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The Benjamin W. Zweifach Microcirculation Laboratories, Veterans Affairs Medical Center, Tucson, Arizona 85723
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ABSTRACT |
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Endothelial monolayer hyperpermeability is regulated by a myosin light chain phosphorylation (MLCP)-dependent contractile mechanism. In this study, we tested the role of Src-dependent tyrosine phosphorylation to modulate endothelial contraction and monolayer barrier function with the use of the myosin phosphatase inhibitor calyculin A (CalA) to directly elevate MLCP with the Src family tyrosine kinase inhibitor herbimycin A (HA) in bovine pulmonary artery endothelial cells (EC). CalA stimulated an increase in MLCP, Src kinase activity, an increase in the tyrosine phosphorylation of paxillin and focal adhesion (FA) kinase (p125FAK), and monolayer hyperpermeability. Microscopic examination of CalA-treated EC revealed a contractile morphology characterized by peripheral contractile bands of actomyosin filaments and stress fibers linked to phosphotyrosine-containing FAs. These CalA-dependent events were HA sensitive. HA alone stimulated an improvement in monolayer barrier formation by reducing the levels of MLCP and phosphotyrosine-containing proteins and the number of large paracellular holes. These data show that Src kinase plays an important role in regulating monolayer hyperpermeability through adjustments in tyrosine phosphorylation, MLCP, and EC contraction.
nonmuscle myosin; myosin light chain phosphorylation; paxillin; immunofluorescent digital imaging; size-selective solute permeability
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INTRODUCTION |
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THE VASCULAR ENDOTHELIUM provides the permeability barrier that controls the passage of fluid and solutes into the perivascular space. Inflammation of this barrier initiates a hyperpermeability state characterized by the formation of large paracellular holes between adjacent endothelial cells (EC). These events occur most frequently in the systemic postcapillary venule and pulmonary arteriole circulations. The formation of paracellular gaps is the result of reorganization of the endothelial cell-cell junctional morphology that permits the enhanced leakage of plasma proteins and fluid into the tissues, thus causing edema and organ dysfunction. Although changes in EC shape are controlled by cytoskeletal and cell-cell junctional proteins, the signaling mechanisms that modulate these structural events are not completely understood.
The Src family of nonreceptor tyrosine kinases play important roles in regulating cell growth. Recent evidence suggests that activated p60Src (Src) may adjust signaling to the cytoskeleton and cell-cell junctions (9, 16). In viral (v)-Src-transfected fibroblasts, where Src is constitutively active and oncogenic, this kinase binds to newly formed actomyosin stress fibers (SF), which are linked to focal adhesions (FA) (3). In addition, Src is recruited to filamentous (F)-actin bundles in thrombin-treated platelets (14). These data suggest that Src may regulate the cytoskeletal events of EC shape change leading to vascular hyperpermeability (12, 13, 30). In this regard, inhibition of Src kinase protects against the hyperpermeability consequences of stroke (23). In addition, thrombin- and VEGF-induced endothelial hyperpermeability are associated with the Src-dependent tyrosine phosphorylation of FA kinase (p125FAK) and paxillin, which are concentrated at FA (5, 6, 8, 24). Because these events involve the Src-dependent regulation of multiple receptor-signaling cascades (17), we studied the direct links between endothelial contraction, the actomyosin cytoskeleton, and Src kinase using the myosin phosphatase inhibitor calyculin A (CalA).
EC contraction is due to the phosphorylation of 20-kDa myosin light chain (MLCP) on Ser19 and Thr18 (1, 13). This event initiates the formation of actomyosin bundles that attach to newly formed FA (18). The level of MLCP is adjusted through the oppositional activities of two enzymes: Ca2+-calmodulin-dependent MLC kinase (MLCK) and myosin phosphatase (PP1M). Activation of MLCK elevates myosin ATPase activity and increases MLCP, endothelial contraction, and monolayer hyperpermeability (1, 12, 13, 17). Although Ca2+-calmodulin and cAMP-dependent regulation of MLCK is well known (1, 12), recent evidence shows that Src kinase binds to MLCK and regulates its activity (4, 31). These data suggest that Src kinase plays a more important role in regulating the MLCK-dependent phosphorylation of MLC than previously believed. The amount of MLCP is also controlled by adjusting its degradation. At basal levels of intracellular Ca2+, the level of MLCP is modulated by the receptor-mediated inhibition of PP1M. This so-called Ca2+ sensitization of EC contraction is initiated by the activation of the small GTPase Rho and its kinase (ROCK) (2, 5, 6, 11, 17, 19, 21, 24). Thus Src-dependent regulation of MLCK and ROCK's inhibition of PP1M represent novel modulators of MLCP (32, 33). In the present study, we used CalA, a selective inhibitor of PP1M (4, 10), as a Rho mimic to bypass the complex web of receptor-mediated second-messenger signaling cascades and directly stimulate an increase in MLCP, EC contraction, and barrier hyperpermeability.
The purpose of this study was to test the hypothesis that EC contraction and monolayer hyperpermeability are Src dependent. We used CalA to directly elevate MLCP and actomyosin filament formation in combination with the Src-specific inhibitor herbimycin A (HA), which reverses the Src phenotype in kidney cells by specific inhibition of v-Src tyrosine kinase activity (15, 32). We show that the CalA-dependent tyrosine phosphorylation of p125FAK and paxillin at FA, the formation of MLCP, EC contraction, and monolayer hyperpermeability are Src dependent. HA inhibited these CalA-induced characteristics, and HA alone stimulated a reduction in monolayer permeability. These data indicate that Src-dependent reduction of EC contraction and the tyrosine phosphorylation of FA play important roles in regulating endothelial hyperpermeability.
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MATERIALS AND METHODS |
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EC culture. Our personal stock of low-passage (P5-P11) EC, isolated from bovine pulmonary arteries as previously described (25), were grown in DMEM containing 10% fetal calf serum (Hyclone; Ogden, UT) and used between 4 and 5 days postconfluence.
Immunoprecipitation and immunoblotting.
EC grown in gelatin-coated 60-mm dishes were treated with or without 1 µM HA (CalBiochem; San Diego, CA) for 16 h, followed by the
presence or absence of 2.5 nM CalA (Sigma; St. Louis, MO) for the times
indicated in the text. EC were lysed and immunoprecipitated for
phosphotyrosine (PY)-containing proteins with 2 µg of monoclonal antibodies PY99 (Santa Cruz Biotechnology; Santa Cruz, CA)
or paxillin with the use of anti-paxillin IgG (Transduction
Laboratories; Lexington, KY) and Western blotted for
anti-phosphotyrosine (4G10, Upstate Biotechnology; Lake Placid, NY),
p125FAK, and paxillin, as previously described
(5). In separate experiments, protein bands to activated
Src kinase and
-actin were detected from EC lysates by
immunoblotting with phosphospecific polyclonal IgG to
Tyr416 of activated Src (Src PY416, Cell
Signaling Technology) and
-actin (Sigma) with the use of SuperSignal
West Pico (Pierce; Rockford, IL). Chemiluminescence photons were
detected with a Storm phosphoimager using ImageQuant software or a
liquid nitrogen-cooled charge-coupled device (CCD) camera (Roper
Scientific; Tucson, AZ) using MetaMorph Software (Universal Imaging;
Brandywine, PA).
Endothelial monolayer barrier function. The techniques listed herein have been described in detail elsewhere (27, 29). In brief, the size-dependent passage of FITC-labeled hydroxy ethyl starch (FITC-HES) macromolecules across bovine pulmonary artery EC monolayers was used to measure the presence or absence of a small "pore" permeability barrier. FITC-HES samples from both sides of the monolayer-filter support barrier were analyzed by high-pressure size-exclusion liquid chromatography and quantified with a fluorescence spectrophotometer computer detection system (29).
EC monolayers were prepared by seeding 75 × 103 cells onto gelatin/fibronectin-coated Transwell inserts (2,000 Å pore radius filter supports, 0.33 cm2 surface area; Costar; Cambridge, MA) in a 24-well plate, as previously described (26). At 4-5 days postconfluence, each monolayer was incubated with 1 µM HA for 16 h. Barrier function studies were performed by washing each Transwell with 37°C serum-free HEPES-buffered (pH 7.4) MEM. The experiment was initiated by the addition of 100 µl FITC-HES (3 mg/ml) to the top chamber (Transwell insert) and 650 µl serum-free HEPES-MEM to the bottom chamber (24-well plate), followed by the addition of 1 µM HA and/or 2.5 nM CalA. Samples (30 µl) from the bottom chamber were collected at 30-min intervals, and the top chamber was removed after 1.5 h for HPLC size separation with fluorescence quantitation. Computation of permeability/free diffusion coefficients was performed exactly as previously described (7). Monolayer experiments that did not achieve restricted diffusion in controls were excluded from the data analysis.Digital imaging immunofluorescence microscopy. A microscope digital-imaging workstation (model IMT-2, Olympus) was used as previously described (8). In brief, a ×60 1.4 numerical aperture oil-immersion objective, CCD camera (model PXL, Photometrics; Tucson, AZ), a z-axis controller (Ludl Electronic Products; Hawthorne, NY), and a personal computer (Athlon XP) with MetaMorph software version 4.5 (Universal Imaging; West Chester, PA) were used to acquire epifluorescent digital images with online background subtraction and shading correction. MetaMorph was used to identify regions of colocalization by color encoding the separate immunofluorescent images of each cell.
Labeling of cytoskeletal structures.
EC grown to 4 days postconfluence in eight-well slides were treated and
stained as previously described (6) and in the text.
Primary rabbit antibodies to
-catenin (1:100 dilution, Zymed
Laboratories) were used to detect the adherens junctions and mouse
anti-paxillin IgG (1:200 dilution, Chemicon; Temecula, CA) and
anti-phosphotyrosine IgG (4G10, 1:100 dilution, Upstate Biotechnology)
were used to detect FA. After the slides were washed, secondary goat
tetramethylrhodamine isothiocyanate or Cy5-labeled anti-rabbit IgG
(1:25 dilution) and goat-Cy5 anti-mouse IgG (1:25 dilution; Jackson
Immunoresearch Laboratories; Westgrove, PA) were used to label each
primary IgG. Alexa 488-phalloidin (Molecular Probes; Eugene, OR) was
used to label F-actin. Each slide was covered with a mounting medium
(Vectashield; Vector Laboratories; Burlingame, CA), a no. 1 coverslip
was applied, and the edges were sealed with nail polish.
MLCP. The phosphorylation of MLC was measured by urea/glycerol PAGE separation of the unphosphorylated (P0), monophosphorylated (P1), and diphosphorylated (P2) forms, as previously described (5, 22). In brief, EC grown in 60-mm dishes were pretreated with 1 µM of HA for 16 h, followed by the addition of 2.5 nM CalA for 15 min or no treatment, and the reaction was stopped by the addition of 1.0 ml ice-cold 10% perchloric acid. ECs were scraped and then centrifuged for 10 min at 20,000 g at 4°C. The pellets were washed with 1 ml of ice-cold water, followed by 1 ml of ice-cold ethanol, and the pellet was redissolved in sample buffer (6.7 M urea, 10 mM Tris, 22 mM glycine, and 270 mM sucrose, pH 9.0). Equal amounts of protein were added to each lane of a 40% glycerol-10% acrylamide gel and run at 400 V for ~1 h. The protein samples were transferred to nitrocellulose in 0.25 mM phosphate buffer (pH 7.6) for ~1 h. The P0, P1, and P2 forms of MLC were detected by Western blotting with a polyclonal MLC antibody (1:1,000, James Stull; Dallas, TX), followed by detection with ECL+ (Amersham) and Storm phosphoimager (Molecular Dynamics). The stoichiometry of MLCP (mol phosphate/mol MLC) was determined with the use of ImageQuant software and calculated using the formula (P1 + 2 × P2)/(P0 + P1 + P2), as previously described (7).
Statistical analysis. The Student's test (paired) was used for the statistical analysis of the results. These values are expressed as means ± SE.
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RESULTS |
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CalA activates Src kinase in an HA-dependent manner.
With the use of a site-specific IgG that detects the phosphorylation of
Tyr416 within the activation loop of Src, we blotted EC
lysates treated with CalA in the presence or absence of the Src kinase
inhibitor HA (Fig. 1). Our data show that
CalA stimulated a ~25% increase in the content of PY416
that was HA sensitive. This effect was not due to changes in Src
expression or protein loading because the amount of nonphospho-Src and
-actin did not change with each treatment. Because phosphorylation of PY416 predicts an increase in enzymatic activity, these
data indicate that CalA stimulates an HA-sensitive activation of Src
kinase.
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HA reduces EC monolayer solute permeability and inhibits
CalA-induced EC monolayer hyperpermeability.
We (6, 7) have reported that thrombin-induced formation of
MLCP and EC monolayer hyperpermeability is Rho and ROCK dependent. In
the present study, we tested whether CalA-induced formation of MLCP and
monolayer barrier dysfunction were HA sensitive. We quantitatively
measured the size and number of paracellular holes formed across
CalA-stimulated EC monolayers in the presence or absence of the Src
family tyrosine kinase inhibitor HA by analyzing their size-selective
solute permeability characteristics with a high-pressure size-exclusion
liquid chromatography technique (29). Restricted
diffusion, created by predominantly small "pores" (<250 Å pore
radius), is characterized by a decline in the size-selective permeability/free diffusion coefficient (P/Do)
with increasing solute molecular radius (ae)
(27). In contrast, the formation of large holes (>2,000
Å pore radius) is displayed by an increase in
P/Do for solutes with a large molecular radius
(28). Control EC monolayers showed significant restricted
diffusion, a property that was substantially enhanced by pretreatment
with 1 µM HA (Fig. 2). In contrast,
CalA-stimulated monolayers displayed large hole barrier
hyperpermeability as illustrated by a shift in the
P/Do-versus-ae curve up
and to the right. HA inhibited this hyperpermeability effect.
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CalA stimulates EC contraction in an HA-sensitive manner.
To identify the cytoskeletal characteristics associated with how HA
inhibits CalA-induced monolayer hyperpermeability, confluent EC were
exposed to 2.5 nM CalA (30 min) with and without 1 µM HA pretreatment
(16 h), followed by fixation and triplet labeling for F-actin (green),
myosin II (blue), and paxillin (red). Figure 3a displays a control EC with
a few F-actin SF (arrows) linked to paxillin-containing FA (arrowhead).
CalA (Fig. 3b) stimulated a rounded contractile morphology
illustrated by multiple peripheral bands of actomyosin (blue-green)
filaments (double arrowhead) suggesting an increase in centripetal
tension. This behavior caused the formation of large open areas between
adjacent cells (marked by asterisks) with a few F-actin SF (arrows)
linked to paxillin-containing FA (arrowheads). HA-treated EC (Fig. 3,
c and d) displayed an increased formation of
F-actin SF (arrows) linked to paxillin-containing FA (arrowhead).
Although HA-CalA-treated monolayers (Fig. 3d) displayed
multiple blue-green actomyosin filaments at the cell periphery
(double arrowhead), the size and number of large paracellular holes
(asterisks) were markedly reduced compared with EC exposed to CalA
alone (Fig. 3b).
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HA reduces MLCP and inhibits CalA-induced hyperphosphorylation.
CalA is known to stimulate the rapid phosphorylation of MLC, achieving
a maximum within 15 min and initiating the EC contractile forces
associated with EC monolayer hyperpermeability (10). We
tested the effects of HA to prevent the CalA-induced formation of MLCP
(Fig. 4). Confluent EC were pretreated
with HA (1 µM for 16 h), followed by stimulation with 2.5 nM
CalA for 15 min. The P0, P1, and P2
forms of MLC were separated (Fig. 4A), quantified by
densitometry, and expressed as moles of phosphate per mole of MLC (Fig.
4B), as described in MATERIALS AND METHODS. CalA stimulated the rapid incorporation of phosphate into MLC that was
2.25-fold above control. Pretreatment with 1 µM HA attenuated this
CalA effect, whereas 1 µM of HA alone reduced the level of MLCP
substantially (~50%) below the control levels.
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CalA initiates HA-sensitive tyrosine phosphorylation of paxillin
and p125FAK.
Thrombin-dependent EC contraction is associated with the formation of
FA at the ends of F-actin SF and the tyrosine phosphorylation of the FA
proteins paxillin and p125FAK, characteristics inhibited by
the Rho inhibitors C3 exoenzyme and Y27632 (5, 6), and the
MLC kinase inhibitor KT5926 (26). We tested whether
CalA-dependent EC contraction also stimulates the tyrosine
phosphorylation of these FA proteins in a HA-sensitive manner. EC were
treated with CalA (2.5 nM, 15 min) with and without HA pretreatment (1 µM for 16 h), followed by immunoprecipitation with anti-paxillin
and anti-phosphotyrosine (PY99) antibodies and Western
blotting with anti-phosphotyrosine (4G10), anti-p125FAK,
and anti-paxillin IgG, as described in MATERIALS AND
METHODS. Figure 5,
A-D, shows that, although HA did not affect
the quantity of immunoprecipitated paxillin (Fig. 5A), this
inhibitor caused a decline in the PY content of two protein bands,
paxillin and p125FAK, with or without CalA treatment (Fig.
5, B-D). Densitometry of the
CalA-stimulated PY-containing proteins revealed an increase in the PY
content of paxillin and p125FAK (Fig. 5D).
Immunoblotting for p125FAK confirmed the identity of
this band (data not shown). Because HA prevented these CalA
events, the tyrosine phosphorylation of paxillin and
p125FAK appear to be Src dependent.
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PY-containing proteins and large hole formation.
Finally, we tested whether HA inhibited the CalA-induced formation of
PY-containing FA and large paracellular holes. EC monolayers pretreated
with and without HA (1 µM for 16 h), followed by stimulation with and without CalA (2.5 nM for 0.5 h), were triple stained for
F-actin,
-catenin, and PY, and digital images were collected. Figure
6, a-d, shows
a control EC displaying F-actin SF (arrows, a) linked to a
few PY-stained FA (arrowheads, c) with a rim of
-catenin
(b). The tricolor overlay displays that PY-containing FA
(arrowheads) are linked to the ends of F-actin SF (arrows, inset). Figure 6, e-h,
illustrates the effects of HA to increase F-actin SF (arrows, Fig.
6e) but reduce the content of PY-containing FA (arrowheads,
Fig. 6g). This HA-dependent loss of yellow-red PY staining
at FA is revealed by comparing the tricolor overlay insets of the
control (Fig. 6d) and HA-treated (Fig. 6h) EC.
Figure 7, a-d,
shows that CalA caused the formation of large paracellular holes
(asterisks in a, b, and d) in
association with increased F-actin SF (arrows, Fig. 7, a and
d) linked to enlarged PY-containing FA (arrowheads,
c). The colocalization of PY-containing (red) FA at the ends
of F-actin SF are shown in Fig. 7d, inset. Figure 7, e-h, illustrates that HA prevented this
CalA effect, as revealed by the loss of PY staining (arrowheads, Fig.
7, g and h, inset) at the ends of SF
(arrows, Fig. 7, e and h) compared with the CalA
control (arrowheads, Fig. 7d, inset).
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DISCUSSION |
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In the present study, we provide evidence for the first time that Src kinase-dependent tyrosine phosphorylation plays an important role in regulating EC monolayer barrier function. By using CalA to directly elevate MLCP and EC contraction, we found that these events activated Src kinase-dependent tyrosine phosphorylation of the FA-containing proteins p125FAK and paxillin. These biochemical events stimulated monolayer hyperpermeability characterized by rounded EC, which showed multiple peripheral actomyosin contractile bands and enlarged spaces between adjacent cells. Because these CalA-dependent characteristics were inhibited by HA, they appear to be Src dependent. In addition, HA alone selectively reduced monolayer permeability to small solutes (ae <30 Å) by reducing the number of large paracellular holes as previously observed after treatment with cAMP or the MLCK inhibitor KT-5926 (25, 26). This HA-induced improvement in endothelial barrier function was associated with the loss of Src kinase activity and reduced amounts of MLCP and PY-containing substrates. Immunostaining of HA-treated EC revealed an increase in the number of SFs linked to paxillin-containing FA, but with reduced levels of PY-containing proteins. Taken together, our data suggest that Src kinase plays an important role in the modulation of EC barrier function by adjusting MLCP and the PY content of FA. Because HA does not completely prevent CalA-induced paracellular hole formation and monolayer hyperpermeability, this process may be partially mediated by Src-independent noncytoskeletal forces.
A role for the Src family of nonreceptor tyrosine kinases in the control of cellular function is not new. The infection of fibroblasts with v-Src, the oncogenic product of Rous sarcoma virus that is constituently active, leads to increased cell migration and growth in association with Src binding to the cytoskeleton (3, 18). Recent evidence (16) shows that Src not only regulates the activation of receptor tyrosine kinases, but also plays an important role in G protein-coupled receptor-mediated signal transduction. Previous work (20) has identified that Src-dependent tyrosine phosphorylation is a critical requirement for the functional formation of integrin-dependent FA attachment to F-actin SFs. In the present study, we extend these data to show that Src also regulates endothelial monolayer permeability at the cytoskeletal level by adjusting the content of both MLCP and the PY-containing FA proteins paxillin and p125FAK. To confirm the role of Src in CalA-induced EC cytoskeletal signaling, we show that the selective Src kinase inhibitor HA (15, 32) prevents the CalA-dependent activation of Src kinase and limits the formation of MLCP. HA alone reduced the level of MLCP to nearly 50% of the control EC. These data are consistent with a recent report (4) where Src regulated MLCK activity in vitro. In addition, our data are consistent with the idea whereby reducing the PY content at FA, HA inhibits the hyperpermeability effects of CalA. Taken together, these data support a role for Src in regulating EC contraction and monolayer solute permeability through the inhibition of MLCP and the tyrosine phosphorylation of the FA proteins paxillin and p125FAK.
It is not clear how CalA stimulates the activation of Src kinase. CalA is a Rho mimic (4, 10) that elevates the levels of MLCP by inhibiting the catalytic activity of PP1M (33). This phosphatase inhibitor has been previously used to increase the formation of MLCP and actomyosin filaments and elevate monolayer permeability (10). Because increased amounts of MLCP stimulate actomyosin filament formation, this CalA effect may recruit Src to the F-actin cytoskeleton as previously shown in v-Src transformed cells (3). Src contains two important regulatory tyrosine phosphorylation sites. Phosphorylation at Tyr527 in the carboxyl tail decreases kinase activity, whereas phosphorylation within the activation domain at Tyr416 positively regulates Src kinase activity (16). With the use of an antibody that detects the amount of phosphorylated Tyr416 in Src, we show that the CalA-dependent elevation in MLCP and actomyosin filaments linked to newly formed FA were associated with increased Src kinase activity. Taken together, these data suggest a link between the activation of Src kinase and the formation of the actomyosin cytoskeleton.
Thrombin stimulates actomyosin-based SF contractile forces, causing cell retraction and rounding in EC and neurites (12, 13, 17). We have shown that this process is mediated by Rho and ROCK (6, 7). In the present study, we confirm a separate report by Diwan et al. (10) that CalA elevates monolayer hyperpermeability by stimulating EC contraction. However, these authors showed that although the MLC kinase inhibitor KT-5926 prevented MLCP formation, it did not block monolayer hyperpermeability. These data suggested that changes in cell-cell adhesion may be involved in the process. In the present study, although HA limited the CalA-dependent increase in the phosphorylation of MLC, these treatments did not affect the formation of F-actin SF. In addition, HA did not completely prevent CalA-induced large hole formation. These data suggest that CalA-induced monolayer hyperpermeability is only partially dependent on MLCP and actomyosin SF formation. Taken together, CalA-induced monolayer barrier dysfunction appears to involve both the phosphorylation of MLC leading to EC contraction and other noncytoskeletal mechanisms.
In conclusion, our results confirm recent reports that the inhibition of PP1M acts as an important mediator to regulate cytoskeletal contraction and EC monolayer hyperpermeability. CalA-dependent increases in EC contraction and monolayer hyperpermeability were associated with increased Src kinase activity and tyrosine phosphorylation of PY-containing FA. Our finding that HA alone stimulates reduced monolayer solute permeability in association with a reduction in large paracellular holes indicates an important role for Src-dependent tyrosine phosphorylation in the modulation of EC barrier function. This process appears due to Src-dependent adjustment of MLCP and the PY content of FA at the ends of SF.
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ACKNOWLEDGEMENTS |
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The authors thank Alex Cohen and Yen Tran for excellent technical contributions and Dr. M. A. Katz for support of this study.
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FOOTNOTES |
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This study was supported by National Institutes of Health Grants RO1-HL48816-7 and RO1-DK55151-1 and by a Veterans Affairs Merit Review Grant.
Address for reprint requests and other correspondence: R. C. Schaeffer, Jr., B. W. Zweifach Microcirculation Laboratories, Research Service 151, Veterans Affairs Medical Center, Tucson, AZ 85723 (E-mail: rcschaeffer{at}earthlink.net).
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. Section 1734 solely to indicate this fact.
First published 27 November 2002;10.1152/ajpheart.00862.2002
Received 3 October 2002; accepted in final form 21 November 2002.
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