]
but required intracellular
[Ca2+].
We next examined the requirement of
[Ca2+] on
CCK-stimulated RhoA activation. Elimination of extracellular
Ca2+ (by the addition of 1 mM EGTA
plus 0 CaCl2 in the PSS) did not inhibit mass increases in RhoA in response to various concentrations of
CCK-8 and carbachol (Fig. 5,
A-D). On the other hand,
preloading of pancreatic acini with the intracellular
Ca2+ chelator BAPTA-AM at 100 µM
for 10 min abolished the immunodetectable RhoA band in CCK- and
carbachol-stimulated pancreatic crude microsomes (Fig. 5,
E and
F, respectively). These results
suggest that stimulation of RhoA is independent of extracellular
[Ca2+]
([Ca2+]o)
but requires intracellular
[Ca2+]
([Ca2+]i).
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Increases in immunodetectable RhoA were mediated by the
Gq protein and PLC pathway.
We have recently demonstrated that, depending on the CCK agonists used,
the CCK-A receptor in rat pancreatic acini is coupled to three
different effectors and/or signal transduction pathways (30-32, 34, 35). The low-affinity CCK-A receptor is coupled to the
conventional Gq
/PLC-
pathway, resulting in the production of
D-myo-inositol
1,4,5-trisphosphate (to release
Ca2+ and activate calmodulin) and
diacylglycerol (to activate PKC). In addition, the
low-affinity CCK-A receptor also appears to be coupled to the
nonreceptor protein tyrosine kinase pathway, in which
pp60c-src-phosphoinositide
3 kinase (PI 3-kinase) are the key enzymes in mediating
[Ca2+]o-dependent
pancreatic exocytosis. On the other hand, the high-affinity CCK-A
receptor is coupled to the
Gq
-cytosolic phospholipase
A2 (cPLA2) pathway to produce
arachidonic acid, which enhances intracellular Ca2+ oscillations. To determine
which pathways are involved in functional roles of the RhoA protein, we
examined the effects of specific inhibitors of these three signal
transduction pathways. The specificity of these inhibitors has been
previously determined (30-32, 34, 35). The G protein antagonist GP
antagonist-2A (10 µM), which selectively inhibits the activation of
Gq, and the PLC inhibitor U-73122
(10 µM) inhibited the intensities of the RhoA band evoked by CCK-8
(Fig. 6, A
and B). In contrast, the calmodulin
kinase inhibitor W-7 (100 µM) and the PI 3-kinase inhibitor
wortmannin (6 µM) had no effect (Fig. 6,
C and
E). The Src inhibitor herbimycin A
(6 µM) decreased the RhoA band in response to CCK-8 (Fig.
6D). In separate experiments, we
showed that the PKC activator TPA (10-1,000 nM) increased the
intensities of the RhoA band, whereas the PKC inhibitor K-252a, a
substance closely related to staurosporine, inhibited the action of
CCK-8 (Fig. 7,
A and
B). Densitometry data from these
results are shown in Fig. 8. These results
suggest that increases in immunodetectable RhoA are mediated by the
stimulation of PKC and Src cascades via the
Gq protein and PLC pathway.
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DISCUSSION |
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Several lines of evidence suggest that the monomeric small GTP-binding
protein Rho plays an important role in mediating signal transduction in
various cell types (16). In this study, we demonstrated the existence
of Rho protein in rat pancreatic acini and its functional role in
mediating pancreatic enzyme secretion. We showed that, with the use of
an anti-RhoA mouse monoclonal antibody (26C4), a single band (p21)
could be detected by Western immunoblotting during the basal state in
rat pancreatic acini. On stimulation with CCK-8 or carbachol, an
increase in RhoA band intensities was observed. Peak increases in the
p21 RhoA band were observed when intact acini were stimulated with
submaximal concentrations of CCK-8 (
1 nM). Reduction of the
intensities of the RhoA band occurred with supramaximal concentrations
of CCK-8 (>1 nM). This phenomenon is similar to the biphasic
pancreatic amylase secretion stimulated by CCK-8, suggesting a
functional relationship between RhoA and amylase secretion. If RhoA
mediates cytoskeletal assembly, it is conceivable that high
concentrations of CCK-8 may disrupt the cytoskeletal system, resulting
in the reduction of enzyme secretion (19, 22).
In several cell types, it has been shown that the Rho protein may translocate from the cytosol to the plasma membrane during receptor activation (13, 14, 27, 36). Because we used Triton X-100-soluble and crude microsomal fractions (10,000 rpm, supernatant of the cell sonicates) for immunoblotting, it is unclear whether quantitative increases in the RhoA band during cell stimulation are due to translocation of RhoA from the cytosol to the plasma membrane or actual activation of membrane RhoA proteins. One possibility is that RhoA may translocate from Triton X-100-insoluble to -soluble fractions after cell stimulation. Because RhoA but not RhoB proteins were increased during CCK and carbachol stimulation, it appears that activation of the Rho family by these agonists is protein specific. Our studies also demonstrated that [Ca2+]o is not necessary for increases in RhoA in response to either CCK or carbachol. On the other hand, application of the intracellular Ca2+ chelator BAPTA-AM significantly inhibited the appearance of the RhoA band in response to CCK or carbachol stimulation, suggesting that [Ca2+]i at the basal level is required for stimulation of RhoA.
The interrelationship between Rho and other serine/threonine kinases or tyrosine kinases may vary in different cell systems. For example, the tyrosine kinase pp60c-src regulates rearrangement of actin cytoskeleton and p190Rho-GTPase activating protein (GAP) after stimulation by epidermal growth factor in fibloblast cell lines (6). On the other hand, it has been shown that, in Swiss 3T3 cells, translocation of Src kinase to the cell periphery is mediated by the actin cytoskeleton under the control of the Rho family (12). Furthermore, activation of PI 3-kinase in Swiss 3T3 cells and platelets is dependent on Rho, suggesting that PI 3-kinase lies downstream of Rho (20, 36). These observations suggest that there is a close interaction between Rho and protein tyrosine kinases. On the other hand, in several cell types, the serine/threonine kinase PKC has been shown to activate Rho (28, 29). Our studies demonstrated that, in rat pancreatic acini, increases in immunodetectable RhoA are mediated by Gq and PLC pathways via the PKC cascade but not calmodulin pathways. Furthermore, we showed that, in contrast to CCK-8 and carbachol, high-affinity CCK-A-receptor agonists, which fail to stimulate PKC (35), do not increase Rho. Thus it appears that RhoA activation may depend on PKC stimulation at the basal level of [Ca2+]i rather than on the Ca2+ signal frequency and amplitude (Ref. 4 and this study). In addition, in response to CCK-8 stimulation, PKC translocation (30 s) precedes Rho activation (3 min), suggesting that PKC lies upstream of Rho (Refs. 4 and 35 and this study). It is still unknown, however, whether PKC directly or indirectly mediates increases in immunodetectable Rho. In rat pancreatic acini, it has been shown that CCK stimulates the formation of Shc-Grb2-SOS complex through a PKC-dependent mechanism (7). It is conceivable that this complex may activate Rho to form "GTP-bound Rho" in a manner similar to Ras (7, 10). Because PKC is a serine/threonine kinase and Shc is a tyrosine-phosphorylated protein, the precise mechanism by which PKC activates Shc remains to be determined.
Alternatively, our study showed that RhoA is also regulated by
pp60c-src.
This is because herbimycin A, which abolishes Src kinase activities in
response to CCK in rat pancreatic acini (34), inhibits RhoA intensities
stimulated by CCK. Because RhoA was coimmunoprecipitated with Src, RhoA
may interact with Src. The precise mechanism by which Src forms the
immunocomplex with Rho remains to be determined. Because Rho does not
possess Src homology domains, this interaction may be mediated by
Rho-GAP, which possesses Src homology domains. Indeed,
p190Rho-GAP is considered to be a preferred substrate of
c-Src in fibroblast cell lines (6). This possibility is supported by
the fact that Ras-GAP is known to be associated with
pp60c-src,
and the observation that tyrosine phosphorylation of Ras-GAP (by Src)
decreases its ability to enhance the GTPase activity, maintaining Ras
in its activated GTP-bound state (11). Because Rho possesses the formin
homology (FH) 1 domain, which is enriched in proline, this domain may
directly interact with the Src homology (SH) 3 domain of Src.
Alternatively,
p34cdc-2,
a substrate for
pp60c-src,
may be an intermediate between Src and Rho (34). Our laboratory (34)
previously identified
pp60c-src in
rat pancreatic acini, characterized its functional role in mediating
pancreatic enzyme secretion, and suggested its association with PI
3-kinase in response to CCK. Several lines of evidence reveal that PI
3-kinase is a direct substrate of
pp60c-src
(5). In other cell types, PI 3-kinase binds directly to Rho-guanosine 5'-O-(3-thiotriphosphate)
(GTP
S) and is thereby activated, probably via the
Rho-GAP-like domain located on the p85 regulatory subunit of PI 3-kinase (36). These observations suggest possible interactions among Src, Rho, and PI 3-kinase. Furthermore, it has recently been reported (15) that, in rat pancreatic acini, Rho plays a role in
the ability of CCK to stimulate tyrosine phosphorylation of focal
adhesion kinase (p125FAK) and the cytoskeletal protein
paxillin utilizing PLC-dependent and -independent pathways. Because
pancreatic acini possess actin and myosin and actin-associated
proteins (e.g., vinculin and villin) that are preferred substrates of
Src (9, 18), it is conceivable that Src, RhoA, PI 3-kinase, and focal
adhesion kinase may reciprocally act on the actin cytoskeleton in
mediating pancreatic exocytosis.
Finally, we determined the functional role of RhoA in the mediation of pancreatic enzyme secretion. We demonstrated that the Rho inhibitor C3 exoenzyme inhibited [Ca2+]-dependent amylase secretion in permeablized acini, suggesting that RhoA is likely to play a role in pancreatic exocytosis. Although C3 exoenzyme inhibited [Ca2+]-dependent enzyme secretion in permeabilized acini, the high-affinity CCK-A-receptor agonists JMV-180 and CCK-OPE, which elicit intracellular Ca2+ oscillations (30-32, 35), did not increase the amount of Rho. This suggests that [Ca2+] in permeable cells may directly act on the Rho-associated actin cytoskeleton in mediating enzyme secretion, in which small soluble proteins are extruded from the cells. It has recently been reported that pretreatment of intact rat pancreatic acini with the high concentration of C3 exoenzyme (25 µg/ml) for 120 min resulted in a significant inhibition of amylase secretion elicited by either CCK or TPA. This result further supports the interaction between PKC and Rho on pancreatic enzyme secretion (25). In conclusion, the small GTP-binding protein RhoA p21 appears to be involved in the mediation of pancreatic enzyme secretion. RhoA pathways are involved in the activation of PKC and pp60c-src cascades via Gq protein and PLC.
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ACKNOWLEDGEMENTS |
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We thank Dr. Koji Nakao for valuable suggestions and technical advice.
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FOOTNOTES |
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This work was supported in part by National Institute of Diabetes and Digestive and Kidney Diseases Grants DK-32830 and P30-DK-34933.
The costs of publication of this article were defrayed in part by the payment of page charges. The article must therefore be hereby marked "advertisement" in accordance with 18 U.S.C. §1734 solely to indicate this fact.
Address for reprint requests and other correspondence: C. Owyang, Univ. of Michigan Medical Center, 3912 Taubman Center, Box 0362, Ann Arbor, MI 48109.
Received 20 April 1998; accepted in final form 30 December 1998.
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