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We demonstrate that these modifications are physio-logically relevant because: a they occur ex vivo in human liver cell lines and in vivo in human plasma; b in the case of the propeptide,

Trang 1

kinase ex vivo and circulates as a phosphoprotein

in humans

Thilina Dewpura1,*, Angela Raymond1,*, Jose´e Hamelin2, Nabil G Seidah2, Majambu Mbikay1, Michel Chre´tien1and Janice Mayne1

1 Chronic Disease Program, Ottawa Health Research Institute, The Ottawa Hospital, Canada

2 Laboratory of Biochemical Neuroendocrinology, Clinical Research Institute of Montreal, Canada

Proprotein convertase subtilisn⁄ kexin 9 (PCSK9) is a

member of the mammalian PCSK family that, to date,

includes eight other members: PCSK1 (PC1⁄ 3), PCSK2

(PC2), PCSK3 (Furin), PCSK4 (PC4), PCSK5

(PC5⁄ 6), PCSK6 (Pace4), PCSK7 (PC7) and PCSK8

(SKI-1⁄ S1P) [1] Collectively, this family is responsible

for the proteolytic maturation of secretory precursors

to bioactive proteins and peptides including

neuro-peptides, pro-hormones, cytokines, growth factors,

receptors, cell-surface proteins and serum proteins [2,3] Fitting with its role in cholesterol metabolism, PCSK9 is highly expressed in the liver and intestine, two tissues important in cholesterol homeostasis [4] It

is also found in circulation [5–7] PCSK9, like its fam-ily members, is synthesized as a preproprotein contain-ing several defined motifs: a signal peptide domain for routing the PCSKs to the secretory pathway, a prodomain important for folding and acting as an

Keywords

cholesterol; hypercholesterolemia; kinase;

PCSK9; phosphoprotein

Correspondence

J Mayne, Chronic Disease Program,

Ottawa Health Research Institute, 725

Parkdale Avenue, Ottawa, Ontario K1Y 4E9,

Canada

Fax: +1 613 761 4355

Tel: +1 613 798 5555, ext 16084

E-mail: jmayne@ohri.ca

*These authors contributed equally to this

article

(Received 4 March 2008, revised 23 April

2008, accepted 6 May 2008)

doi:10.1111/j.1742-4658.2008.06495.x

Proprotein convertase subtilisin⁄ kexin 9 (PCSK9) is a secreted glycoprotein that regulates the degradation of the low-density lipoprotein receptor Sin-gle nucleotide polymorphisms in its gene associate with both hypercholes-terolemia and hypocholeshypercholes-terolemia, and studies have shown a significant reduction in the risk of coronary heart disease for ‘loss-of-function’ PCSK9 carriers Previously, we reported that proPCSK9 undergoes autocatalytic processing of its prodomain in the endoplasmic reticulum and that its inhibitory prosegment remains associated with it following secretion Herein, we used a combination of mass spectrometry and radiolabeling to report that PCSK9 is phosphorylated at two sites: Ser47 in its propeptide and Ser688 in its C-terminal domain Site-directed mutagenesis suggested that a Golgi casein kinase-like kinase is responsible for PCSK9 phosphory-lation, based on the consensus site, SXE⁄ S(p) PCSK9 phosphorylation was cell-type specific and occurs physiologically because human plasma PCSK9 is phosphorylated Interestingly, we show that the naturally occur-ring ‘loss-of-function’ variant PCSK9(R46L) exhibits significantly decreased propeptide phosphorylation in the Huh7 liver cell line by 34% (P < 0.0001) PCSK9(R46L) and the engineered, unphosphorylated vari-ant PCSK9(E49A) are cleaved following Ser47, suggesting that phosphory-lation protects the propeptide against proteolysis Phosphoryphosphory-lation may therefore play an important regulatory role in PCSK9 function These find-ings will be important for the future design of PCSK9 inhibitors

Abbreviations

GCK, Golgi casein kinase; LDLR, low density lipoprotein receptor; PCSK9, proprotein convertase subtilisin ⁄ kexin 9; SAP, shrimp alkaline phosphatase.

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endogenous inhibitor, a catalytic domain characteristic

of serine proteases and a C-terminal Cys- and His-rich

domain implicated in enzyme stability and protein–

protein interaction [3] We reported that PCSK9 is

autocatalytically processed in the endoplasmic

reticu-lum at the site FAQ152flSIP indicative of its consensus

cleavage motif, travels to the Golgi where its sugar

res-idues at the glycosylation site N533CS are matured

and its propeptide is sulfated at Tyr38, and is secreted

[4,5] PCSK9 is unique among the PCSK family

because it is secreted in association with its inhibitory

propeptide

Cell culture and animal models have established that

the low-density lipoprotein receptor (LDLR) is one of

the main downstream targets of PCSK9 [4,8–11]

Sup-porting this, several groups have reported that secreted

PCSK9 can interact with and enter the endocytic

recy-cling pathway with LDLR, affecting the equilibrium of

LDLR recycling versus LDLR lysosomal-dependent

degradation [6,12–15] The ‘gain-of-function’ D374Y

mutation in the catalytic domain of PCSK9 results in

the most severe form of autosomal-dominant

hyper-cholesterolemia [16,17] Studies have shown that this

variant binds the LDLR (within its epidermal growth

factor-A domain) at the cell surface 25 times more

effi-ciently than wild-type PCSK9, thereby shifting the

equilibrium toward LDLR lysosomal-dependent

degra-dation [12,15] However the effect of other

autosomal-dominant hypercholesterolemia-associated PCSK9

mutations, such as the PCSK9(S127R) on

PCSK9-LDLR dependent degradation is less obvious because

their binding equilibrium to the LDLR is only

moder-ately increased [15,18] Crystal structures have shown

that this Ser127 residue does not interact directly with

the LDLR [19]

Longitudinal population studies have shown

signifi-cant reduction in the risk of coronary heart disease in

‘loss-of-function’ PCSK9 carriers [20,21] Reduced

plasma PCSK9 concentrations for at least three

PCSK9 variants, R46L, Y142X and C679X, increase

the amount of LDLR that is recycled, effectively

reducing plasma LDL cholesterol [7,22] As is the case

with ‘gain-of-function’ PCSK9 variants, not all

‘loss-of-function’ variants can be attributed to a single

mechanism, in this case, reduced plasma PCSK9

However these studies, along with the identification of

two healthy PCSK9 ‘null’ individuals [7,23] have

gen-erated much interest toward understanding the exact

details of the mechanism(s) of PCSK9-dependent

LDLR degradation, its site(s) of action, whether the

effect is direct or indirect, and how different PCSK9

single nucleotide polymorphisms alter its function It

is believed that the design of PCSK9 inhibitors may

provide a promising therapy for treatment of hyper-cholesterolemia [7,11,24] Toward this goal we decided

to further analyze post-translational modifications of PCSK9 We had previously reported on molecular mass heterogeneity of the propeptide [4], showing that this was in part due to sulfation of Tyr38 [5] Here

we demonstrate that the heterogeneity is also due to phosphorylation of the propeptide at Ser47 as assessed by MS analysis of PCSK9 immunoprecipi-tates in the presence and absence of shrimp alkaline phosphatase (SAP) Radiolabeling and site-directed mutagenesis also demonstrated the existence of a sec-ond major site of phosphorylation in the Cys- and His-rich domain at Ser688, very near its C-terminus

We demonstrate that these modifications are physio-logically relevant because: (a) they occur ex vivo in human liver cell lines and in vivo in human plasma; (b) in the case of the propeptide, phosphorylation is decreased in the naturally occurring ‘loss-of-function’ R46L and A53V PCSK9 variants; and (c) decreasing the level of PCSK9-propeptide phosphorylation increases subsequent proteolysis following Ser47, the site of phosphorylation Site-directed mutagenesis of amino acids surrounding both the propeptide and C-terminal sites suggest that PCSK9 phosphorylation

is carried out by a Golgi casein kinase (GCK)-like kinase

Results The secreted propeptide of PCSK9 is phosphorylated in a cell-type specific manner

We examined the heterogeneity of the molecular mass

of the propeptide of endogenous PCSK9 in the media

of HepG2 cells by MS analyses of immunoprecipitates with immune (I) sera directed against PCSK9 or pre-immune (PI) sera (Fig 1A,B, respectively) Figure 1A illustrates the two molecular forms of secreted PCSK9-propeptide, the peak at 13 834.6 Da is due to sulfation

at Tyr38 (SO4 )Y38; calculated mass 13 835.5 Da with modification at pyroGlu31) [5], whereas the peak at

13 915.5 Da is due to SO4 )Y38 with an additional modification of  80 Da Figure 1B shows a nonspe-cific peak interacting with the PI serum at 14 417 Da

To examine whether PCSK9-propeptide heterogeneity was due to phosphorylation, immunoprecipitates were incubated in the presence (Fig 1C,D) of SAP Follow-ing SAP incubation, PCSK9-propeptide heterogeneity was lost and a single peak corresponding to its sulfated molecular form was resolved at 13 834.5 Da (Fig 1C), whereas the nonspecific peak was unaffected by this treatment (Fig 1D) Heterogeneity of the propeptide

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of PCSK9 in the absence of SAP indicated that not all

secreted propeptide is phosphorylated (Fig.1A) This

partial modification has been reported for a number of

other secreted phosphoproteins such as insulin growth

factor-binding proteins and osteopontin [25], and is

unlike the complete modification reported for

phos-phoproteins secreted from mammary and salivary

glands [25] Interestingly, MS analyses of the

PCSK9-propeptide immunoprecipitated from HepG2 total cell

lysates did not show intracellular phosphorylation of

the PCSK9-propeptide (data not shown) suggesting

that this phosphorylation occurs just prior to PCSK9

secretion, as we had previously documented for its

sulfation at Tyr38 [4,5]

Using the same technique, we next examined

propeptide phosphorylation from the media of several

cell lines transfected with the expression vector for a

C-terminal V5-tagged wild-type hPCSK9 [hPCSK9

(WT)-V5], including the human liver cell lines HepG2

and Huh7, the human embryonic kidney cell line

HEK293 and the Chinese hamster ovary cell line

CHOK1 (Fig 1E–H, respectively) These cell lines are

the most commonly used to study PCSK9 biosynthe-sis and PCSK9-dependent LDLR degradation [5,10,26] The ratio of secreted propeptide phosphory-lation, assessed by determining the ratio between unphosphorylated but sulfated propeptide and phos-phorylated propeptide signal (SO4)⁄ PO4 )) as the area under the peak, was similar between transduced hPCSK9(WT)-V5 expressed in HepG2 cells (Fig 1E;

46⁄ 54 ± 0.02, n=5) and that produced endogenously (Fig 1A; 55⁄ 45 ± 0.05, p=0.16, n=7) However, the ratio of unphosphorylated but sulfated propeptide to phosphorylated propeptide from the media of Huh7 cells transfected with hPCSK9(WT)-V5 was

30⁄ 70 ± 0.04 suggesting that significantly more of the PCSK9-propeptide is secreted as a phosphoprotein from this cell line (Fig 1F; p=0.003, n=5) By con-trast, the HEK293 cell line expressing hPCSK9 (WT)-V5 secreted only 23 ± 0.2% (n=3) of PCSK9-propeptide in its phosphorylated form and signifi-cantly less than both liver cell lines; P < 0.0001 for both (Fig 1G) No phosphorylation of PCSK9-pro-peptide was detected in the CHOK1 cell line (Fig 1H,

E

Endogenous PCSK9 + SAP

Preimmune Control Endogenous PCSK9

Preimmune + SAP

Control

0

2.5

5

7.5 14417.0 + H

B

12000 13000 14000 15000 16000

0

2.5

5

7.5

13834.6 + H 13915.5 + H

A

0

2.5

5

7.5

13834.5 + H

C

0

2.5

5

7.5

D

14407.0 + H

Mass/charge (m/z) Mass/charge (m/z)

Huh7 + PCSK9-V 5 HepG2 + PCSK9-V5

HEK293 + PCSK9-V5

CHOK1 + PCSK9-V5

13833.7 + H

SO 42–/PO 42– = 100/0

14073.3 + H

13831.6 + H

H

F 13913.7 + H

0

5

10

15

13831.5 + H

13911.6 + H

14152.0 + H

0

5

10

15

12000 13000 14000 15000 16000

14155.4 + H

0

5

10

15

13831.6 + H 13911.6 + H

G

ns

ns

SO 42–/PO 42– = 30/70 ± 0.04

14075.5 + H

0

5

10

15

SO 42–/PO 42– = 77/23 ± 0.002

SO 42–/PO 42– = 55/45 ± 0.05 SO 42–/PO 42– = 46/54 ± 0.02

Fig 1 MS analysis of the PCSK9-propep-tide molecular mass heterogeneity (A–D) TOF-MS analyses of the molecular forms of endogenously expressed PCSK9-propeptide immunoprecipitated from the media of HepG2 cells with either immune (anti-hPCSK9 IgG; A, C) or preimmune sera (B, D), and following dephosphorylation (C, D) (E–H) TOF-MS analyses of the molecular forms of the propeptide of V5-tagged PCSK9 immunoprecipitates from the media

of transfected and overexpressing HepG2 (E), Huh7 (F), HEK293 (G) and CHOK1 (H) cells The ratio of the sulfated (SO4)) to sulfated and phosphorylated (PO 4 )),

calculated as the area under the peak as described in Experimental procedures, is shown ± SE Analyses were conducted on

at least three independent experiments.

ns, nonspecific peak.

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n=3) These results demonstrate the cell-type

specific-ity of phosphorylation of the PCSK9-propeptide, with

the ratio of unphosphorylated to phosphorylated

differing significantly among the cell lines examined

This may be due, in part, to cell-specific kinase

and⁄ or phosphatase activities and ⁄ or differing levels

therein Although sulfated and phosphorylated

peptides < 8000 Da differ in their detection efficiency

by MS this difference is lost when comparing like

molecules that are > 8000 Da [27,28] Therefore, our

measure of the area under the peak for

unphosphory-lated but sulfated PCSK9-propeptide (13 835.5 Da) to

phosphorylated and sulfated PCSK9-propeptide

(13 915.5 Da) is a valid comparison In addition, a

minor but specific band is present in these

spec-tra at  14 150 Da (Fig 1E,F) and  14 070 Da

(Fig 1G,H) that represents alternative signal

pepti-dase cleavage site following Ala28 (calculated mass

14 159.8 Da for SO4 )PO4 ) propeptide and

14 079.8 Da for SO4 ) propeptide) instead of Ala30

(Fig 1E–H) Indeed, signalp 3.0 server (a signal

peptide prediction program) predicted the primary

sig-nal peptide site as ARA30flQE and a secondary sigsig-nal

peptide site as A28flRAQE

Ser47 is the site of phosphorylation in the propeptide of PCSK9

To define the site of phosphorylation in the PCSK9-propeptide we immunoprecipitated hPCSK9(WT)-V5 from transfected HepG2 cells, treated half with SAP and then digested with trypsin (Fig 2) MS analyses of the tryptic peptides incubated in the absence or pres-ence of SAP revealed a peptide that shifted by 79.5 Da, corresponding to pyroGlu31–Arg66 within the propeptide (Fig 2A: observed 4172.9 Da versus calculated 4174.2 Da; and Fig 2B: observed 4093.4 Da versus calculated 4094.2 Da, respectively) Ser47 within this peptide (Fig 2C) exhibits a minimal consensus site (S47EED) for two kinases demonstrated to act on secretory proteins; GCK [consensus site SXE⁄ S(P)] [29] and casein kinase II (consensus site S⁄ TXXE ⁄ D) [30] Phosphorylation of Ser47 was confirmed by site-direc-ted mutagenesis (Fig 2); when this residue was mutated to Ala and the construct [hPCSK9(S47A)-V5] transduced into Huh7 cells, the propeptide was no longer phosphorylated, showing a single peak of

13 817.3 Da, corresponding to SO4) propeptide (calculated size 13 819.5 Da; Fig 2D)

CAKDPWRLPGTYVVVLKEETHLSQSERTARRLQAQAARRGYLTKILHV FHGLLPGFLVKMSGDLLEALKLPHVDYIEEDSSVFAQ152

C

Mass/charge (m/z)

PCSK9-V5 + trypsin

PCSK9-V5 + trypsin + SAP

B

A

0

10

20

4000 4050 4100 4150 4200 4250

4093.4 + H

4172.9 + H

0

10

20 4093.4 + H

Mass/charge (m/z)

PCSK9(S47A)-V5

Δ –16 Da

12000 13000 14000 15000 16000

0

5

10

15

13817.3 + H

14045.9 + H

ns

D

4 1 7

Fig 2 MS analysis of PCSK9-propeptide tryptic digests and phosphorylation site PCSK9-propeptide variant (A, B) TOF-MS analyses of the tryptic peptides from the immunoprecipitates of the propeptide of V5-tagged PCSK9 from the media of transfected and overexpressing Huh7 cells in the absence (A) and presence (B) of SAP (C) Amino acid sequence of the propeptide of PCSK9 pyroQ31, SO4)Y38 and

PO 4 )S47 are in bold The phosphorylated tryptic peptide is highlighted by gray boxes in (A) and (B) and the corresponding amino acid

sequence highlighted by a gray font in (C) (D) MS analyses of the molecular form of the propeptide variant (S47A) of V5-tagged PCSK9 immunoprecipitates from the media of transfected and overexpressing Huh7 cells Analyses were conducted on at least three independent experiments ns, nonspecific peak.

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Phosphorylation of Ser47 in the propeptide of

PCSK9 is decreased by the naturally occurring

R46L and A53V PCSK9 variants

We next examined the effect of several hPCSK9-V5

variations on the phosphorylation of secreted

propep-tide, namely the Y38F variation preventing sulfation

of the prodomain, the common naturally occurring

A53V variation that has no significant effect on

plasma cholesterol levels and the R46L variation, a

naturally occurring variant associated with

hypocholes-terolemia [31] and reduced plasma PCSK9 [22] As

shown in Fig 3A, mutating the site of propeptide

sulf-ation [hPCSK9(Y38F)-V5] did not significantly affect

PCSK9-propeptide phosphorylation in comparison

with hPCSK9(WT)-V5 (Fig 3D, p=0.67), as assessed

by comparing the area under the peak for the

unphos-phorylated versus phosunphos-phorylated signals By contrast,

levels of propeptide phosphorylation for both the

R46L and the A53V PCSK9 variants were reduced by

34% (p=0.0001) and 17% (p=0.04) respectively, in

comparison with hPCSK9(WT)-V5 (Fig 3B–D) In

addition, the level of phosphorylation of the R46L var-iant (46 ± 2%, n=6) was significantly less than the A53V PCSK9 variant (58 ± 4%, n=5, p=0.01) (Fig 3D) Therefore, replacement of the n)1 basic residue Arg by Leu, decreases the rate of phosphoryla-tion at Ser47, indicating the importance of this residue

in the consensus site or conformation recognition by its cognate kinase Also, the reduced phosphorylation

of the A53V variant in comparison with wild-type indi-cates that residues downstream of Ser47 may also impact its post-translational modification In a previ-ous study, we observed that individuals heterozygprevi-ous for the PCSK9(R46L) variant have reduced circulating PCSK9 compared with individuals carrying the normal PCSK9alleles [22]

Site-directed mutagenesis shows consensus sequence site of GCK [SXE⁄ S(p)] for propeptide phosphorylation

To determine the consensus site of phosphorylation within the propeptide of PCSK9, immunoprecipitates

R46L

UM – Y38F

0 10 20 30 40 50 60 70 80

PO 4 2–

SO 4 2–

SO 4 2–

PO 4 2–

SO 4 2–

PO 4 2–

PO 4 2–

WT

Percent molecular form A53V

D

PCSK9(R46L)-V5

Mass/charge (m/z)

SO42– /PO42– =54/46 ± 0.02

14044.6 + H

5

10

15

13800.3 + H 13879.6 + H

14120.2 + H

ns

B

0

12000 13000 14000 15000

SO 4 2– /P O 4 2– = 42/58 ± 0.04

0

5

10

15

13865.0 + H

13948.2 + H 14194.4 + H

ns

C PCSK9(A53V)-V5

13823.8+H

0

5

10

15

13745.4+H 14065.0+H

A PCSK9(Y38F)-V5

Δ +16 Da

Δ –43 Da

UM/PO42– =

32/68 ±0.003

+28 Da

Fig 3 MS analysis of immunoprecipitated PCSK9-propeptide from the media of trans-fected Huh7 cells overexpressing V5-tagged PCSK9 variants (A–C) TOF-MS analyses of the propeptide of V5-tagged PCSK9 variants

as labeled from the media of transfected and overexpressing Huh7 cells For each variant the change in molecular mass due to the specific amino acid change is show as DDa (D) A graphic representation of the data incorporating results from analyses of the propeptide of V5-tagged wild-type PCSK9 The ratio of unmodified (UM; white bar) or sulfated (SO 4 ); gray bars) to

sul-fated and phosphorylated (PO4); black bars), calculated as area under the peak as described in Experimental procedures, is shown ± SE t-Tests were carried out to compare significant changes in phosphoryla-tion of the propeptide of PCSK9 between variants Analyses were conducted on at least three independent experiments ns, nonspecific; *P < 0.05; **P < 0.005;

***P < 0.0005.

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of V5-tagged recombinant PCSK9 from transfected

Huh7 cells were analyzed by MS (Fig 4) Below each

spectra is the observed and calculated (in parentheses)

molecular masses for each mutant in its SO4 ) and

SO4 )+ PO4 )forms, as well as the major molecular

form observed Mutations E48A and E48D did not

affect phosphorylation (Fig 4C,D), nor did D50A

and D50E (Fig 4G,H) However mutations E49A and

E49D prevented phosphorylation of the propeptide

(Fig 4E,F) The requirement of a Glu at n+2

(Fig 4C) and the inability of Asp (Fig 4D) to mimic

its effect, is a strict requirement for phosphorylation

by GCK, SXE⁄ S(p) [29], and not casein kinase II

whose consensus site requires n+3 E or D

(SXXE⁄ D)

Interestingly, a cleaved PCSK9-propeptide product

was detected in the media of Huh7 cells transfected

with the E49A PCSK9 variant at 11738.2 Da (Fig 4E,

inset), due to cleavage following Ser47 and

corre-sponded to 13% of the area under the peak for total

propeptide (observed DDa Q31-Ser47 2026.1 Da

versus calculated 2044.1 Da), but not with the E49D

variant (Fig 4F, inset) This product was also

observed in immunoprecipitates from the media of

cells expressing the R46L variant and corresponded to

5% of the area under the peak for total propeptide

(Fig 4B, inset) (observed DDa Q31-Ser47 2000.1 Da

versus calculated 2001.0 Da) Phosphorylation is

known to alter the stability of proteins and their

resis-tance to proteolysis [32,33] Our results suggest that

Ser47 phosphorylation stabilizes the propeptide of

PCSK9 by preventing its proteolysis Also, cleavage of

the propeptide of the R46L and E49A PCSK9

vari-ants, but not E49D PCSK9 variant, suggests that

charge distribution around this site is also important

for its stability

PCSK9 is phosphorylated in its C-terminal

domain

To further examine PCSK9 phosphorylation, we grew

untransfected and transfected

hPCSK9(WT)-V5-expressing HepG2 cells in media containing32

P-ortho-phosphate, immunoprecipitated PCSK9 from cells and

media, and analyzed samples by SDS⁄ PAGE

fraction-ation followed by phosphorimaging (Fig 5) Lanes 1

and 2 and 3 and 4 represent immunoprecipitated

PCSK9 from media and total cell lysates of HepG2,

respectively PCSK9 and its co-immunoprecipitating

propeptide were secreted as phosphoproteins, whereas

no phospho-PCSK9 or -prodomain were detected

intracellularly Radiolabeling and analyses were also

conducted for untransfected and transfected Huh7 cells

hPCSK9(WT) (lanes 6 and 7, respectively) Again the phosphorylated form of PCSK9 and its propeptide were only detected extracellularly (data not shown) These results, and the MS analyses presented previ-ously, suggest that phosphorylation occurs just prior

to PCSK9 secretion from the cell, or after secretion by

an ectokinase [34] Quantification of the ratio of

PO4 )-propeptide to PO4 )-PCSK9 is shown below each lane The ratio of PCSK9-propeptide to mature PCSK9 phosphorylation for endogenous protein secreted into the media from Huh7 cells was 1.9 ± 0.1 (n=3) and 1.0 ± 0.1 for HepG2 cells (n=3; p=0.006), reflecting the significantly higher level of phosphorylation of PCSK9-propeptide in Huh7 versus HepG2 shown earlier (Fig 1) This difference was not due to changes in the amount of total PCSK9 relative

to its propeptide as assessed by 35S-Met⁄ Cys labeling

of PCSK9 (data not shown) The minor, but specific band just above the major propeptide band represents the propeptide generated by the alternate signal pepti-dase cleavage following Ala28 instead of Ala30, as shown in the mass spectra previously (Figs 1E–H and 4A–H)

We also noted that the ratio of PO4 ) -propep-tide⁄ PO4 )-PCSK9 differed between endogenous PCSK9 (Fig 5, lane 2; 1.0 ± 0.1) and hPCSK9(WT)-V5 (Fig 5, lane 1; 3.2 ± 0.1) secreted from HepG2 cells The attenuated phosphorylation of V5-tagged versus endogenous PCSK9 could be a consequence of: (a) saturation of the responsible kinase upon over-expression, or (b) the C-terminal V5-tag affecting the conformation of PCSK9 preventing kinase access-ibility To test the first possibility we carried out sequential immunoprecipitations of V5-tagged PCSK9 followed by endogenous PCSK9 from transfected HepG2 cells (Fig 5) Phosphorylation of endogenous secreted PCSK9 was identical in transfected (0.92 ± 0.1, n=3; Fig 5, lane 5) and untransfected HepG2 cells (1.0 ± 0.1, n=3, p=0.39; Fig 5, lane 2)

so the responsible kinase was not saturated To examine the second possibility, transfection of untag-ged hPCSK9(WT) into Huh7 cells did not affect C-terminal phosphorylation (1.7 ± 0.1, n=4; Fig 5, lane 7) when compared with endogenous PCSK9 from the same cell line (1.9 ± 0.1, n=3, p=0.2; Fig 5, lane 6) The same result was noted when this experiment was duplicated in the HepG2 cell line (data not shown)

In addition, there is a commercially available anti-body whose epitope (C679RSRHLAQASQELQ692) was directed toward the C-terminus of PCSK9 and contained a potential consensus site of phosphoryla-tion [SXE⁄ S(P), in this case S688QE] [29] This

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antibody reacted with immunoprecipitates of

trans-fected V5-labeled PCSK9 (Fig 6A, lane 1) but was

unable to detect endogenous PCSK9

immunoprecipi-tates (Fig 6A, lane 2) However, dephosphorylation

of immunoprecipitated endogenous PCSK9 with SAP,

restored antibody recognition (Fig 6A, lanes 3 and

4) Of significance, this modification also occurs at

Ser688 in vivo, as assessed by immunoblotting (using

the same C-terminal PCSK9 antibody as above) of

PCSK9 immunoprecipitates from human plasma in

the absence and presence of SAP (Fig 6B, lanes 1

and 2, respectively) MS analyses of

immunoprecipi-tates using preimmune sera (Fig 6C) and immune

sera against PCSK9 (Fig 6D) and human plasma show that its propeptide also circulates as a phospho-protein (Fig 6D; observed mass 13 919 Da versus calculated 13 915.5 Da) Figure 6C shows nonspecific peaks that are immunoprecipitated with preimmune sera

Phosphorylation of C-terminal PCSK9 was also dependent on GCK-like activity

To confirm and determine the consensus site of phos-phorylation within the C-terminal of PCSK9, we cultured Huh7 cells, untransfected and transfected

phosphorylate d

sulfated

phosphorylate d

sulfated Form

13919.0 Da (13929.5 Da)

No PO 4 2– (13901 Da) 13898.8 Da (13901.5 Da)

13864.0 Da (13872.5 Da)

PO 4 2–

13853.3 Da (13849.5 Da) 13822.3 Da (13821.5 Da)

13822.2 Da (13821.5 Da) 13782.9 Da (13792.5 Da)

SO 4 2–

Mass/charge (m/z)

0

25

50

75

0

5

10 11782.8+H

11000 12500

0

5

10

11000 12500

0

5

10

11000 12500

11000 12500

0

5

10

D50E

R46L

B

SO 4 2–

PO 4 2–

SO 4 2–

PO 4 2–

PO 4 2–

ACS ACS

ACS ACS

SO 4 2–

SO 4 2–

phosphorylate d

sulfated

phosphorylate d phosphorylate d

Form

13875.0 Da (13871.5 Da)

No PO 4 2– (13857.5 Da) 13863.9 Da (13857.5 Da)

13906.4 Da (13915.5 Da)

PO 4 2–

13798.4 Da (13791.5 Da) 13775.1 Da (13777.5 Da)

13782.9 Da (13777.5 Da) 13827.9 Da (13835.5 Da)

SO 4 2–

0

25

50

75

SO42–

ACS

ACS

0

5

10

11000 12500

0

5

10

11000 12500

0

5

10 11738.2+H

11000 12500

0

5

10

11000 12500

PO 4 2–

SO42–

PO 4 2–

PO 4 2–

SO 4 2–

SO 4 2–

Mass/charge (m/z)

H

Fig 4 MS analysis of the consensus site of PCSK9-propeptide phosphorylation from the media of transfected Huh7 cells overexpressing V5-tagged PCSK9 variants (A–H) TOF-MS analyses of the propeptide of V5-tagged PCSK9 variants as labeled from the media of transfected and overexpressing Huh7 cells For each variant the observed versus calculated (in brackets) molecular mass is shown below each panel for the sulfated (SO4)) and sulfated and phosphorylated (PO4)) propeptide, as well as the major molecular form observed Insets highlight the presence or absence of proteolysis fragments of the parent propeptide Analyses were conducted on at least three independent experi-ments ns, nonspecific ACS, alternate signal peptidase cleavage site.

Trang 8

with expression vectors for untagged hPCSK9

mutants in media containing 32P-orthophosphate We

immunoprecipitated PCSK9 from these media, and

analyzed itby SDS⁄ PAGE fractionation followed by

phosphorimaging To assess total protein expression

35S-Met⁄ Cys labeling was carried out (Fig 7) There

was  3.5 · more expression of both the S688A

(3.5· for PCSK9 and 3.2 · for its propeptide,

respec-tively; lanes 1A and 1B) and E690A PCSK9 mutants (3.4· for PCSK9 and 3.5 · for its propeptide, respec-tively; lanes 3A and 3B) when compared with endoge-nous levels of PCSK9 or its propeptide (both set as 1; lanes 2A and 2B) The mutation of either S688A (lanes 5B and 7B) or E690A (lanes 6B and 8B) in the C-terminal region of PCSK9 did not affect propeptide phosphorylation which was also  3 · more than

3.2 ± 0.1 1.0 ± 0.1 0.92 ± 0.1 1.9 ± 0.1 1.7 ± 0.1

5

IP: V5 Ab IP: hPCSK9 Ab

4

3

2

1

PCSK9 proPCSK9

HepG2

UT WT

Huh7

UT PIP-WT

WT-V5 UT WT-V5

propeptide / PCSK9

prodomain ACS

Fig 5 The prodomain and mature PCSK9 are secreted as phosphoproteins in vitro HepG2 and Huh7 cells untransfected (lanes 2, 4 and 6) and transfected with the expression vector for either untagged (lane 7) or V5-tagged hPCSK9 (lanes 1, 3 and 5) were radiolabeled with

32 P-orthophosphate as per Experimental procedures Total cell lysates and media were immunoprecipitated with anti-hPCSK9 IgG or anti-V5 IgG ?accolade "acc1a"> and fractionated by SDS ⁄ PAGE for phosphorimaging as per Experimental procedures Lane 5 represents the post-immunoprecipitation of endogenously labeled protein following a primary immunoprecipitation for overexpressed V5-tagged protein The positions of PCSK9, propeptide and alternate propeptide signal peptidase cleavage product (ACS) are noted Quantitation of the ratio of phos-phorylation for propeptide to PCSK9 is shown below each lane Analyses were conducted on at least three independent experiments.

PCSK9-V5

IB: Anti- hPCSK9 C-terminal IgG

B

PCSK9

IB: Anti- hPCSK9 C-terminal IgG

Human plasma HepG2 media

A

PCSK9 IgG

4 3 2 1

WT–V5 UT UT UT

PCSK9 propeptide from human plasma

Mass/charge (m/z)

12000 13000 14000 15000 16000 0

1 2

3 ns:13754.4 + H

13919.3 + H

Immune sera

C

12000 13000 14000 15000 16000 0

1 2 3

ns: 13604.7 + H ns:13754.9 + H

Preimmune sera

ns:13894.6 + H ns:13973.2 + H

2 1

Fig 6 The prodomain and mature PCSK9

are secreted as phosphoproteins in vivo (A)

Immunoprecipitation of overexpressed

V5-labeled PCSK9 (lane 1) or endogenous

PCSK9 (lanes 2–4) from the media of

HepG2 cells followed by dephosphorylation

of immunoprecipitates (lanes 3 and 4) and

immunoblotting analyses with the

anti-hPCSK9 C-terminal IgG (Imgenex) (B)

Immunoprecipitation of PCSK9 from human

plasma with the anti-hPCSK9 IgG followed

by incubation in the absence (lane 1) or

presence (lane 2) of SAP and

immunoblot-ting analyses with the anti-(C-terminal

hPCSK9) IgG (Imgenex) IgG,

immuno-globulin band (C, D) TOF-MS of the

molecular forms of PCSK9-propeptide

immunoprecipitated from human plasma

with either preimmune sera (C) or immune

(anti-hPCSK9 IgG; D) ns, nonspecific peaks.

Trang 9

endogenous PCSK9 (lane 4B) However, mutation of

either S688A (lanes 5A and 7A) or E690A (lanes 6A

and 8A) prevented phosphorylation at the C-terminus

of PCSK9 because only background levels of

phos-phorylation due to endogenous PCSK9 were measured

(lane 4A) This can also be seen by comparing the

ratio of propeptide⁄ PCSK9 phosphorylation for

wild-type untagged PCSK9 (1.9; Fig 5, lane 6) with both

of these untagged mutants (Fig 7, lanes 5–8) The

requirement for an E at n+2 suggests that, like for

propeptide phosphorylation, this phosphorylation is

carried out by a GCK-like kinase [consensus site

SXE⁄ S(p)]

Discussion

PCSK9 undergoes several post-translational

modifica-tions; while in the ER it is glycosylated at a single

N-linked site at amino acid 533 that is further matured

in the Golgi increasing the molecular mass of secreted

versus intracellular PCSK9 by 2200 Da [4] We have

also reported on sulfation of Tyr38 within the

propep-tide of PCSK9 Sulfation occurred just prior to

secre-tion from the trans-Golgi network because it was

barely detected intracellularly [4,5] In this study, we

report that secreted PCSK9 is phosphorylated at Ser47

in its propeptide and at Ser688 in its Cys- and His-rich

domain Phosphorylation of the propeptide was

cell-type specific with 70 ± 4% phosphorylation in Huh7

cells, followed by 54 ± 2% in HepG2 cells,

23 ± 0.2% in HEK293 cells and none in CHOK1 cells (Fig 1) It also occurred very late in the secretory pathway or at the cell surface because no phosphory-lated PCSK9 was detected intracellularly by either MS analyses of immunoprecipitates or radiolabeling fol-lowed by immunoprecipitation and autoradiography, two very sensitive techniques

Serine phosphorylation occurred within the site RS47EED and was 100% dependant on Glu at the n+2 position (Fig 1) This site is completely con-served among primates except for the tamarin monkey where an amino acid change occurs at n+3 (D50E), which should not affect propeptide phosphorylation based on our site-directed mutagenesis results (Fig 4) There are two possible sites of prodomain phosphory-lation in the mouse and rat The first site is conserved between human (RSEED), mouse and rat PCSK9 (both PSQED; supplementary Fig S1A) Although, the n)1 and n+1 residues differ, they still conform to

a consensus phosphorylation site for GCK (SXE) The second site is only conserved between mouse and rat (CSKEA), not human (CAKEP; supplementary Fig S1A) The prodomain of mouse PCSK9 is phos-phorylated (supplementary Fig S1B,C) at PS50QED (supplementary Fig S1D) and not at CSKEA (supple-mentary Fig S1E)

Phosphorylation is an important post-translational modification shown to affect several parameters inclu-ding: (a) stability and turnover by interfering with or promoting proteolysis [32,33], (b) activating or inacti-vating enzymes [35], (c) subcellular localization and transport [36,37], and (d) protein–protein interactions and⁄ or protein conformation [33,38,39] What is the function of propeptide phosphorylation in PCSK9? Biophysical studies of the structure of PCSK9 have shown that its propeptide region is solvent exposed, and crystal structure studies of PCSK9 have failed in this region due to lack of electron density [15,19,40,41] and therefore descriptions of the prodomain of PCSK9 begin downstream of the site of phosphorylation (Ser47) at Thr61 [15,19] Neither study predicts direct interaction of the PCSK9-propeptide with the LDLR epidermal growth factor-A domain; however, it is interesting to note that several documented ‘loss-of-function’ PCSK9 variants such as the R46L [31,42,43] occur within this domain, suggesting a regulatory func-tion for this region We provide evidence here that phosphorylation at Ser47, as well as charge distri-bution within this propeptide region, stabilizes it against proteolysis following this site of post-transla-tional modification (Fig 4) Recently, Kwon et al [19] reported that recombinant propeptide D53-PCSK9 exhibited greater than sevenfold affinity for the

4 3 2

35 S - Met/Cys labeled 32 P - orthophosphate labeled

Media from Huh7 cells

C E690A

C E690A

1 3.5 1

1 3.4 1 3.5

S688A

S688A

PCSK9

propeptide

ACS

Relative

propeptide

Relative PCSK9

E690A A

B

Fig 7 Site-directed mutagenesis of the C-terminal phosphorylation

region of PCSK9 Huh7 cells untransfected (lanes 2 and 4;

endoge-nous-C) and transfected with cDNAs encoding untagged PCSK9

C-terminal variants (lane 1 and 3 and 5–8 as labeled) were

radiola-beled with either 35S-Met ⁄ Cys (lanes 1–3) or 32

P-orthophosphate (lanes 4–8) as per Experimental procedures Media was

immuno-precipitated with anti-hPCSK9 IgG, fractionated by SDS ⁄ PAGE for

phosphorimaging as per Experimental procedures The positions of

PCSK9, propeptide and alternate propeptide signal peptidase

cleav-age product (ACS) are noted Quantitation of the ratio of total

pro-tein immunoprecipitated (setting untranfected endogenous-C as 1)

is shown below each lane.

Trang 10

extracellular, epidermal growth factor-A domain of

LDLR in comparison with wild-type PCSK9,

support-ing our results that the N-terminal region of the

pro-peptide of PCSK9 may modulate or stabilize its

interaction with LDLR, either directly or indirectly

We also report that PCSK9 is phosphorylated in its

Cys- and His-rich domain, five amino acids from its

C-terminus at Ser688, within the sequence

QAS688-QELQ (Figs 5 and 6) Like the N-terminal propeptide

region of PCSK9, its C-terminal region (from amino

acids 683–692) has not been characterized by existing

crystal structure studies [15], and although this site is

not conserved in the mouse or rat (KASWVQ and

KASWVHQ, respectively), it is 100% conserved

among 12 of the 14 primate species [44] Because the

C-terminus of PCSK9 is solvent-exposed, it may be

involved in interactions with other PCSK9 domains

(e.g the propeptide) or other peptides⁄ proteins

Phos-phorylation status may be an important mode of

regulating such interactions

We also demonstrated that the addition of the

C-ter-minal V5-tag greatly diminished phosphorylation at

Ser688 (Fig 5) Many binding, co-localization and

crystal structure studies for PCSK9 and LDLR have

been carried out using tagged and therefore

hypo-phosphorylated PCSK9 and⁄ or employing cell lines in

which propeptide phosphorylation is diminished or

absent (that is, the HEK293 and CHO cell lines,

respectively, Fig 1)

PCSK9 is co-regulated at the transcriptional level

with LDLR and many studies have asked the

physio-logical relevance of a co-directional regulation of two

proteins with opposing functions Recent studies have

shown that PCSK9 catalytic activity is not required

for LDLR degradation and suggest that it instead

binds to LDLR directly, re-routing it to the lysosome

[45,46] Most studies have focused on the physiological

consequences of the ‘gain-of-function’ D374Y PCSK9

mutation that causes severe hypercholesterolemia This

variant binds 6-25· more strongly to the LDLR than

wild-type PCSK9 at pH 7.5 and 8-25· more strongly

at pH 5.3 found in the late endosomes [15,47] Few

studies have addressed how wild-type PCSK9 might

alter its affinity toward the LDLR under normal

physi-ology Could phosphorylation of PCSK9 and⁄ or its

propeptide affect PCSK9⁄ LDLR binding and provide

an acute mechanism(s) to regulate its ‘activity’ in

circu-lation and⁄ or upon appropriate stimulation?

Not all tissues or cell-types respond equally to

PCSK9 [48] We have shown that PCSK9

phosphory-lation is cell-type specific (Fig 1), so tissue-specific

kinases and⁄ or phosphatases may provide an

addi-tional trophic level of regulation

We previously reported that heterozygous carriers of the PCSK9 R46L variant have less circulating PCSK9 than those carrying normal alleles for PCSK9 [22] In this report we show that the propeptide region of this variant is subject to proteolysis in the Huh7 cell line Does this occur in vivo and does it effectively shorten the half-life of PCSK9 resulting in the ‘loss-of-function’ phenotype documented for carriers of these variants, or

as hypothesized above, could the reduction in propep-tide phosphorylation decrease its affinity for the LDLR?

If phosphorylation regulates PCSK9 activity, under-standing the physiological stimuli that affect it, as well

as mapping any additional sites of phosphorylation will be important in further understanding of its cell biology, and will improve PCSK9 drug-design strate-gies, having important implications in the future treat-ment of hypercholesterolemic individuals To begin to address the importance of PCSK9 and its propeptide phosphorylation we examine the effects of these phosp-homutants (in both hypo- and hyperphosphorylated states) on PCSK9-dependent LDLR degradation

Experimental procedures Constructs and antibodies The cDNA of human PCSK9 was cloned into the pIRES2-enhanced green fluorescent protein with or without a C-ter-minal V5 tag as described previously [2] Mutations were introduced by site-directed mutagenesis as described [49] Anti-hPCSK9 IgG, used for the immunoprecipitation of endogenous or untagged recombinant PCSK9 was raised in rabbits by cDNA vaccination with the mammalian expres-sion vector pcDNA3 into which the cDNA for human PCSK9had been inserted [50] Animal protocol for antibody production was approved by the institutional Animal Care Committee The mouse anti-V5 IgG used for immunopre-cipitation of V5-tagged recombinant PCSK9 was from Invi-trogen (Burlington, Canada) and the goat anti-(C-terminal PCSK9) IgG used for immunoblotting from Imgenex (San Diego, CA, USA) Secondary anti-mouse and anti- (rabbit HRP) IgG were from Amersham (Piscataway, NJ, USA) and the secondary anti-(goat HRP) IgG was from Santa Cruz Biotechnology (Santa Cruz, CA, USA)

Cell culture, transfection and sample collection HepG2, Huh7, HEK293 and CHOK1 cells were grown at

37C in Dulbecco’s modified Eagle’s medium + 10% FBS + gentamycin (28 lgÆmL)1) Cells (3· 105

) were trans-fected with a plasmid expression vector for human PCSK9 (hPCSK9; 1.5 lg) as described using Lipofectamine 2000 (Invitrogen) in a 1 : 1 ratio to cDNA [2] Spent media from untransfected and transfected cells were collected in the

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