Oncogene (2004) 23, 9–20 & 2004 Nature Publishing Group All rights reserved 0950-9232/04 $25.00 www.nature.com/onc ORIGINAL PAPERS Opposite effects of Ha-Ras and Ki-Ras on radiation-induced apoptosis via differential activation of PI3K/Akt and Rac/p38 mitogen-activated protein kinase signaling pathways Jung-A Choi1,4, Moon-Taek Park1,4, Chang-Mo Kang1, Hong-Duck Um2, Sangwoo Bae1, Kee-Ho Lee3, Tae-Hwan Kim1, Jae-Hong Kim4, Chul-Koo Cho1, Yun-Sil Lee1, Hee Yong Chung5 and Su-Jae Lee1,* 1 Laboratory of Radiation Effect, Korea Institute of Radiological & Medical Sciences, Seoul 139-706, Korea; 2Laboratory of Experimental Pathology, Korea Institute of Radiological & Medical Sciences, Seoul 139-706, Korea; 3Laboratory of Molecular Oncology, Korea Institute of Radiological & Medical Sciences, Seoul 139-706, Korea; 4Graduate School of Biotechnology, Korea University, Seoul 136-701, Korea; and 5Department of Microbiology, College of Medicine, Hanyang University, Seoul 133-791, Korea It has been well known that Ras signaling is involved in various cellular processes, including proliferation, differentiation, and apoptosis. However, distinct cellular functions of Ras isozymes are not fully understood. Here we show the opposing roles of Ha-Ras and Ki-Ras genes in the modulation of cell sensitivity to ionizing radiation. Overexpression of active isoform of Ha-Ras (12V-HaRas) in Rat2 cells increases resistance to the ionizing radiation. Constitutive activation of phosphoinositide-3kinase (PI3K) and Akt is detected specifically in 12V-HaRas-overexpressing cells. The specific PI3K inhibitor LY294002 inhibits PI3K/Akt signaling and potentiates the radiation-induced apoptosis, suggesting that activation of the PI3K/Akt signaling pathway is involved in the increased radio-resistance in cells overexpressing 12VHa-Ras. Overexpression of activated Ki-Ras (12V-KiRas), on the other hand, markedly increases radiation sensitivity. The p38 mitogen-activated protein kinase (MAPK) activity is selectively enhanced by ionizing radiation in cells overexpressing 12V-Ki-Ras. The specific p38 MAPK inhibitor, PD169316, or dominant-negative p38 MAPK decreases radiation-induced cell death. We further show that the mechanism that underlies potentiation of cell death in cells overexpressing 12V-Ki-Ras involves Bax translocation to the mitochondrial membrane. Elevated Bax translocation following ionizing irradiation in 12V-Ki-Ras-overexpressing cells is completely inhibited by PD169316 or dominant-negative p38 MAPK. In addition, introduction of cells with RacN17, a dominant-negative mutant of Rac, resulted in a marked inhibition of radiation-induced Bax translocation and apoptotic cell death as well as p38 MAPK activation. Taken together, these findings explain the opposite effects of Ha-Ras and Ki-Ras on modulation of radiosensitivity, *Correspondence: S-J Lee, Laboratory of Radiation Effect, Korea Institute of Radiological and Medical Sciences, Gongneung-Dong, Nowon-Ku, Seoul 139-706, Korea; E-mail: [email protected] This work was supported by the Nuclear R&D Program of the Ministry of Science and Technology in Korea Received 15 April 2003; revised 6 July 2003; accepted 7 July 2003 and suggest that differential activation of PI3K/Akt and Rac/p38 MAPK signaling by Ha-Ras and Ki-Ras may account for the opposing response to the ionizing radiation. These data provide an explanation for the diverse biological functions of Ras isozymes, and partly accounts for the differential response of transformed cells to anticancer treatments. Oncogene (2004) 23, 9–20. doi:10.1038/sj.onc.1206982 Keywords: 12V-Ki-Ras; 12V-Ha-Ras; radiation-induced apoptosis; PI3K/Akt; Rac/p38 MAPK; Bax translocation Introduction Signaling from the small GTPase, Ras, has been under intense investigation in the past decade due to the importance of the Ras as a switch mediating pathways that control transcriptional activation of genes governing such critical and diverse cellular functions as proliferation, development, differentiation, and apoptosis (Ayllon and Rebollo, 2000; Crespo and Leon, 2000; Kolch, 2000; Brooks et al., 2001; Cheng and Meinkoth, 2001; Fedorov et al., 2001; Pervaiz et al., 2001; Radhika and Dhanasekaran, 2001). It is not surprising, therefore, that deregulation of Ras activity by mutation may have such profound consequences for the cell. Mutations conferring constitutive activation of Ras occur frequently in many types of human cancers (Bos, 1989; Ahuja et al., 1990), and oncogenically mutated Ras can also confer radiation resistance (FitzGerald et al., 1985; Sklar, 1988; Ling and Endlich, 1989; McKenna et al., 1990; Hermens and Bentvelzen, 1992; Miller et al., 1993; Pirollo et al., 1993; Bernhard et al., 1996; Bernhard et al., 2000). Evidence for Ras-mediated radioresistance has been reported in both rodent and human tumor cell lines including NIH3T3 fibroblasts, REF fibroblasts, DLD-1 colon carcinoma, and HT1080 fibrosarcoma. Recent studies demonstrated that the phosphoinositide-3-kinase (PI3K) pathway plays a critical role in mediating Differential modulation of radiosensitivity by Ras isozymes J-A Choi et al 10 enhanced radioresistance by the Ras oncogene (Rosenzweig et al., 1997; Hosoi et al., 1998; Gupta et al., 2001; Grana et al., 2002). The studies showed that the PI3K inhibitor wortmannin or LY294002 sensitized cells bearing a constitutively active Ras mutant to ionizing radiation. Inhibition of the PI3K downstream target p70S6K by rapamycin, of the Raf–MEK–MAPK pathway (MEK, mitogen-activated protein kinase kinase; MAPK, mitogen-activated protein kinase) by PD98059, or of the Ras–MEK kinase–p38 pathway by SB203580 had no effect on radiation survival in cells with oncogenic Ras (Gupta et al., 2001) (http://mct.aacrjournals.org/cgi/content/full/2/4/-R16). Furthermore, the expression of active PI3K in cells with wild-type Ras resulted in increased radiation resistance that could be inhibited by LY294002 (Gupta et al., 2001). However, overexpression of Ras or the presence of activated Ras does not increase radioresistance in all contexts (Harris et al., 1990; Alapetite et al., 1991). According to some reports, introduction of a mutated Ras did not increase radioresistance in human retinoblasts, fibroblasts, and keratinocytes (Gupta et al., 2000). Moreover, in some circumstances, oncogenic Ras has even been reported to increase radiation sensitivity (Harris et al., 1990; Alapetite et al., 1991). Although a number of studies demonstrate that mutated Ras can clearly modulate the survival and radiation sensitivity, the signaling pathways by which this is accomplished are not fully understood and are likely to be cell type dependent. The fact that oncogenic transformation and radiosensitivity modulation can be uncoupled is shown by the inability of the transforming oncogenes Myc and Abl to confer radioresistance (Pirollo et al., 1993). Therefore, although several signaling pathways downstream of Ras have been fairly well defined, and their contribution to Ras-mediated transformation has been well studied, it remains unclear as to which of these pathways also contribute to Rasmediated radiosensitivity modulation. The three major isoforms of this small GTPase protein are Ha-Ras, Ki-Ras, and N-Ras. They share a high degree of sequence homology. The only region that exhibits significant sequence divergence is the final 24 residues of the protein, the hypervariable domain at the COOH termini. Although they are almost identical, distinct cellular functions for the Ras isoforms have started to accumulate. For example, oncogenic Ki-Ras but not oncogenic Ha-Ras blocks integrin b1-chain maturation in colon epithelial cells (Yan et al., 1997). More compelling observations on the functional distinctiveness of Ras isoforms came from experiments with transgenic animals showing that only Ki-Ras is essential for normal mouse development. Ha-Ras or N-Ras knockouts showed no distinct phenotypes, whereas a Ki-Ras knockout was embryonic lethal at 12–14 days of gestation (Joneson and Bar-Sagi, 1997; Prior and Hancock, 2001). Furthermore, opposing roles of Ki-Ras and Ha-Ras genes in the regulation of redox signals has been observed (Santillo et al., 2001; Cuda et al., 2002); Oncogene Ha-Ras protein increases the number of cells undergoing apoptosis after oxidative stress, conversely the KiRas has a protective effect. Distinct biological functions of Ras isoforms are exerted through the selective activation of downstream effectors (Joneson and Bar-Sagi, 1997; Campbell et al., 1998), such as the serine/threonine kinases Raf, the p110 catalytic subunit of PI3K, and Ral-GDS, the exchange factor for Ral GTPase. Raf proteins initiate a kinase cascade that leads to MEK and extracellular-regulated kinase (ERK) activation, which can influence various cytosolic events and gene transcription in the nucleus (Hagemann and Rapp, 1999). Raf/ERK signaling has been shown to suppress apoptosis in many experimental cell systems, although in some systems the Raf/ERK activity can enhance apoptosis (Lander et al., 1996; Pennisi, 1997; Cuda et al., 2002). PI3K that consistently prevents apoptosis in many cell systems, generate PIP3, which promotes a kinase cascade involving Akt, and the substrates of Akt include proteins that modulate the apoptotic signaling pathway (Datta et al., 1999). RalGDS can activate CDC42 and Rac, which activate various MEK kinases that are involved in the regulation of the stress-activated protein kinase/c-Jun N-terminal kinase (SAPK/JNK) and p38 MAPK pathways (Johnson, 1999). SAPK/JNK and p38 MAPK are most frequently associated with the induction of apoptosis (Chuang et al., 2000; Stadheim et al., 2000; Kunz et al., 2001). In addition, it has been reported that SAPK/JNK and p38 MAPK act at an early step prior to dysfunction of mitochondria and caspase activation in several cell types. For example, the stimulation of p38 MAPK is an early regulatory event for the cadmium-induced apoptosis in human promonocytic cells (Galan et al., 2000; Cheng et al., 2001). Ras proteins activate their effectors by direct interaction. Despite the fact that the amino-acid sequences are almost identical, recent studies have demonstrated that the Ras isoforms can differentially activate PI3K and Raf. For example, H-Ras is a more potent activator of PI3K than K-Ras (Yan et al., 1998), whereas K-Ras recruits Raf-1 to the cell membrane more efficiently than H-Ras (Yan et al., 1998; Voice et al., 1999). In addition, K-Ras is a more potent activator of the Rac pathway than H-Ras (Walsh and Bar-Sagi, 2001). These hierarchies appear to result, at least in part, from differences in the mechanisms of membrane attachment of the Ras isoforms (Yan et al., 1998; Walsh and Bar-Sagi, 2001). We investigated distinct signaling pathways downstream of Ras isozymes in the modulation of cellular response to the ionizing radiation. The Ha-Ras protein increases resistance to the ionizing radiation by activation of the PI3K/Akt signaling pathway. Ki-Ras, on the other hand, decreases the radiation resistance by enhancing Bax translocation via activation of a p38 MAPK- dependent pathway. These findings link Ras activity to the modulation of cell sensitivity to ionizing radiation, providing an explanation for the divergent biological activities of Ras isozymes, and may account for the differential response of transformed cells to anticancer agents. Differential modulation of radiosensitivity by Ras isozymes J-A Choi et al 11 Results Differential modulation of radiosensitivity by activated Ki-Ras and Ha-Ras Rat2 cells were stably transfected with activated Ha-Ras (12V-Ha-Ras) or Ki-Ras (12V-Ki-Ras) to determine their role in the response to ionizing radiation. The expression of mutant forms of Ki-Ras and Ha-Ras was confirmed by Western blot analysis as shown in Figure 1a. The cells were irradiated with the indicated doses of ionizing radiation and clonogenic survival assays were performed. 12V-Ha-Ras-overexpressing cells showed increased clonogenic survival following radiation compared to the parental cells. Surprisingly, however, the clonogenic survival curves for cells overexpressing 12V-Ki-Ras indicated that they were much more sensitive to radiation than the parental cells (Figure 1b). We next investigated whether the differential clonogenic survival by activated Ha-Ras and Ki-Ras was associated with the differential regulation of apoptosis. To examine radiation-induced apoptosis, cultures were treated with 4 Gy radiation, and were stained with Figure 2 Differential modulation of radiation-induced apoptosis by overexpression of 12V-Ha-Ras and 12V-Ki-Ras. Parental Rat2, and 12V-Ha-Ras-, or 12V-Ki-Ras-overexpressing Rat2 cells were treated with 4 Gy of g-radiation. (a) Cells were stained with Hoechst 33258 and apoptotic cells were scored at 24 and 48 h after irradiation. The data represent averages of three independent experiments with standard deviations. (b) Sandwich enzyme assay for quantitative determination of cytoplasmic histone-associated DNA fragments was performed using a Cell Death Detection ELISA Kit to detect the degree of apoptosis 48 h after irradiation. The data represent averages of three independent experiments with standard deviations. (c) After 48 h, DNAs were extracted and electrophoresed on 1.5% agarose gel and visualized by UV light after ethidium bromide staining. The Rat2-Ki-Ras lane shows a more extensive DNA ladder following irradiation, indicating more DNA cleavage than the other lanes. A representative of three independent experiments is shown Figure 1 Differential modulation of clonogenic survival after radiation by activated Ha-Ras (12V-Ha-Ras) and Ki-Ras (12V-KiRas). Exponentially growing Rat2 cells were stably transfected with activated-Ha-Ras (12V-Ha-Ras) or -Ki-Ras (12V-Ki-Ras). (a) Expression levels of 12V-Ha-Ras and 12V-Ki-Ras were determined by Western blot analysis using antibody specific for Ha-Ras or KiRas, respectively. (b) The Rat2 cells expressing activated forms of Ha-Ras or Ki-Ras were plated and treated with indicated doses of g-radiation. After 10–15 days, the plates were stained with trypan blue and scored for colony formation. The data represent average values of triplicate experiments with standard deviations Hoechst 33258 at 24 and 48 h and examined microscopically. Figure 2a shows that the number of apoptotic cells induced by radiation in Ha-RasV12expressing cells was less than 15%, but a dramatic increase in the number of apoptotic cells was observed in 12V-Ki-Ras-overexpressing cells (up to 40%), compared to the parental cells (less than 25%). Using a sandwich enzyme immunoassay, quantitative analysis of cytoplasmic histone-associated DNA fragments was also performed, and the results showed that a marked increase in apoptosis was observed in cells expressing 12VKi-Ras (Figure 2b). To confirm these results further, the DNAs from cells expressing 12V-Ki-Ras and 12V-HaRas were analysed for ladder formation after 48 h of 4 Gy irradiation. As shown in Figure 2c, the DNA from 12V-Ki-Ras-expressing cells was more extensively cleaved than the parental or 12V-Ha-Ras-expressing cells after irradiation. These results demonstrate that in contrast to Ha-Ras, activated Ki-Ras augments radiation-induced apoptotic cell death in Rat2 fibroblasts. Oncogene Differential modulation of radiosensitivity by Ras isozymes J-A Choi et al 12 To elucidate whether the high apoptotic index in Rat2 cells expressing 12V-Ki-Ras cells was due to overexpression of activated Ki-Ras or clonal variation, we transiently transfected Rat2 and L929 fibroblasts with a retroviral vector containing activated Ki-Ras (MFGpuro-12V-Ki-Ras). The transient expression of 12V-Ki-Ras clearly repressed clonogenic survival after radiation, and markedly enhanced radiation-induced apoptotic cell death in both types of cells, compared to cells transfected with the control retroviral vector (data not shown), thereby reproducing the higher apoptotic index found in 12V-Ki-Ras-expressing cells constitutively expressing activated Ki-Ras. Role of PI3K/Akt pathway in the increased radioresistance in cells overexpressing 12V-Ha-Ras Since it has been reported that mutant Ras activates PI3K by direct binding, which in turn activates Akt (Joneson and Bar-Sagi, 1997; Campbell et al., 1998), we determined the level of PI3K activity and phospho-Akt in 12V-Ha-Ras- and 12V-Ki-Ras-overexpressing cells. PI3K activity is high in Ha-Ras-expressing cells relative to Ki-Ras-expressing or parental cells (Figure 3a). The constitutive activation of Akt is also apparent only in cells expressing 12V-Ha-Ras, but not in the parental and 12V-Ki-Ras-expressing cells (Figure 3a). The PI3K/Akt signaling pathway has been known to enhance survival after a variety of cellular stresses; however, the nature of its response to ionizing radiation has not been established. To determine if the increased resistance to the Figure 3 Activation of PI3K and Akt is involved in increased radioresistance in cells overexpressing 12V-Ha-Ras. (a) Cell lysates in exponentially growing parental Rat2, and 12V-Ha-Ras-, or 12V-KiRas-overexpressing Rat2 cells were prepared and immunoprecipitated with PI3K antibody (anti-p85). Immune complexes were then adsorbed using protein-A sepharose and subjected to a PI3K assay. The products of the reactions were analysed by thin layer chromatography, and visualized by autoradiogaphy. A representative autoradiogram of PI3K assay is shown and the position of phosphatidylinositol phosphate (PIP) is indicated (upper panel). Rat2, and 12V-Ha-Ras- or 12V-Ki-Ras-overexpressing Rat2 cells were prepared and phosphorylated/activated Akt were detected by Western blot analysis with antibody specific for phosphorylated-Akt. The data represent a typical experiment conducted three times with similar results (bottom panel). (b) Rat2 and 12V-Ha-Ras-overexpressing Rat2 cells were treated with 4 Gy of g-radiation in the presence or absence of LY294002 (10 mm). Cells were harvested 36 h after irradiation and PI3K activity was analysed. The data represent a typical experiment performed three times with similar results (upper panel). Phosphorylated/activated Akt was detected by Western blot analysis with an antibody specific for phosphorylated/activated Akt (lower panel). (c) Rat2- and 12V-Ha-Ras-overexpressing Rat2 cells were treated with 4 Gy of g-radiation in the presence or absence of LY294002. Cells were harvested 48 h after irradiation and DNA contents were analysed after PI staining (Cont; control, LY; LY294002, IR; ionizing radiation). The data represent averages of three independent experiments. Error bar, SD (upper panel). Rat2and 12V-Ha-Ras-overexpressing Rat2 cells were transiently transfected with dominant-negative Akt or control vector and were treated with 4 Gy of g-radiation. Cells were harvested 48 h after irradiation and cell death was analysed by PI staining. (pCMV5; control vector, IR; ionizing radiation, DN-Akt; dominant-negative Akt). The data represent averages of three independent experiments. Error bar, SD (bottom panel) Oncogene radiation in Ha-Ras transfected cells is directly correlated with PI3K signaling pathway, we examined the effect of the PI3K inhibitor, LY294002, on Akt Differential modulation of radiosensitivity by Ras isozymes J-A Choi et al 13 phosphorylation and radiation-induced apoptosis. Cells treated with LY294002 completely inhibited PI3K activity and Akt phosphorylation, and decreased resistance to the ionizing radiation in 12V-Ha-Rasexpressing cells (Figure 3b). Further evidence of the involvement of the PI3K/Akt pathway was obtained by expressing dominant-negative Akt in cells, resulting in the suppression of Ha-Ras-mediated resistance to ionizing radiation (Figure 3c). These results suggest that the constitutive activation of the PI3K/Akt signaling pathway is involved in the increased radioresistance in cells expressing 12V-Ha-Ras. activity, respectively. Transfection of 12V-Ki-Ras-expressing cells with a dominant-negative mutant of p38 MAPK markedly inhibited radiation-induced apoptosis, whereas dominant-negative ERK had no effect on the cell death caused by ionizing radiation. In addition, transfection of 12V-Ki-Ras-expressing cells with RacN17, a dominantnegative form of Rac1, significantly repressed p38 MAPK activity and radiation-induced apoptosis (Figure 5d), suggesting that Rac is positioned upstream of p38 MAPK in the radiation-induced apoptotic signaling pathway in Activation of p38 MAPK by ionizing radiation in cells overexpressing 12V-Ki-Ras The best-known Ras signaling pathways are the MAPK cascades, which include the extracellularly regulated ERK pathway, the stress-activated SAPK/JNK pathway, and the p38 MAPK pathway. To determine the involvement of MAPK in the modulation of radiationinduced apoptosis by Ras, we first investigated the activation of the MAPK signal transduction pathway in cells expressing different isoforms of Ras. As shown in Figure 4a, the expression of both Ras led to the constitutive activation of MEK/ERK and JNK. Interestingly, however, p38 MAPK activity was much higher in the 12V-Ki-Ras-expressing cells than the parental or cells expressing 12V-Ha-Ras. Moreover, p38 MAPK activity was markedly increased following ionizing irradiation in 12V-Ki-Ras-overexpressing cells, but not in Rat2 cells or 12V-Ha-Ras-overxpressing cells (Figure 4b). In addition, radiation caused increased phosphorylation of ERK in Ki-Ras-expressing cells, but not JNK, suggesting selective activation of p38 MAPK and ERK by radiation in cells overexpressing Ki-Ras. Activation of p38 MAPK is involved in the increased radiation-induced apoptosis in 12V-Ki-Rasoverexpressing cells As MAPKs are regulated differentially by Ha-Ras and KiRas, we tested whether differential activation of MAPKs influences the radiation-induced apoptosis. We pretreated the cells with PD98059, a specific inhibitor of MEK/ERK, or PD169316, a specific inhibitor of p38 MAPK, and performed Hoechst 33258 staining. Pretreatment of 12VKi-Ras-expressing cells with PD169316 inhibited radiation-induced apoptotic cell death in a dose-dependent manner; apoptosis was almost completely blocked by 30 mm PD169316 (Figure 5a). However, the MEK/ERKspecific inhibitor PD98059 did not affect radiation-induced apoptosis of the 12V-Ki-Ras-expressing cells (Figure 5b). To confirm further the role of p38 MAPK in enhanced apoptosis in cells expressing 12V-Ki-Ras following radiation, we transfected cells with plasmids expressing dominant-negative mutants of ERK or p38 MAPK and examined the radiation-induced apoptotic cell death. As shown in Figure 5c, transient transfection of dominantnegative ERK or p38 MAPK markedly reduced the cellular level of phosphorylated ERK or the p38 MAPK Figure 4 Activation of p38 MAPK by ionizing irradiation in cells overexpressing 12V-Ki-Ras. (a) Exponentially growing parental Rat2, and 12V-Ha-Ras- or 12V-Ki-Ras-overexpressing Rat2 cells were harvested, and phosphorylated/activated MEK, ERK, JNK, and p38 MAPK were assessed by Western blot analysis with antibodies specific for phospho-MEK, -ERK, -JNK, and -p38 MAPK. The p38 MAPK activity was determined with an immune complex kinase assay using GST-ATF-2 as a substrate. (b) Parental Rat2, and 12V-Ha-Ras- or 12V-Ki-Ras-overexpressing Rat2 cells were treated with 4 Gy of g-radiation. After 36 h, cells were harvested and phosphorylated/activated ERK and JNK were assessed by Western blot analysis with antibodies specific for phospho-ERK and -JNK. The p38 MAPK activity was determined with an immune complex kinase assay using GST-ATF-2 as a substrate Oncogene Differential modulation of radiosensitivity by Ras isozymes J-A Choi et al 14 cells overexpressing 12V-Ki-Ras. Taken together, these results suggest that the selective activation of p38 MAPK signaling pathway by ionizing radiation is involved in the increased radiation-induced apoptosis in the 12V-Ki-Rasexpressing cells. Overexpression of 12V-Ki-Ras enhances ionizing radiation-radiation-induced apoptosis through increased intracellular redistribution of Bax, cytochrome c release, and caspase 3 activation To evaluate the contribution of the mitochondrial pathway to the enhanced apoptosis seen with activated Oncogene Ki-Ras following radiation, we examined cytochrome c release into the cytosol of irradiated 12V-Ki-Ras- or 12V-Ha-Ras-transformed cells. Figure 6a shows that a much higher level of cytosolic cytochrome c was detected in Ki-Ras-expressing cells than in Ha-Rastransfected cells at 36 h after radiation. In addition, the activation of caspase 3 and poly ADP-ribose polymerase (PARP) cleavage was detected in 12V-Ki-Ras-expressing cells along with the cytochrome c release into the cytosol (Figure 6b), in agreement with previous studies suggesting that caspase 3 activation follows cytochrome c release (Bossy-Wetzel and Green, 1999; Nagase et al., 2001; Pan et al., 2001). These results indicate that Differential modulation of radiosensitivity by Ras isozymes J-A Choi et al 15 mitochondrial cytochrome c release and caspase 3 activation are essential mediators in the process of enhanced apoptosis following radiation in 12V-Ki-Rasexpressing cells. Since it has been shown that translocation of Bax from the cytosol to the mitochondria causes a decline of mitochondrial membrane potential subsequent to cytochrome c release and caspase activation (Yoshino et al., 2001), we investigated whether the expression of activated Ki-Ras enhances radiation-induced mitochondrial translocation of Bax. Figure 6c shows that ionizing radiation dramatically increased the translocation of Bax from cytosol to the mitochondria in a timedependent manner, without changing the protein levels of Bcl-2, Bcl-xL, and Bax (data not shown). Indirect immunofluorescence staining of Bax also clearly indicated its translocation to the mitochondria after radiation treatment in cells expressing 12V-Ki-Ras (Figure 6d). These results suggest that enhanced radiation-induced cell death in 12V-Ki-Ras-expressing cells involves alterations in the intracellular redistribution of Bax protein. Activation of p38 MAPK is required for the radiationinduced Bax translocation in 12V-Ki-Ras-overexpressing cells To assess the role of activation of p38 MAPK in the process of Bax translocation to the mitochondria and cytochrome c release, we pretreated 12V-Ki-Ras-expressing cells with PD169316, an inhibitor of p38 MAPK (Figure 7a), or transiently expressed dominant-negative p38 MAPK (Figure 7b), and examined the intracellular distribution of the Bax protein and cytochrome c by immunoblot analysis with mitochondrial and cytosolic fractions. We found that the pretreatment almost completely prevented Bax translocation to the mitochondria, release of cytochrome c into the cytosol, caspase 3 activation, and PARP cleavage (Figure 7a and b). Indirect immunofluorescence staining of Bax clearly showed that its translocation to the mitochondria is dependent on the activation of p38 MAPK signaling pathway (Figure 7c). In addition, transfection of 12VKi-Ras-expressing cells with RacN17, a dominant- negative Rac1, significantly repressed radiation-induced Bax translocation and cytochrome c release as well as p38 MAPK activation in 12V-Ki-Ras-overexpressing cells (Figure 7d). Conversely, the introduction of the constitutive active form of Rac1 (RacV12) clearly enhanced radiation-induced p38 MAPK activation, Bax translocation, and apoptotic cell death (data not shown). These results indicate that p38 MAPK functions as an important effector of the radiation-induced apoptosis in 12V-Ki-Ras-expressing cells by facilitating Bax translocation to the mitochondria and cytochrome c release into the cytosol. Discussion Recently, the evidences for distinct cellular functions for the Ras isoforms have been accumulated in various studies. The differential biological functions of Ras proteins are exerted through the selective activation of downstream effectors. In this study, we demonstrate that Ha-Ras and Ki-Ras protein significantly differ in their abilities to modulate response to the ionizing radiation and to activate downstream effectors. The HaRas protein increases resistance to ionizing radiation by activation of the PI3K/Akt signaling pathway; Ki-Ras, on the other hand, decreases the radiation resistance by enhancing Bax translocation via activating an Rac/p38 MAPK-dependent pathway. A clear difference was observed in the abilities of Ha-Ras and Ki-Ras to enhance radiation-induced apoptosis. The overexpression of active isoform of HaRas (12V-Ha-Ras) in Rat2 cells increases resistance to the ionizing radiation. The constitutive activation of PI3K and Akt is detected specifically in 12V-Ha-Rasexpressing cells. The PI3K inhibitor LY294002 or dominant-negative Akt attenuates Ha-Ras-induced radioresistance, suggesting that the activation of PI3K/ Akt has a critical role in the induction of radioresistance in cells overexpressing 12V-Ha-Ras. These results were consistent with recent reports demonstrating that PI3K is an important mediator of Ras-induced radiation resistance (Gupta et al., 2001; Grana et al., 2002), and that PI3K mediates survival-associated signaling Figure 5 Effects of p38 MAPK inhibition on radiation-induced apoptosis in 12V-Ki-Ras-overexpressing cells. (a) Rat2 cells overexpressing 12VKi-Ras were treated with 4 Gy of g-radiation in the presence or absence of the indicated doses of PD169316. The p38 MAPK activity was determined with an immune complex kinase assay using GST-ATF-2 as a substrate (upper panel). Apoptosis was determined by Hoechst 33258 staining and scored for apoptotic changes in nuclear morphology 36 h after irradiation. The data represent averages of three independent experiments. Error bars, SD (lower panel). (b) Rat2 cells overexpressing 12V-Ki-Ras were treated with 4 Gy of g-radiation in the presence or absence of PD98059 (10 mm). ERK activity was detected by an immune complex kinase assay using myelin basic protein (MBP) as a substrate (upper panel). Apoptosis was determined by Hoechst 33258 staining and scoring for apoptotic changes in nuclear morphology 36 h after irradiation. The data represent averages of three independent experiments. Error bar, SD (lower panel). (c) Rat2 cells overexpressing 12V-Ki-Ras were transiently transfected with dominant-negative p38 MAPK (DN-p38), -ERK (DN-ERK) or control vector and were treated with 4 Gy of gradiation. Cells were harvested at 36 h and p38 MAPK activity was determined with an immune complex kinase assay using GST-ATF-2 as a substrate. Phosphorylated/activated ERK1/2 was detected by Western blot analysis with antibodies specific for phospho-ERK1/2. The data represent a typical experiment conducted three times with similar results (left panel). Apoptosis was determined by Hoechst 33258 staining and apoptotic changes in nuclear morphology were scored at 36 h after irradiation. The data represent averages of three independent experiments. Error bars, SD (right panel). (d) Rat2 cells overexpressing 12V-Ki-Ras were transiently transfected with dominant-negative Rac (RacN17) or control vector and were treated with 4 Gy of g-radiation. Cells were harvested at 36 h and phosphorylated/activated p38 MAPK and ERK1/2 were detected by Western blot analysis with antibodies specific for phospho-p38 MAPK or -ERK1/2. The data represent a typical experiment conducted three times with similar results (left panel). Apoptosis was determined by Hoechst 33258 staining and apoptotic changes in nuclear morphology were scored at 36 h after irradiation. The data represent averages of three independent experiments. Error bars, SD (right panel) Oncogene Differential modulation of radiosensitivity by Ras isozymes J-A Choi et al 16 apoptotic cell death in response to radiation. The activation of caspase 3 and PARP cleavage was detected in 12V-Ki-Ras-expressing cells along with the cyto- Figure 6 Ionizing radiation enhances Bax translocation, cytochrome c release, and caspase 3 activation in cells overexpressing 12V-Ki-Ras. Rat2 cells overexpressing 12V-Ki-Ras or 12V-Ha-Ras were treated with 4 Gy of g-radiation. (a) After 36 h, cytosolic fractions were prepared and cytochrome c was detected by Western blot analysis. The data represent a typical experiment conducted four times with similar results. (b) After 24 and 48 h, whole cell lysates were prepared and assessed by Western blot analysis for caspase 3 and PARP. The data represent a typical experiment conducted three times with similar results. (c) After 24 and 48 h, mitochondrial fraction was prepared and Bax was detected by Western blot analysis using anti-Bax antibody. The data represent a typical experiment conducted four times with similar results. (d) Cells overexpressing 12V-Ki-Ras were treated with 4 Gy of gradiation. After 36 h, cells were incubated with Mitotracker and stained with FITC-conjugated anti-Bax antibody. The slides were analysed by a confocal laser scanning microscope. Mitochondrial localization of Bax was defined by yellow spots indicating overlap of FITC and Mitotracker Red pathway that allows cells to tolerate a variety of cellular insults better, including serum deprivation, extracellular matrix detachment, and DNA damage (Yao and Cooper, 1995; Khwaja et al., 1997; Kulik et al., 1997). However, we failed to detect the activation of PI3K/Akt pathway in cells overexpressing activated Ki-Ras, suggesting differential activation of downstream effector molecules by different Ras isozymes. In contrast to Ha-Ras, stable or transient transfection of cells with activated Ki-Ras markedly increased Oncogene Differential modulation of radiosensitivity by Ras isozymes J-A Choi et al 17 chrome c release into the cytosol, in agreement with previous studies suggesting that caspase 3 activation follows cytochrome c release (Bossy-Wetzel and Green, 1999; Nagase et al., 2001; Pan et al., 2001). These results indicate that mitochondrial cytochrome c release and caspase 3 activation are essential mediators of enhanced apoptosis following radiation observed in Ki-Ras-overexpressing cells. We also found that activated Ki-Ras enhances radiation-induced cell death through cytochrome c release following intracellular redistribution of cell death activator Bax. Analysis of various Bax mutations indicated that cell death was only observed when the Bax protein was capable of translocating to the mitochondria (Nechushtan et al., 1999). Bax translocation to the mitochondria has been shown to reduce mitochondrial membrane potential, enhance cytochrome c release from mitochondria, and activate caspases (Desagher et al., 1999; Finucane et al., 1999). In this study, we observed the activation of ERK and p38 MAPK by ionizing radiation in cells overexpressing 12V-Ki-Ras. Inhibition of the MEK/ERK pathway by using the MEK inhibitor, PD98059 or by expressing dominant-negative ERK did not show any changes in apoptotic cell death. These results were consistent with others who previously showed that the inhibition of MEK activity does not influence radioresistance (Belka et al., 2000; Gupta et al., 2000, 2001; Grana et al., 2002). However, inhibition of the p38 MAPK activity by p38 Figure 7 Inhibition of p38 MAPK attenuates radiation-induced Bax translocation, cytochrome c release, and caspase 3 activation in cells overexpressing 12V-Ki-Ras. (a) Rat2 cells overexpressing 12V-Ki-Ras were treated with 4 Gy radiation in the presence or absence of 30 mm PD169316. After 36 h, mitochondrial fraction was prepared and mitochondria-localized Bax and HSP60 were detected by Western blot analysis using anti-Bax or -HSP60 antibody. Cytosolic fractions were prepared and released cytochrome c from mitochondria was detected by Western blot analysis using anti-cytochrome c antibody. Whole cell lysates were prepared and assessed by Western blot analysis for caspase 3 and PARP. The data represent a typical experiment conducted at least three times with similar results (b) Rat2 cells overexpressing 12V-Ki-Ras were transiently transfected with dominant-negative p38 MAPK (DN-p38) or control vector and were treated with 4 Gy of g-radiation. After 36 h, mitochondrial fraction was prepared and mitochondria-localized Bax and HSP60 were detected by Western blot analysis using anti-Bax or -HSP60 antibody. Cytosolic fractions were prepared and released cytochrome c from mitochondria was detected by Western blot analysis using anti-cytochrome c antibody. Whole cell lysates were prepared and assessed by Western blot analysis for caspase 3 and PARP. The data represent a typical experiment conducted three times with similar results. (c) Cells overexpressing 12V-Ki-Ras were treated with 4 Gy of g-radiation in the presence or absence of 30 mm PD169316. After 36 h, cells were incubated with Mitotracker and stained with FITC-conjugated antiBax antibody. The slides were analysed by a confocal laser scanning microscope. Mitochondrial localization of Bax was defined by yellow spots indicating overlap of FITC and Mitotracker Red. (d) Cells overexpressing 12V-Ki-Ras were transiently transfected with dominant-negative Rac (RacN17) or control vector and were treated with 4 Gy of g-radiation. After 36 h, the mitochondrial fraction was prepared and mitochondria-localized Bax and HSP60 were detected by Western blot analysis using anti-Bax or -HSP60 antibody. Cytosolic fractions were prepared and released cytochrome c from mitochondria was detected by Western blot analysis using anti-cytochrome c antibody. Whole cell lysates were prepared and assessed by Western blot analysis for PARP. The data represent a typical experiment conducted three times with similar results MAPK inhibitor, PD169316, or by expressing dominantnegative p38 MAPK markedly attenuated radiationinduced apoptosis, suggesting that the activation of p38 MAPK is involved in Ki-Ras-induced radiosensitivity. We also found that the inhibition of p38 MAPK almost completely prevented Bax translocation to the mitochondria, release of cytochrome c into the cytosol, caspase 3 activation, and PARP cleavage. These results are consistent with the fact that p38 MAPK are frequently associated with the induction of apoptosis (Chuang et al., 2000; Stadheim et al., 2000; Kunz et al., 2001), and that p38 MAPK acts at an early step prior to dysfunction of mitochondria and caspase activation in several cell types (Galan et al., 2000; Cheng et al., 2001). The significant reduction of caspase 3 activation and PARP cleavage after concomitant treatment with radiation and p38 MAPK inhibitor in cells overexpressing Ki-Ras is consistent with our demonstration that Bax translocation is regulated by p38 MAPK. Thus we propose that in 12V-Ki-Ras-expressing cells, ionizing radiation activates p38 MAPK, which promotes Bax translocation to the mitochondria followed by cytochrome c release and caspase activation. The results of the present study suggest that Bax translocation to the mitochondria is subject to regulation by p38 MAPK in response to concomitant introduction of radiation and activated Ki-Ras. This finding is consistent with recent studies demonstrating that NH2 (Goping et al., 1998) and COOH termini (Nechushtan et al., 1999) of Bax are rich in glycine and hydroxyl amino acids such as serine and threonine that are potential targets of the p38 MAPK (Ghatan et al., 2000), and critical for regulating the subcellular distribution of Bax. Phosphorylation of either terminus may cause conformational change, facilitating mitochondrial membrane insertion of Bax. However, in contrast to Bcl-2 and Bad, evidence for Bax phosphorylation is rare. Alternatively, it is conceivable that while Bax is not directly phosphorylated, the phosphorylation of a Bax-binding protein may facilitate membrane targeting and insertion. Ral-GDS is another Ras effector that can activate CDC42 and Rac, which in turn activate various MEK kinases that are involved in the regulation of the SAPK/ JNK and p38 MAPK pathways (Johnson, 1999). It is well established that the Rac/p38 MAPK pathway is activated by various types of membrane-associated cellular signals induced by many apoptosis-inducing agents. In this study, we also provided evidence of the fact that Rac is involved in the Ki-Ras-mediated enhancement of radiation-induced apoptosis. Inhibition of Rac1 activity with RacN17, a dominant-negative mutant of Rac1, in 12V-Ki-Ras-expressing Rat2 cells significantly reduced radiation-induced apoptosis as well as p38 MAPK activation, Bax translocation, and cytochrome c release. Furthermore, introduction of activated Rac1 (RacV12) into Rat2 cells resulted in an increase in the activation of p38 MAPK and in the sensitivity to ionizing radiation (data not shown), demonstrating that Rac acts as an upstream regulator of p38 MAPK during ionizing radiation-induced apoptosis. This is in good agreement with the recent study Oncogene Differential modulation of radiosensitivity by Ras isozymes J-A Choi et al 18 showing that the Rac/p38 MAPK/Bax translocation pathway has an essential role in the apoptosis induced by UV irradiation (Eom et al., 2001). On the other hand, it has been recently reported that the activation of PI3K also leads to the activation of Rac GTPase (Rebollo and Martinez, 1999), which acts as a downstream effector molecule of Ras signaling pathways that control actin polymerization, transcriptional activation, and cell proliferation. However, we failed to detect PI3K activation in cells overexpressing Ki-Ras; moreover, pretreatment of LY294002, a specific inhibitor of PI3K, did not affect radiation-induced p38 MAPK activation, suggesting that the activation of Rac/p38 MAPK signaling pathway by radiation in Ki-Ras-overexpressing cells is independent of PI3K signaling. Recently, opposing roles of Ki-Ras and Ha-Ras genes in the regulation of redox signals and apoptosis have been observed (Santillo et al., 2001; Cuda et al., 2002). The study shows that the Ha-Ras protein increases the intracellular level of reactive oxygen species and the number of cells undergoing apoptosis after oxidative stress, conversely the Ki-Ras has a protective effect. On the contrary, however, here we show that cells overexpressing Ki-Ras are more sensitive than Ha-Rasexpressing cells to ionizing radiation. Moreover, radiation increases the level of intracellular reactive oxygen species more potently in Ki-Ras-overexpressing cells than Ha-Ras-expressing cells (unpublished data). We also find that the increased level of reactive oxygen species in activated Ki-Ras-expressing cells after ionizing irradiation is dependent on the Ras/Rac/p38 MAPK signaling pathway (unpublished data). Differences in the regulation of reactive oxygen species level and apoptosis by Ras isozymes in previous reports and our results are likely to be stress type and cell type dependent. In conclusion, in this study, we showed that the sensitivity to ionizing radiation is differentially modulated by activated Ki-Ras and Ha-Ras. Our findings explain the opposite effects of Ha-Ras and Ki-Ras on radiation-induced apoptosis and suggest that differential activation of Akt and p38 MAPK signaling may account for the opposing response to ionizing radiation by HaRas or Ki-Ras. The Ha-Ras protein increases resistance to ionizing radiation by activation of the PI3K/Akt signaling pathway; Ki-Ras, on the other hand, decreases the radiation resistance by enhancing Bax translocation via activation of an Rac/p38 MAPK-dependent pathway. These findings link Ras activity to the modulation of cell sensitivity to ionizing radiation, provide an explanation for the divergent biological activities of Ras isozymes, and partly account for the differential response of transformed cells to anticancer agents. Materials and methods Chemicals and plasmids Monoclonal antibodies to H-Ras and K-Ras were purchased from Santa Cruz Biotechnology (Santa Cruz, CA, USA), and monoclonal antibodies to phosphorylated ERK, p38 MAPK and JNK were obtained from Cell Signaling (Beverly, MA, USA). Polyclonal antibodies to caspase 3 and PARP were Oncogene purchased from Upstate Biotechnology, and monoclonal antibody to Bax, Bcl-2, and Bcl-XL was obtained from Santa Cruz Biotechnology (Santa Cruz, CA, USA). PD98059, SB203580, and PD169316 were obtained from Calbiochem (San Diego, CA, USA). pSPORT-Ki-Ras (V12) and pSPORTHa-Ras (V12) were gifts from Dr P Kirshmeier (ScheringPlough Research Institute). pCMV5-DN-p38, an expression vector encoding dominant-negative mutant of p38 MAPK, and pLCEP4-DN-ERK, a dominant-negative mutant of ERK, were gifts from Dr Roger Davis (University of Massachusetts Medical School, Worcester, MA, USA). pEXV-RacN17, an expression vector encoding a dominant-negative mutant of Rac1, and pEXV-RacV12, an expression vector encoding a constitutively active form of Rac1, were gifts from Dr Alan Hall (University College London, London, UK). pCMV5DN-Akt, an expression vector encoding a dominant-negative mutant of Akt was a gift from Dr Richard A Roth (Stanford University School of Medicine, Stanford, CA, USA). Cell culture Rat2 and L929 murine fibroblast cells were obtained from the American Type Culture Collection (Rockville, MD, USA), and were grown in RPMI 1640 medium supplemented with 10% fetal bovine serum (FBS, GIBCO) and antibiotics at 371C in a humidified incubator with 5% CO2. Irradiation Cells were irradiated with 4 Gy using a g-cell irradiator with 137 Cs source (Atomic Energy of Canada, Ltd, Canada). Stable transfection of the activated Ki-Ras (12V-Ki-Ras) and activated Ha-Ras (12V-Ha-Ras) constructs into Rat2 cells Using the Lipofectamin method (GIBCO/BRL), exponentially growing Rat2 cells were transfected with expression plasmids encoding 12V-Ki-Ras, 12V-Ha-Ras, or a control vector for 6 h at 371C, and the cells were incubated with a standard medium for 24 h. At that time G418 selection was begun at a concentration just high enough to kill 100% of the parental cells (400 mg/ml). After 10–15 days, colonies were picked by the cloning cylinder technique and were expanded into cell lines. Clonogenic survival assay The clonogenic survival assay was performed as described previously (Bache et al., 2001). Cells were seeded into 60-mm dishes at densities sufficient to produce approximately 200 colonies per dish in the controls, and were incubated for 10–14 days. Colonies were fixed with 75% ethanol and 25% acetic acid, and stained with trypan blue. The number of colonies consisting of more than 50 cells was counted. Preparation of membrane fractions To gain the cytosol and membrane fractions, harvested cells were suspended in fractionation buffer (10 mm Tris-HCl, pH 7.5, 1 mm EDTA, 1 mm phenylmethylsulfonyl fluoride, 20 mm leupeptin) and lysed by sonication. The lysate was centrifuged at 100 000 g for 1 h at 41C to obtain cytosol fraction (supernatant). The pellet representing particulate proteins was resuspended in the above buffer containing 0.1% Triton X-100 and lysed by sonication. The lysate was centrifuged at 100 000 g for 1 h at 41C to obtain membrane fraction (supernatant). Preparation of cytosolic and mitochondrial fractions Cells were collected and washed twice in ice-cold PBS, resuspended in S-100 buffer (20 mm HEPES, pH 7.5, 10 mm Differential modulation of radiosensitivity by Ras isozymes J-A Choi et al 19 KCl, 1.9 mm MgCl2, 1 mm EGTA, 1 mm EDTA, mixture of protease inhibitors), and incubated on ice for 20 min. After 20 min of incubation on ice, the cells were homogenized with a Dounce glass homogenizer and a loose pestle (Wheaton, Millville, NJ, USA) for 70 strokes. Cell homogenates were spun at 1000 g to remove unbroken cells, nuclei, and heavy membranes. The supernatant was respun at 14 000 g for 30 min to collect the mitochondria-rich (the pellet) and the cytosolic (the supernatant) fractions. The mitochondria-rich fraction was washed once with the extraction buffer, followed by a final resuspension in lysis buffer (150 mm NaCl, 50 mm Tris-HCl, pH 7.4, 1% NP-40, 0.25% sodium deoxycholate, 1 mm EGTA) containing protease inhibitors for Western blot analysis. Hoechst 33258 staining Hoechst 33258 staining was performed as described previously (Choi et al., 2001). Briefly, cells were fixed with 4% paraformaldehyde for 30 min at room temperature, and then washed once with PBS. Hoechst 33258 (50 ng/ml) was added to the fixed cells, incubated for 30 min at room temperature, and washed with PBS. Cells were mounted and examined by fluorescence microscopy. Apoptotic cells were identified by the condensation and fragmentation of their nuclei. The percentage of apoptotic cells was calculated as the ratio of apoptotic cells to total cells counted 100. A minimum of 500 cells were counted for each treatment. Sandwich enzyme immunoassay Both adherent and floating cells were collected 48 h after g-radiation treatment and washed with ice-cold PBS. Quantitative determinations of cytoplasmic histone-associated DNA fragments were performed using the Cell Death Detection ELISA Kit (Boehringer Mannheim, Indianapolis, IN, USA). Flow cytometric analysis of apoptosis Apoptosis was identified and quantified by flow cytometry with propidium iodide (PI) staining. Both adherent and floating cells were collected after g-radiation treatment, washed with ice-cold PBS, and fixed with 70% ice-cold ethanol overnight at 41C. Fixed cells were washed twice with PBS and treated with 1 mg/ml RNase for 30 min at 371C. Cellular DNA was stained with 50 mg/ ml PI in PBS containing 0.05% Nonidet P-40. Cells were then analysed by FACScan flow cytometer (Becton Dickinson, Franklin Lakes, NJ, USA). From the analysis of DNA histograms, the percentages of cells in different cell cycle phases were evaluated. Cells with DNA content less than the G1 phase (sub-G1) were taken as apoptotic cells. Extraction of DNA and agarose-gel electrophoresis Parental Rat2, and 12V-Ha-Ras- and 12V-Ki-Ras-expressing Rat2 cells were treated with 4 Gy of g-radiation and were lysed in a lysis buffer (20 mm Tris/HCl, pH 8.0, 0.1 mm EDTA, 1% SDS, and 0.5 mg/ml proteinase K). DNA samples were extracted and separated by agarose-gel electrophoresis. Western blot analysis Western blot analysis was performed as described (Lee et al., 1998). Briefly, cell lysates were prepared by extracting proteins with lysis buffer (40 mm Tris-HCl (pH 8.0), 120 mm NaCl, 0.1% Nonidet-P40) supplemented with protease inhibitors. Proteins were separated by SDS–PAGE and transferred onto a nitrocellulose membrane. The membrane was blocked with 5% nonfat dry milk in Tris-buffered saline and then incubated with primary antibodies for 1 h at room temperature. Blots were developed with a peroxidase-conjugated secondary antibody, and proteins were visualized by enhanced chemiluminescence (ECL) procedures (Amersham, Arlington Heights, IL, USA) according to the manufacturer’s recommendations. Immune complex kinase assay The immune complex kinase assay was performed as previously described (Riabowol et al., 1989). Briefly, cell lysates were incubated with an anti-p38 MAPK antibody (Cell Signaling, Beverly, MA, USA), and immunocomplexes were collected on protein A-Sepharose beads (Sigma, St Louis, MI, USA) and resuspended in a kinase assay mixture containing [g-32P]ATP (ICN) and GST-ATF-2 (Santa Cruz Biotechnology, Santa Cruz, CA, USA) as a substrate. The proteins were separated on SDS–PAGE, and the bands were detected by autoradiography. Immunofluorescence analysis For immunofluorescence analysis, cells were fixed with 2% paraformaldheyde, permeabilized with 0.1% Triton X-100 in PBS, incubated with 25 nm Mitotracker Red CMXRos (Molecular Probes, Inc., Eugene, OR, USA) for 30 min at room temperature, and then washed three times with PBS. Cells were then incubated with rabbit anti-human Bax diluted 1 : 200 in 5% FBS/PBS for 1 h at room temperature in a humidified chamber. Excess antibody was removed by washing the coverslips three times with PBS. Cells were then incubated with biotin-labeled goat anti-rabbit IgG (Zymed Laboratories, Inc., South San Francisco, CA, USA) diluted 1 : 200 in 5% FBS/PBS, and protected from light at room temperature for 1 h. After washing three times with PBS, cells were incubated with FITC-streptavidin diluted 1 : 200 in 5% FBS/PBS for 4 h. 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