Endocrinology Vol. 142, No. 2 802-811
Copyright © 2001 by The Endocrine Society
Glucocorticoids Protect against Apoptosis Induced by Serum Deprivation, Cyclic Adenosine 3',5'-Monophosphate and p53 Activation in Immortalized Human Granulosa Cells: Involvement of Bcl-21
Ravid Sasson,
Kimihisa Tajima and
Abraham Amsterdam2
Department of Molecular Cell Biology, Weizmann Institute of
Science, Rehovot 76100, Israel
Address all correspondence and requests for reprints to: Dr. Abraham Amsterdam, Department of Molecular Cell Biology, Weizmann Institute of Science, Rehovot 76100, Israel. E-mail:
abraham.amsterdam{at}weizmann.ac.il
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Abstract
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Glucocorticoid hormones are known to enhance gonadotropin/cAMP-induced
steroidogenesis in rat and human granulosa cells. As glucocorticoids
induce apoptosis in numerous cell types, we investigated the role of
glucocorticoids in the control of apoptosis in immortalized human
granulosa cells (HO-23) transfected with a temperature-sensitive mutant
of p53 (Val135). When HO-23 were incubated with forskolin
in the presence or absence of dexamethasone (Dex) at 32 or 37 C,
progesterone production was higher by 4- and 8-fold in the presence of
Dex at 37 or 32 C, respectively (P < 0. 01). The
expression of adrenodoxin (ADX), which is an intrinsic part of the
cytochrome P450 side-chain cleavage enzyme system, remained the same in
the presence or absence of Dex in forskolin-stimulated cells. Dex
reduced apoptosis (to 33% of control) in cultures after activation of
p53 by shifting the temperature from 37 to 32 C. Moreover, Dex
suppressed apoptosis induced by serum deprivation (to 40% of control)
or forskolin stimulation (to 28% and 40% at 37 and at 32 C,
respectively). The protective effect of Dex on cAMP-, p53-, and serum
deprivation-induced apoptosis was confirmed by both
4',6-diamido-2-phenylindole hydrochloride DNA staining and terminal
deoxynucleotidyltransferase-mediated dUTP nick end labeling with an
ED50 of 7 nM Dex. Hydrocortisone showed a
similar antiapoptotic effect. The protective effect of glucocorticoids
against apoptosis was completely abolished by RU486 when cells were
coincubated with 10 nM Dex and 10100 nM
RU486. The protection against apoptosis by glucocorticoid involved a
sharp elevation in intracellular levels of Bcl-2 (37.6 fold;
P < 0.01). In contrast to the effect of Dex in the
prevention of apoptosis in HO-23 granulosa cells, Dex dramatically
stimulated apoptosis by 3-fold in LTR-6 myeloid leukemia cells
expressing the same temperature-sensitive mutant
(Val135 p53) and the same amount of glucocorticoid
receptor-
. Forskolin did not stimulate apoptosis when incubated with
these cells. However, it augmented by 1.2-fold the p53-induced
apoptosis in cells shifted from 37 to 32 C. Dex further enhanced
apoptosis by 1.9-fold in p53-activated cultures (32 C). Incubation of
the cells with Dex dramatically reduced Bcl-2 levels to 15% of control
at 37 C (P < 0.01) or 32 C in the presence or
absence of forskolin (P < 0.01). Our data suggest
that glucocorticoids exert a protective effect against induced
apoptosis in immortalized granulosa cells and a stimulatory
effect on apoptosis in myeloid leukemia cells. Moreover, modulation of
Bcl-2 levels plays an important role in mediating the glucocorticoid
effect on cell survival. The opposite effect of glucocorticoids on
Bcl-2 levels in the two cell lines may be due to the different
ontogeneses of the two cell types: epithelial for granulosa cells
vs. mesenchymal for myeloid cells studied in the present
work.
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Introduction
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HUMAN GRANULOSA cells are the subject of
extensive research due to their crucial role in reproduction.
Surrounding and nursing the oocyte, they support its maturation. The
high level of steroid hormone secretion by these cells ensures a
receptive environment for the implantation and development of the early
embryo (reviewed in Refs. 1, 2, 3, 4). Numerous reports on
granulosa cells obtained from women participating in in
vitro fertilization programs confirm that these cells become
highly steroidogenic due to their previous overexposure to stimulation
with gonadotropic hormones (5, 6, 7). Freshly prepared cells
fail to show consistent response to hCG/LH; no response to FSH was
observed in short-term cultures (8, 9, 10), probably due to
their refractory state as a consequence of intensive in vivo
gonadotropin stimulation. However, prolonged culture of the cells in
gonadotropin-free medium reestablished responsiveness to both FSH and
LH/hCG, as was evident by cAMP accumulation and production of estradiol
and progesterone (11). These limitations emphasize the
need for immortalized human granulosa cells obtained from in
vitro fertilization patients.
Highly steroidogenic human granulosa cell lines were recently
established by triple transfection with simian virus 40 DNA,
Ha-ras oncogene, and the temperature-sensitive (TS) mutant
of p53 (p53 Val135) (12). Although
these immortalized cells (HO-23) lose their ability to respond to
gonadotropins (LH/hCG/and FSH), they secrete progesterone at levels
comparable to primary human granulosa cells in response to forskolin
(FK) or 8-bromo-cAMP (12). These cells preserve their high
steroidogenic capacity by expressing the Ad4 binding
protein/steroidogenic factor-1 (Ad4BP/SF-1), which is characteristic of
a steroidogenic tissue (13, 14), and by enhancement of
expression, in a cAMP-dependent manner, of the steroidogenic acute
regulatory protein (StAR), which is an essential and rate limiting
factor in steroidogenesis that is responsible for the transport of
cholesterol into mitochondria (15, 16), and the cytochrome
P450 side-chain cleavage enzyme system (17, 18, 19). HO-23
cells can undergo rapid and massive apoptosis after shifting the
temperature of growth of cAMP-stimulated cells from 37 to 32 C, which
allows manifestation of the wild-type p53 activity (20).
Therefore, establishment of immortalized human granulosa cell lines
that keep their high steroidogenic potential allow systemic studies of
the cellular and molecular mechanisms that control steroidogenesis and
apoptosis in the most abundant somatic follicular cells, the granulosa
cells (21).
Early observation demonstrated that glucocorticoids augment the
gonadotropin-induced production of progesterone in MA-10 Leydig tumor
cells (22) and immature preantral rat granulosa cells
(23). Recently, dexamethasone (Dex) was demonstrated to
enhance progesterone, pregnenolone, and 20
-hydroxy-4-pregnen-3-one
in primary rat granulosa cells prepared from preovulatory follicles and
in immortalized rat granulosa cells (24). However, to date
no work has been reported on the effect of glucocorticoids on
cAMP-induced steroidogenesis in primary or immortalized human granulosa
cells. We therefore decided to test in detail the effect of
glucocorticoids on steroidogenesis in HO-23 immortalized human
granulosa cells.
Ovarian cell death is an essential process for the homeostasis of
ovarian function in human and other mammalian species (reviewed in
Refs. 21, 25 , and 26). Recent observations
suggest that degeneration of follicular and luteal cells is mediated
via programmed cell death (27, 28, 29). Typical morphological
and biochemical events characterizing apoptosis have been observed in
primary human and rat granulosa cells obtained from either preantral or
preovulatory follicles. These include chromatin condensation and
fragmentation of DNA (11, 29, 30). Estradiol was found to
act as a survival factor in both the rabbit corpus luteum and granulosa
cells, and it is associated with a shift in the expression of Bcl-2
gene family members (31). In contrast to estrogen,
androgens enhance ovarian granulosa cell apoptosis from rats
(32), and progesterone was recently suggested to suppress
apoptosis in human granulosa cell (33). Androgens were
reported to antagonize the protective effect of diethylstilbestrol
(DES), which exerts an estrogen-like activity, in attenuating rat
granulosa cells apoptosis (32).
Glucocorticoids induced apoptosis in most cells of the vascular system,
such as rat thymocytes, myeloma cells, and peripheral blood monocytes
(34, 35, 36, 37). In contrast, in the mouse mammary gland,
glucocorticoid and progesterone inhibited involution and programmed
cell death (38). The effect of glucocorticoids on
apoptosis in the female reproductive organs is not well understood. Dex
did not stimulate apoptosis in cultured porcine granulosa cells
(39). However, no data were presented in that work showing
whether Dex could protect against apoptotic stimuli such as serum
deprivation. Thus, the effect of Dex on apoptosis in human ovary is not
completely understood. In the present report we demonstrate that Dex
and hydrocortisone protect against serum deprivation-, cAMP-, and
p53-induced apoptosis in immortalized HO-23 human granulosa cells. The
protective effect involved an increase in Bcl-2 levels. Moreover,
glucocorticoid protection against apoptosis does not involve
stimulation of the cell cycle.
As glucocorticoids induce apoptosis in most cells of the vascular
system, such as rat thymocytes, myeloma cells, and peripheral blood
cells (34, 35, 36, 37), it seemed essential to compare the effect
of glucocorticoid on a representative cell type that is sensitive to
glucocorticoid-induced apoptosis. We chose LTR-6 myeloma cells because
they express the same TS mutant of p53 (Val135)
as the HO-23 cells and discovered that the glucocorticoid-induced
apoptosis in myeloid cells involved down-regulation of the
intracellular level of Bcl-2.
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Materials and Methods
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Antibodies
Antibody against progesterone was a gift from Dr. F. Kohen
(Department of Biological Regulation, Weizmann Institute of Science,
Rehovot, Israel). Polyclonal rabbit antihuman Bcl-2, polyclonal rabbit
antihuman glucocorticoid receptor-
(GR
), and monoclonal mouse
antihuman Mdm2 (Marine Double Minute 2(20) were purchased from
Santa Cruz Biotechnology, Inc. (Heidelberg, Germany). Goat
antirabbit and antimouse IgG coupled to horseradish peroxidase were
obtained from Biomakor (Rehovot, Israel). Antihuman StAR antibodies
were provided by Dr. J. F. Strauss III (University of Pennsylvania
Medical Center, Philadelphia, PA). Antihuman adrenodoxin polyclonal
antibodies were provided by Dr. W. L. Miller (University of
California, San Francisco, CA).
Reagents
Reagents for terminal deoxynucleotidyltransferase-mediated dUTP
nick end labeling (TUNEL) were purchased from Roche Molecular Biochemicals, (Mannheim, Germany). FK (a potent activator of
adenylate cyclase), Dex, and 4',6-diamido-2-phenylindole hydrochloride
(DAPI; for DNA staining) were purchased from Sigma. RU-486
was a gift from Dr. F. Kohen (Department of Biological Regulation,
Weizmann Institute of Science).
Cells and treatments
The human granulosa cell line HO-23 was established by triple
transfection of primary human granulosa cells with simian virus 40 DNA,
Ha-ras oncogen, and a TS mutant of p53 (p53
Val135) as described previously
(12). Shifting the temperature from 37 to 32 C leads to
manifestation of wild-type p53 activity (28, 40). The
LTR-6 cell line was derived from mouse M1 myeloid leukemia
cells, which contain a stable, transfected TS mutant of p53
(Val135 p53). At 32 C wild-type p53 function was
exerted by its mutant in LTR6 cells, resulting in programmed cell death
(41).
Biochemical assays
Progesterone was determined by RIA at the end of stimulation
(42, 43). Protein was quantified by the Bradford method
(44).
Western blot analysis
Cells were washed with cold PBS and harvested with a rubber
policeman using lysis buffer containing 50 mM HEPES (pH
7.2), 150 mM NaCl, 1.5 mM
MgCl2, 1 mM EGTA, 1 mM
phenylmethylsulfonylfluoride, 1% Triton X-100, 10 µg/ml leupeptin,
10% glycerol, 30 mM NaF, 30 mM sodium
pyrophosphate, 1 mM orthovanadate, and 5 µg/ml aprotinin.
Lysates were boiled in sample buffer for 10 min. Samples containing
equal amounts of protein (30 µg) were separated by 12% (to detect
Bcl-2) or 10% (to detect GR
and Mdm2) SDS-PAGE. The blots were
blocked using 5% milk powder in PBS plus 0.05% Tween-20 and reacted
(overnight, 4 C) with antihuman Bcl-2 antibody or antihuman Mdm2
antihuman GR
, followed by 1-h incubation at room temperature with
goat antirabbit or antimouse IgG conjugated to horseradish peroxidase.
The detection was carried out using enhanced chemiluminescence
(12, 20).
Phase contrast and immunofluorescent microscopy
Staining for DAPI and TUNEL reaction were performed on cells
grown on glass coverslips. At the end of culture period, medium was
aspirated and stored at -20 C for progesterone measurement. Cells were
washed with PBS, fixed with 3% paraformaldehyde for 30 min in 24 C,
and permeabilized for 4 min with 1% Triton X-100 in PBS at 4 C,
incubated with TUNEL reaction mixture (fluorescein-deoxy-UTP and
terminal deoxynucleotidyl transferase) for 60 min at 37 C in a
humidified atmosphere in the dark. Cells were washed with PBS and
stained with DAPI for 30 min at 24 C (20). Cells were
washed intensively with PBS, mounted in Mowiol, and analyzed by
Carl Zeiss Axioskop Microscope (Carl Zeiss,
Oberkochen, Germany) in both phase and fluorescent modes.
Fluorescence-activated cell sorting (FACS) analysis of DNA
content
Floating cells and trypsinized cells, which were originally
attached to the bottom of the culture dishes from each treatment, were
collected and combined to ensure a complete recovery of the cell
population. Cells were washed with cold PBS and fixed in cold methanol
(-20 C) for 1 h. Subsequently, cells were centrifuged,
resuspended in 0.5 ml cold PBS, and stained for 15 min with 50 µg/ml
propidium iodide in the presence of ribonuclease A (100 µg/ml). Cells
were then analyzed in the fluorescence-activated cell sorter. Five
thousand events from the gated subpopulation were recorded separately
(20).
Statistical analysis
Analysis of progesterone production and densitometer tracing on
Western blots autoradiograms (mean ± SD) were
performed using ANOVA followed by Fishers least significant
difference test. Differences between treatment groups were considered
statistically significant at P < 0.05.
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Results
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Steroidogenesis and apoptosis in the HO-23 human granulosa cell
line
To study the effect of glucocorticoids on apoptosis and its
relationship to steroidogenesis we incubated HO-23 cells with forskolin
(20 µM) for 29 h at 37 C or for 24 h at 37 C,
followed by 5 h at 32 C in the presence or absence of 100
nM Dex (Fig. 1A
). Production
of progesterone in nonstimulated cells was 10
pg/106 cells·24 h. FK elevated progesterone
production by 240- and 180-fold (P < 0. 05) at 37 C
for 29 h and at 24 h at 37 C, followed by 5 h at 32 C,
respectively. Dex had no effect on progesterone production by itself,
but enhanced the level of FK-stimulated progesterone production by 4-
and 8-fold at 37 and 32 C respectively (P < 0.01; Fig. 1A
). To verify whether this synergistic effect of Dex and FK on
progesterone production involves increased expression of steroidogenic
enzymes, we analyzed cell lysates by Western blot. Although there was a
clear induction of StAR and ADX by forskolin (which is a specific
marker for the cytochrome P450 side chain cleavage enzyme system), no
further induction of expression of these gene products was revealed in
the presence of Dex (Fig. 1B
), suggesting that enhancement of
steroidogenesis by Dex in the absence of serum does not involve
regulation of StAR and ADX.

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Figure 1. Dex augments the progesterone production induced
by forskolin in the HO-23 granulosa cell line. Cells were incubated for
24 h at 37 C in DMEM/Hams F-12 medium containing 5% FCS. After
24 h the culture medium was replaced with serum-free medium
containing the stimulants; 20 µM FK, 100 nM
Dex, or both for 24 h. At the end of 24-h incubation an additional
incubation was carried out at 37 or 32 C for 5 h. A, Progesterone
production was measured by RIA. Data are the mean ±
SD of triplicate culture plates. a, c, e, and g are
different from b, d, f, and h (P < 0.01). b is
different from d, and f is different from h (P <
0.01). B, Cell lysates were prepared, and Western blot analysis was
performed using specific antibodies to StAR and ADX.
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To examine whether Dex can protect against apoptosis in HO-23 cell
line, cells were analyzed by DAPI staining using the TUNEL method (Fig. 2
) and FACS analysis of propidium
iodide-treated cells (Figs. 3
and 4
) in which the
Go/G1 subfraction of cells
(peak I) was considered the apoptotic population, and peaks II and III
represent cells with 2N and 4N chromosomes characteristic of this cell
line (20). At 37 C it was clearly demonstrated by all the
methods that Dex protects against serum deprivation- and FK-induced
apoptosis (Figs. 2
and 3
). Shifting the temperature to 32 C, which
activates p53, led to a 4.3-fold increase in the rate of apoptosis. FK
increased apoptosis by 2-fold at 37 C and by 1.7-fold at 32 C compared
with that in nonstimulated cells at the same temperature (Fig. 4
)

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Figure 2. Dexamethasone protects the human granulosa cell
line (HO-23) from FK-induced apoptosis. Cells were cultured on plastic
dishes in medium containing 5% FCS at 37 C. After 24 h the
culture medium was replaced with serum-free medium containing the
stimulants 20 µM FK or the combination of FK and 100
nM Dex for 24 h. At the end of 24-h incubation, an
additional incubation for 5 h was carried out in 32 C. Cells were
double stained with DAPI and TUNEL reaction, and were visualized under
the light microscope in phase a, b and fluorescent modes visualizing
either DAPI a', b' or TUNEL a'', b'' of the different treatments (FK+DEX
a, a' a''and FK b, b' b''). Dex clearly reduced apoptosis that was
induced by FK, as shown in phase and fluorescent images.
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Figure 3. DNA breakdown in HO-23 cells during apoptosis.
HO-23 cells were incubated for 24 h at 37 C in DMEM/Hams F-12
medium supplemented with 5% FCS. The culture medium was replaced with
serum-free medium (CONT) containing the stimulants 20 µM
FK, 100 nM Dex, or both for 24 h. An additional
incubation for 5 h was carried out at 37 and 32 C in the presence
or absence of the same stimulants. Cells were fixed with methanol,
stained with propidium iodide, and examined by FACS. CONT,
Nonstimulated cells. The numbers on the y-axis indicate
the number of particles (cells), and those on the x-axis
indicate the DNA content in arbitrary units.
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Figure 4. Effects of glucocorticoids on apoptosis in HO-23
human granulosa cells incubated at 37 C (A) and 32 C (B). HO-23 cells
were incubated for 24 h at 37 C in DMEM/Hams F-12 medium
supplemented with 5% FCS. The culture medium was replaced with medium
containing serum (CONT+S) or serum-free medium alone (CONT) or medium
containing the stimulants 20 µM FK, 100 nM
Dex, both FK and Dex, 100 nM hydrocortisone (Hydroc), or
Dex (10 nM) with different doses of RU486 in the presence
or absence of FK for 24 h. An additional incubation for 5 h
was carried out at 37 and 32 C in the absence or presence of the same
stimulants. Cultures were stained with propidium iodide and processed
for FACS analysis. Data are means of duplicate plates that did not
deviate by more than 5% of the mean.
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Dex was able to block apoptosis induced by serum deprivation (to 40%
of control), p53 (to 33%), and cAMP (to 28% and 40% at 37 and at 32
C, respectively; Fig. 4
, A and B). Hydrocortisone (100 nM)
blocked serum deprivation-induced apoptosis to 50% at 37 C and to
94% at 32 C. Hydrocortisone (100 nM) also attenuated
cAMP-induced apoptosis to 50% at 37 C and to 80% at 32 C.
Glucocorticoids are therefore able to attenuate apoptosis induced by
serum deprivation, p53 activation, or forskolin stimulation. As shown
in Fig. 3
, the protection by Dex against apoptosis did not involve
changes in the incidence of cells in the G2/M
phase (peak IV) (20), suggesting that this protection does
not involve stimulation of cell proliferation.
Does Dex protect against apoptosis via interaction with the
GR?
To examine the sensitivity of the cells to the protection against
apoptosis by Dex, cells starved for 24 h were incubated during
this period with increasing concentrations of Dex. Dex protected
against apoptosis in a dose-dependent manner with an
ED50 of 7 nM, and 80% of protection
was achieved already at 10 nM (Fig 5
).

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Figure 5. Dose response of Dex in the HO-23 granulosa cell
line. HO-23 cells were incubated for 24 h at 37 C in DMEM/Hams
F-12 medium containing 5% FCS. After 24 h the culture medium was
replaced with serum-free medium containing different concentrations of
dexamethasone. Cultures were stained with propidium iodide and
processed for FACS analysis. Data are means of duplicate plates that
did not deviate by more than 5% of the mean.
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To determine whether the protective effect of Dex is mediated by its
receptor, we incubated the cells with 10 nM Dex at 32 C in
the presence or absence of forskolin and in the absence or presence of
increasing concentrations of RU486. RU486 at 10100 nM
almost completely abolished the inhibitory effect of Dex on apoptosis
induced by activation of p53 and by incubation with forskolin. Similar
results were obtained when RU486 was introduced with Dex at 37 C in the
presence of forskolin (Fig. 4A
).
Protective effect of glucocorticoids against granulosa cell
apoptosis involves increase in Bcl-2 levels
To examine whether such a protection involves modulation of the
expression of tumor suppressor genes or survival genes, we tested the
intracellular levels of Bcl-2 and Mdm2. Cells treated at 37 C or 32 C
with 100 nM Dex showed significant elevation of Bcl-2
expression compared with nontreated cells (3.1-fold at 37 C and 3-fold
at 32 C; P < 0.01; Fig 6
). Thus, an increase in Bcl-2 levels
stimulated by Dex may be involved in the protective effect of Dex on
apoptosis induced by p53 activation (Fig. 6
) and serum deprivation (not
shown in Fig. 6
). Stimulation of cells with 20
µM forskolin for 29 h at 37 C or for
24 h at 37 C followed by 2 or 5 h at 32 C reduced the level
of Bcl-2 by 50% (P < 0.05). This decrease in Bcl-2
level exerted by forskolin was completely abolished by 100
nM Dex. Mdm2 expression was not affected by Dex
treatment, although its expression was reduced by forskolin
(20).

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Figure 6. Expression of Bcl-2 and Mdm2 in response to Dex
and FK in the HO-23 human granulosa cell line. HO-23 cells were
cultured for 24 h in medium containing 5% serum at 37 C for
24 h. The culture medium was replaced with serum-free medium in
the absence of stimulants (CONT) or in the presence of 20
µM FK, 100 nM Dex or both for 24 h at 37
C. At the end of 24-h incubation, an additional incubation for 2 or
5 h was carried out in parallel at 32 or 37 C. A, Cell lysates
were prepared, and Western blot analysis was performed using specific
antibodies to Bcl-2 and Mdm-2. B, Densitometric tracing of Bcl-2. Data
are the mean ± SD of three independent measurements.
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Stimulation of apoptosis by glucocorticoids in LTR-6 myeloid
leukemia cells
We examined whether the antiapoptotic effect of the glucocorticoid
is cell specific, in view of its proapoptotic effect in many cell types
(33). LTR6 myeloid leukemia cells expressing the same TS
mutant of p53 (Val135 p53) as HO-23 granulosa
cells were found to express the same amount of GR
(Fig. 7
). LTR-6 cells were treated with 100
nM Dex at 37 and 32 C with or without 20 µM
forskolin, a concentration similar to that used for treatment of HO-23
human granulosa cells. Cells incubated at 32 C were stimulated for
apoptosis due to activation of the mutant p53 (2-fold), but FK was
without effect (Fig. 8B
). Interestingly
100 nM Dex clearly enhanced apoptosis by 3.5-fold at 37 C
and by 1.9-fold at 32 C compared with cells incubated either at 37 or
32 C without Dex (Fig. 8
, A and B). FK did not augment apoptosis in the
presence of Dex (Fig. 8B
). The apoptotic effect of Dex was mainly due
to the shift of the G1/G0
population to the G0 subpopulation, which is
characteristic for apoptotic cells (Fig. 8A
, peak I). These data
suggest that Dex exerts an opposite apoptotic effect in myeloid
leukemia cells, in contrast to its effect in HO-23 cells.

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Figure 8. Effect of Dex on apoptosis in the LTR-6 cell line.
Cells were cultured in RPMI medium containing 10% FCS at 37 C for
24 h. The culture medium was replaced with serum-free medium in
the absence of stimulants (CONT) or in the presence of 20
µM FK, 100 nM Dex, or both for 24 h. At
the end of 24-h incubation, an additional incubation for 5 h was
carried out at 32 or 37 C. Cultures were stained with propidium iodide
and processed for FACS analysis. A, DNA breakdown in control
nonstimulated cells and Dex-treated cells. B, Data are means of
duplicate plates that did not deviate by more than 5% of the mean.
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We further investigated the effect of Dex on Bcl-2 levels. Bcl-2 levels
were dramatically suppressed to 15% of control (P <
0.01) after 29 h of incubation with 100 nM
Dex and to 19% of control after 24 h at 37 C, followed by 5
h at 32 C (P < 0.01; Fig 9
). Forskolin (20
µM) only slightly reduced Bcl-2 levels at 37 C.
However, it did not affect Bcl-2 levels at 32 C, but reduced Bcl-2
levels to 15% (P < 0.01) if cells were coincubated
with Dex and forskolin. Thus, Bcl-2 levels are involved at least in
part in the apoptotic signal exerted by Dex in LTR6 myeloid leukemia
cells.

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Figure 9. Expression of Bcl-2 in the LTR-6 cell line. Cells
were cultured in RPMI medium containing 10% FCS at 37 C for 24 h.
The culture medium was replaced with serum-free medium containing 20
µM in the absence of stimulants (CONT) or in the presence
of 20 µM FK, 100 nM Dex, or both for 24
h. At the end of 24-h incubation, an additional incubation for 5 h
was carried out at 32 or 37 C. A, Cell lysates were then prepared, and
Western blot analysis was performed using specific antibody to Bcl-2.
B, Data from the densitometer tracing of Bcl-2 in A are the mean of
three independent measurements. a, c, e, and g are different from b, d,
f, and h (P < 0.01).
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Discussion
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In the present work we demonstrate that glucocorticoid hormones
were able to protect against apoptosis in immortalized human granulosa
cells (HO-23) induced by serum deprivation, cAMP stimulation, and
activation of p53. The inhibitory effect of Dex on apoptosis suggests
that the immortalized cells can serve as a useful system to analyze the
effect of glucocorticoids in cells that are closely related to normal
granulosa cells (11, 12, 17, 28, 43, 45). Also, serum
deprivation (30, 46) and p53-induced apoptosis
(47) were typical for normal granulosa cells (30, 46, 47) as well as the immortalized ones (20, 28).
As glucocorticoids are implicated in induction of apoptosis in many
cell types, such as immature thymocytes (48), mature
activated peripheral T lymphocytes (49, 50), several
leukemic cell lines (51), and multiple myeloma-derived
cell lines (36), our finding of the protection against
granulosa cell apoptosis is somewhat unusual, although it was recently
demonstrated that glucocorticoids attenuate apoptosis induced by serum
deprivation in human peripheral blood neutrophils (52) and
suppress apoptosis induced by tumor necrosis factor in glomerular
endothelial cells (53) and by interferon-
and
transforming growth factor-ß1 in lung epithelial cells and in
hepatoma cells, respectively (54, 55, 56).
Nevertheless, in the present work we demonstrate for the first time
that glucocorticoid hormones such as dexamethasone and hydrocortisone
can inhibit p53- and cAMP-induced apoptosis, which are among the
most common effectors of apoptosis in normal and immortalized granulosa
cells (11, 28, 30, 57).
p53 levels are enhanced dramatically after x-ray and ionic radiation as
well as by chemotherapy with cisplatin, hypoxia, nitric oxide, and
other stresses that may lead to massive apoptosis in target cells
(reviewed in Ref. 58). Elevation of nuclear p53 protein in
apoptotic granulosa cells was clearly demonstrated in atretic
follicles, and activation of p53 was correlated with apoptosis in
steroidogenic immortalized rat and human granulosa cells (20, 28, 47). We suggest that glucocorticoids, in particular in
epithelial cells such as ovarian granulosa, mammary gland, and liver
parenchymal, may negate the p53 signals for apoptosis and therefore may
prevent excessive damage of essential glandular cells and tissue after
different kinds of stress stimuli implicated with p53
up-regulation.
Dex exerts its antiapoptotic effect in a dose-dependant manner with an
ED50 of 7 nM, which is in line with
the Kd found in human osteosarcoma cell lines
(59), and can be blocked by RU486, which has been shown to
inhibit the release of GR from cytoplasmic complexes containing heat
shock proteins, thus suppressing the subsequent translocation of
receptors into the nucleus (60, 61). Taken together, our
observation of the low ED50 for inhibition of
apoptosis and the blocking of this effect by RU486 strongly suggest
that the antiapoptotic effect of glucocorticoid in granulosa cells is
exerted through interaction with its specific receptor. Indeed, we
identified GRs in HO-23 cells by Western blot.
Nonstimulated HO-23 cells produce extremely low levels of progesterone
(10 pg/106·24 h). However, it is very unlikely
that this amount of progesterone contributes significantly to the
antiapoptotic effect of Dex exerted by serum deprivation or p53
activation, as the actual concentration of progesterone in these cell
cultures is 0.01 nM, which is 150 times lower than the
Kd level (1.5 nM) calculated for the
affinity of progesterone to its receptor (62). It is even
more unlikely that FK-induced steroidogenesis contributes to the
protective effect of Dex, as the elevation in progesterone produced by
cAMP stimulation coincides with an elevation rather than a decrease in
apoptosis in HO-23 cells. However, we cannot exclude the possibility
that progesterone may have some antiapoptotic effect in primary human
granulosa cells (33).
We demonstrated that Dex increases cAMP-induced steroidogenesis in
immortalized granulosa cells (24), but no information is
available on specific enhancement of cAMP-induced steroidogenesis in
human granulosa cells. In the present work we demonstrated that Dex can
enhance cAMP-induced steroidogenesis concomitantly with attenuation of
apoptosis, and in preliminary work we show that Dex enhances
hCG/cAMP-induced steroidogenesis in preovulatory human granulosa cells
(Sasson, R., and A. Amsterdam, in preparation), suggesting that this
process can explain at least in part the enhancement of steroidogenesis
by Dex. Although we cannot rule out that Dex may moderately change the
expression of steroidogenic enzymes or factors as was demonstrated for
the FSH-17 rat granulosa cell line (24), we did not find
significant changes in the expression of StAR and ADX by Dex in
cAMP-treated HO-23 cells. The main differences between the previous
(24) and the present work is the use of cells of different
mammalian origins and that the stimulation of steroidogenesis was
performed in serum-free medium, whereas previous experiments were
performed in the presence of 5% FCS, which may contain growth factors
and other factors that may enhance de novo synthesis of StAR
and ADX. In the absence of serum, the inhibition of apoptosis by Dex is
probably the main cause of the enhanced cAMP-induced steroidogenesis,
especially in cultures of HO-23 cells that were incubated at 32 C,
which dramatically activated the apoptotic effect of p53.
We demonstrated that Dex significantly changes Bcl-2 levels. It was
recently demonstrated that Dex suppresses apoptosis in human gastric
cancer cell lines through modulation of bcl-x gene
expression (63). Inhibition by Dex of transforming growth
factor-induced apoptosis in rat hepatoma cells is associated with
Bcl-xL induction, another survival gene of the
Bcl-2 family (56). However, in this work we for the first
time report the involvement of Bcl-2 in Dex protection against
apoptosis through the up-regulation of its intracellular levels.
Whether Dex can enhance other survival factors that may protect against
ovarian cell death, such as Bcl-xL, should be
explored in the future. Moreover, the possibility that glucocorticoids
can enhance specific ovarian survival factors, such as inhibitor of
apoptosis proteins (64) and growth differentiation
factor-9 (65) secreted by the egg, should be explored
either in vivo or in intact follicles in
vitro.
Glucocorticoids are known to induce apoptosis in acute myeloid leukemia
cell lines and in other cell types, such as mature activated peripheral
T lymphocytes (66, 67). However, the mechanism is not
completely understood. On the one hand, in myeloid leukemia cells lines
no change in Bcl-2 level was recorded upon Dex-induced apoptosis. On
the other hand, it was suggested that the Bcl-2 level in T lymphocytes
can switch the effect of glucocorticoids from proapoptotic to
antiapoptotic when lymphocytes expressing Bcl-2 are exposed to other
apoptotic stimuli, such as serum depletion (68). In the
present work we observed that in the LTR-6 myeloid leukemia cell line
expressing the same Ts p53 plasmid (Val135 p53)
and the same type of GR as in the granulosa cell line HO-23,
glucocorticoids enhanced p53-induced apoptosis, in contrast to HO-23
cells, where glucocorticoids suppressed p53-induced apoptosis. Thus,
different cell types can respond in opposite ways to stimulation by
Dex, which may involve in both cases modulation of the Bcl-2 level in
an opposite manner. Here we observed a situation in which Dex can
display different activities in different cell types, implying some
sort of communication with other factors that affect or reflect cell
specificity (69). It was already shown that the cell
specificity of GR action at PifG (proliferin gene) is determined by the
composition of AP-1, specifically the ratio of c-Jun to c-Fos
(69, 70). F9 cells, which lack AP-1 activity under
appropriate culture conditions, displayed no hormonal regulation from
PifG-linked CAT sequences; HeLa cells, which express AP-1 predominantly
as c-Jun homodimers, enhanced reporter expression in response to the
steroid hormone Dex, and CV-1 cells, in which AP-1 is comprised mostly
of c-Jun and c-Fos heterodimers, repressed reporter gene expression
upon hormone addition (69). Thus, the ratio of c-Jun and
c-Fos can sometimes operate to determine the different glucocorticoid
responses in different cells.
The roles of glucocorticoids in the direct regulation of ovarian
function are poorly understood. However, it was recently hypothesized
that glucocorticoids serve an antiinflammatory role during ovulation,
thereby promoting rapid healing of the wound left by follicular rupture
(71). Glucocorticoid interference with PG synthesis
(71) and with granulosa cell apoptosis as described in the
present paper in HO-23 cells may deepen our understanding of the
mechanism by which glucocorticoids exert their antiinflammatory action
in the ovary.
 |
Acknowledgments
|
|---|
We thank Dr. M. Walker, Weizmann Institute, for helpful
discussion and Dr. F. Kohen, Weizmann Institute, for antiprogesterone
antibodies, Dr. J. F. Strauss III, University of Pennsylvania
Medical Center (Philadelphia, PA), for antibodies to StAR, Dr. W.
L. Miller, University of California (San Francisco, CA), for
antiadrenodoxin, and Dr. Selvaraj N, University of Illinois
(Chicago, IL), for his assistance with the statistical analysis of the
data.
 |
Footnotes
|
|---|
1 This work was supported by grants from Israel Academy of
Sciences. 
2 Incumbent of the Joyce and Ben B. Eisenberg Chair of Molecular
Endocrinology and Cancer Research at Weizmann Institute of Science
(Rehovot, Israel). 
Received May 30, 2000.
 |
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