Hypoxia is common to several inflammatory diseases, where multiple cell types release adenine-nucleotides (particularly adenosine triphosphate/adenosine diphosphate). Adenosine triphosphate/adenosine diphosphate is metabolized to adenosine through a 2-step enzymatic reaction initiated by CD39 (ectonucleoside-triphosphatediphosphohydrolase-1). Thus, extracellular adenosine becomes available to regulate multiple inflammatory endpoints. Here, we hypothesized that hypoxia transcriptionally up-regulates CD39 expression. Initial studies revealed hypoxia-dependent increases in CD39 mRNA and immunoreactivity on endothelia. Examination of the human CD39 gene promoter identified a region important in hypoxia inducibility. Multiple levels of analysis, including site-directed mutagenesis, chromatin immunoprecipitation, and inhibition by antisense, revealed a critical role for transcription-factor Sp1 in hypoxiainduction of CD39. Using a combination of cd39 ÏȘ/ÏȘ mice and Sp1 small interfering RNA in in vivo cardiac ischemia models revealed Sp1-mediated induction of cardiac CD39 during myocardial ischemia. In summary, these results identify a novel Sp1-dependent regulatory pathway for CD39 and indicate the likelihood that CD39 is central to protective responses to hypoxia/ischemia.
IntroductionCirculating or locally released nucleotides are rapidly metabolized by vascular cell surface ectoenzymes. 1,2 It is now accepted that the major pathway for extracellular hydrolysis of adenosine triphosphate (ATP) and adenosine diphosphate (ADP) is the ectonucleoside triphosphate diphosphohydrolase 1 (E-NTPDase1), 3 previously identified as ecto-ATPase, ecto-ATPDase, or CD39. 4,5 CD39 is expressed on the endothelium and inflammatory cells 6 and modulates vascular cell and platelet purinoreceptor activity by the sequential hydrolysis of extracellular ATP or ADP to adenosine monophosphate (AMP). 5,7 The thromboregulatory and antiinflammatory role of CD39 has been recently demonstrated by the generation of mutant mice with disruption of the CD39 gene, 8,9 and by a series of experiments where high levels of ATPDase expression are attained by administration of adenoviral vectors at injured tissue sites. [10][11][12] These and other studies indicate that ATP hydrolysis by CD39 provides a readily available extracellular source for adenine nucleotides during hypoxia/inflammation. 13,14 Surface-bound CD39 converts ATP/ADP to AMP, which in turn is enzymatically hydrolyzed by ecto-5Đ-nucleotidase (CD73) to adenosine (Ado). When generated extracellularly by this cascade, Ado can activate each of 4 7-transmembrane-spanning adenosine receptors or can be internalized through dipyridamole-sensitive carriers. 2 These pathways have been shown to regulate diverse physiologic and pathophysiologic outcomes. 1,[15][16][17] At present, only very little is known about the regulation of CD39 and whether regulated expression provides a physiologic role. [18][19][20] Several studies have suggested that CD39 contributes to the protective aspects of adenine nucleoti...