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Purpose:
The biologic relevance of human connective tissue growth factor (hCTGF) for primary human tenon fibroblasts (HTFs) was investigated by RNA expression profiling using affymetrix (TM) oligonucleotide array technology to identify genes that are regulated by hCTGF.
Methods:
Recombinant hCTGF was expressed in HEK293T cells and purified by affinity and gel chromatography. Specificity and biologic activity of hCTGF was confirmed by biosensor interaction analysis and proliferation assays. For RNA expression profiling HTFs were stimulated with hCTGF for 48h and analyzed using affymetrix (TM) oligonucleotide array technology. Results were validated by real time RT-PCR.
Results:
hCTGF induces various groups of genes responsible for a wound healing and inflammatory response in HTFs. A new subset of CTGF inducible inflammatory genes was discovered (e.g., chemokine [C-X-C motif] ligand 1 [CXCL1], chemokine [C-X-C motif] ligand 6 [CXCL6], interleukin 6 [IL6], and interleukin 8 [IL8]). We also identified genes that can transmit the known biologic functions initiated by CTGF such as proliferation and extracellular matrix remodelling. Of special interest is a group of genes, e.g., osteoglycin (OGN) and osteomodulin (OMD), which are known to play a key role in osteoblast biology.
Conclusions:
This study specifies the important role of hCTGF for primary tenon fibroblast function. The RNA expression profile yields new insights into the relevance of hCTGF in influencing biologic processes like wound healing, inflammation, proliferation, and extracellular matrix remodelling in vitro via transcriptional regulation of specific genes. The results suggest that CTGF potentially acts as a modulating factor in inflammatory and wound healing response in fibroblasts of the human eye.
Neoplasms of the skin represent the most frequent tumors worldwide; fortunately, most of them are benign or semi-malignant and well treatable. However, the two most aggressive and deadly forms of malignant skin-neoplasms are melanoma and Merkel cell carcinoma (MCC), being responsible for more than 90% of skin-cancer related deaths. The last decade has yielded enormous progress in melanoma therapy with the advent of targeted therapies, like BRAF or MEK inhibitors, and immune-stimulating therapies, using checkpoint antibodies targeting CTLA- 4, PD-1 or PD-L1. Very recent studies suggest that also MCC patients benefit from a treatment with checkpoint antibodies. Nevertheless, in an advanced metastatic stage, a cure for both of these aggressive malignancies is still hard to achieve: while only a subset of patients experience durable benefit from the immune-based therapies, the widely applicable targeted therapies struggle with development of resistances that inevitably occur in most patients, and finally lead to their death. The four articles included in this thesis addressed current questions concerning therapy and carcinogenesis of melanoma and MCC. Moreover, they are discussed in the light of the up-to-date research regarding targeted and immune-based therapies. In article I we demonstrated that besides apoptosis, MAPK pathway inhibition in BRAF-mutated melanoma cells also induces senescence, a permanent cell cycle arrest. These cells may provide a source for relapse, as even permanently arrested cancer cells can contribute to a pro-tumorigenic milieu. To identify molecular factors determining the differential response, we established M14 melanoma cell line derived single cell clones that either undergo cell death or arrest when treated with BRAF/MEK inhibitors. Using these single cell clones, we demonstrated in article IV that downregulation of the pro-apoptotic BH3-only protein BIK via epigenetic silencing is involved in apoptosis deficiency, which can be overcome by HDAC inhibitors. These observations provide a possible explanation for the lack of a complete and durable response to MAPK inhibitor treatment in melanoma patients, and suggest the application of HDAC inhibitors as a complimentary therapy to MAPK pathway inhibition. Concerning MCC, we scrutinized the interactions between the Merkel cell polyomavirus’ (MCV) T antigens (TA) and the tumor suppressors p53 and Rb in article II and III, respectively. In article III, we demonstrated that the cell cycle master regulator Rb is the crucial target of MCV large T (LT), while it - in contrast to other polyomavirus LTs - exhibits much lower affinity to the related proteins p107 and p130. Knockdown of MCV LT led to proliferation arrest in MCC cells, which can be rescued by knockdown of Rb, but not by knockdown of p107 and p130. Contrary to Rb, restriction of p53 in MCC seems to be independent of the MCV TAs, as we demonstrated in article II. In conclusion, the presented thesis has revealed new molecular details, regarding the response of melanoma cells towards an important treatment modality and the mechanisms of viral carcinogenesis in MCC.
Deregulated MYC expression contributes to cellular transformation as well as progression and
maintenance of human tumours. Interestingly, in the absence of additional genetic alterations,
potentially oncogenic levels of MYC sensitise cells to a variety of apoptotic stimuli. Hence, MYC-induced
apoptosis has long been recognised as a major barrier against cancer development.
However, it is largely unknown how cells discriminate physiological from supraphysiological levels
of MYC in order to execute an appropriate biological response.
The experiments described in this thesis demonstrate that induction of apoptosis in mammary
epithelial cells depends on the repressive actions of MYC/MIZ1 complexes. Analysis of gene
expression profiles and ChIP-sequencing experiments reveals that high levels of MYC are required
to invade low-affinity binding sites and repress target genes of the serum response factor SRF.
These genes are involved in cytoskeletal dynamics as well as cell adhesion processes and are likely
needed to transmit survival signals to the AKT kinase. Restoration of SRF activity rescues MIZ1-
dependent gene repression and increases AKT phosphorylation and downstream function.
Collectively, these results indicate that association with MIZ1 leads to an expansion of MYC’s
transcriptional response that allows sensing of oncogenic levels, which points towards a tumour-suppressive
role for the MYC/MIZ1 complex in epithelial cells.
Chlamydia trachomatis is an obligate intracellular pathogen that replicates inside a vacuole, the so-called inclusion. During replication by a biphasic life-cycle Chlamydia secrete via their type 3 secretion system various effector proteins into the inclusion lumen, the inclusion membrane or the host cell cytosol to form their favored replication niche. Chlamydia-infected cells are highly resistant against apoptosis since the replicative form of Chlamydia is non-infectious and premature cell death would cause complete loss of one Chlamydia generation. The bacteria block apoptosis by preventing mitochondrial outer membrane permeabilization. Various proteins with anti-apoptotic function are enriched in Chlamydia-infected cells such as Mcl-1, cIAP2, Survivin or HIF1α. The accumulation of these proteins is a result of increased gene expression and direct protein stabilization. However, the molecular mechanisms and involved bacterial effector proteins are mostly unknown.
With this work the molecular mechanisms of Mcl-1 stabilization and the participation of chlamydial factors were investigated. Mcl-1 is a member of the Bcl-2 protein family and has an extremely short half-life causing its permanent ubiquitination and subsequent degradation by the 26S proteasome under normal homeostasis whilst Mcl-1 accumulation results in apoptosis inhibition. It was shown that during C. trachomatis infection Mcl-1 ubiquitination is reduced causing its stabilization albeit no cellular ubiquitin-proteasome-system components are involved in this process. However, C. trachomatis express the two deubiquitinases ChlaDUB1 and ChlaDUB2 which are mostly uncharacterized. With this work the expression profile, subcellular localization, substrates and function of the deubiquitinases were investigated. It was shown that ChlaDUB1 is secreted to the surface of the inclusion where it interacts with Mcl-1 which is accumulated in the proximity of this compartment. By utilization of infection experiments, heterologous expression systems and in vitro experiments a direct interaction of ChlaDUB1 and Mcl-1 was demonstrated. Furthermore, it was shown that Mcl-1 is deubiquitinated by ChlaDUB1 causing its stabilization. During replicative phase of infection, ChlaDUB2 seems to be accumulated in the chlamydial particles. However, ChlaDUB2 substrates could not be identified which would give an indication for the physiological role of ChlaDUB2.
Since 2011, a protocol to transform C. trachomatis with artificial plasmid DNA is available. As part of this work the transformation of C. trachomatis with plasmid DNA suitable for the permanent or inducible protein overexpression on a routinely basis was established. In addition, the first targeted homologous recombination into the chlamydial genome to replace the ChlaDUB1 gene by a modified one was performed and validated. The targeted homologous recombination was also used to create a ChlaDUB1 knock-out mutant; however deletion of ChlaDUB1 seems to be lethal for C. trachomatis. Due to the fact that ChlaDUB1-lacking Chlamydia could not be obtained an inhibitor screen was performed and identified CYN312 as a potential ChlaDUB1 inhibitor. Application of CYN312 during infection interfered with chlamydial growth and reduced Mcl-1 quantity in infected cells. Furthermore, CYN312 treated Ctr-infected cells were significantly sensitized for apoptosis.
Taken together, C. trachomatis secretes the deubiquitinase ChlaDUB1 to the surface of the inclusion where it deubiquitinates Mcl-1 causing its accumulation in infected cells resulting in apoptosis resistance. Application of the ChlaDUB1 inhibitor CYN312 interferes with Mcl-1 stabilization sensitizing infected cells for apoptosis.
Human adult cartilage is an aneural and avascular type of connective tissue, which consequently reflects reduced growth and repair rates. The main cell type of cartilage are chondrocytes, previously derived from human mesenchymal stem cells (hMSCs). They are responsible for the production and maintainance of the cartilaginous extracellular matrix (ECM), which consists mainly of collagen and proteoglycans. Signal transmission to or from chondrocytes, generally occurs via interaction with signalling factors connected to the cartilaginous ECM. In this context, proteins of the CCN family were identified as important matricellular and multifunctional regulators with high significance during skeletal development and fracture repair. In this thesis, main focus lies on WISP1/CCN4, which is known as a general survival factor in a variety of cell types and seems to be crucial during lineage progression of hMSCs into chondrocytes. We intend to counter the lack of knowledge about the general importance of WISP1-signalling within the musculoskeletal system and especially regarding cell death and survival by a variety of molecular and cell biology methods. First, we established a successful down-regulation of endogenous WISP1 transcripts within different cell types of the human musculoskeletal system through gene-silencing. Interestingly, WISP1 seems to be crucial to the survival of all examined cell lines and primary hMSCs, since a loss of WISP1 resulted in cell death. Bioinformatical analyses of subsequent performed microarrays (WISP1 down-regulated vs. control samples) confirmed this observation in primary hMSCs and the chondrocyte cell line Tc28a2. Distinct clusters of regulated genes, closely related to apoptosis induction, could be identified. In this context, TRAIL induced apoptosis as well as p53 mediated cell death seem to play a crucial role during the absence of WISP1 in hMSCs. By contrast, microarray analysis of WISP1 down-regulated chondrocytes indicated rather apoptosis induction via MAPK-signalling. Despite apoptosis relevant gene regulations, microarray analyses also identified clusters of differentially expressed genes of other important cellular activities, e.g. a huge cluster of interferon-inducible genes in hMSCs or gene regulations affecting cartilage homeostasis in chondrocytes. Results of this thesis emphasize the importance of regulatory mechanisms that influence cell survival of primary hMSCs and chondrocytes in the enforced absence of WISP1. Moreover, findings intensified the assumed importance for WISP1-signalling in cartilage homeostasis. Thus, this thesis generated an essential fundament for further examinations to investigate the role of WISP1-signalling in cartilage homeostasis and cell death.
Upon oncogenic stress, the tumor suppressor Arf can induce irreversible cell cycle arrest or apoptosis, depending on the oncogenic insult. In this study, it could be shown that Arf interacts with Myc and the Myc-associated zinc-finger protein Miz1 to facilitate repression of genes involved in cell adhesion. Formation of a DNA-binding Arf/Myc/Miz1 complex disrupts interaction of Miz1 with its coactivator nucleophosmin and induces local heterochromatinisation, causing cells to lose attachment and undergo anoikis. The assembly of the complex relies on Myc, which might explain why high Myc levels trigger apoptosis and not cell cycle arrest in the Arf response. This mechanism could play an important role in eliminating cells harboring an oncogenic mutation. Arf furthermore induces sumoylation of Miz1 at a specific lysine by repressing the desumoylating enzyme Senp3. A sumoylation-deficient mutant of Miz1 however does not show phenotypic differences under the chosen experimental conditions. Myc can also be modified by Sumo by multisumoylation at many different lysines, which is unaffected by Arf. The exact mechanism and effect of this modification however stays unsolved.
Chlamydiales are obligate intracellular gram-negative bacteria that have gained high medical relevance. These important human pathogens cause diverse diseases including trachoma and wide spread sexually transmitted diseases. Chlamydia establishes membrane bound inclusions in the host cell and loots the host for nutritional requirements. Infections are usually recognized by the host immune system and eliminated systematically, by triggering apoptosis. However, the pathogen Chlamydia has evolved various strategies to prevent the detection as well as protect the invaded cell against apoptosis or any other form of cell death. The evolutionary conservation of cell death regulation has not been investigated in the order Chlamydiales, which also includes Chlamydia-like organisms with a broader host spectrum. The present study was aimed at investigating the apoptotic response of human cells infected with the Chlamydia-like organism Simkania negevensis (Sn). Simkania infected cells exhibited strong resistance to apoptosis induced by intrinsic stress or by the activation of cell death receptors. Apoptotic signaling was blocked upstream of mitochondria since Bax translocation, Bax and Bak oligomerisation and cytochrome c release were absent in these cells. Caspases were differentially regulated upon Sn infection. Caspase-3 and -9 were not activated upon Sn infection and apoptosis induction; whereas caspases-8 was activated in Sn infected cells even without apoptosis induction. This indicates that, Sn utilizes death receptor association independent caspase activation for thriving in the host environment. Infected cells turned on pro-survival pathways like cellular Inhibitor of Apoptosis Proteins (IAP-1/2 and XIAP) and the Akt/PI3K pathway. Sn infection also 20 activated the pro-survival transcription factor NF-кB. Blocking any of these survival pathways sensitized the infected host cell towards apoptosis induction, demonstrating their role in infection-induced apoptosis resistance. The NF-кB mutant cells also showed reduced infectivity of Sn, which indicated an essential role of NF-кB in Sn infection. It was interesting to observe that, Acanthamoeba castellanii, a natural host of Sn, survived maintaining its trophozoite forms after infection with Sn upon starvation. The metacaspases, responsible for encystment could be regulated by Sn upon infection. This suggests an early level of gene regulation indicating how the pathogen evolved its ability to inhibit apoptosis in higher organisms. The resistance to apoptosis pathways subverted in Sn-infected cells was similar but not identical to those modulated by Chlamydia. Together, the data supports the hypothesis of evolutionary conserved signaling pathways to apoptosis resistance as common denominators in the order Chlamydiales.
Chlamydia are Gram-negative obligate intracellular bacteria responsible for a wide spectrum of relevant diseases. Due to their biphasic developmental cycle Chlamydia depend on an intact host cell for replication and establishment of an acute infection. Chlamydia have therefore evolved sophisticated strategies to inhibit programmed cell death (PCD) induced by a variety of stimuli and to subvert the host immune system. This work aimed at elucidating whether an infection with C. trachomatis can influence the cellular response to double-stranded RNA (dsRNA). The synthesis of dsRNA is a prominent feature of viral replication inside infected cells that can induce both PCD and the activation of a cellular innate immune response. In order to mimic chlamydial and viral co-infections, Chlamydia-infected cells were transfected with polyinosinic:polycytidylic acid (polyI:C), a synthetic dsRNA. In the first part of this work it was investigated whether C. trachomatis-infected host cells could resist apoptosis induced by polyI:C. A significant reduction in apoptosis, determined by PARP cleavage and DNA fragmentation, could be observed in infected cells. It could be shown that processing of the initiator caspase-8 was inhibited in infected host cells. This process was dependent on early bacterial protein synthesis and was specific for dsRNA because apoptosis induced by TNFalpha was not blocked at the level of caspase-8. Interestingly, the activation of cellular factors involved in apoptosis induction by dsRNA, most importantly PKR and RNase L, was not abrogated in infected cells. Instead, RNA interference experiments revealed the crucial role of cFlip, a cellular caspase-8 inhibitor, for chlamydial inhibition of dsRNA-induced apoptosis. First data acquired by co-immunoprecipitation experiments pointed to an infection-induced concentration of cFlip in the dsRNA-induced death complex of caspase-8 and FADD. In the second part of this work, the chlamydial influence on the first line of defense against viral infections, involving expression of interferons and interleukins, was examined. Activation of the interferon regulatory factor 3 (IRF-3) and the NF-kappaB transcription factor family member p65, both central regulators of the innate immune response to dsRNA, was altered in Chlamydia-infected epithelial cells. polyI:C-induced degradation of IkappaB-alpha, the inhibitor of NF-kappaB, was accelerated in infected cells which was accompanied by a change in nuclear translocation of the transcription factor. Translocation of IRF-3, in contrast, was significantly blocked upon infection. Together the data presented here demonstrate that infection with C. trachomatis can drastically alter the cellular response to dsRNA and imply an impact of chlamydial infections on the outcome of viral super-infections.
In this century new experimental and computational techniques are adding an enormous amount of information, revealing many biological mysteries. The complexities of biological systems still broach new questions. Till now the main approach to understand a system has been to divide it in components that can be studied. The upcoming new paradigm is to combine the pieces of information in order to understand it at a global level. In the present thesis we have tried to study infectious diseases with such a global ‘Systems Biology’ approach. In the first part the apoptosis pathway is analyzed. Apoptosis (Programmed cell death) is used as a counter measure in different infections, for example viral infections. The interactions between death domain containing proteins are studied to address the following questions: i) How specificity is maintained - showing that it is induced through adaptors, ii) how proliferation/ survival signals are induced during activation of apoptosis – suggesting the pivotal role of RIP. The model also allowed us to detect new possible interacting surfaces. The pathway is then studied at a global level in a time step simulation to understand the evolution of the topology of activators and inhibitors of the pathway. Signal processing is further modeled in detail for the apoptosis pathway in M. musculus to predict the concentration time course of effector caspases. Further, experimental measurements of caspase-3 and viability of cells validate the model. The second part focuses on the phagosome, an organelle which plays an essential role in removal of pathogens as exemplified by M. tuberculosis. Again the problem is addressed in two main sections: i) To understanding the processes that are inhibited by M. tuberculosis; we focused on the phospholipid network applying a time step simulation in section one, which plays an important role in inhibition or activation of actin polymerization on the phagosome membrane. ii) Furthermore, actin polymers are suggested to play a role in the fusion of the phagosome with lysosome. To check this hypothesis an in silico model was developed; we find that the search time is reduced by 5 fold in the presence of actin polymers. Further the effect of length of actin polymers, dimensions of lysosome, phagosome and other model parameter is analyzed. After studying a pathway and then an organelle, the next step was to move to the system. This was exemplified by the host pathogen interactions between Bordetella pertussis and Bordetella bronchiseptica. The limited availability of quantitative information was the crucial factor behind the choice of the model type. A Boolean model was developed which was used for a dynamic simulation. The results predict important factors playing a role in Bordetella pathology especially the importance of Th1 related responses and not Th2 related responses in the clearance of the pathogen. Some of the quantitative predictions have been counterchecked by experimental results such as the time course of infection in different mutants and wild type mice. All these computational models have been developed in presence of limited kinetic data. The success of these models has been validated by comparison with experimental observations. Comparative models studied in chapters 6 and 9 can be used to explore new host pathogen interactions. For example in chapter 6, the analysis of inhibitors and inhibitory paths in three organism leads to the identification of regulatory hotspots in complex organisms and in chapter 9 the identification of three phases in B. bronchiseptica and inhibition of IFN-γ by TTSS lead us to explore similar phases and inhibition of IFN-γ in B. pertussis. Further an important significance of these models is to identify new components playing an essential role in host-pathogen interactions. In silico deletions can point out such components which can be further analyzed by experimental mutations.
Density arrested AKR-2B cells die rapidly in response to serum starvation or treatment by Anisomycin. Cell death is associated with typical hallmarks of apoptosis including membrane blebbing and chromatin condensation but lacks energy dissipation in mitochondria and intranucleosomal fragmentation. During apoptosis a considerable DEVDase activity has been detected which seemed to be represented by a single enzyme. This enzyme had typical effector caspase characteristics, like caspase-3, but exhibited an unusual high KM values of ~100 µM and its large subunit exhibited a molecular weight of 19 kDa, instead of expected 17 kDa. In the present study, this enzyme was identified to be caspase-3 with the help of the generation of recombinant mcaspase-3 protein. N-terminal sequencing of the recombinant mcaspase-3 protein revealed that its prodomain cleavage site differs from that in the human homologue (Asp-9 instead of Asp-28). Thus the large subunit of active caspase-3 was found to be 19 kDa. Furthermore the KM value of recombinant mcaspase-3 was ~100 µM in perfect agreement with that found in cell extracts. Affinity labeling in combination with 2D-GE confirmed that indeed caspase-3 is activated as the main executioner in AKR-2B cells during apoptosis. Since the receptor mediated pathway has already been excluded previously [129], a possible involvement of mitochondria mediated pathway in the activation of caspase-3 was examined. Gel filtration experiments revealed that caspase-3 is mainly eluted as free enzyme and in lower levels within the differently sized high molecular weight complexes of ~600 kDa and 250 kDa in response to serum starvation or Anisomycin treatment. Though the apparent molecular weight of the complexes containing caspase-3 are in accordance with recently published data, they were devoid of Apaf-1 and caspase-9. Apparently, mitochondria mediated pathway is also not involved since neither formation of high molecular weight complexes of Apaf-1 nor cleavage of caspase-9 was observed. Thus, the activation of caspase-3 is caused by a noncanonical pathway during apoptosis. In addition a new 450 kDa complex containing activated caspase-6 was found in response to serum starvation which is clearly separated from caspase-3 containing complexes. Generally caspase-3 has been found to be responsible for most of the morphological changes during apoptosis. One of those is intranucleosomal fragmentation. Although caspase-3 was found to be the main executioner caspase in AKR-2B cells the lack of the intranucleosomal fragmentation led to examine its localization. As detected by overexpression of the Caspase-3-GFP fusion construct in AKR-2B, procaspase-3 was localized in the cytoplasm, wheras the active caspase-3 was mainly found in the membrane blebs and partially in the cytoplasm. Clearly no nuclear localization of active caspase-3 was detected. These data gave first hints on the mechanism of degradation of AKR-2B cells demonstrating that cytoplasmic membrane is the primary site of activation of caspase-3. The possible role of caspase-12 and ER stress mediated pathway of apoptosis was also examined in AKR-2B cells. Kinetic studies showed that caspase-12 is activated at the same time together with caspase-3 in response to serum starvation or Anisomycin treatment resulting in two cleavage products of 47 kDa and 35 kDa, respectively. It was therefore examined whether these two caspases were eluted in the same complexes. Gel filtration experiments revealed that caspase-12 is released as free enzyme during apoptosis. To date all the studies have identified that caspase-12 is specifically activated in response to ER stress. After serum starvation or Anisomycin addition there was no increase of the protein expression level of the chaperone protein Grp 78 which is known to be higly elevated in response to ER stress indicating that both treatments did not lead to ER stress. In contrast treatment with ER stressor substances i.e. Thapsigargin, A23187 (ionophore) induced an ER stress in AKR-2B which lead to unspecifically degradation of caspase-12. Thus it is unlikely that caspase-12 is activated in response to ER stress in AKR-2B cells. However, after the in vitro addition of recombinant caspase-3 to cytosolic extracts caspase-12 is cleaved into 47 kDa and 35 kDa fragments similiar to those observed in vivo. In conclusion the present data demostrated that caspase-12 is activated in AKR-2B cells during apoptosis triggered through pathways that do not involve (the) ER stress and provided evidence that caspase-3 might be involved in activation of caspase-12. Thus the present study in AKR-2B cells gives hints for the existence of additional pathways for apoptosis other than the classical ones.
The identification of NRAGE
(2001)
The inhibitor of apoptosis proteins (IAPs) have been shown to interact with a growing number of intracellular proteins and signalling pathways in order to fulfil their anti-apoptotic role. In order to investigate in detail how the avian homologue ITA interfered with both TNF induced apoptosis and the NGF mediated differentiation in PC12 cells, a two hybrid screen was performed with a PC12 library using ITA as a bait. The screen resulted in the identification of several overlapping fragments of a previously unknown gene. The complete cDNA for this gene was isolated, the analysis of which revealed a high homology with a large family of tumour antigens known as MAGE (melanoma associated antigens). This newly identified member of the MAGE family, which was later named NRAGE, exhibited some unique characteristics that suggested for the first time a role in normal cellular physiology for this protein family. MAGE proteins are usually restricted in their expression to malignant or tumour cells, however NRAGE was also expressed in terminally differentiated adult tissue. NRAGE also interacted with the human XIAP in direct two-hybrid tests. The interactions observed in yeast cells were confirmed in mammalian cell culture, employing both coimmunoprecipitation and mammalian two-hybrid methods. Moreover, the results of the coimmunoprecipitation experiments indicated that this interaction requires the RING domain. The widely studied 32D cell system was chosen to investigate the effect of NRAGE on apoptosis. NRAGE was stably transduced in 32D cells, and found to augment cell death induced by the withdrawal of Interleukin-3. One reason for this reduced cell viability in NRAGE expressing cells could be the binding of endogenous XIAP, which occurred inducibly after growth factor withdrawal. Interestingly, NRAGE was able to overcome the protection afforded to 32D cells by the exogenous expression of human Bcl-2. Thus NRAGE was identified during this research doctorate as a novel pro-apoptotic, IAP-interacting protein, able to accelerate apoptosis in a pathway independent of Bcl-2 cell protection.