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Journal of Virology, April 2001, p. 3453-3461, Vol. 75, No. 7
0022-538X/01/$04.00+0 DOI: 10.1128/JVI.75.7.3453-3461.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.
Branched Polyamines Cure Prion-Infected
Neuroblastoma Cells
Surachai
Supattapone,1,2
Holger
Wille,1,2
Lisa
Uyechi,3
Jiri
Safar,1,2
Patrick
Tremblay,1,2
Francis C.
Szoka,3
Fred E.
Cohen,1,4,5,6
Stanley B.
Prusiner,1,2,6,* and
Michael R.
Scott1,2
Institute for Neurodegenerative
Diseases,1 and Departments of
Neurology,2 Biopharmaceutical
Sciences,3 Cellular and Molecular
Pharmacology,4
Medicine,5 and Biochemistry and
Biophysics,6 University of California at San
Francisco, San Francisco, California 94143
Received 30 October 2000/Accepted 14 December 2000
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ABSTRACT |
Branched polyamines, including polyamidoamine and
polypropyleneimine (PPI) dendrimers, are able to purge
PrPSc, the disease-causing isoform of the prion protein,
from scrapie-infected neuroblastoma (ScN2a) cells in culture (S. Supattapone, H.-O. B. Nguyen, F. E. Cohen, S. B. Prusiner, and M. R. Scott, Proc. Natl. Acad. Sci. USA
96:14529-14534, 1999). We now demonstrate that exposure of ScN2a cells
to 3 µg of PPI generation 4.0/ml for 4 weeks not only reduced
PrPSc to a level undetectable by Western blot but also
eradicated prion infectivity as determined by a bioassay in mice.
Exposure of purified RML prions to branched polyamines in vitro
disaggregated the prion rods, reduced the
-sheet content of PrP
27-30, and rendered PrP 27-30 susceptible to proteolysis. The
susceptibility of PrPSc to proteolytic digestion induced by
branched polyamines in vitro was strain dependent. Notably,
PrPSc from bovine spongiform encephalopathy-infected brain
was susceptible to PPI-mediated denaturation in vitro, whereas
PrPSc from natural sheep scrapie-infected brain was
resistant. Fluorescein-labeled PPI accumulated specifically in
lysosomes, suggesting that branched polyamines act within this acidic
compartment to mediate PrPSc clearance. Branched polyamines
are the first class of compounds shown to cure prion infection in
living cells and may prove useful as therapeutic, disinfecting, and
strain-typing reagents for prion diseases.
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INTRODUCTION |
Prion diseases are caused by an
infectious protein (20, 25). These invariably fatal
illnesses cannot be cured using routine antimicrobial agents, and
materials contaminated with prions cannot be disinfected by
conventional methods. Therefore, it is important to identify compounds
that can be used either as therapeutic or disinfecting reagents for
prion diseases. Ongoing epidemics of new variant Creutzfeldt-Jakob
disease and bovine spongiform encephalopathy (BSE) in the United
Kingdom highlight the urgency of this task.
We recently reported that branched polyamines could purge
scrapie-infected neuroblastoma (ScN2a) cells of PrPSc, the
disease-causing isoform of the prion protein (33). The ability of these compounds to eliminate PrPSc from ScN2a
cells depended upon a highly branched structure and a high surface
density of primary amino groups. The most potent compounds
identified were generation 4.0 polyamidoamine (PAMAM) and
polypropyleneimine (PPI) dendrimers. Dendrimers are branched polyamines manufactured by a repetitive divergent growth technique, allowing the synthesis of successive, well-defined "generations" of
homodisperse structures. In the current study, we demonstrate that branched polyamines cure prion-infected cells and identify the
site and mechanism of polyamine-mediated prion clearance. We also demonstrate that these compounds can be employed in a rapid and
simple assay to discriminate between different prion strains in vitro.
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MATERIALS AND METHODS |
Chemical compounds.
High-molecular-weight polyethyleneimine
(PEI) was purchased from Fluka. SuperFect transfection reagent was
purchased from Qiagen. All other polyamines were purchased from
Sigma-Aldrich. Fluorescein-labeled PPI was synthesized by mixing 30 mg
of fluorescein isothiocyanate (FITC) with 1 mg of PPI generation 4.0 in
2 ml of ethanol overnight at 4°C. Labeled PPI was separated from
residual, unreacted FITC using a Sephadex P-2 column.
Cultured cells.
Cultures of ScN2a cells were maintained as
described previously (33). Cytotoxicity after treatment
with polyamines was assessed in ScN2a cells by the following four
methods: (i) examination of morphology under phase contrast microscopy,
(ii) observation of growth curves and cell counts for 3 weeks after
treatment, (iii) vital staining of living cells with 0.4% trypan blue
(Sigma-Aldrich), and (iv) assay of dehydrogenase enzymes with
3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide (MTT)
(Sigma-Aldrich). For ScN2a cells treated with either PAMAM or PPI
generation 4.0 continuously for 1 week, the 50% toxic dose was ~50
µg/ml.
To prepare samples for infectivity assays, 100-mm-diameter plates
(Falcon) of confluent cells were washed three times with 5 ml of
phosphate-buffered saline, scraped into 2 ml of phosphate-buffered saline, and homogenized by repeated extrusion through a 26-gauge needle. Prion infectivity was determined by intracerebral inoculation of 30 µl of cell homogenate into Tg(MoPrP)4053 mice. Mice were observed for clinical signs of scrapie, and a subset of diagnoses were
confirmed by neuropathological examination. Samples were prepared for
sodium dodecyl sulfate (SDS)-polyacrylamide gel electrophoresis as
described previously (33).
Mixture of brain homogenates and purified prions with polyamines
in vitro.
Brain homogenates were prepared as described previously
(33). Except for Tg(BoPrP) samples, 50 µl of 1-mg/ml
brain homogenate was mixed with 450 µl of 1% NP-40-50 mM sodium
acetate (pH 3.0) (final measured pH = 3.6) plus or minus 60 µg
of PPI generation 4.0/ml and shaken constantly for various periods at
37°C.
Purified prions were prepared as described previously
(21), utilizing both proteinase K digestion and sucrose
gradient sedimentation, and resuspended in 1% NP-40-1-mg/ml bovine
serum albumin (BSA). For pH studies, 475 µl of 0.5-µg/ml purified
RML PrP 27-30 in 1% NP-40-1-mg/ml BSA was mixed with 25 µl of 1 M
buffers from pH 3 to 8 (sodium acetate for pHs 3 to 6 and Tris acetate
for pHs 7 and 8) plus or minus 60 µg of PPI generation 4.0/ml for 2 h at 37°C with constant shaking. The final pH value of each sample was measured directly with a calibrated pH electrode (Radiometer Copenhagen). For compound screening, 475 µl of 0.5-µg/ml purified RML PrP 27-30 in 1% NP-40-1-mg/ml BSA was mixed with 25 µl of 1 M
sodium acetate (pH 3.0) plus 60 µg of polyamine/ml for 2 h at
37°C with constant shaking.
Following incubations, each sample was neutralized with an equal volume
of 0.2 M HEPES (pH 7.5) containing 0.3 M NaCl and 4% Sarkosyl. Samples
not treated with proteinase K were mixed with an equal volume of 2×
SDS sample buffer. For proteinase K digestion, samples were incubated
with 20 µg of proteinase K (Boehringer Mannheim)/ml for 1 h at
37°C. Proteolytic digestion was terminated by the addition of 8 µl
of 0.5 M phenylmethylsulfonyl fluoride. Digested samples were then
mixed with equal volumes of 2× SDS sample buffer. All samples were
boiled for 5 min prior to SDS-polyacrylamide gel electrophoresis.
Western blotting was performed as previously described
(27), using human-mouse chimeric Fab D13.
The mixture protocol was modified for Tg(BoPrP) samples.
Incubations were carried out at room temperature, and deoxycholate was
substituted for Sarkosyl in the neutralization buffer. Protease-treated samples were concentrated 10-fold by centrifugation for 1 h at 100,000 × g. Immunoblotting was performed with Fab
clone P as the primary antibody to recognize bovine PrP.
FTIR.
Samples were lyophilized and resuspended in
D2O. Prior to the spectroscopic measurements, the samples
were centrifuged briefly (14,000 × g for 2 min), and
1.5-µl samples from the bottom of the tube were enclosed between
2 AgCl windows (International Crystal Laboratories, Garfield,
N.J.), creating a path length of 50 µm. Spectra were recorded with a
Perkin-Elmer (Norwalk, Conn.) System 2000 Fourier transform infrared
resonance (FTIR) spectrophotometer. Blank controls identical in buffer
conditions and PPI content were used to subtract any nonprotein
contributions from the spectra. Spectral analysis and
self-deconvolution were carried out as previously described
(6) and modified (15).
Confocal microscopy.
Confocal images were obtained using a
Bio-Rad (Hercules, Calif.) laser scanning confocal microscope
(MRC-1024) outfitted with a Nikon Diaphot 200 microscope and a
helium-neon laser. Laser power was set at 10% and scanned with a slow
speed across the sample. Individual laser lines confirmed the lack of
"bleed-through" between detection channels. The images were
averaged with a Kalman filter (n = 4).
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RESULTS |
Branched polyamines cure prion-infected neuroblastoma cells.
ScN2a cells were incubated with 3 µg of PPI/ml in supplemented
Dulbecco's modified Eagle's medium for 4 weeks and then cultured for
an additional 2 weeks in polyamine-free medium. This transient exposure
to PPI was not cytotoxic (see Materials and Methods) and completely
purged the cells of protease-resistant PrPSc (Fig.
1A, lanes 2 and 4). In contrast,
protease-sensitive PrPC bands migrating between 32 and 38 kDa appear to be present at similar levels in cells treated with PPI
(lane 2) and in uninfected N2a cells (data not shown). Elimination of
PrPSc was measured by the disappearance of the
protease-resistant core of PrPSc, denoted PrP 27-30. The
elimination of PrP 27-30 appeared to be relatively specific, since the
steady-state levels of proteins in PPI-treated cells were similar to
those in control ScN2a cells (Fig. 1B). To assess the effect of PPI
treatment on prion infectivity, homogenates prepared from
polyamine-treated and control ScN2a cells were inoculated into
Tg(MoPrP)4053 mice. The average scrapie incubation time was 61 ± 2 days for mice inoculated with control ScN2a cells and >200 days
for mice inoculated with ScN2a cells treated with PPI
(n/n0 = 0/13) (Fig. 1C). These incubation
times indicate that the titer of infectious prions in ScN2a cells was reduced from ~106 50% infective dose (ID50)
units/100-mm plate to <102 ID50
units/plate by PPI treatment (Fig. 1D). Thus, exposure to PPI
eliminates measurable prion infectivity from ScN2a cells.

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FIG. 1.
Treatment of scrapie-infected neuroblastoma cells with
PPI dendrimer. ScN2a cells were treated with 3 µg of PPI generation
4.0/ml in supplemented Dulbecco's modified Eagle's medium or control
medium for 4 weeks. After two additional weeks of culture in
compound-free medium, cells were harvested for analysis. (A) PrP
immunostain. Apparent molecular masses based on migration of protein
standards are 30 and 27 kDa. (B) Silver stain was performed as
previously described (23). Apparent molecular masses based
on migration of protein standards are 49, 36, 25, and 19 kDa. For
panels A and B, samples were assigned lanes as follows: 1, undigested
control; 2, undigested, PPI treated; 3, proteinase K-digested control;
4, proteinase K digested, PPI treated. All samples possessed equivalent
protein concentrations prior to proteinase K digestion. (C) Infectivity
bioassay of cell homogenates in Tg(MoPrP)4053 indicator mice.
Filled circles, control cells; open squares, PPI-treated cells. (D) The
calibration of Tg(MoPrP)4053 mice (36) with RML prions
was performed as described previously (22). The brain
homogenate used for calibration was prepared from a large pool of CD1
Swiss mice inoculated intracerebrally with RML prions. Each data point
is an average ± the standard error of the mean obtained from
three end-point titrations. Fewer than 100% of mice developed scrapie
when the infectivity of the inocula was <102
ID50 units/ml. The data correlating the end-point titer to
the time intervals from inoculation to onset of clinical illness were
best fitted using the least squares method. ID50, 50%
infectious dose.
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Branched polyamines act directly on purified RML prions.
Having established that branched polyamines reduce prion infectivity,
we sought to identify the mechanism by which these compounds eliminate
PrPSc. Our first objective was to determine the molecular
target of branched polyamines. Previously, we developed an in
vitro assay which was used to show that these compounds could render
PrPSc protease susceptible when mixed directly with
crude brain homogenates (33). We performed a similar assay
with PrP 27-30 purified from mouse brains infected with RML prions to
determine whether or not the molecular target of branched polyamines
was present in this highly purified preparation. PrP 27-30 in purified
preparations of RML prions was rendered protease sensitive by branched
polyamines with a similar acidic pH optimum (Fig. 2A) and
structure-activity profile (Fig. 2B) as
previously obtained in crude brain homogenates (33).
Treatment of purified prions with branched polyamines in vitro also
diminished infectivity. We incubated 15 µg of RML prion rods per ml
in 50 mM sodium acetate (pH 3.0)-1% NP-40-1-mg/ml BSA for
2 h at 37°C, with or without 60 µg of PPI generation 4.0/ml, and measured prion infectivity using a scrapie prion incubation time assay in Tg(MoPrP)4053 mice. PPI treatment reduced prion infectivity from 107 ID50 units/ml to
105 ID50 units/ml (data not shown).

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FIG. 2.
Mixture of purified prions with branched polyamines in
vitro. (A) Purified mouse RML prion rods were incubated with 60 µg of
PPI generation 4.0/ml or control buffer at different pH values, as
indicated. (B) Samples containing purified mouse RML PrP 27-30 were
incubated with various polyamines, shown in lanes as follows: 1 and 2, control; 3, poly-L-lysine; 4, PAMAM 0.0; 5, PAMAM 1.0; 6, PAMAM 2.0; 7, PAMAM 3.0; 8, PAMAM 4.0; 9, PAMAM-OH 4.0; 10, PPI 2.0;
11, PPI 4.0; 12, linear PEI; 13, high-molecular-weight PEI; 14, low-molecular-weight PEI; 15, average-molecular-weight PEI; 16, Qiagen
SuperFect. For panels A and B, all samples possessed equivalent protein
concentrations and were subjected to limited proteolysis. Apparent
molecular masses based on migration of protein standards are 30 and 27 kDa. PK, proteinase K.
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PrPSc susceptibility to PPI-induced conformational
change is sequence and strain specific.
Although the PrP sequence
is well conserved among mammals, a small number of amino acid
substitutions retard prion transmission across species
(27). Furthermore, prions can exist as different phenotypic strains that yield distinct incubation times,
neuropathology, and distribution of PrPSc upon
infection of susceptible hosts. In certain cases, these phenotypic
differences can be correlated with differences in the conformation of PrPSc (3, 26, 29, 37). We
sought to determine whether different species and strains of rodent
prions, which presumably contain different conformations of
PrPSc, vary in their susceptibility to branched
polyamines. Homogenates were prepared from the brains of rodents
infected with one of several Syrian hamster (SHa designations), mouse
(Mo designations), or artificial prion strains. Individual
samples were mixed with 60 µg of PPI generation 4.0/ml in vitro for
2 h at 37°C, neutralized, and subjected to limited proteolysis.
The results indicate that susceptibility to the PPI dendrimer is
dependent on both the prion strain and PrP sequence (Fig.
3A).

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FIG. 3.
Treatment of different prion strains with PPI in vitro.
(A) Samples containing 1% (wt/vol) brain homogenates were incubated
for 2 h at 37°C with 60 µg of PPI generation 4.0/ml. Paired lanes
are designated as follows: 1, SHa(Sc237); 2, SHa(139H); 3, SHa(DY); 4, SHa(RML); 5, Tg(MH2M)Prnp0/0(RML); 6, Tg(PrP106)Prnp0/0(RML); 7, Mo(RML); 8, Mo(Me7); 9, Mo(22a); 10, Mo(87V); 11, Mo(139A); 12, Mo(C506). Minus symbols denote
untreated, control samples and plus symbols designate samples exposed
to 60 µg of PPI generation 4.0/ml for 2 h at 37°C. (B) Samples
containing 1% (wt/vol) Mo(RML) or SHa(Sc237) were incubated at 37°C
with 60 µg of PPI generation 4.0/ml or control buffer for the time
periods indicated. For panels A and B, all samples possessed equivalent
protein concentrations and were subjected to limited proteolysis.
Apparent molecular masses based on migration of protein standards are
30 and 27 kDa. (C) Brain homogenates from
Tg(BoPrP)Prnp0/0 mice were incubated with 60 µg
of PPI generation 4.0/ml or control buffer. Lanes: 1, Tg(BoPrP)Prnp0/0 (sheep scrapie); 2, Tg(BoPrP)Prnp0/0 (sheep scrapie) plus PPI; 3, Tg(BoPrP)Prnp0/0 (BSE); 4, Tg(BoPrP)Prnp0/0 (BSE) plus PPI. Minus symbols
denote undigested, control samples and plus symbols
designate samples subjected to limited proteolysis. All samples
possessed equivalent protein concentrations prior to proteolysis.
Apparent molecular masses based on migration of protein standards are
30 and 27 kDa.
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The varying susceptibility of different strains is most clearly
illustrated by the six mouse strains analyzed (paired lanes 7 to 12).
Mo(RML), Mo(22a), and Mo(139A) were susceptible to PPI-induced conformational change (paired lanes 7, 9, and 11, respectively). In
contrast, Mo(Me7) and Mo(87V) were resistant (paired lanes 8 and 10, respectively) and Mo(C506) was marginally susceptible to PPI-induced
conformational change (paired lanes 12).
The effect of PrP sequence can be seen by comparing the relative
susceptibilities of SHa(RML), MH2M(RML), and Mo(RML). Whereas Mo(RML)
was susceptible to PPI-induced conformational change (paired lanes 7), SHa(RML) was resistant (paired lanes 4). MH2M(RML) displayed an intermediate level of susceptibility to PPI (paired lanes 5); MH2M
is a chimeric PrP molecule in which amino acids 94 to 188 of the mouse
sequence have been replaced by the corresponding Syrian hamster
residues (28). Thus, SHaPrPSc appears to be
more resistant to PPI-induced conformational change than
MoPrPSc.
We investigated whether the varying susceptibilities to PPI displayed
by different strains and species of prions might be caused by kinetic
differences. To test this possibility, we incubated samples of each
prion isolate with PPI generation 4.0 for various periods of time. Even
after incubation with PPI for 3 days, PrPSc in samples of
resistant isolates did not become more susceptible to protease
digestion (Fig. 3B). Thus, the differences in susceptibilities of
different prion strains and sequences are not caused simply by
differences in the kinetics of PrPSc unfolding.
Recently, it was demonstrated that Tg(BoPrP)Prnp0/0
mice were susceptible to both BSE and natural sheep scrapie
(30). Furthermore, these two prion strains remain distinct
during passage through Tg(BoPrP)Prnp0/0 mice
(30). These transgenic mice therefore provided an
opportunity to compare the susceptibility of BSE and scrapie prions to
branched polyamines. We incubated brain homogenates from
Tg(BoPrP)Prnp0/0 (BSE) and
Tg(BoPrP)Prnp0/0 (sheep scrapie) mice with
PPI generation 4.0 in vitro. The PrPSc in scrapie-infected
Tg mice was not susceptible to PPI-induced conformational change (Fig.
3C, lanes 1 and 2). In contrast, >90% of the PrPSc in
BSE-infected Tg mice was rendered protease sensitive by treatment with
PPI (Fig. 3C, lanes 3 and 4).
Branched polyamines mediate PrPSc denaturation.
The existence of prion strains resistant to branched polyamines
suggests that PrPSc molecules in these strains might exist
in conformations which are more resistant to denaturation than
PrPSc molecules in polyamine-susceptible strains. To test
this hypothesis, we examined the effect of adding urea to
SHa(Sc237) brain homogenate treated with and without PPI
generation 4.0. In the presence of urea, PrPSc was more
susceptible to protease digestion in samples treated with PPI, whereas
no difference in protease resistance could be detected in the absence
of urea (Fig. 4A). Thus, additional
denaturation enables PrPSc molecules in a resistant strain
to become susceptible to branched polyamines. This result
suggests that the general mechanism of action of branched polyamines
might be to assist PrPSc denaturation. Consistent with this
concept, branched polyamines render PrPSc protease
sensitive more efficiently at lower pH values (Fig. 2A).
Furthermore, polyamine-treated PrPSc did not regain
protease resistance after prolonged neutralization (Fig. 4B) or
dialysis (data not shown). Finally, we excluded the possibility that
acidification might be required only to activate the dendrimer by
demonstrating that preacidified PPI generation 4.0 could not render
PrPSc protease sensitive at a neutral pH (Fig. 4C).

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FIG. 4.
Denaturation of PrPSc is enhanced by PPI.
(A) Samples containing 1% (wt/vol) SHa(Sc237) brain homogenates were
incubated for 2 h at 37°C with 60 µg of PPI generation 4.0/ml
or control buffer, plus various concentrations of urea as indicated.
All samples were subjected to limited proteolysis. (B) Samples
containing 1% Mo(RML) brain homogenate in 1% NP-40-50 mM sodium
acetate (pH 3.6) were incubated at 37°C for 2 h with either no
addition (odd lanes) or 60 µg of PPI/ml (even lanes). All samples
were neutralized with an equal volume of 0.2 M HEPES (pH 7.5)
containing 0.3 M NaCl and 4% Sarkosyl. Lanes: 1 and 2, samples not
subjected to protease digestion; 3 and 4, samples immediately subjected
to limited proteinase K digestion; 5 and 6, samples incubated at pH 7.5 for an additional 16 h at 37°C before proteinase K digestion.
(C) Samples containing 1% Mo(RML) brain homogenate were treated in
the following manner for lanes: 1, control sample at pH 3.6; 2, mixed
with 60 µg of PPI/ml at pH 3.6 for 2 h; 3, mixed with 60 µg of
PPI/ml at pH 7.0 for 2 h; 4, incubated alone at pH 3.6 for 2 h and then mixed with 60 µg of PPI/ml (pretitrated to pH 7.0) for 10 min; 5, incubated alone at pH 7.0 for 2 h and then mixed with 60 µg of PPI/ml (pretitrated to pH 3.0) for 10 min. All incubations were
carried out at 37°C. Minus symbols denote undigested, control samples
and plus symbols designate samples subjected to limited proteolysis by
proteinase K. All samples possessed equivalent protein concentrations
prior to proteolysis. Apparent molecular masses based on migration of
protein standards are 30 and 27 kDa.
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To visualize the effect of branched polyamines on prions, we examined
the ultrastructure of purified prion rods treated in vitro with PPI
generation 4.0. By electron microscopy, RML prion rods were
disaggregated after incubation for 2 h at 37°C with PPI (Fig.
5B). In contrast, SHa(Sc237) PrP 27-30 rods remained intact after treatment with PPI (Fig. 5D).
Disaggregation of purified RML prion rods by treatment with PPI
was accompanied by a loss of
-sheet secondary structure, as
judged by FTIR spectroscopy. Whereas control rods were 57%
-sheet,
25%
-helix, 7%
-turn, and 11% random coil, PPI-dissociated
PrPSc was 47%
-sheet, 25%
-helix, 15%
-turn,
and 13% random coil (Fig. 5E).


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FIG. 5.
Ultrastructure and secondary structure of purified prion
rods treated with PPI in vitro. (A to D) Samples of purified
100-µg/ml PrP 27-30 in 0.1% NP-40-50 mM sodium acetate (pH 3.0)
buffer were incubated overnight at 37°C. Negative-stain electron
microscopy was performed as described previously (32).
Panels: A, Mo(RML) prion rods; B, Mo(RML) prion rods plus 60 µg of
PPI generation 4.0/ml; C, SHa(Sc237) prion rods; D, SHa(Sc237) prion
rods plus 60 µg of PPI generation 4.0/ml. The negative stain used was
2% uranyl acetate; scale bar = 100 nm. (E) FTIR spectra of 0.1 µg of purified Mo(RML) prion rods/ml incubated overnight at 37°C
with (dotted line) or without (solid line) 60 µg of PPI generation
4.0/ml.
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To investigate further the mechanism of polyamine-induced
disaggregation of PrP 27-30, we performed a kinetic study in vitro using purified mouse RML prion rods and various concentrations of PPI.
The results indicate that polyamine-induced PrPSc
disaggregation is not a catalytic process and requires a stoichiometry of approximately one PPI molecule per five PrP 27-30 molecules in
purified RML prion preparations (data not shown).
PPI accumulates in lysosomes.
Branched polyamines apparently
require acidic conditions to render PrPSc protease
sensitive when mixed with brain homogenates or purified prions in vitro
(Fig. 2A). However, these compounds successfully cure living cells of
prion infection when added to culture media buffered at pH 7.4 (Fig.
1). One possible explanation for this discrepancy is that branched
polyamines might localize with prions within an acidic intracellular
compartment. PrPSc has previously been shown to accumulate
in lysosomes (35). Therefore, we sought to determine
whether branched polyamines localize to this same compartment. We
incubated N2a cells with fluorescein-labeled PPI and LysoTracker Red
and performed dual channel confocal microscopy to compare the
localization of the two compounds. Our results indicate that
fluorescein-labeled PPI accumulates in the lysosomes of living cells
(Fig. 6).

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FIG. 6.
PPI localizes to lysosomes. N2a cells grown to 50%
confluence on coverslips were incubated for 4 h with 3 mM FITC-PPI
and 1 h with 75 nM LysoTracker Red (Molecular Probes).
Fluorescence confocal microscopy in green and red channels was
performed as described in Materials and Methods. Bar = 5 µm.
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DISCUSSION |
Branched polyamines as therapeutic agents.
A major finding of
this study is that branched polyamines eliminate prion infectivity from
living cells that were chronically infected. To our knowledge, this is
the first class of compounds shown to cure an established prion
infection. Polyene antibiotics, anionic dyes, sulfated
dextrans, anthracylines, porphyrins, phthalocyanines, dapsone, and a synthetic
-breaker peptide all prolong scrapie incubation times in vivo but only if administered prophylactically (1, 11, 12, 16-19, 31, 34).
The unique ability of branched polyamines to cure an established prion
infection in cells suggests that these compounds might also reverse
disease progession in animals. However, two factors could potentially
limit the use of these compounds as therapeutic reagents against prion
diseases. One potential limitation is that branched polyamines might
not act on all strains of prions in vivo. This possibility is shown by
in vitro studies in which some strains and species of prions were more
resistant than others to branched polyamine-induced disaggregation
(Fig. 3). It remains to be determined whether prion strains
resistant to branched polyamine-induced disaggregation in vitro would
also be resistant to treatment by these compounds in vivo. Treatment of
more resistant strains might require therapy with branched
polyamines in combination with another class of prion-directed
compounds. Significantly, PPI demonstrates substantial in vitro
activity against BSE (Fig. 3C).
The second potential limitation of branched polyamines is that these
highly charged compounds might not cross the blood-brain barrier. If
this proves to be the case, it may be possible to deliver branched
polyamines directly to the cerebrospinal fluid through an
intraventricular reservoir or perhaps to synthesize them as prodrugs
capable of crossing the blood-brain barrier. Preliminary studies
indicate that continuous intraventricular infusion of PPI generation
4.0 is tolerated by FVB mice up to a total dose of approximately 0.5 mg/animal (data not shown). Further studies are required to
characterize the biodistribution of dendrimers and to optimize their
delivery to prion-infected neurons in vivo.
Molecular target, mechanism, and site of action.
The ability
of branched polyamines to render PrPSc sensitive to
proteolytic digestion in purified prion preparations (Fig. 2) suggests
that the molecular target of these compounds must be either (i)
PrPSc itself, (ii) an acid-induced unfolding intermediate
of PrPSc, or (iii) a very tightly bound, cryptic molecule
which copurifies with PrPSc. Cross-linking experiments
indicate that photoaffinity-labeled PPI generation 4.0 binds PrP 27-30 avidly (data not shown), but unfortunately these results cannot prove
conclusively that PrP is the molecular target of branched polyamines.
If the molecular target is PrP, at least one of the polyamine binding
sites must be contained within the amino acid sequence of the PrP106
deletion mutant (32), since PPI renders
PrPSc106 protease sensitive (Fig. 3A, lane 6). The 106 amino acids present in PrP106 are residues 89 to 140 and 177 to 231. PPI also renders a spontaneously protease-resistant, 61-amino-acid-long PrP deletion mutant, PrP(
23-88,
141-221), susceptible to
protease digestion (33a), further delimiting the
boundaries of at least one putative binding site to residues 89 to 140 and 222 to 231.
Several lines of evidence suggest that branched polyamines render
PrPSc molecules protease sensitive by dissociating
PrPSc aggregates. (i) RML prion rods treated in vitro with
PPI become disaggregated, as judged by electron microscopy (Fig. 5).
(ii) Prion strains resistant to branched polyamines in vitro appear to
be more amyloidogenic than polyamine-susceptible strains, as judged by
neuropathology (4, 7, 13, 14). (iii) The ability of
branched polyamines to render PrPSc protease sensitive in
vitro is enhanced by conditions which favor PrPSc
disaggregation. These conditions include acidic pH (Fig. 2A) and the
presence of urea (Fig. 4A).
Theoretically, it is possible that the mechanism by which branched
polyamines remove PrPSc and prion infectivity from ScN2a
cells does not relate to the ability of these compounds to disaggregate
prions in vitro. However, this is unlikely because the relative potency
of 14 different polyamines in eliminating PrPSc from ScN2a
cells correlates with the relative ability of these same compounds to
render PrPSc sensitive to proteolysis in crude brain
homogenates and purified preparations of RML PrP 27-30 in vitro
(33) (Table 1). The structure-activity profile obtained from these studies indicates that
polyamines become more potent at eliminating PrPSc as
they become more branched and possess more surface primary amines. With PPI dendrimers, this effect reaches a plateau at the
fourth generation; PPI generation 5.0 is no more potent than PPI
generation 4.0 at either removing PrPSc from cells or
rendering PrPSc protease sensitive in vitro. Homodisperse,
uniform PPI and PAMAM dendrimers were more potent than the
heterogeneous preparations of PEI or SuperFect, a heat-fractured
dendrimer.
We determined that the process by which PPI renders PrPSc
protease sensitive in vitro was not catalytic. Instead, this process appeared to require a fixed stoichiometric ratio of PPI to
PrPSc of approximately 1:5. How could PPI denature prion
rods stoichiometrically? One possible explanation is that individual
amino groups on the surface of PPI might bind to PrPSc
monomers or oligomers that exist in equilibrium with a large aggregate
under acidic conditions. The dendrimer might then pry bound
PrPSc molecules apart from the aggregate and/or prevent
such molecules from reaggregating.
Another possible mechanism of polyamine-induced prion clearance from
ScN2a cells is that branched polyamines facilitate PrPSc
transport from the plasma membrane through the endocytic pathway into
secondary lysosomes. Several lines of evidence indicate that the
cellular site of action of branched polyamines is secondary lysosomes.
(i) Fluorescein-tagged PPI and PrPSc both localize to
lysosomes (8, 35) (Fig. 6). (ii) The pH optimum of
PrPSc denaturation in vitro is <5.0. When cultured
cells were studied with fluorescent acidotropic pH measurement dyes,
secondary lysosomes were the most acidic cellular compartment detected,
with pH values of ~4.4 to 4.5 (2, 10). (iii) The
lysosomotropic agent chloroquine attenuates the ability of branched
polyamines to eliminate PrPSc from ScN2a cells
(33). Our studies raise the possibility that lysosomal
proteases normally degrade PrPSc in prion-infected cells at
a slow rate and that polyamines accelerate this process by denaturing
PrPSc.
Other applications of branched polyamines.
Beyond their
potential use as therapeutic agents and research tools,
branched polyamines might also be useful as prion strain-typing reagents and/or prion decontaminants. Presently, typing of prion strains is time-consuming and requires the inoculation of samples into
several strains of inbred animals to obtain incubation time and
neuropathology profiles (4, 9). Recently, antibody-based PrPSc conformational stability assays able to distinguish
prion strains have been developed (26) (D. Peretz,
unpublished data). In this study, we observed that different
species and strains of prions displayed varying susceptibilities to
branched polyamine-induced denaturation in vitro (Fig. 3). These
results suggest that a polyamine-based in vitro protease digestion
assay could, in principle, be used as a simple and rapid diagnostic
method for prion strain typing. One practical application which arises
from our results is that a polyamine-based assay could be used to
distinguish between BSE and natural scrapie in flocks of domestic sheep.
Currently, it is very difficult to remove prions from skin, clothes,
surgical instruments, foodstuffs, and surfaces (5). Standard prion decontamination requires either prolonged autoclaving or
exposure to harsh protein denaturants such as 1 N NaOH or 6 M guanidine
thiocyanate (24). Branched dendrimers are nontoxic and
relatively inexpensive. These compounds may therefore be suitable for
use as disinfecting reagents to limit the commercial and iatrogenic spread of prion diseases.
 |
ACKNOWLEDGMENTS |
This work was supported by grants from the National Institutes of
Health (NS14069, AG02132, and AG10770) and by a gift from the Leila and
Harold Mathers Foundation. S.S. was supported by the Burroughs Wellcome
Fund Career Development Award and by an NIH Clinical Investigator
Development Award (K08 NS02048-02).
 |
FOOTNOTES |
*
Corresponding author. Mailing address: Institute for
Neurodegenerative Diseases, Box 0518, University of California, San
Francisco, CA 94143-0518. Phone: (415) 476-4482. Fax: (415) 476-8386. E-mail: hang{at}itsa.ucsf.edu.
 |
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0022-538X/01/$04.00+0 DOI: 10.1128/JVI.75.7.3453-3461.2001
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