蛋白糖基化与肝病.pdf

Special article Alteration of protein glycosylation in liver diseasesq Bram Blomme1 Christophe Van Steenkiste1 Nico Callewaert2 3 Hans Van Vlierberghe1 1Department of Hepatology and Gastroenterology Ghent University Hospital B 9000 Ghent Belgium 2Unit for Molecular Glycobiology Department for Molecular Biomedical Research VIB Ghent University Ghent Belgium 3Department of Biochemistry Physiology and Microbiology Ghent University Ghent Belgium Chronic liver diseases are a serious health problem worldwide The current gold standard to assess structural liver dam age is through a liver biopsy which has several disadvantages A non invasive simple and non expensive test to diagnose liver pathology would be highly desirable Protein glycosylation has drawn the attention of many researchers in the search for an objective feature to achieve this goal Glycosylation is a posttranslational modifi cation of many secreted proteins and it has been known for decades that structural changes in the glycan structures of serum proteins are an indication for liver damage The aim of this paper is to give an overview of this altered protein glycosylation in diff erent etiologies of liver fi brosis cirrhosis and hepatocellular carcinoma Although individual liver diseases have their own specifi c markers the same modifi cations seem to continuously reappear in all liver diseases hyperfucosylation increased branching and a bisecting N acetylglucosamine Analysis at mRNA and protein level of the corresponding glycosyltransferases confi rm their altered status in liver pathology The last part of this review deals with some recently developed glycomic techniques that could potentially be used in the diagnosis of liver pathology 2008 European Association for the Study of the Liver Published by Elsevier B V All rights reserved Keywords Glycosylation Liver fi brosis Hepatocellular carcinoma Glycomics Bio marker 1 Introduction Over the years it has become apparent that changes in protein glycosylation play an important role in the path ogenesis and progression of various liver diseases In order to comprehend the relationship between glycosyl ation and liver diseases some basic insight into this complex phenomenon is necessary Therefore a short introduction is provided which covers basic biochemical aspects of glycosylation see Fig 1 In general glycosylation consists of co and post translational modifi cation steps in which individual gly cansareaddedtoproteinstranslatedintothe endoplasmic reticulum ER forming oligosaccharide chains This is an enzyme directed and a site specifi c process Two types of protein glycosylation exist N gly cosylation to the amide nitrogen of asparagine Asn side chains and O glycosylation to the hydroxyl groups of serine Ser and threonine Thr side chains Most proteins in human serum contain one or more N linked glycans with the exception of albumin and C reactive 0168 8278 34 00 2008 European Association for the Study of the Liver Published by Elsevier B V All rights reserved doi 10 1016 j jhep 2008 12 010 Associate Editor M P Manns q The authors declare that they do not have anything to disclose regarding funding from industries or confl ict of interest with respect to this manuscript Corresponding author E mailaddress Hans Vanvlierberghe UGent be H V Vlierberghe Abbreviations ER endoplasmic reticulum Asn asparagine Ser serine Thr threonine GlcNAc N acetylglucosamine HCC hepato cellular carcinoma ALD alcoholic liver diseases CDT carbohydrate defi cient transferrin ST6GalI b galactoside a2 6 sialyltransferase TSA total sialic acid FSA free sialic acid Hp haptoglobin Con A Concanavalin A Apo E Apolipoprotein E GnT III N acetylglucos aminyltransferase III LAL lysosomal acid lipase HPLC high perf ormance liquid chromatography MALDI TOF matrix assisted laser desorption ionization time of fl ight AGP a1 acid glycoprotein GnT V N acetylglucosaminyltransferase V HBx HBV x protein a1 6 FT a1 6 fucosyltransferase LCA lens culinaris agglutinin E PHA Pha seolus vulgaris erythroagglutinating L PHA Phaseolus vulgaris le uco agglutinating AAT a 1 antitrypsin TF transferrin DEN diethylnitrosamine DSA FACE DNA sequencer assisted fl uoro phore assisted carbohydrate electrophoresis IgG immunoglobulin G Journal of Hepatology 50 2009 592 603 protein O glycans are found in mucins which are abun dantly present on mucosal surfaces and saliva Most modifi cations of glycosylation in liver diseases that have been studied aff ect N glycosylated proteins and these will primarily be discussed The N oligosaccharide chain is attached to asparagine occurring in the tripeptide sequence Asn X Ser in which X could be any amino acid except proline 1 4 The biosynthesis of N and O glycans take place in the ER and the Golgi apparatus and it can be roughly divided in three steps 5 The fi rst step in N glycosyl ation is carried out in the ER and consists of the for mation of an oligosaccharide lipid complex containing three glucoses nine mannoses and two N acetylglu cosamines GlcNAc The lipid portion dolichol acts as a carrier molecule The second step is the transfer of the oligosaccharide portion to a growing nascent polypeptide and the simultaneous removal of the three glucose residues and 1 mannose residue The prema ture glycoprotein is then mediated to the Golgi appa ratus where residual monosaccharides are removed until a mannose 5 GlcNAc 2heptasaccharide chain is formed From here on specifi c glycosyltransferases Table 1 and 9 11 and glycosidases will further modify the core structure by adding or removing monosaccharides respectively 6 Glycosyltransfer ases make use of nucleotides sugars donors in order to incorporate monosaccharides into the N glycan Glycosidases on the other hand catalyze the hydroly sis of the glycosidic linkage In addition glycans can have various branches 2 5 and are termed bi tri tetra and penta antennary respectively The enzy matic addition and removal of monosaccharides allow the formation of glycans with various length compo sition and structure 7 8 The functional role s of the N linked carbohydrate moieties of glycoproteins is are often not well under stood However glycosylation is a necessity in the cor rectfolding ofcertainproteins Aberrant protein folding aff ects various physiochemical and functional properties of proteins protein stability protein solubil ity protein inter intracellular transport and half life in blood The opposite can also be true Carbohydrate moieties on glycoproteins also fulfi ll a role in intercellu lar contact and communication which is an important aspect of host immunity as well as cancer 12 15 The liver contains various receptors on sinusoidal and hepatocyte surfaces A lot of proteins that bind to these receptors rely on their carbohydrate moieties Besides changes in glycosylation patterns the changes in receptor concentration and distribution also occur in various chronic liver diseases cirrhosis hepatocellu lar carcinoma HCC and alcoholic liver diseases N acetylglucosamine Mannose Galactose Sialic acid Fucose a1 6 a1 3 b1 4 b1 4 a1 3b1 6 b1 6 b1 2b1 2 b1 4b1 4b1 4 6 2a6 2aa2 6 Fig 1 N Glycan with indication of the individual monosaccharides and the diff erent binding types between the monosaccharides a1 3 alpha 1 3 binding a1 6 alpha 1 6 binding a2 6 alpha 2 6 binding b1 2 beta 1 2 binding b1 4 beta 1 4 binding b1 6 beta 1 6 binding Table 1 Glycosyltransferases that are important in the modifi cation of N glycans on serum proteins Glycosyltransferase familyMammalian glycosyltransferases Substrate specifi city a1 2 Fucosyltransferase a1 2 Linkage to the terminal Gal residue in N or O glycans Fucosyltransferases 9 a1 3 4 Fucosyltransferase a1 3 or a1 4 Linkage to GlcNAc in GlcNAc Gal structures a1 6 Fucosyltransferasea1 6 Linkage to the innermost core GlcNAc in N glycans N Acetylglucosaminyltransferase IIIGnT III catalyzes the addition of GlcNAc via b1 4 linkage to the b mannose core of N glycans N Acetylglucosaminyltransferases 10 N Acetylglucosaminyltransferase IV GnT IV catalyzes the formation of GlcNac b1 4 branches at the Man a1 3 side of the trimannosyl core of N glycans N Acetylglucosaminyltransferase VGnT V catalyzes the formation of GlcNAc b1 6 branches at the Man a1 6 side of the trimannosyl core of N glycans Sialyltransferases 11 a2 6 Sialyltransferase ST6GalI mediates the transfer of sialic acid residue with an a2 6 linkage to a terminal Gal residue a2 3 Sialyltransferase ST3GalI mediates the transfer of sialic acid to a Gal residue of a terminal Galb1 3GalNAc oligosaccharide Diff erent glycosyltransferases of this class are known B Blomme et al Journal of Hepatology 50 2009 592 603593 ALD This leads to an accumulation of certain glyco proteins in the circulation 16 17 In the following sections we will discuss the role of glycosylation in liver fi brosis and its relation to various liver pathologies ALD hepatitis B bile related diseases and obesity and its role in HCC The last section will deal with analytical advances in glycoresearch in recent years which now allows the rapid and detailed mapping of the complex mixtures present within biofl uid samples 2 Alteration of glycosylation in fi brosis cirrhosis The gold standard to assess liver fi brosis is through a liver biopsy which involves the removal of a small liver sample It is well known that this procedure is accompa nied by several complications Changes in glycosylation of serum proteins have been extensively used as a non invasive alternative and this has resulted in the develop ment of sensitive and discriminating clinical tests for diagnostic purposes The rationale for these tests is that the majority of glycosylated serum proteins are synthe sized by the liver and in all major liver diseases changes in this glycosylation occur Whileearly glycomestudieswereconfi nedto thestudy of sialylation patterns glycomics has evolved ever since 18 In the past two decades the main way of investigat ing glycosylation was by using lectins 19 20 These lectins bind with a particular glycan structure core fucosylated glycans complex glycans Table 2 Today with the advent of high throughput glycomic techniques we are progressing towards a system biology approach comprising genomics and proteomics in order todrawgeneralconclusionsaboutaparticularpathology 2 1 Alcoholic liver disease Carbohydrate defi cient transferrin CDT is the most used marker of chronic alcohol abuse Human serum transferrin is a glycoprotein synthesized by the liver and involved in iron transport between sites of absorp tion and delivery 21 Chronic ethanol intake alters the normal microheterogeneity pattern of transferrin as a consequence of changes in the sialic acid contents 22 23 See Table 3 for an overview of the assays that were used to investigate the glycan status A decreased level of dolichol has been observed in rats fed ethanol 24 The abnormal terminal sialylation can be explained by a decrease in b galactoside a2 6 sialyltransferase ST6GalI mRNA and protein expression and or an increase in hepatocyte membrane associated sialidase observed during chronic alcohol abuse 25 27 Oxida tion products of ethanol such as acetaldehyde interfere with the N glycan biosynthesis and or transfer by bind ing the involved enzymes Therefore CDT is likely the result of changes in glycosylation during biosynthesis and catabolism Although CDT is recognized as a mar ker of chronic alcohol consumption the reliability of this marker is largely dependent on the analytical frac tionation method capillary electrophoresis Alterations in glycosylation and lack of clinical analytical standard methods might contribute to the discrepancy and sensi tivity of CDT in clinical settings 28 29 Desialylationisthemostimportantalteration observed in ALD Besides transferrin many other pro teins are know to be desialylated in ALD including oro somucoid a1 antitrypsin ceruloplasmin 30 Therefore the overall serum desialylation pattern was studied in which serum total sialic acid TSA and serum free sialic Table 2 Commonly used lectins for the study of altered glycan structures in chronic liver diseases 20 LectinCommon name Specifi cityApplication Canavalia ensiformis Concanavalin A Con A Jack BeanMan Glc Man Glc GlcNAc Con A has been extensively used in the isolation and structural studies of glycoconjugates and it has some clinical uses such as crossed affi nity immunoelectrophoresis Lens culinaris LCA LentilMan Glc Man Glc GlcNAc Lens lectin is used for the isolation and analysis of glycoproteins It is also a useful tool for the determination of the degree of fucosylation of alpha fetoprotein and the histochemical staining of glycoconjgates Lotus tetragonolobus LTA Asparagus peaFuc a L Fuc The Lotus lectins have specifi cally been used for the recognition of fucosylated glycans Phaseolus vulgaris erythroagglutinating E type E PHA Kidney beanComplex Galb 1 4 GlcNAcb 1 2 Man Especially used for the identifi cation of glycans with a bisecting modifi cation Phaseolus vulgaris leuco agglutinating L type L PHA Kidney beanComplex Galb 1 4 GlcNacb 1 2 Galb 1 4 GlcNAcb 1 6 Man As L PHA is reactive with b 1 6 branched structures of trimannosyl core asparagine linked glycans which are highly selective markers of the metastatic potential of tumor cells this lectin is used in cancer diagnosis 594B Blomme et al Journal of Hepatology 50 2009 592 603 acid FSA were studied as potential markers of alcohol abuse 31 Both TSA en FSA were signifi cantly increased during alcohol abuse but as markers they have a low sensitivity 46 and negative predictive value 27 Consequently the clinical utility for screen ing alcoholic patients is limited In terms of changes in glycosylation status haptoglo bin Hp has also been proposed as a candidate marker of ALD especially alcoholic cirrhosis 32 33 This hemoglobin scavenger showed two major changes in glycosylation increasedbranchingandincreased fucosylation hyperfucosylation i e the increased pres ence of fucose residues in the glycan structure Hyperfu cosylation is predominantly present at the a1 3 position linked to the subterminal GlcNAc instead of the core fucose position The activity of a1 3 fucosyltransferase in blood is directly associated with elevated Hp concen trations Changes in branching were less frequent but still signifi cant in ALD This was determined by an increased N acetylglucosamine content of the Hp mole cule mol mol Hp However these alterations were not specifi c for alcoholic cirrhosis and were also observed in cases of primary billary cirrhosis and chronic alcohol abusers but were absent in chronic active hepatitis Besides haptoglobin other glycoproteins are known to exhibit an increased branching during alcoholic liver dis ease a1acid glycoprotein a2 HS glycoprotein and transferrin 34 In the alcoholic groups the proportion of Con A unreactive subpopulations of these glycopro teins increased The Golgi apparatus plays an important role in the alteration of glycosylation patterns of all liver diseases This is especially well studied in ALD 35 36 Charac teristic is the signifi cant accumulation of hepatic protein caused by impaired glycosylation and glycoprotein traf fi cking An example of impaired glycosylation is a decrease in the activity of galactosyltransferase 36 A proposed explanation for this reduced Golgi functioning is the defi cient polymerization of microtubular protein as a downstream consequence of hepatic acetaldehyde accumulation due to ethanol oxidation 35 A study by Ghosh et al 37 summarized the previ ously mentioned alterations of N glycosylation in an experimental rat model of ALD decreased enzyme activities of mannosyltransferase and galactosyltransfer ase lowered intracellular dolichol concentration strong decreased synthesis and activity of ST6GalI In addition to these fi ndings an increase of 30 in liver weight was observed compared to the body weight of this rat model This is due to a signifi cant accumulation of hepatic lip ids and proteins which leads to fatty liver and even ste atosis The novelty of this study is that they also showed an alteration in O glycosylation The protein apolipo protein E was used as a model to study this As in N gly cosylation animpairmentofmannosylationand sialylation was shown The relative ratio of labeled sugar to leucine incorporation glycosylation index showed a 50 decrease for relative mannosylation of Apo E molecule at both the microsomal and Golgi level Glycan structures on apolipoprotein E were hypothe sized to play a role in the association between this apo lipoprotein and high density lipoproteins HDL and very low density lipoproteins The observed impairment namely in mannosylation and sialylation of the protein Table 3 Overview of the main assays used to investigate the glycan status at protein or genetic level in diff erent etiologies of chronic liver diseases Etiologies Alcoholic liver diseasesFatty liver diseases bile related diseasesViral liver diseasesHepatocellular carcinoma HPAEC PAD 32 MALDI TOF MS 41 DSA FACE 94 DSA FACE 95 CIAE with Con A 34 CIAE with Con A 60 61 68 71 77 LCA 52 53 60 63 64 68 HPLC 37 HPLC 38 HPLC 100 HPLC 60 64 67 69 Enzyme Assays for GT 24 36 37 MT 37 ST 37 Enzyme Assay for GnT III 39 and a1 6FT 40 Enzyme Assay of GnT III 42 44 GnT IV 42 43 GnT V 42 43 GT 42 Enzyme Assay of a1 6 FT 59 62 GnT I 73 GnT III 62 71 73 79 80 82 GnT IV 62 80 82 GnT V 62 77 79 80 82 83 ST 49 Assays used Fucose binding lectin coupled to Sepharose beads 33 Lectin Blotting with E PHA 38 39 L PHA 39 AAL 40 41 AOL 41 Con A 41 SSA 41 MAM 41 Lectin FLISA 100 Lectin Blotting with Con A 72 LCA 59 E PHA 72 74 L PHA 84 Allo A 66 RT PCR 27 RT PCR 44 45 RT PCR 69 72 77 Northern Blot 25 Northern Blot 38 39 Northern Blot 42 43 45 Northern Blot 59 72 74 79 82 84 Chromatofocusing 23 Affi nity Column Chromatography 54 66 70 FACS analysis 42 43 Lectin Affi nity Electrophoresis Con A 55 LCA 55 59 E PHA 55 Allo A 55 In situ hybridization 48 Immunocytochemical determin