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Endocrinology Vol. 142, No. 2 802-811
Copyright © 2001 by The Endocrine Society


ARTICLES

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


    Abstract
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
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 10–100 nM RU486. The protection against apoptosis by glucocorticoid involved a sharp elevation in intracellular levels of Bcl-2 (3–7.6 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-{alpha}. 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.


    Introduction
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
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{alpha}-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.


    Materials and Methods
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
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-{alpha} (GR{alpha}), 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{alpha} 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{alpha}, 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 Fisher’s least significant difference test. Differences between treatment groups were considered statistically significant at P < 0.05.


    Results
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
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. 1AGo). 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. 1AGo). 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. 1BGo), 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/Ham’s 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.

 
To examine whether Dex can protect against apoptosis in HO-23 cell line, cells were analyzed by DAPI staining using the TUNEL method (Fig. 2Go) and FACS analysis of propidium iodide-treated cells (Figs. 3Go and 4Go) 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. 2Go and 3Go). 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. 4Go)



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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/Ham’s 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/Ham’s 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.

 
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. 4Go, 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. 3Go, 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 5Go).



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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/Ham’s 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.

 
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 10–100 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. 4AGo).

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 6Go). 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. 6Go) and serum deprivation (not shown in Fig. 6Go). 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.

 
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{alpha} (Fig. 7Go). 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. 8BGo). 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. 8Go, A and B). FK did not augment apoptosis in the presence of Dex (Fig. 8BGo). 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. 8AGo, 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 7. Expression of GR{alpha} in HO-23 cells and LTR-6 cells. HO-23 cells and LTR-6 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) and in the presence of 20 µM FK. Cell lysates were prepared, and Western blot analysis was performed using specific antibody to GR{alpha}.

 


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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.

 
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 9Go). 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).

 

    Discussion
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
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-{gamma} 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. Back

2 Incumbent of the Joyce and Ben B. Eisenberg Chair of Molecular Endocrinology and Cancer Research at Weizmann Institute of Science (Rehovot, Israel). Back

Received May 30, 2000.


    References
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 

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