ABSTRACT
In previous studies we have described a 5.0 kb HindIII fragment downstream of muscle exon 1 that exhibits properties consistent with a muscle-specific transcriptional enhancer. The goal of this study has been to identify the sequence elements responsible for muscle-specific enhancer activity. Functional studies indicated that this enhancer is active in pre- and post-differentiated H9C2(2-1) myoblasts but functions poorly in L6 and C2C12 myotubes. The core enhancer region was delimited to a 195 bp SpeI-AccI fragment and sequence analysis identified three MEF-1/E box and two MEF-2/AT-rich motifs as potential muscle-specific regulatory domains. EMSA competition and DNase footprinting indicated that sequences within a 30 bp region containing single adjoining MEF-1/E box and MEF-2/AT-rich motifs are target binding sites for trans-acting factors expressed in H9C2(2-1) myotubes but not in L6 or C2C12 myotubes. Site-specific mutations within these motifs resulted in a significant reduction in enhancer activity in H9C2(2-1) myotubes. These results suggest that the mechanisms governing DMD gene expression in muscle are similar to those identified in other muscle-specific genes. However, the myogenic profile of enhancer activity and trans-acting factor binding suggests a more specialized role for this enhancer that is consistent with its potential involvement in dystrophin gene regulation in cardiac muscle.
The 14 kb transcript encoding the muscle isoform of the human dystrophin (Duchenne muscular dystrophy, DMD) gene is spliced from 79 exons spread over 2500 kb or ~1.5% of the entire length of the X chromosome (1 ,2 ). The muscle-specific transcript is one of several isoforms that arise from tissue-specific promoters within introns throughout the dystrophin gene (3 -10 ). For example, a brain-specific transcript originates from a novel first exon positioned 120-150 kb upstream of muscle exon 1 and the first exon of a cerebellar Purkinje cell-specific transcript is located 30-60 kb downstream of muscle exon 1 (4 ,11 ,12 ). The first exons of each of these transcripts are spliced to the 62 bp exon 2 positioned 170-200 kb downstream of muscle exon 1. The functional roles of these and other non-muscle isoforms in their respective tissues have not been firmly established.
The muscle isoform of the dystrophin gene is expressed primarily in skeletal and cardiac muscle and to a lesser extent in smooth muscle (13 ) and coincides with the pathological profile of tissue involvement in the disease. Mutations that disrupt the abundance and/or integrity of the 427 kDa protein product dystrophin lead to progressive degeneration of muscle tissues which may be severe (DMD) or relatively mild (Becker muscular dystrophy, BMD) (14 ). DMD reduces life expectancy to 20-25 years, at which time patients succumb to respiratory or cardiac insufficiency.
Typical of muscle-specific genes, dystrophin gene transcription has been shown to be up-regulated as myoblasts differentiate into multinucleated myotubes in vitro (15 -18 ). Studies of transcript accumulation with myoblast differentiation have verified the predicted transcription time of 14-24 h based on published elongation rates for RNA polymerase II (18 ) and established a mean half-life of 15 h for dystrophin gene transcripts in immature myotubes (19 ).
In a previous study we have described the isolation and characterization of the muscle promoter region upstream of muscle exon 1 in the human dystrophin gene. A 918 bp HindIII-BglII fragment containing the transcriptional start site and 850 bp of upstream sequence was shown to confer muscle-specific regulation upon promoterless and enhancerless reporter gene expression plasmids when transiently transfected into primary human, primary mouse and H9C2(2-1) rat myoblast cultures (17 ). The muscle promoter was inactive in fibroblasts and functioned poorly in both the L6 and C2 myogenic cell lines, despite the fact that several muscle-specific regulatory domain homologies were identified within this region [e.g. MEF-1/E box (20 ,21 ), MEF-2 (22 ,23 ), CArG box (24 -26 ) and MCAT (27 )]. Regulatory domains responsible for transcriptional induction of reporter gene expression during myoblast differentiation were found to lie within 150 bp of the transcription start site (17 ). This `minimal' promoter region contains single GC box, MEF-1/E box and CArG box motifs and in an independent study the CArG box motif was shown to be an essential functional regulatory element and to have trans-acting factor binding properties similar to the cardiac actin promoter CArG box motif (28 ). The MEF-1/E box motif, on the other hand, was found to be non-responsive to trans-activation by MyoD.
The observation of low levels of dystrophin promoter activity in mouse skeletal muscle in vivo provided indirect evidence that additional muscle-specific regulatory control elements may be present in sequences surrounding muscle exon 1 (12 ). Functional analysis of HindIII fragments from within a 36 kb region surrounding muscle exon 1 resulted in the identification of a 5.0 kb fragment that generated high levels of reporter gene expression in both immature H9C2(2-1) myotubes and mature mouse skeletal muscle. This 5 kb fragment was functionally independent of position and orientation and inactive in fibroblasts, properties consistent with the definition of a muscle-specific enhancer. The identification of X-linked dilated cardiomyopathy patients having deletions through the muscle promoter and into intron 1 of the dystrophin gene (29 ,30 ) and reports that the H9C2(2-1) cell line retains residual cardiac-specific transcriptional properties (31 -34 ) provided indirect evidence that this enhancer may play a role in regulating dystrophin gene expression in cardiac muscle.
The goal of this study has been to identify sequence elements within this enhancer responsible for transcriptional activity in immature cultured myotubes. The core enhancer region was defined as a 195 bp SpeI-AccI fragment containing three MEF-1/E box and two MEF-2/AT-rich-like motifs as potential muscle-specific regulatory domains. EMSA competition, DNase footprinting and mutational studies demonstrated that single adjoining MEF-1/E box and Mef2/AT-rich sequence motifs are involved in mediating the activity of this enhancer in H9C2(2-1) myotubes.
Chloramphenicol acetyltransferase (CAT) expression constructs were prepared in the pBLCAT2 vector containing the enhancerless Herpes simplex virus thymidine kinase (HSVtk) promoter upstream of the CAT gene (35 ). Deletion constructs were prepared utilizing internal restriction enzyme sites. Some fragments were initially subcloned into the pBluescript vector (Stratagene Cloning Systems, La Jolla, CA) and subsequently transferred to the pBLCAT2 vector using common polylinker restriction sites. Exonuclease III/mung bean nuclease deletions were prepared from the HindIII site of a 3.5 kb XbaI-HindIII fragment isolated from DME.H5 and subcloned into the pBluescript vector (36 ).
Mutant constructs were prepared by synthesizing oligonucleotides containing specific base changes and using these to generate overlapping PCR products which were subsequently annealed, extended and PCR amplified using vector-based primers. Mutant PCR primers used in these experiments were E box mut (5'-TGACTCAC
H9C2(2-1) myoblasts were seeded at a density of 100 cells/mm2 on plastic culture dishes in [alpha]MEM containing 16 mM glucose, 10% fetal bovine serum and 40 [mu]g/ml gentamycin (growth medium). Cells were transfected using the modified calcium phosphate precipitation protocol (37 ) using 10 [mu]g test plasmid and 10 [mu]g reference plasmid pXGH5 (38 ) per 100 mm2 dish. The pXGH5 reference plasmid contains the human growth hormone gene driven by the mMT-1 promoter and was included as a control for transfection efficiency. Transfected cells were exposed to fusion medium ([alpha]MEM containing 16 mM glucose, 5% horse serum and 100 U/ml penicillin, 0.1 mg/ml streptomycin) for 72 h prior to harvesting for CAT and growth hormone assays. C2C12 and L6 myoblasts were grown and transfected under the same conditions. In experiments requiring pre-differentiated H9C2(2-1) myoblasts, cells were seeded at 25 cells/mm2 and maintained in growth medium. NIH 3T3 fibroblasts were maintained in growth medium at all times.
CAT assays were performed according to the dual phase diffusion procedure (39 ). Briefly, cell extracts (25 [mu]g protein) were added to reaction mixtures containing 100 mM Tris-HCl, pH 7.8, 1.0 mM chloramphenicol and 0.1 mM acetyl-CoA (2-5 [mu]Ci [3H]acetyl-CoA; 198 mCi/mmol; Dupont Canada Inc., Mississauga, Ontario, Canada) in a final volume of 250 [mu]l. Reactions were overlaid with 5 ml Econofluor (Dupont Canada Inc.) and assayed at 30-60 min intervals. CAT activities were calculated using values which fell within the linear range of the reaction and were converted from c.p.m. to units CAT using standard CAT activity values determined in each experiment. Human growth hormone levels in 20 [mu]l aliquots of fusion medium were determined using a dual antibody radioimmunoassay (Nichols Institute Diagnostics, Los Angeles, CA). Values were converted to ng growth hormone/ml using a standard curve prepared with each experiment. Cell extract protein concentrations were determined using the procedure of Lowry et al. (40 ). CAT activities are expressed as units CAT/mg protein/ng growth hormone.
Sequences within the 195 bp SpeI-AccI fragment were determined from a series of overlapping fragments (1.4 kb EcoRI-exonuclease III, 710 bp HincII, 800 bp EcoRI-AccI) subcloned into the pBluescript vector. Each fragment was sequenced from T3 and T7 primer sites within the vector, as well as from internal primer sites using the dideoxy chain termination procedure (41 ) and Sequenase (US Biochemical Corp., Cleveland, OH) according to the manufacturer's protocol.
Protein extracts were prepared from H9C2(2-1) myoblasts and myotubes, L6 and C2C12 myotubes and 3T3 fibroblasts essentially as described by Lassar et al. (42 ) and stored at -80oC. Protein concentrations were determined according to the Bradford procedure using the reagent kit and manufacturer's protocol (BioRad Laboratories, Richmond, CA).
A schematic representation of the relative positions of muscle exon 1 (ME1), the first exons of the brain (BE1) and cerebellar Purkinje cell (CPE1)-specific transcripts and exons 2-7 within a 400 kb region at the 5'-end of the human dystrophin gene are shown in Figure 1 . Below the long range map is a HindIII restriction map of a 36 kb cosmid clone (XJcos8) containing muscle exon 1. The 5 kb fragment downstream of muscle exon 1 (DME1.H5) displays characteristics typical of a muscle-specific enhancer and is the focus of this study. The DME1.H5 fragment is positioned immediately downstream of 3.4 kb HindIII fragment that contains muscle exon 1 and the core muscle promoter region. A restriction map of the DME1.H5 fragment is shown below XJcos8.
To determine whether these MEF-1/E box and MEF-2/AT-rich motifs behave as functional trans-acting factor binding sites within the context of the SA195 fragment, synthetic double-stranded oligonucleotides spanning each of the three MEF-1/E box motifs within the SA195 region were prepared and used as unlabelled competitors in EMSA binding reactions. The positions of each of these competitor oligonucleotides (designated E-1, E-2 and E-3) are indicated in Figure 4 a. The profile of protein-DNA complexes formed in binding reactions containing H9C2(2-1) myotube nuclear extracts is shown in Figure 5 a, as well as in positive control lanes in Figure 5 b and c. Four major protein-DNA complexes (bands B-E) were consistently observed in these experiments. Formation of a fifth protein-DNA complex (band A) was less consistent in terms of its intensity relative to bands B-E. Inclusion of a 100-fold molar excess of unlabelled SA195 DNA in the binding reaction completely abolished EMSA complex formation (Fig. 5 b), demonstrating the specificity of nuclear factor binding to this probe. Competitor oligonucleotides were tested over a range of 10- to 500-fold molar excess over labelled SA195 probe. As shown in Figure 5 b, inclusion of a 100-fold molar excess of unlabelled competitor E-1 (bp 51-80) in EMSA binding reactions resulted in the complete loss of three bands corresponding to complexes C-E and a reduction in the intensity of band B. Competitor oligonucleotides E-2 and E-3, on the other hand, had no effect on EMSA complex formation when present at either 100-fold (Fig. 5 b) or 500-fold (not shown) molar excess over labelled probe. The introduction of mutations into either the MEF-1/E box (E-mut) or the MEF-2/AT-rich (AT-mut) motifs within the E-1 oligonucleotide abolished competition for EMSA complexes C-E (Fig. 5 b). These results pointed to the specific involvement of these cis-acting sequence motifs in factor binding to the SA195 enhancer core.
To examine whether differences in enhancer function in myogenic cell lines are reflected in changes in trans-acting factor binding to the 195 bp enhancer core, EMSAs were performed using nuclear extracts prepared from L6 and C2C12 myotubes and 3T3 fibroblasts. As shown in Figure 5 c, L6 myotube extracts support the formation of four EMSA complexes with similar mobilities to bands A, B, D and E formed with H9C2(2-1) myotube extracts. Protein-DNA complexes with mobilities resembling bands A and B, along with a complex with slightly greater mobility than band D, were observed in EMSAs using C2C12 myotube extracts. Nuclear extracts prepared from 3T3 fibroblasts supported the formation of complexes resembling bands A, B and E as well as a complex with slightly greater mobility than band D, similar to that seen with C2C12 myotube extracts. The absence of band C in L6, C2C12 and 3T3 EMSAs suggested that formation of this complex is necessary for full enhancer function. The observation that band C is one of the three protein-DNA complexes competed by oligonucleotide E-1 provided further support for the notion that sequences within this 30 bp region play an important role in establishing the transcriptional activity of this enhancer in H9C2(2-1) myotubes.
Figure
The involvement of this 30 bp region (bp 51-80) in trans-acting factor binding was explored further in DNase fooprinting experiments utilizing H9C2(2-1), L6 and C2C12 myotube nuclear extracts. As shown in Figure 6 , DNase protection of a region corresponding to bp 45-73 was seen with H9C2(2-1) myotube extracts but not with equivalent concentrations of L6 or C2C12 myotube extracts. The positions of MEF-1/E box (bp 52-65) and MEF-2/AT-rich (bp 63-72) motifs within the footprinted region are indicated. These results confirmed that sequences within the E-1 region specifically bind trans-acting factors expressed in H9C2(2-1) myotubes and further implicated these MEF-1/E box and MEF-2/AT-rich motifs in enhancer function. The absence of DNase protection through this region with L6 or C2C12 extracts indicated that formation of EMSA complexes resembling bands D and E in these cell lines involves cis-acting sequences positioned elsewhere within the enhancer core.
Figure To more specifically address the involvement of MEF-1/E box and MEF-2/AT-rich motifs in enhancer function, SA195 fragments containing site-specific mutations within each motif were prepared and tested in H9C2(2-1) myotubes. Sequence changes introduced into each motif were the same as those introduced into mutant E-1 oligonucleotides in EMSA competition studies and are based on mutations that abolish trans-acting factor binding the muscle creatine kinase gene upstream enhancer (48 -51 ). As shown in Figure 7 , mutation of the MEF-1/E box motif (E-mut) resulted in a 6-fold decrease in mean CAT activity, while mutation of the MEF-2/AT-rich motif (AT-mut) resulted in a 9-fold decrease in CAT activity relative to the wild-type SA195 fragment. CAT activities generated by a construct mutated for both motifs (E-mut + AT-mut) were reduced even further to levels that were 17-fold lower than the wild-type enhancer. These results provided direct evidence for the involvement of these regulatory motifs in enhancer function in H9C2(2-1) myotubes.
In a recent report we presented functional evidence for the existence of a muscle-specific transcriptional enhancer within intron 1 of the human dystrophin gene (12 ). This enhancer element was found to be active in both immature H9C2(2-1) myotubes in vitro and mature mouse skeletal muscle in vivo and to increase transcription from the core muscle promoter of the human dystrophin gene as well as from heterologous viral promoters. The description of X-linked dilated cardiomyopathy (XLCD) arising from a deletion that extends through the muscle promoter and into muscle intron 1 raised the possibility that this enhancer plays a role in regulating dystrophin gene transcription in cardiac muscle (17 ). In this study we have delimited enhancer activity to within a 195 bp SpeI-AccI fragment and provide evidence that a 30 bp region within the core enhancer contains binding sites for trans-acting factors expressed in H9C2(2-1) myotubes but not in L6 or C2C12 myotubes. This 30 bp region contains single adjoining MEF-1/E box and MEF-2/AT-rich motifs and mutation of one or both of these motifs resulted in a significant loss of enhancer activity in H9C2(2-1) myotubes. These results provide the first evidence for a role for the MyoD family of transcription factors (MyoD1, myf5, myogenin and MRF4; 52 ) in the regulation of dystrophin gene expression.
Figure
The MEF-2/AT-rich motif within the E-1 region is the second functional MEF-2 binding site identified within the dystrophin gene. The first is located within the core muscle promoter (28 ) in a region that also contains several E box consensus motifs. Like the intron 1 enhancer, sequences within this region of the muscle promoter are also functional in pre-differentiated H9C2(2-1) myoblasts when positioned upstream of a heterologous promoter (53 ). One of the questions raised in this study is the mechanism by which only one of three consensus E box motifs within the SA195 fragment binds trans-acting factors in H9C2(2-1) myotubes. Studies of the MCK and MLC1/3 gene enhancers have demonstrated cooperativity in MEF-2 and MyoD binding at their respective sites (22 ,46 ,54 -57 ). Whether a similar mechanism is operating within the dystrophin gene and contributes to selective utilization of adjoining E box and MEF-2 motifs remains to be determined.
The profile of enhancer activity in H9C2(2-1), L6 and C2C12 myotubes also raises interesting questions regarding the nature of the trans-acting factors that bind to these E box and MEF-2 motifs. This profile is remarkably similar to that observed in studies of the muscle promoter (17 ). Electrophoretic mobility shift assays and DNase footprinting experiments indicated that H9C2(2-1) myotubes express one or more trans-acting factors that bind to sequences within the 30 bp E-1 region and, based on the absence of this binding activity in L6 and C2C12 myotubes, appear to be required for optimal enhancer activity. That no factor binding was observed through the E-1 region in DNase footprinting experiments involving L6 and C2C12 myotubes is also interesting in that both of these cell lines express trans-acting factors that bind to MyoD/E box and MEF-2 motifs within other muscle-specific genes (22 ,58 ). While it remains unclear how motifs within the E-1 region differ from similar motifs in other muscle-specific genes, it may be relevant that this MEF-1/E box motif displays relatively poor homology (60%) to the MyoD binding site consensus as compared, for example, with the MEF-1/E box motif within the E-3 region (80% homology). Furthermore, the H9C2(2 -1 ) cell line was originally derived from an embryonic rat heart culture and retains residual cardiac-specific transcriptional properties (31 -34 ). These observations raise the possibility that sequences within the E-1 region are target binding sites for cardiac-specific trans-acting factors, a function that would be consistent with a role for this enhancer in regulating dystrophin gene expression in cardiac muscle.
Finally, it should be noted that sequences within the E-1 region are not solely responsible for enhancer function. For example, a significant decrease in activity was observed upon deletion of 51 bp at the 3'-end of the SA195 fragment (construct 12, Fig. 3 ). In addition, EMSA competition with the E-1 oligonucleotide did not abolish complex B formation, suggesting that sequences involved in formation of this complex lie outside this region. Also, enhancer activity in L6 and C2C12 myotubes, while reduced relative to H9C2(2-1) myotubes, were significantly higher than in 3T3 fibroblasts. Studies aimed at determining the precise nature of trans-acting factors targeted to E-1 and other regions of the core enhancer in H9C2(2-1), L6 and C2C12 myotubes could provide important insights into the regulation of gene expression in cardiac and skeletal muscle.
In summary, the remarkably large size of the dystrophin gene presents special problems for both maintenance of transcript levels in muscle tissues and for identification of transcriptional control regions. The presence of a muscle-specific enhancer containing functional MEF-1/E box and MEF-2/AT-rich motifs suggests that the mechanisms regulating this gene are similar to those identified in other muscle-specific genes studied to date. On the other hand, the unusual profile of enhancer activity and of trans-acting factor binding to these regulatory motifs in different myogenic cell lines suggests a more specialized role for this enhancer that is consistent with its potential involvement in regulating dystrophin gene expression in cardiac muscle.
This work was supported by grants from the Medical Research Council of Canada, Muscular Dystrophy Association, the Muscular Dystrophy Association of Canada and the Canadian Networks of Centres of Excellence.
*To whom correspondence should be addressed. Tel: +1 416 946 2981; Fax: +1 416 946 2984; Email: hklamut@oci.utoronto.ca
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