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Mueller A, Davis A, Carlson SS, Robinson FR. N-acetylgalactosamine positive perineuronal nets in the saccade-related-part of the cerebellar fastigial nucleus do not maintain saccade gain. PLoS One 2014; 9:e86154. [PMID: 24603437 PMCID: PMC3945643 DOI: 10.1371/journal.pone.0086154] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Accepted: 12/05/2013] [Indexed: 11/19/2022] Open
Abstract
Perineuronal nets (PNNs) accumulate around neurons near the end of developmental critical periods. PNNs are structures of the extracellular matrix which surround synaptic contacts and contain chondroitin sulfate proteoglycans. Previous studies suggest that the chondroitin sulfate chains of PNNs inhibit synaptic plasticity and thereby help end critical periods. PNNs surround a high proportion of neurons in the cerebellar nuclei. These PNNs form during approximately the same time that movements achieve normal accuracy. It is possible that PNNs in the cerebellar nuclei inhibit plasticity to maintain the synaptic organization that produces those accurate movements. We tested whether or not PNNs in a saccade-related part of the cerebellar nuclei maintain accurate saccade size by digesting a part of them in an adult monkey performing a task that changes saccade size (long term saccade adaptation). We use the enzyme Chondroitinase ABC to digest the glycosaminoglycan side chains of proteoglycans present in the majority of PNNs. We show that this manipulation does not result in faster, larger, or more persistent adaptation. Our result indicates that intact perineuronal nets around saccade-related neurons in the cerebellar nuclei are not important for maintaining long-term saccade gain.
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Affiliation(s)
- Adrienne Mueller
- Department of Biological Structure, University of Washington, Seattle, Washington, United States of America
- * E-mail:
| | - Adam Davis
- Department of Biological Structure, University of Washington, Seattle, Washington, United States of America
| | - Steven S. Carlson
- Department of Physiology and Biophysics, University of Washington, Seattle, Washington, United States of America
| | - Farrel R. Robinson
- Department of Biological Structure, University of Washington, Seattle, Washington, United States of America
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Carlson SS, Valdez G, Sanes JR. Presynaptic calcium channels and α3-integrins are complexed with synaptic cleft laminins, cytoskeletal elements and active zone components. J Neurochem 2010; 115:654-66. [PMID: 20731762 DOI: 10.1111/j.1471-4159.2010.06965.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
At chemical synapses, synaptic cleft components interact with elements of the nerve terminal membrane to promote differentiation and regulate function. Laminins containing the β2 subunit are key cleft components, and they act in part by binding the pore-forming subunit of a pre-synaptic voltage-gated calcium channel (Ca(v)α) (Nishimune et al. 2004). In this study, we identify Ca(v)α-associated intracellular proteins that may couple channel-anchoring to assembly or stabilization of neurotransmitter release sites called active zones. Using Ca(v)α-antibodies, we isolated a protein complex from Torpedo electric organ synapses, which resemble neuromuscular junctions but are easier to isolate in bulk. We identified 10 components of the complex: six cytoskeletal proteins (α2/β2 spectrins, plectin 1, AHNAK/desmoyokin, dystrophin, and myosin 1), two active zone components (bassoon and piccolo), synaptic laminin, and a calcium channel β subunit. Immunocytochemistry confirmed these proteins in electric organ synapses, and PCR analysis revealed their expression by developing mammalian motor neurons. Finally, we show that synaptic laminins also interact with pre-synaptic integrins containing the α3 subunit. Together with our previous finding that a distinct synaptic laminin interacts with SV2 on nerve terminals (Son et al. 2000), our results identify three paths by which synaptic cleft laminins can send developmentally important signals to nerve terminals.
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Affiliation(s)
- Steven S Carlson
- Department of Physiology and Biophysics, University of Washington, Seattle, Washington 98195, USA.
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Nishimune H, Sanes JR, Carlson SS. A synaptic laminin-calcium channel interaction organizes active zones in motor nerve terminals. Nature 2005; 432:580-7. [PMID: 15577901 DOI: 10.1038/nature03112] [Citation(s) in RCA: 199] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2004] [Accepted: 10/13/2004] [Indexed: 11/10/2022]
Abstract
Synapse formation requires the differentiation of a functional nerve terminal opposite a specialized postsynaptic membrane. Here, we show that laminin beta2, a component of the synaptic cleft at the neuromuscular junction, binds directly to calcium channels that are required for neurotransmitter release from motor nerve terminals. This interaction leads to clustering of channels, which in turn recruit other presynaptic components. Perturbation of this interaction in vivo results in disassembly of neurotransmitter release sites, resembling defects previously observed in an autoimmune neuromuscular disorder, Lambert-Eaton myasthenic syndrome. These results identify an extracellular ligand of the voltage-gated calcium channel as well as a new laminin receptor. They also suggest a model for the development of nerve terminals, and provide clues to the pathogenesis of a synaptic disease.
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Affiliation(s)
- Hiroshi Nishimune
- Department of Anatomy and Neurobiology, Washington University School of Medicine, St Louis, Missouri 63110, USA
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Sunderland WJ, Son YJ, Miner JH, Sanes JR, Carlson SS. The presynaptic calcium channel is part of a transmembrane complex linking a synaptic laminin (alpha4beta2gamma1) with non-erythroid spectrin. J Neurosci 2000; 20:1009-19. [PMID: 10648706 PMCID: PMC6774149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023] Open
Abstract
Nerve regeneration studies at the neuromuscular junction (NMJ) suggest that synaptic basal lamina components tell the returning axon where to locate neurotransmitter release machinery, including synaptic vesicle clusters and active zones. Good candidates for these components are the synaptic laminins (LNs) containing alpha4, alpha5, or beta2 chains. Results from a beta2 laminin knockout mouse have suggested a linkage of this extracellular laminin to cytosolic synaptic vesicle clusters. Here we report such a transmembrane link at the electric organ synapse, which is homologous to the NMJ. We immunopurified electric organ synaptosomes and found on their surface two laminins of 740 and 900 kDa. The 740 kDa laminin has a composition of alpha4beta2gamma1 (laminin-9). Immunostaining reveals that as in the NMJ, alpha4 and beta2 chains are concentrated at the electric organ synapse. Using detergent-solubilized synaptosomes, we immunoprecipitated a complex containing alpha4beta2gamma1 laminin, the voltage-gated calcium channel, and the cytoskeletal protein spectrin. Other presynaptic proteins such as 900 kDa laminin are not found in this complex. We hypothesize that alpha4beta2gamma1 laminin in the synaptic basal lamina attaches to calcium channel, which in turn is attached to cytosolic spectrin. Spectrin could then organize synaptic vesicle clusters by binding vesicle-associated proteins.
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Affiliation(s)
- W J Sunderland
- Department of Physiology and Biophysics, University of Washington, Seattle, Washington 98195, USA
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Son YJ, Scranton TW, Sunderland WJ, Baek SJ, Miner JH, Sanes JR, Carlson SS. The synaptic vesicle protein SV2 is complexed with an alpha5-containing laminin on the nerve terminal surface. J Biol Chem 2000; 275:451-60. [PMID: 10617638 DOI: 10.1074/jbc.275.1.451] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Interactions between growing axons and synaptic basal lamina components direct the formation of neuromuscular junctions during nerve regeneration. Isoforms of laminin containing alpha5 or beta2 chains are potential basal lamina ligands for these interactions. The nerve terminal receptors are unknown. Here we show that SV2, a synaptic vesicle transmembrane proteoglycan, is complexed with a 900-kDa laminin on synaptosomes from the electric organ synapse that is similar to the neuromuscular junctions. Although two laminins are present on synaptosomes, only the 900-kDa laminin is associated with SV2. Other nerve terminal components are absent from this complex. The 900-kDa laminin contains an alpha5, a beta1, and a novel gamma chain. To test whether SV2 directly binds the 900-kDa laminin, we looked for interaction between purified SV2 and laminin-1, a laminin isoform with a similar structure. We find SV2 binds with high affinity to purified laminin-1. Our results suggest that a synaptic vesicle component may act as a laminin receptor on the presynaptic plasma membrane; they also suggest a mechanism for activity-dependent adhesion at the synapse.
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Affiliation(s)
- Y J Son
- Department of Physiology, University of Washington, Seattle, Washington 98195-7290, USA
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Russell AB, Carlson SS. Neurexin is expressed on nerves, but not at nerve terminals, in the electric organ. J Neurosci 1997; 17:4734-43. [PMID: 9169533 PMCID: PMC6573345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Neurexins are highly variable transmembrane proteins hypothesized to be nerve terminal-specific cell adhesion molecules. As a test of the hypothesis that neurexin is restricted to the nerve terminal, we examined neurexins in the electric organ of the elasmobranch electric fish. Specific antibodies generated against the intracellular domain of electric fish neurexin were used in immunocytochemical and Western blot analyses of the electromotor neurons that innervate the electric organ. Our results indicate that neurexin is not expressed at electric organ nerve terminals, as expected by the neurexin hypothesis. Instead, neurexin is expressed by electromotor neurons and on myelinated axons. This neurexin has a molecular weight of 140 kDa, consistent with an alpha-neurexin. In addition, we find that perineurial cells of the electromotor nerve also express a neurexin. These cells surround bundles of axons to form a diffusion barrier and are thought to be a special form of fibroblast. The results of the study argue against a universal role for neurexins as nerve terminal-specific proteins but suggest that neurexins are involved in axon-Schwann cell and perineurial cell interactions.
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Affiliation(s)
- A B Russell
- Department of Physiology and Biophysics, University of Washington, Seattle, Washington 98195, USA
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Carlson SS, Iwata M, Wight TN. A chondroitin sulfate/keratan sulfate proteoglycan, PG-1000, forms complexes which are concentrated in the reticular laminae of electric organ basement membranes. Matrix Biol 1996; 15:281-92. [PMID: 8892227 DOI: 10.1016/s0945-053x(96)90118-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Previously, we identified PG-1000 as part of a disulfide-linked complex of two large proteoglycans (PG-1000 and the beta component) and three smaller proteins purified from the extracellular matrix of elasmobranch electric organ (Iwata and Carlson, 1991, J. Biol. Chem. 266: 323-333). PG-1000 is a chondroitin sulfate/keratan sulfate proteoglycan with a molecular mass of about 1.2 x 16(6) daltons. When visualized in the electron microscope, PG-1000 has the typical "bottle-brush" appearance expected for a proteoglycan with an average total length of about 345 nm and about 20 chains of approximately 110 nm (Carlson and Wight, 1987, J. Cell Biol. 105: 3075-3086). Using immunocytochemical methods, we now demonstrate that PG-1000 is a component of the interstitial extracellular matrix of the electric organ. PG-1000 immunoreactivity is found throughout the interstitial matrix, but it is highly concentrated in that region of the matrix immediately adjacent to the basal lamina, the reticular lamina. The reticular and basal laminae together form the basement membrane. PG-1000 immunoreactivity is especially apparent on basal laminae that surround nerve fibers and nerve terminals. When the disulfide-linked PG-1000 complexes are purified and examined in the electron microscope following rotary shadowing, they appear as bottle-brush structures which are often attached at a central region and radiate like spokes of a wheel. These aggregates contain two to six proteoglycan monomers. We hypothesize that the PG-1000 complexes are disulfide-stabilized parts of an extended network of linked proteoglycans in the reticular lamina.
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Affiliation(s)
- S S Carlson
- Department of Physiology and Biophysics, University of Washington, Seattle, USA
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Snow AD, Nochlin D, Sekiguichi R, Carlson SS. Identification in immunolocalization of a new class of proteoglycan (keratan sulfate) to the neuritic plaques of Alzheimer's disease. Exp Neurol 1996; 138:305-17. [PMID: 8620929 DOI: 10.1006/exnr.1996.0069] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Previous studies have demonstrated three distinct classes of proteoglycans (PGs)/glycosaminoglycans (GAGs) localized to the characteristic lesions (i.e., neuritic plaques, cerebrovascular amyloid deposits, and neurofibrillary tangles) of Alzheimer's disease (AD). These include heparan sulfate (i.e., perlecan), dermatan sulfate (i.e., decorin), and chondroitin sulfate PGs/GAGs. In the present study, two different antibodies demonstrated the presence of a new class of PG (i.e., keratan sulfate) in the neuritic plaques of AD. Asynaptic vesicle keratan sulfate PG (known as SV2PG) was detected by the monoclonal antibodies, anti-SV2 and anti-SV4, which recognize the keratan sulfate core protein and GAG chains, of the SV2PG antigen, respectively. Both antibodies immunolocalized SV2PG primarily to synapses and to dystrophic neurites within neuritic plaques of AD and normal aged brain. The SV2PG was not immunolocalized to diffuse plaques, cerebrovascular amyloid deposits, or neurofibrillary tangles in AD or normal aged brain. SV2PG immunoreactivity in AD brain was similar in distribution to synaptophysin and showed apparent reduced immunoreactiviy+in AD cortex in comparison to age-matched controls. In conjunction with previous studies, these results now suggest that within the neuritic plaques of AD, there are at least four different classes of PGs present. Although heparan sulfate PGs are still the only class of PG immunolocalized to amyloid fibrils within the neuritic plaques of AD, the specific immunolocalization of keratan sulfate, dermatan sulfate, and chondroitin sulfate containing PGs to the periphery of plaques, suggests that these particular PGs/GAGs may also play distinct and important roles in neuritic plaque pathogenesis.
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Affiliation(s)
- A D Snow
- Department of Pathology, University of Washington, Seattle, 98195-6480, USA
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Carlson SS. SV2proteoglycan: a potential synaptic vesicle transporter and nerve terminal extracellular matrix receptor. Perspect Dev Neurobiol 1996; 3:373-86. [PMID: 9117267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
SV2Proteoglycan (SV2pg) is a specific component of small clear synaptic vesicles. It is a keratan sulfate proteoglycan with oligosaccharide side chains N-linked to a core protein of 80 kDa. Two glycosylated forms, H and L, are present in synaptic vesicles. The amino acid sequence suggests that SV2pg contains 12 transmembrane domains and is homologous to bacterial and eukaryotic sugar transporters. Although its structure suggests that SV2pg is a vesicular transporter, what it transports is unknown. SV2pg is probably not a neurotransmitter transporter, since that function resides in an unrelated family of synaptic vesicle proteins. In addition to its vesicular function, SV2pg may have a secondary function as an extracellular matrix (ECM) receptor on the nerve terminal surface. At the electric organ synapse, which is closely related to the neuromuscular junction. SV2pg is bound to laminin, a component of the synaptic ECM. SV2pg is only associated with laminin on the nerve terminal surface, not in the synaptic vesicle. Studies on synaptogenesis during motor nerve regeneration have suggested that nerve terminal ECM receptors play an important role in synaptic recognition.
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Affiliation(s)
- S S Carlson
- Department of Physiology and Biophysics, University of Washington, Seattle 98195, USA
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Abstract
The transverse tubule system (T-tubule, T-system) of skeletal muscle is a membranous network that penetrates the interior of myofibers. The T-system is continuous with the sarcolemma and therefore provides a path for membrane excitation to reach internal myofibrils. In this study we demonstrate that T-tubules in elasmobranch fish, frog, and rat skeletal muscle contain a matrix of chondroitin sulfate proteoglycans. We used anti-T1, a mouse monoclonal antibody that recognizes a rare chondroitin sulfate epitope, for immunolocalization and biochemical studies. First, we find that T1 immunoreactivity colocalizes with a T-tubule marker, the dihydropyridine receptor alpha 2 subunit, in both frog and fish muscle. Secondly, the distribution of T1 immunoreactivity exactly matches the different distribution of T-tubules in rat and frog muscle. In rat muscle, two bands of T1 immunoreactivity are detected per sarcomere, a distribution that corresponds to the T-tubules located at the two A-I junctions of each sarcomere. In frog muscle, we detect one band of T1 immunoreactivity per sarcomere that corresponds to the one T-tubule per sarcomere located at the Z line. Lastly, we have isolated and biochemically characterized T1 antigenicity from fish skeletal muscle. Like extracellular matrix proteoglycans of cartilage, T1 antigenicity requires denaturing conditions to be solubilized. In fish muscle, two chondroitin sulfate proteoglycans bear T1: a heavily glycosylated proteoglycan with a molecular mass of about 1000 kDa, and a smaller proteoglycan that has a mobility on SDS-PAGE like a protein of molecular mass 280 kDa. We propose that proteoglycans function as structural components in the T-system. The proteoglycans may form a matrix, like the one formed by the cartilage proteoglycans they resemble, that can withstand the cytosolic osmotic pressures present in muscle cells and therefore may prevent the T-tubule from collapsing. We present a quantitative argument in support of this hypothesis.
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Affiliation(s)
- A K Davis
- Department of Physiology and Biophysics, University of Washington, Seattle 98195, USA
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Lark MW, Gordy JT, Weidner JR, Ayala J, Kimura JH, Williams HR, Mumford RA, Flannery CR, Carlson SS, Iwata M. Cell-mediated catabolism of aggrecan. Evidence that cleavage at the "aggrecanase" site (Glu373-Ala374) is a primary event in proteolysis of the interglobular domain. J Biol Chem 1995; 270:2550-6. [PMID: 7852317 DOI: 10.1074/jbc.270.6.2550] [Citation(s) in RCA: 152] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
A rat chondrosarcoma cell line and primary bovine chondrocytes have been used to study cell-mediated aggrecan catabolism. Addition of 1 microM retinoic acid to chondrosarcoma cultures resulted in aggrecan proteolysis with the release of greater than 90% of the cell layer aggrecan into the medium within 4 days. NH2-terminal sequencing of chondroitin sulfate-substituted catabolic products gave a single major NH2-terminal sequence of ARGNVILTXK, initiating at Ala374. This showed that the proteinase, commonly referred to as "aggrecanase," which cleaves the Glu373-Ala374 bond of the interglobular domain of aggrecan (Sandy, J. D., Neame, P. J., Boynton, R. E., and Flannery, C. R. (1990) J. Biol. Chem. 266, 8683-8685), is active in this cell system. Aggrecan G1 domain, generated by cleavage of the interglobular domain, was also liberated during catabolism and this was characterized with three antipeptide antisera. Anti-CDAGWL was used as a general probe for G1 domain. Anti-FVDIPEN was used to specifically detect G1 domain with COOH terminus of Asn341, the form which is readily generated by cleavage of aggrecan by a wide range of matrix metalloproteinases. Anti-NITEGE antiserum was used to specifically detect G1 domain with COOH terminus of Gln373, the form which is the expected product of "aggrecanase"-mediated cleavage of aggrecan. Western blot analysis indicated that a single form of G1 domain of about 60 kDa was formed. G1 domain of this size reacted with both anti-CDAGWL and anti-NITEGE but not with anti-FVDIPEN. Similar experiments with primary bovine chondrocyte cultures, treated with either retinoic acid or interleukin 1, showed that two forms of catabolic G1 domain, of about 62 and 66 kDa, were formed. Both of these forms reacted on Western blots with anti-CDAGWL and also with anti-NITEGE. It is suggested that cell-mediated catabolism of the aggrecan interglobular domain in these culture systems, whether promoted by retinoic acid or interleukin 1, primarily involves cleavage of the Glu373-Ala374 bond by aggrecanase. The accumulation of G1 domain with a COOH-terminal of Glu373 shows that such aggrecanase-mediated cleavage can occur independent of the cleavage of the Asn341-Phe342 bond by matrix metalloproteinases.
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Affiliation(s)
- M W Lark
- Department of Immunology, Merck Research Laboratories, Rahway, New Jersey 07065
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Iwata M, Wight TN, Carlson SS. A brain extracellular matrix proteoglycan forms aggregates with hyaluronan. J Biol Chem 1993; 268:15061-9. [PMID: 8325882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Unlike many tissues, the adult central nervous system extracellular matrix (ECM) has few known components. Previously, we characterized a large chondroitin sulfate proteoglycan, pgT1, from adult rat brain which has the properties of a general brain ECM component and is immunologically distinct from aggrecan and versican (Iwata, M., and Carlson, S.S. (1993) J. Neurosci. 13, 195-207). In this study we demonstrate that pgT1 binds hyaluronan with relatively high affinity. The pgT1 preparation isolated from rat brain aggregates in non-denaturing conditions. This aggregation is abolished by incubation of pgT1 with Streptomyces hyaluronidase. Examination of these aggregates by electron microscope reveals a structure in which an average of 18 subunits arise laterally from opposite sides of an elongated 350-nm filament. These pgT1 aggregates resemble the proteoglycan aggregates in cartilage which are composed of aggrecan and hyaluronan. Using affinity coelectrophoresis, we measure a dissociation constant (Kd) of 0.9 +/- 0.2 nM for the interaction of pgT1 and hyaluronan. These new findings, combined with the general distribution of pgT1 in brain, suggest that pgT1/hyaluronan aggregates are an extended general structure of the brain extracellular matrix network.
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Affiliation(s)
- M Iwata
- Department of Physiology and Biophysics, University of Washington, Seattle 98195
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Abstract
We have determined that synaptic vesicles contain a vesicle-specific keratan sulfate integral membrane proteoglycan. This is a major proteoglycan in electric organ synaptic vesicles. It exists in two forms on sodium dodecyl sulfate-polyacrylamide gel electrophoresis, i.e., the L form, which migrates like a protein with an M(r) of 100,000, and the H form, with a lower mobility that migrates with an M(r) of approximately 250,000. Both forms contain SV2, an epitope located on the cytoplasmic side of the vesicle membrane. In addition to electric organ, we have analyzed the SV2 proteoglycan in vesicle fractions from two other sources, electric fish brain and rat brain. Both the H and L forms of SV2 are present in these vesicles and all are keratan sulfate proteoglycans. Unlike previously studied synaptic vesicle proteins, this proteoglycan contains a marker specific for a single group of neurons. This marker is an antigenically unique keratan sulfate side chain that is specific for the cells innervating the electric organ; it is not found on the synaptic vesicle keratan sulfate proteoglycan in other neurons of the electric fish brain.
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Affiliation(s)
- T W Scranton
- Department of Physiology and Biophysics, University of Washington, Seattle 98195
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Iwata M, Carlson SS. A large chondroitin sulfate proteoglycan has the characteristics of a general extracellular matrix component of adult brain. J Neurosci 1993; 13:195-207. [PMID: 7678642 PMCID: PMC6576310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Extracellular matrix (ECM) is a secreted extracellular network. Few components of adult brain ECM are known. We have identified a new, large chondroitin sulfate proteoglycan (T1 antigen) that acts like a general ECM protein of brain. First, it is present throughout the brain; second, it has the properties of an extracellular protein; and third, it is extracted only under denaturing conditions. Immunocytochemical localization of the T1 antigen by light microscope shows it to be present throughout the rat brain in both white and gray matter. The T1 antigen outlines Purkinje and other large cells. No antigenicity is seen inside these cells. Biochemical evidence suggests that the T1 antigen is extracellular rather than cytosolic or intravesicular. The T1 antigen is disulfide-linked to two other proteins. Disulfide bonds are found only in extracellular or intravesicular proteins, not in intracellular cytosolic proteins. Moreover, the T1 antigen is probably not intravesicular. Unlike intravesicular proteins, only a small amount of T1 antigen is solubilized by nondenaturing detergents. While nondenaturing detergents extract but a small amount of T1 antigen from rat brain, the majority is solubilized by denaturing conditions (6 M guanidine-HCl). This behavior is similar to that of ECM components in other tissues and is unlike that of membrane proteins, even those linked to the cytoskeleton. We hypothesize that the insolubility of the T1 antigen in brain is due to its presence in an extracellular aggregate. The T1 antigen is a proteoglycan with a highly glycosylated protein core of 300 kDa. It does not appear to be related to the large, heavily glycosylated chondroitin sulfate proteoglycans aggrecan and versican, which were discovered in non-neural tissues. Antibodies to a 15 residue peptide present in both aggrecan and versican do not react with the T1 antigen.
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Affiliation(s)
- M Iwata
- Department of Physiology and Biophysics, University of Washington, Seattle 98195
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Iwata M, Carlson SS. A large chondroitin sulfate basement membrane-associated proteoglycan exists as a disulfide-stabilized complex of several proteins. J Biol Chem 1991; 266:323-33. [PMID: 1985903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Proteoglycan (PG)-1000 (formerly TAP-1) is a large (Mr = 10(6)) highly glycosylated chondroitin sulfate proteoglycan found associated with Schwann cell and electrocyte basement membranes in elasmobranch electric fish. Previously, purified PG-1000 was visualized in the electron microscope as a "bottlebrush" structure about 345 nm long with about 20 side projections of 113 nm. This molecule was characterized with material purified from electric organ under denaturing and reducing conditions. Here we report that PG-1000, when purified under denaturing conditions without exposure to a reducing agent, exists as a complex of several proteins. In addition to PG-1000, this complex consists of a somewhat smaller, heavily glycosylated protein (beta component) and three smaller proteins with Mr values of 39,000, 21,000, and 18,000. The complex remains intact when exposed to denaturing and non-reducing conditions but falls apart in denaturing and reducing conditions. Presumably the complex is stabilized by disulfide bonds. The beta component of the PG-1000 complex is probably a proteoglycan. However, unlike PG-1000, the beta component does not contain chondroitin sulfate chains and lacks the epitope, T1, that is found on PG-1000. Both molecules share a protease-insensitive antigenic site, SV4, which is probably a modified keratan sulfate epitope. Evidence for the identity of this antigen is that it is found as a minor subfraction in commercial preparations of shark cartilage chondroitin and corneal keratan sulfates but not in other glycosaminoglycan preparations. These SV4 antigens are resistant to chondroitin ABC lyase digestion. However, the SV4 antigen in commercial keratan sulfate is cleaved by keratinase to a smaller antigenic fragment.
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Affiliation(s)
- M Iwata
- Department of Physiology and Biophysics, University of Washington, Seattle 98195
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Iwata M, Carlson SS. A large chondroitin sulfate basement membrane-associated proteoglycan exists as a disulfide-stabilized complex of several proteins. J Biol Chem 1991. [DOI: 10.1016/s0021-9258(18)52438-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Carlson SS, Wight TN. Nerve terminal anchorage protein 1 (TAP-1) is a chondroitin sulfate proteoglycan: biochemical and electron microscopic characterization. J Biophys Biochem Cytol 1987; 105:3075-86. [PMID: 3693407 PMCID: PMC2114688 DOI: 10.1083/jcb.105.6.3075] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
The plasma membranes of the nerve terminal and the postsynaptic cell of electric organ are separated by a basal lamina. We have purified, biochemically characterized, and visualized in the electron microscope a macromolecule which appears to anchor the nerve terminal to this basal lamina. This molecule, terminal anchorage protein 1 (TAP-1) is associated with the nerve terminal membrane of electric organ, has the properties of an integral membrane protein, and is tightly bound to the extracellular matrix (Carlson, S.S., P. Caroni, and R.B. Kelly. 1986. J. Cell Biol. 103:509-520). TAP-1 can be solubilized from an electric organ extracellular matrix preparation with guanidine-HCl/3-[(3-cholamidopropyl)-dimethylammnio]-1-propane sulfonate and purified by a combination of permeation chromatography on Sephacryl S-1000, sedimentation velocity, and ion exchange chromatography on DEAE Sephacel. The total purification from electric organ is 91-fold and results in at least 86% purity. Digestion of the molecule with chondroitin ABC or AC lyase produces a large but similar shift in the molecular weight of the molecule on SDS-PAGE. The presence of chondroitin-4- or 6-sulfate is confirmed by identification of the isolated glycosaminoglycans with cellulose acetate electrophoresis. Gel filtration of the isolated chains indicates an average molecular weight of 42,000. Digestion of TAP-1 with other glycosaminoglycan lyases such as heparitinase indicates that only chondroitin sulfate is present. These results demonstrate that TAP-1 is a proteoglycan. Visualization of TAP-1 in the electron microscope reveals a "bottlebrush" structure expected for a proteoglycan. The molecule has an average total length of 345 +/- 17 nm with 20 +/- 2 side projections of 113 +/- 5 nm in length. These side projections are presumably the glycosaminoglycan side chains. From this structure, we predict that the TAP-1 glycosaminoglycan side chains should have a molecular weight of approximately 50,000, which is in close agreement with the biochemical studies. Both biochemical and morphologic data indicate that TAP-1 has a relative molecular weight of approximately 1.2 X 10(6). The large size of TAP-1 suggests that this molecule could span the synaptic cleft and make a significant contribution to the structure of the nerve terminal basal lamina of electric organ.
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Affiliation(s)
- S S Carlson
- Department of Physiology and Biophysics, University of Washington, Seattle 98195
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Abstract
The nerve terminal and the postsynaptic receptor-containing membranes of the electric organ are both linked to the basal lamina that runs between them. We have identified an extracellular matrix protein whose physical properties suggest it anchors the nerve terminal to the basal lamina. The protein was identified because it shares an epitope with a proteoglycan component of electric organ synaptic vesicles. It too behaves like a proteoglycan. It is solubilized with difficulty from extracellular matrix fractions, elutes from DEAE Sephacel at pH 4.9 only at high ionic strength, and binds to a laminin affinity column from which it can be eluted with heparin. Under denaturing conditions it sediments rapidly and has a large excluded volume although it can be included in Sephacryl S-1000 columns. This large, highly charged extracellular matrix molecule can be readily reconstituted into liposomes consistent with the presence of a hydrophobic tail. By immunoelectron microscopy the antigen is found both in synaptic vesicles and on the plasma membrane of the nerve terminal. Since this is the first protein described that links the nerve terminal membrane to the extracellular matrix, we propose calling it terminal anchorage protein one (TAP-1).
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Caroni P, Carlson SS, Schweitzer E, Kelly RB. Presynaptic neurones may contribute a unique glycoprotein to the extracellular matrix at the synapse. Nature 1985; 314:441-3. [PMID: 2580240 DOI: 10.1038/314441a0] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
As the extracellular matrix at the original site of a neuromuscular junction seems to play a major part in the specificity of synaptic regeneration, considerable attention has been paid to unique molecules localized to this region. Here we describe an extracellular matrix glycoprotein of the elasmobranch electric organ that is localized near the nerve endings. By immunological criteria, it is synthesized in the cell bodies, transported down the axons and is related to a glycoprotein in the synaptic vesicles of the neurones that innervate the electric organ. It is apparently specific for these neurones, as it cannot be detected elsewhere in the nervous system of the fish. Therefore, neurones seem to contribute unique extracellular matrix glycoproteins to the synaptic region. Synaptic vesicles could be involved in transporting these glycoproteins to or from the nerve terminal surface.
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Dahlström A, Larsson PA, Carlson SS, Bööj S. Localization and axonal transport of immunoreactive cholinergic organelles in rat motor neurons--an immunofluorescent study. Neuroscience 1985; 14:607-25. [PMID: 2581170 DOI: 10.1016/0306-4522(85)90314-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Antisera produced in rabbits against pure fractions of cholinergic vesicles from Narcine brasiliensis were used to study cholinergic organelles in rat motor neurons. The indirect immunofluorescence method was used on perfusion-fixed material. The rats were surgically sympathectomized to remove sympathetic adrenergic and cholinergic nerves from the sciatic nerve. In the intact animal immunoreactive material, likely to represent cholinergic vesicles, was observed in motor endplates, identified by labelling with rhodamine-conjugated alpha-bungarotoxin or with subsequent acetylcholinesterase staining. The motor perikarya contained very little immunoreactive material. Non-terminal axons were virtually devoid of immunofluorescence in the intact animal. After crushing the sciatic nerve, immunoreactive material (likely to represent axonal cholinergic organelles) accumulated rapidly on both sides of the crush, indicating a rapid bidirectional transport. The transport was sensitive to local application of mitotic inhibitors. The axons which accumulated immunoreactive organelles were motor axons, as demonstrated by various procedures: Cutting of ventral roots prevented accumulation of immunoreactive material in the nerve. Deafferentation did not notably influence accumulations of immunoreactive material. Ligated axons with immunoreactive material were acetylcholinesterase positive when identification was made on the same section; the intra-axonal distribution of immunoreactive material and acetylcholinesterase was not identical, however, and the Narcine antisera did not cross-react with bovine acetylcholinesterase in a solid phase immunoassay. Most axons in ventral roots, but not in dorsal roots, accumulated strongly fluorescent immunoreactive material, while axons in dorsal roots contained weakly fluorescent material. On the other hand, substance P-like immune reactivity was present in many dorsal root axons, but only very rarely in ventral roots. It is suggested that the antisera against Narcine cholinergic vesicles can be used as a marker for cholinergic organelles in the motor neuron, and may be an important tool for studying the axonal cholinergic vesicles. It cannot, however, be used to identify cholinergic structures in unknown locations because it recognizes common antigenic determinants in transmitter organelles of other nerves, e.g. adrenergic nerves. The axonal cholinergic organelles may carry important molecules, other than acetylcholine to the nerve endings.
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Carlson SS, Kelly RB. A highly antigenic proteoglycan-like component of cholinergic synaptic vesicles. J Biol Chem 1983; 258:11082-91. [PMID: 6193120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
A monoclonal antibody, tor70, recognizes an antigenic determinant on the inside surface of synaptic vesicles, purified from the electric organ of Narcine brasiliensis. The antigenic determinant appears to be unique to vesicles since it co-purifies with vesicle content and is blocked by an antiserum specific for synaptic vesicle antigens. Immunoblotting of vesicle proteins after sodium dodecyl sulfate-polyacrylamide gel electrophoresis shows that the antigen has a low heterogeneous electrophoretic mobility and corresponds to a major protein component of pure synaptic vesicles. Synaptic vesicles contain a proteoglycan-like material since proteolytic digestion yields a ruthenium red-binding material that migrates during electrophoresis with a mammalian heparin standard. The only major vesicle component with which the proteoglycan-like material co-elutes during chromatography on Sepharose 6B is the material recognized by tor70. The antigen adsorbs specifically to beads coated with the lectin wheat germ agglutinin. Isolation of the tor70 antigen by velocity sedimentation in sodium dodecyl sulfate-sucrose gradients shows it to contain glucosamine (0.75 nmol/microgram of protein) and uronic acid but no galactosamine. Earlier work has shown that specific antiserum to pure synaptic vesicles could be used to identify nerve terminals, quantitate vesicle components, purify membranes, and monitor exocytosis. We now know that one of the components recognized by the antiserum is a molecule with properties of a proteoglycan, attached to the inside surface of vesicle membranes.
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Kelly RB, Buckley KM, Burgess TL, Carlson SS, Caroni P, Hooper JE, Katzen A, Moore HP, Pfeffer SR, Schroer TA. Membrane traffic in neurons and peptide-secreting cells. Cold Spring Harb Symp Quant Biol 1983; 48 Pt 2:697-705. [PMID: 6327173 DOI: 10.1101/sqb.1983.048.01.073] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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von Wedel RJ, Carlson SS, Kelly RB. Transfer of synaptic vesicle antigens to the presynaptic plasma membrane during exocytosis. Proc Natl Acad Sci U S A 1981; 78:1014-8. [PMID: 7015327 PMCID: PMC319936 DOI: 10.1073/pnas.78.2.1014] [Citation(s) in RCA: 57] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
We have utilized immunofluorescence techniques to look for synaptic vesicle antigens on the plasma membrane of resting and active nerve terminals. Rabbit antiserum was raised against purified cholinergic synaptic vesicles from the electric organ of Narcine brasiliensis, a marine electric ray. Antibodies to synaptic vesicles were shown to bind selectively to nerve terminals in cryostat sections of frog nerve-muscle preparations. Binding was demonstrated indirectly by using fluorescein-labeled goat anti-rabbit antibodies. Structures in cross sections that bound antiserum were identified as nerve terminals because of their size, shape, and position and because they coincided with sites that bound rhodamine-conjugated alpha-bungarotoxin and had acetylcholine esterase activity. Presumably, sectioning gave antibodies access to binding sites within the nerve terminal. However, when antibodies to synaptic vesicles were added to the bathing medium of intact neuromuscular preparations prior to sectioning, antibody binding was marginal or undetectable, suggesting that few vesicle antigens were normally accessible on the outer surface of resting nerve terminals. When intact preparations were stimulated to release their vesicular acetylcholine by the addition of 1 mM LaCl3, antibody binding to the intact nerve terminals became striking. These findings suggest that the synaptic vesicle membrane and the synaptic terminal plasma membrane differ in composition. They also provide further support for the exocytotic hypothesis of neurotransmitter release, which predicts that vesicle markers should be exposed on the outside of nerve terminals when vesicles fuse with the plasma membrane during stimulation.
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Dahlström A, Bööj S, Carlson SS, Larsson PA. Rapid accumulation and axonal transport of "cholinergic vesicles" in rat sciatic nerve, studied by immunohistochemistry. Acta Physiol Scand 1981; 111:217-9. [PMID: 7282399 DOI: 10.1111/j.1748-1716.1981.tb06728.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Abstract
Rabbit antisera to highly purified synaptic vesicles from the electric organ of Narcine brasiliensis, an electric ray, reveal a unique population of synaptic vesicle antigens in addition to a population shared with other electric organ membranes. Synaptic vesicle antigens were detected by binding successively rabbit antivesicle serum and radioactive goat anti-rabbit serum. To remove antibodies directed against antigens common to synaptic vesicles and other electric organ fractions, the antivesicle serum was extensively preadsorbed against an electric organ membrane fraction that was essentially free of synaptic vesicles. The adsorbed serum retained 40% of its ability to bind to synaptic vesicles, suggesting that about half of the antigenic determinants are unique. Vesicle antigens were quantified with a radioimmunoassay (RIA) that utilized precipitation of antibody-antigen complexes with Staphylococcus aureus cells. By this assay, the vesicles, detected by their acetylcholine (ACh) content and the antigens detected by the RIA, have the same buoyant density after isopycnic centrifugation of crude membrane fractions on sucrose and glycerol density gradients. The ratio of ACh to antigenicity was constant across the vesicle peaks and was close to that observed for vesicles purified to homogeneity. Even though the vesicles make up only approximately 0.5% of the material in the original homogenate, the ratio of acetylcholine to vesicle antigenicity could still be measured and also was indistinguishable from that of pure vesicles. We conclude that synaptic vesicles contain unique antigenic determinants not present to any measurable extent in other fractions of the electric organ. Consequently, it is possible to raise a synaptic vesicle-specific antiserum that allows vesicles to be detected and quantified. These findings are consistent with earlier immunohistochemical observations of specific antibody binding to motor nerve terminals.
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Hooper JE, Carlson SS, Kelly RB. Antibodies to synaptic vesicles purified from Narcine electric organ bind a subclass of mammalian nerve terminals. J Cell Biol 1980; 87:104-13. [PMID: 6158518 PMCID: PMC2110736 DOI: 10.1083/jcb.87.1.104] [Citation(s) in RCA: 38] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Antibodies were raised in rabbits to synaptic vesicles purified to homogeneity from the electric organ of Narcine brasiliensis, a marine electric ray. These antibodies were shown by indirect immunofluorescence techniques to bind a wide variety of nerve terminals in the mammalian nervous system, both peripheral and central. The shared antigenic determinants are found in cholinergic terminals, including the neuromuscular junction, sympathetic ganglionic and parasympathetic postganglionic terminals, and in those synaptic areas of the hippocampus and cerebellum that stain with acetylcholinesterase. They are also found in some noncholinergic regions, including adrenergic sympathetic postganglionic terminals, the peptidergic terminals in the posterior pituitary, and adrenal chromaffin cells. They are, however, not found in many noncholinergic synapse-rich regions. Such regions include the molecular layer of the cerebellum and those laminae of the dentate gyrus that receive hippocampal associational and commissural input. We conclude that one or more of the relatively small number of antigenic determinants in pure electric fish synaptic vesicles have been conserved during evolution, and are found in some but not all nerve terminals of the mammalian nervous system. The pattern of antibody binding in the central nervous system suggests unexpected biochemical similarities between nerve terminals heretofore regarded as unrelated.
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Carlson SS, Wagner JA, Kelly RB. Purification of synaptic vesicles from elasmobranch electric organ and the use of biophysical criteria to demonstrate purity. Biochemistry 1978; 17:1188-99. [PMID: 418798 DOI: 10.1021/bi00600a009] [Citation(s) in RCA: 124] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
We have purified cholinergic synaptic vesicles from the electric organs of two related marine elasmobranchs, Torpedo californica and Narcine brasiliensis, to a specific activity higher than had previously been obtained. We have demonstrated the homogeneity of the vesicles by biophysical criteria. The purification scheme consisted of differential centrifugation, flotation equilibrium in sucrose density gradients, and permeation chromatography on glass bead columns of average pore size 3000 A. Our criteria for purity were that bound acetylcholine, bound nucleotide triphosphate, protein, and lipid--phosphorus behave identically when vesicles were analyzed by procedures which depend on vesicle size, density, and charge. Contaminants were not detected when vesicles were fractionated by preparative and analytical sedimentation, by preparative equilibrium sedimentation using glycerol density gradients, or by electrophoresis in Ficoll density gradients. Pure synaptic vesicles, which have been purified 290-fold from the initial homogenate, contain per mg of protein: 8 mumol of acetylcholine, 3 mumol of ATP, and 7 mumol of lipid phosphorus. These procedures may be of general value in the purification of membrane vesicles.
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Carlson SS, Mross GA, Wilson AC, Mead RT, Wolin LD, Bowers SF, Foley NT, Muijsers AO, Margoliash E. Primary structure of mouse, rat, and guinea pig cytochrome c. Biochemistry 1977; 16:1437-42. [PMID: 191069 DOI: 10.1021/bi00626a031] [Citation(s) in RCA: 53] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
For immunochemical and evolutionary reasons we determined the primary structure of cytochrome c from two strains of laboratory mice. Thioacetylthioethane and thioacetylthioglycolic acid were used in addition to conventional reagents for sequence determinations. The sequence was found to be identical with that of the rabbit except for residues 44 and 89 and consistent with the peptide compositional data reported by Hennig (Hennig, B. (1975), Eur. J. Biochem. 55, 167-183). The rat cytochrome c cymotryptic peptides were identical with those of the mouse in amino acid composition and amino-terminal residues. Further, peptide maps of cytochromes c of the guinea pig and two strains of rat indicate that all these animals have the same cytochrome c as the laboratory mouse. It is concluded that rodent cytochromes c are evolutionarily conservative and that there is no evidence for a generation-time effect in cytochrome c evolution.
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Abstract
Mothers at inner city clinics differ from middle-class suburban mothers with private pediatricians in their attitudes and expectations regarding toilet training, such as the ideal age to initiate bladder and bowel training, ideal age for completion of toilet training, response to the child who soils after a program of toilet training has been initiated, and source of information to guide in toilet training. Possible explanations to account for these differences are explored; the implications for training health personnel are discussed.
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Affiliation(s)
- S S Carlson
- Pediatric Ambulatory Care Division, Department of Pediatrics, Columbia University College of Physicians and Surgeons, Babies Hospital, Children's Medical and Surgical Center of New York, New York, N.Y., USA
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