NF1 tumor suppressor in epidermal differentiation and growth - implications for wound epithelialization and psoriasis

Jussi Koivunen

Department of Anatomy and Cell Biology, University of Oulu
Department of Dermatology and Venereology, University of Oulu

Abstract

Neurofibromatosis type 1 (NF1) is a dominantly inherited neurocutaneous disorder caused by mutations in the NF1 gene. Common clinical manifestations associated with NF1 are neurofibromas, café-au-lait macules (CALM), axillary freckling and Lisch nodules of the iris. Other important manifestations are vasculopathy, a variety of osseous lesions, including short stature, scoliosis and pseudoarthrosis, optic gliomas and an increased risk for certain malignancies. The best characterized function of the NF1 gene is to act as a downregulator of Ras proto-oncogene signalling by accelerating the switch of active Ras-GTP into inactive Ras-GDP. The NF1 gene is considered a tumor suppressor since some malignancies may display a loss of heterozygosity or homozygotic inactivation of the gene.

The present study investigated the behaviour and function of the NF1 gene during keratinocyte differentiation, wound healing and psoriasis using human epidermis and epidermal keratinocytes as a model. The NF1 protein was shown to associate with the intermediate filament network during keratinocyte differentiation both in vitro and in vivo, and it is thus suggested to play a role in the cytoskeletal re-organization or in the formation of cell adhesions. NF1 gene expression was also studied in psoriasis, in which keratinocytes are hyperproliferative and cell differentiation is altered. NF1 gene expression was downregulated in psoriatic keratinocytes both in vivo and in vitro, suggesting that the NF1 gene might have role in downregulating keratinocyte proliferation. During epidermal wound healing, NF1 gene expression was increased. However, the process of wound healing showed no apparent differences between NF1 patients and controls. Furthermore, an increased number of cells immunoreactive for active Ras-MAPK was demonstrated in vascular tissues of NF1 patients, but not in epidermal keratinocytes or dermal fibroblasts. The finding suggests that the NF1 protein functions as a Ras-GAP in some, but not all tissues.


Dedication

To my family

Table of Contents
Acknowledgements
Abbreviations
List of original publications
1. Introduction
2. Review of the literature
2.1. Neurofibromatosis type 1
2.2. NF1 gene
2.3. NF1 protein
2.4. Ras-MAPK signaling pathway
2.5. Animal models for NF1
2.6. Cytoskeleton and cell adhesions
2.6.1. Cytoskeleton
2.6.2. Cell adhesions
2.7. Skin
2.7.1. Epidermis
2.7.2. Dermis and hypodermis
2.7.3. Wound healing of skin
2.7.4. Psoriasis
3. Aims of the present study
4. Materials and Methods
4.1. Materials
4.2. Methods
5. Results
5.1. NF1 protein expression during keratinocyte differentiation (I)
5.1.1. Alteration in the subcellular location of NF1 protein after induction of cellular differentiation
5.1.2. NF1 protein associates with an intermediate filament network during cellular differentiation
5.1.3. Association of NF1 protein with the intermediate filament network is temporally parallel to the formation of desmosomes and hemidesmosomes
5.1.4. Phenotype of keratinocytes cultured from NF1 patients
5.2. Ultrastructural localization of NF1 protein in human skin (I,II)
5.3. NF1 gene expression in psoriatic skin and in keratinocytes cultured from psoriatic patients (III)
5.3.1. NF1 gene expression in psoriatic lesions
5.3.2. NF1 gene expression in keratinocytes cultured from psoriatic patients
5.4. NF1 and epidermal wound healing (IV)
5.4.1. NF1 gene expression in healing wounds
5.4.2. Wound healing in NF1 patients
5.4.3. Cell proliferation and active MAPK in the skin of NF1 patients after wounding
6. Discussion
6.1. Methodological aspects
6.2. Discussion of the results
6.2.1. NF1 tumor suppressor in epidermal differentiation
6.2.2. NF1 tumor suppressor in psoriasis in vivo and in vitro
6.2.3. NF1 and epidermal wound healing
6.2.4. NF1 gene and the Ras-MAPK pathway
7. Conclusions
References
List of Tables
1. Diagnostic criteria for NF1(Gutmann et al. 1997).
2. The patients, tissues and cell lines used are listed below. All the patient material and tissue samples were collected with appropriate approvals from the ethical committees of the respective universities and university hospitals.
3. The analytical tools used for protein studies
4. The analytical tools used for RNA studies.
5. The methods used in the original communications (I-IV).
List of Figures
1. Schematic presentation of the NF1 gene, mRNA and protein. This illustration of the NF1 gene presents all the exons of the NF1 gene, and the four large introns are marked with arrows. The OMGP, EVI2A and EVI2B genes in intron 27 are marked in the picture. The diagram is modified from (Friedman & Riccardi 1999). The illustrations of NF1 mRNA and protein present the alternatively spliced exons (9a, 23a and 48a) and the GAP-related domain (Gutmann & Collins 1993, Skuse & Cappione 1997). aa, amino acid; bp, base pair; GRD, GAP-related domain.
2. The Ras-MAPK-signaling pathway. Growth signals (ligand coupled to receptor) activate the guanine nucleotide exchange factor sos, which is bound to the receptor by the shc-grb2 complex. Activation of sos enables GTP binding to Ras proteins. The NF1 protein acts as a negative regulator of Ras. The GRD of the NF1 protein accelerates the switch of active Ras-GTP into inactive Ras-GDP. The signaling pathways downstream of Ras-GTP include Raf-MEK-ERK kinase, phosphatidylinositol-3-kinase (PI3-kinase), RalGDS and phoshpholipase C (PLC) cascades.
3. A schematic presentation of cell adhesions and their association with the cytoskeleton in epithelium.
4. Schematic presentation of molecular interactions within adherens and desmosomal junctions.
5. Formation of cell-cell adhesion between epithelial cells after elevation of the extracellular calcium level (Vasioukhin et al. 2000).
6. Structure of human skin with its appendages and epidermis. The three layers of skin are epidermis, dermis and hypodermis. The epidermis consists of four layers: stratum basale (SB), stratum spinosum (SS), stratum granulosum (SG) and stratum corneum (SC). The epidermis also contains some melanocytes and Langerhans cells. The figure has been modified from (Havu et al. 1998, Young et al. 2000).
7. Keratinocyte differentiation and activation. Basal keratinocytes can either differentiate or become activated. Differentiation is associated with keratin 1 and 10 expression (K1/K10) and can be promoted by Ca2+, vitamin D (D3), protein kinase C (PKC) and vitamin A (vit. A). Activation occurs in a cyclic manner. Interleukin-1 (IL-1) promotes activation and is associated with keratin 6 and 16 (K6/16) expression. Tumor necrosis factor α (TNFα) and transforming growth factor α (TGFα) maintain the activated phenotype. Interferon-γ (IFNγ ) helps the cells to become contractive with keratin 17 (K17) expression, and the basal phenotype is restored by transforming growth factor beta (TGFβ ).
8. Alteration in the subcellular location of NF1 protein after the induction of cellular differentiation. NF1 protein undergoes marked translocation to the filamentous network after incubation of keratinocytes with high-calcium medium (B) compared to low-calcium medium (A).