The Journal of Neuroscience, July 23, 2003, 23(16):6413-6422
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Gap Junctions Mediate Bystander Cell Death in Developing Retina
Karen Cusato,1
Alejandra Bosco,1
Renato Rozental,1
Cinthya A. Guimarães,2
Benjamin E. Reese,3
Rafael Linden,2 * and
David C. Spray1 *
1Department of Neuroscience, Albert Einstein
College of Medicine, Bronx, New York 10461, 2Institute
of Biophysics, Federal University of Rio de Janeiro, 21949-900, Rio de
Janeiro, Brazil, and 3Neuroscience Research Institute
and Department of Psychology, University of California at Santa Barbara, Santa
Barbara, California 93106
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Abstract
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During development of the retina, programmed cell death helps to establish
the final size and distribution of various cell classes in distinct layers of
the tissue. Here we show that dying cells in the developing ganglion and inner
nuclear layers are clustered spatially and that gap junction inhibitors
decrease the clustering of dying cells. To confirm the role of gap junctions
in cell death, we induced targeted cell death via intracellular cytochrome
c (Cc) and examined the induced cells and their neighbors
for apoptotic morphology or caspase-3 cleavage. These studies indicate that
bystander killing extends to coupled cells.
Quantitative studies of bystander killing were performed by scrape-loading
retinas with Cc in the presence of rhodamine dextran (RD; to identify
Cc-loaded cells) and by counting pyknotic cells in cryosections.
Although only 1.5% of control scrape-loaded cells (RD alone) showed apoptotic
morphology, 97% of Cc scrape-loaded cells were pyknotic. Moreover,
bystander killing extended to neighboring cells, not labeled with RD, and was
reduced significantly by the gap junction inhibitors octanol and
carbenoxolone. We hypothesize that dying cells in the retina generate a gap
junction-permeant apoptotic signal that mediates bystander killing. This novel
finding of naturally occurring bystander cell death may have important
implications in the histogenesis and pathology of the nervous system.
Key words: retina; cell death; gap junctions; bystander effect; development; inner nuclear layer
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Introduction
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Programmed cell death occurs naturally during development of the retina in
many species (Perry et al.,
1983
; Young, 1984
;
Cook et al., 1998
;
Georges et al., 1999
;
Johnson et al., 1999
) as well
as in degenerative disorders (Chang et al.,
1993
; Jomary et al.,
2001
) and retinal traumas (Cook
et al., 1995
). Although it has been thought that the apoptotic
form of programmed cell death occurs at the level of individual cells in
tissues (Kerr et al., 1972
),
including the retina (Cook et al.,
1998
), clustering of dying cells has been reported
(Glucksman, 1951
;
Gavrieli et al., 1992
;
Milán et al., 1997
),
and evidence exists that developmentally regulated apoptosis is induced in
groups of cells simultaneously via paracrine signals
(Coucouvanis and Martin, 1995
;
Graham et al., 1996
).
Bystander killing, in which the death of one cell propagates to other
cells, has been described previously in cells transfected with herpes simplex
virus thymidine kinase and treated with ganciclovir
(Vile and Hart, 1993
;
Trosko and Goodman, 1994
).
This cell death is propagated by gap junction-mediated passage of toxic
metabolites (Elshami et al.,
1996
; Mesnil et al.,
1996
; Vrionis et al.,
1997
). Gap junctions are intercellular channels that allow the
direct diffusion of small molecules (below
1 kDa)
(Simpson et al., 1977
). Other
bystander cell death studies suggest that a natural byproduct of apoptosis
itself may pass between coupled cells (Lin
et al., 1998
). The finding that communication via gap junctions
persists during apoptosis in epithelial cell lines
(Wilson et al., 2000
) and
during ischemia in the brain (Lin et al.,
1998
) allows for the possibility that gap junctions can provide a
route for bystander cell killing in ischemia, degenerative diseases, and
neural development.
Gap junction proteins are highly expressed in the developing and adult
retina (Dermietzel et al.,
2000
), where they provide electrical and metabolic coupling
between both neurons and glia (Vaney,
1991
; Penn et al.,
1994
; Mills and Massey,
1995
; Becker et al.,
2002
). Although the participation of gap junctions in naturally
occurring developmentally regulated programmed cell death in the retina has
been suggested (Linden, 2000
),
evidence for such a role is far from conclusive. The present study
demonstrates that dying cells in the developing retina are clustered
spatially, consistent with bystander cell death, and that the clustering of
dying cells during retinal development is decreased by a gap junction-blocking
agent, suggesting that the spread of cell death via gap junctions is a
mechanism of naturally occurring programmed cell death in the developing
nervous system. Further, cell death in the retina induced by intracellular
delivery of cytochrome c (Cc) led to apoptotic morphology
and caspase-3 cleavage in bystander cells. This bystander killing was reduced
greatly by inhibitors of gap junction intercellular communication, indicating
that gap junctions mediate the spread of cell death. Finally, we show that
single-cell injection of Cc and gap junction-permeant dyes leads to
cleavage of caspase-3 in clusters of coupled cells, indicating that bystander
killing occurs in cells coupled via gap junctions. Taken together, these data
provide compelling evidence for a role of gap junctions in the spread of cell
death in retinal tissue and may provide a mechanistic explanation for the
propagation of cell death in injury or disease.
 |
Materials and Methods
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Terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end
labeling assay. C57BL mice, postnatal day 5 (P5) and P8, were killed by
decapitation, and the eyes were fixed in 4% paraformaldehyde (PFA) for 2 hr.
Retinas were embedded, cryosectioned, and processed for terminal
deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL)
labeling (Gavrieli et al.,
1992
) as previously described
(Johnson et al., 1999
;
Cusato et al., 2001
), with the
exception that the TUNEL marker was Cy2-streptavidin (1:200, 1 hr at room
temperature; Jackson ImmunoResearch, West Grove, PA).
Spatial analysis. P5 and P8 C57BL mice were perfused with PFA; the
retinas were flat-mounted, stained with 0.5% cresyl violet, and dehydrated.
Two-dimensional surface reconstructions of positions of pyknotic nuclei in the
ganglion cell layer (GCL) and inner nuclear layer (INL) were generated via
camera lucida. The drawings were measured on a digitizing tablet (Bioquant
Image Analysis, Nashville, TN) or, after scanning, using Scion Image (Scion,
Frederick, MD). Nearest neighbor (NN) analysis was performed by measuring the
distance from each pyknotic cell in the field to the closest pyknotic cell.
Cells closer to the edge of the field than to another cell were excluded,
although they might be the closest neighbor to another cell. The frequency
distribution of the NN of four fields per retina was plotted. These were
compared with NN distributions of randomly generated points of equal density
and area by using the Kolmogorov-Smirnov test for cumulative distributions.
Random x, y coordinates were generated with Rand software (kindly
provided by L. Galli-Resta, Istituto di Neuroscienze, CNR, Pisa, Italy), and
their NN distributions were measured. Some P5 animals (n = 3) were
pretreated with carbenoxolone (20 mg/kg, s.c., in dH2O; Sigma, St.
Louis, MO) and were perfused after 4 hr; they underwent spatial analysis of
dying cells.
Scrape-loading: dye-coupling experiments. To confirm that the
in vivo carbenoxolone treatment decreased gap junctional coupling, we
injected P5 animals with carbenoxolone as described above (n = 2), or
saline (n = 2); the animals were decapitated at 2 or 4 hr after the
injection. Retinas were removed and flat-mounted GCL up on Millicell-CM
inserts (Millipore, Bedford, MA) in Neurobasal medium (Invitrogen,
Gaithersburg, MD). All liquid was removed, and 10 µl of 0.5% rhodamine
dextran (RD; Molecular Probes, Eugene, OR) and 3% Neurobiotin (NB; Vector
Laboratories, Burlingame, CA) solution in 100 mM KCl was placed on
top of the retina. Immediately, the retina was touched with a scalpel, rinsed
with medium, and incubated at 37°C in 5% CO2 for 15 min. This
scrape-loading procedure is a modification of a previously described
transection-loading procedure for studying gap junctional communication
(Menezes et al., 2000
).
Retinas were fixed in PFA for 30 min, rinsed in PBS, placed on filter paper,
and sectioned to 150 µm on a tissue slicer (Stoelting, Wood Dale, IL).
Sections were mounted on coverslips and pretreated with 1% bovine serum
albumin (BSA; Sigma) for 20 min; NB was detected with Cy2-streptavidin
(Jackson ImmunoResearch) at a ratio of 1:200 for 1 hr. Sections were rinsed,
mounted in Fluoromount-G (Fisher Scientific, Pittsburgh, PA), and imaged by
confocal microscopy (Olympus Fluoview 500 series, Melville, NY).
Quantification was performed on four z-series reconstructions per
retina (z-step, 1 µm; 20 µm total thickness). Because RD is too
large to pass through gap junctions and NB readily passes, RD served as a
marker for the cells that were loaded by the scrape-loading procedure, whereas
cells single-labeled for NB must have been labeled by the passage of NB from a
scrape-loaded cell via gap junctional communication. The number of
single-labeled NB cells was quantified as well as the number of cells
colocalizing NB and RD. Cells single-labeled for NB were considered to be
coupled cells. A "coupling index" was calculated for each field
(the number of single-labeled NB cells divided by the total of NB-labeled
cells), giving the proportion of cells labeled via gap junctional
communication. Because no differences were observed in the Coupling Index
between retinas from 2 or 4 hr conditions, the data were pooled and compared
by Student's t test (two-tailed; p < 0.01).
Scrape-loading: bystander killing experiments. Lister hooded rats
(P13-P15) from our colony at Federal University of Rio de Janeiro were
anesthetized and decapitated. Retinas were hemisected and flat-mounted GCL up
on Millicell-CM inserts in Neurobasal medium. All liquid was removed, and 10
µl of either 0.5% RD or 0.5% RD plus 1 mM Cc (Sigma)
solution in dH2O was placed on top of the retina. Immediately, the
retina was touched with a scalpel, rinsed with medium, and cultured for 1 hr.
Finally, retinas were fixed, embedded in gelatin, and cryosectioned at 20
µm.
Treatments of the retinal whole mounts included 1 hr preincubation in
octanol (100 µM; Sigma),
S-nitroso-DL-penicillamine (SNAP, 100 µM;
Sigma-RBI), 1 mM 8-Br-cAMP (Calbiochem, San Diego, CA), or 1H-
[1,2,4]oxadiazolo[4,3a]quinoxalin-1-one (ODQ; 30 nM; Sigma-RBI) in
Neurobasal medium. Some animals were injected with carbenoxolone (20 mg/kg,
s.c.), and their retinas were preincubated in carbenoxolone (10
µM) for 1 hr. Then these retinas were scrape-loaded with
Cc and RD or RD alone, rinsed, and cultured for 1 hr in the same
condition of preincubation. Cryosections either were stained with
4,6-diamino-2-phenylindole (DAPI; Molecular Probes) or were processed for
immunofluorescence with cleaved caspase-3 (1:50, overnight; Cell Signaling
Technology, Beverly, MA) and goat anti-rabbit IgG Alexa Fluor 488 (1: 200, 3
hr; Molecular Probes) antibodies.
To demonstrate functional gap junctional coupling and its inhibition in
this model, we scrape-loaded retinas with 0.5% RD and 3% NB, as described
above, in the presence or absence of carbenoxolone (10 µM) and
cultured them for 1 hr. Carbenoxolone-treated retinas were from animals
preinjected as described above. Retinas were cryosectioned, and NB was
visualized with Cy2-streptavidin as described above.
To confirm that RD marked the cells loaded with Cc, we
scrape-loaded retinas with RD and Cc conjugated to biotin
(biotin-Cc). Biotin-Cc was prepared by following the kit
manufacturer's instructions (Molecular Probes) and was dialyzed to remove
excess free biotin. Retinas were fixed in PFA, and cryosectioned to 20 µm.
Biotin-Cc was visualized with Cy2-streptavidin at a ratio of 1:250
for 1 hr.
Analysis. Dying cells were quantified on the basis of pyknotic
morphology in cryosections of scrape-loaded and DAPI-stained tissue
(400x magnification, oil immersion objective). Data were collected from
the GCL and INL and combined. Six to eight fields per retina, 175 µm long
each, were analyzed in three retinas per condition, unless otherwise stated.
All fields were from nonadjacent sections. For controls scrape-loaded with RD
in the presence of gap junction inhibitors and for the octanol experiments,
eight fields from a single retina per condition were quantified in each case.
In Neurobiotin dye-coupling experiments eight fields from two
carbenoxolone-treated retinas and two control retinas were analyzed. Retinas
were imaged by confocal microscopy, and digital images of z-series
reconstructions were processed with Adobe Photoshop software (Mountain View,
CA).
Single-cell injections. For single-cell injections Long-Evans
rats, the strain from which Lister hooded rats were derived and the most
closely related strain available in the USA, were purchased from Charles River
Laboratories (Wilmington, MA). Retinas from P13-P21 rats were dissected in
oxygenated Locke's solution [containing (in mM) 112.5 NaCl, 20
NaHCO3, 3.6 KCl, 1.2 CaCl2, 2.4 MgCl2, 10
glucose, and 10 HEPES, pH 7.3] and flat-mounted vitreal side up on
nitrocellulose paper (Millipore) with a 5 mm hole. Single cells were impaled
with a high-resistance microelectrode, and Alexa Fluor 488 (AF488, 1
mM; Molecular Probes) was injected by using brief overcompensation
of the negative capacitance control (World Precision Instruments, Sarasota,
FL). AF488 was injected alone or coinjected with 1 mM Cc
(in 150 mM NaCl) on a Nikon Eclipse 600FN microscope equipped with
xenon arc lamp illumination and micromanipulators (PCS-PS60, Burleigh,
McHenry, IL). Some injections were made in the presence of 75 µM
carbenoxolone. During injection or afterward the injected cells were
photographed (Coolpix 950, Nikon). Retinas subsequently were cultured at
37°C in 5% CO2 for 1 hr, fixed in PFA for 30 min, and rinsed in
PBS. Finally, retinas were processed for immunofluorescence with CM1 (1:5000;
kindly provided by Dr. Anu Srinivasan, IDUN Pharmaceuticals, San Diego, CA) or
cleaved caspase-3 (1:50) for 3 d (both antibodies recognize the cleaved form
of caspase-3), followed by goat anti-rabbit IgG Alexa Fluor 594 (1:200 for 3
hr). Retinas were mounted in Vectashield (Vector Laboratories) and
photographed (Spot camera, Morrell Instruments, Melville, NY).
All animals were treated, maintained, and killed in accordance with Society
for Neuroscience resolutions on the use of animals in research and National
Institutes of Health guidelines as well as institutional protocols.
 |
Results
|
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Distribution of dying cells in developing retina
When cryosections of developing mouse retina were labeled with DAPI,
pyknotic cells were evident and often were observed to be in columns
(Fig. 1a, arrowheads).
In a single plane of focus often just a few dying cells were observed, but
they were usually near one another. In TUNEL-labeled sections from P5 mouse
retina the dying cells were found in both the ganglion cell layer (GCL) and
the inner nuclear layer (INL), sometimes spanning the INL in columns. As in
DAPI-stained tissue, a single plane of focus revealed some dying cells,
usually clustered. However, z-series reconstructions (15 µm thick)
from confocal images of TUNEL-labeled sections of P5 and P8 mouse retina
showed that, within a few micrometers of retinal thickness, many dying cells
were present, and multiple columns were visible
(Fig. 1b,c,
arrowheads). Given that the estimated clearance time of apoptotic cells in the
developing retina is on the order of 1 hr or less
(Perry et al., 1983
;
Voyvodic et al., 1995
), the
presence of groups of dying cells suggests that the cells have undergone death
simultaneously or within a relatively short period of time, indicating that
cell death does not necessarily operate at the level of individual cells.

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Figure 1. Spatial analysis of dying cells in the developing retina revealed a
clustered distribution. a, Dying cells (arrowheads) evidenced by
nuclear condensation (pyknosis) in DAPI-stained radial sections (20 µm) of
P5 mouse retina. Z-series projections (15 µm) of TUNEL-labeled P5
(b) and P8 (c) mouse retina show that clusters of dying
cells are frequent in developing retina. Scale bars in a-c, 10 µm.
GCL, Ganglion cell layer; INL, inner nuclear cell layer; IPL, inner plexiform
layer; NBL, neuroblastic layer; ONL, outer nuclear layer; OPL, outer plexiform
layer; pOPL, presumptive OPL. d-i, Single field from a P5 mouse
retina stained with cresyl violet, whole-mounted, and observed at different
focal planes. Arrowheads point to pyknotic cells, and the white arrowhead
indicates a pyknotic nucleus visible in multiple planes. d, Ganglion
cell layer. e, Inner plexiform layer. f, g, Inner portion
and outer portion (h) of inner nuclear layer. i, A
two-dimensional surface reconstruction of the positions of the dying cells
throughout the GCL and INL denotes the tendency of the dying cells to be
clustered. Scale bar, d-i, 20 µm. j, Nearest neighbor
(NN) distributions of P5 mouse retina (left) and of random points in fields of
equal size and density (right). k, NN distribution of P8 mouse retina
(left) and NN distribution of random points in fields of equal size and
density (right). At both ages more dying cells are located near to one another
in the retinas than in the random fields. All retinal NN distributions were
significantly different from the associated random field NN distributions
(Kolmogorov-Smirnov test, p < 0.001).
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Nearest neighbor distributions
To confirm that dying cells are clustered in the developing retina, we
performed NN analysis (Wässle and
Reimann, 1978
) on P5 and P8 retinal whole mounts stained with
cresyl violet. Pyknotic cells were found at different focal planes through the
thickness of the GCL and INL (Fig.
1d-h, arrowheads), and, when their relative positions
were plotted in two dimensions, a clustered distribution was evident
(Fig. 1i). Fields of
random x, y coordinates of equal size and density were generated, and
their NN distribution was determined also.
Figure 1, j and
k, shows representative NN distributions from single P5
and P8 retinas, respectively. NN distributions of dying cells from P5 mouse
retina show that, on average (n = 3), 64% of pyknotic cells have a NN
distance of <15 µm, whereas in random distributions only 23% of the NN
distances were <15 µm. In P8 mouse retina, on average (n = 2),
69% of pyknotic cells had NN distances of <15 µm, whereas 29% of the NN
distances were <15 µm in random distributions. All retinas were
significantly different from the associated random distributions (one-tailed
Kolmogorov-Smirnov test, p < 0.001), clearly showing that the
distribution of dying cells in the developing retina is clustered.
There are a number of developmental events that may account for a clustered
distribution of dying cells in the retina, including paracrine release of
diffusible survival-promoting molecules, release of diffusible death-inducing
molecules, and intercellular transport of death-inducing substances via gap
junctions. Many types of retinal cells are coupled by gap junctions in
adulthood (Raviola and Raviola,
1982
; McMahon et al.,
1989
; Vaney, 1991
;
Mills and Massey, 1995
;
De Vries et al., 2002
) and
during development (Penn et al.,
1994
; Becker et al.,
2002
). We have tested the hypothesis that gap junction-mediated
cell-cell signaling plays a role in the clustering of dying cells by treating
P5 mice in vivo with carbenoxolone (20 mg/kg, s.c.), a gap junction
inhibitor (Davidson and Baumgarten,
1988
). To determine that our carbenoxolone injection regimen
decreased gap junctional communication in the developing retina, we have used
a modification of the well established scrape-loading dye-transfer technique,
which interrupts the membranes of multiple cells simultaneously, allowing the
passage of water-soluble dyes (El-Fouly et
al., 1987
; De Pina-Benabou et
al., 2001
). In this case we have removed the retinas 2 or 4 hr
after subcutaneous carbenoxolone injection, scrape-loaded them with a solution
containing 0.5% RD (70 kDa) and 3% NB (286 D), and allowed the NB to diffuse
for 15 min before fixation. Because RD is too large to pass through gap
junctions and therefore is retained in the scrape-loaded cells but NB is
gap-junction permeable (Kita and
Armstrong, 1991
; Vaney,
1991
), gap junctional coupling is evidenced by cells that are
labeled with Neurobiotin but lack RD
(Becker et al., 2002
).
Gap junctional coupling was evidenced by NB transfer from RD-containing
scrape-loaded cells in vehicle-injected animals
(Fig. 2a,b,
arrowheads); however, the intercellular spread of NB was decreased in retinas
from carbenoxolone-injected animals (Fig.
2c,d, arrowheads). In controls, the inner plexiform layer
(IPL) contained many NB-labeled cell processes
(Fig. 2b, double
arrowheads), whereas in carbenoxolone-treated animals the labeling in the IPL
was reduced (Fig. 2d,
double arrowheads). However, horizontal cell processes in the presumptive OPL
(pOPL) were labeled strongly for NB (Fig.
2d, double arrowheads), indicating that the decreased
labeling in the IPL was attributable to a reduced number of processes labeled
in the IPL. Quantification of dye coupling showed that the proportion of all
NB-labeled cells that were single-labeled (the Coupling Index) was decreased
significantly in carbenoxolone-treated animals
(Fig. 2e; p
< 0.01, two-tailed t test). When NN distributions from P5 mice
(n = 3) treated in vivo with carbenoxolone were compared
with untreated P5 mice (n = 3), the percentage of dying cells with a
NN distance of <15 µm was decreased significantly from 64 to 30.3%,
suggesting that the clustering of dying cells is mediated by gap junctions
(Fig. 2f; p
< 0.01, two-tailed t test with correction for unequal variance).
The fact that the proportion of cells labeled via coupling and the percentage
of dying cells with a NN distance <15 µm were reduced by carbenoxolone
to a remarkably similar degree (compare
Fig. 2e,f) suggests
that the decrease in coupling accounts for the decrease in the clustering of
dying cells.

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Figure 2. Carbenoxolone treatment decreased dye coupling and clustering of dying
cells in vivo. a, b, Z-series projection (20 µm) of retinal
sections from P5 mouse injected with vehicle and scrape-loaded with RD and NB.
a, RD labels cells in GCL and NBL (arrows). b, NB
(Cy2-streptavidin) is localized in cells that were scrape-loaded with RD
(arrows) and other cells not loaded with RD (arrowheads). Many processes in
the IPL were labeled with NB (double arrowhead). Arrowheads in a
indicate position of coupled cells in b. c, d, Carbenoxolone
treatment decreases spread of NB. c, RD labeling (arrows) of
scrape-loaded retina from treated animal (20 mg/kg, s.c.). d, NB
labeling of same field shows few NB-labeled cells that do not colocalize with
RD (arrowheads). Processes in IPL and pOPL are indicated by double arrowheads.
Scale bars in a-d, 20 µm. e, Coupling Index for control
(Con) and carbenoxolone (Cbx) indicates a significant decrease in dye coupling
by Cbx treatment (asterisks indicate groups significantly different from
controls; Student's t test, p < 0.01). f, Cbx
reduces the percentage of dying cells with a NN distance shorter than 15 µm
in a manner that closely parallels the decrease in the Coupling Index.
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Induction of bystander killing
If a spread of cell death signals occurs, then induction of cell death in
targeted cells should lead to cell death in other "bystander"
cells. Because such studies require the absence of naturally occurring cell
death, we have used rat retinas (which make exceptional in vitro
preparations) from P13-P15 animals, a time at which the majority of
developmental cell death already has occurred
(Horsburgh and Sefton, 1987
).
To test the hypothesis that dying cells induce bystander cell death, we have
used the modified scrape-loading technique to introduce Cc into the
cytoplasm of retinal cells in situ. Scrape-loading not only is used
to study gap junctional coupling, but also has been shown to be an effective
method for loading multiple cells simultaneously with functional proteins
(McNeil et al., 1984
;
Ortiz et al., 1987
;
Morris et al., 1989
;
Linseman et al., 2001
).
Cc release from the mitochondria during apoptosis
(Liu et al., 1996
) activates
caspase-9, which then activates important effectors of cell death including
caspase-3 (P. Li et al.,
1997
). Because RD (70 kDa) and Cc (12.6 kDa) are both too
large to pass through gap junctions, they are confined to the cells that have
had their membranes permeabilized by the scrape-loading procedure; thus RD
labeling should serve as an indicator of which cells were lesioned by the
procedure so that the fate of the Cc-loaded cells could be followed.
To confirm this, we scrape-loaded retinas with RD and Cc that is
conjugated to biotin (biotin-Cc;
Fig. 3a-c). Both RD
and biotin-Cc were found in many cell types in the GCL and INL near
the lesion (asterisks). RD and biotin-Cc showed a high degree of
colocalization with near total overlap, not only in the somata but in the
processes as well (Fig.
3c, double arrowheads). Rarely were cells labeled for
biotin-Cc alone (Fig.
3b,c, arrowhead), indicating that RD efficiently
identified the population of cells loaded with Cc.

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Figure 3. Targeted killing of primary cells induced bystander cell death in
vitro. a-i, Confocal images of radial sections (20 µm) from P13-P15
rat retinas scrape-loaded with or without Cc in the presence of
RD-dextran. a-c, Retina scrape-loaded with RD and biotin-Cc.
The asterisks denote the shallow scrape-loading incision spanning the GCL and
IPL in part of the z-series. Shown are RD (red, a),
biotin-Cc (Cy2-streptavidin; green, b), and the merged image
(c). RD and Cc are both too large to pass through gap
junctions and thus remain confined to the scrape-loaded cells. Both somata
(arrows) and processes (double arrowheads) are labeled. RD and Cc
colocalize (c) with only occasional cells labeled for Cc
alone (arrowhead); therefore, RD clearly identifies the cells loaded with
Cc. d-f, Retina scrape-loaded with RD and Cc, immunolabeled
for cleaved caspase-3. d, RD-labeled cells (red; arrows) were
immunopositive (e) for cleaved caspase-3 (green; arrows). Cells not
labeled with RD also were labeled for cleaved caspase-3 (arrowheads),
indicating bystander cell death. Cleaved caspase-3 was detected in both somata
and processes (double arrowheads). f, Merged image indicates that RD
and cleaved caspase were colocalized (arrows) in some cells, but other dying
cells did not contain RD (arrowheads). g-i, Control retina
scrape-loaded with RD alone. g, RD-labeled cells (red) were not
labeled for cleaved caspase-3 (h). However, one cell not labeled with
RD was dying (h, i; arrowhead). This indicates that neither the
scrape-loading nor the RD was a potent inducer of cell death. i,
Merged image. Scale bars in a-i, 20 µm.
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Scrape-loading with RD and Cc induced caspase-3 cleavage both in
RD-labeled cells and in bystander cells as evidenced by immunolabeling with an
antibody that recognizes only the cleaved form of caspase-3
(Fig. 3d-f), which is
the active protease (Nicholson et al.,
1995
; P. Li et al.,
1997
). This finding indicates that both primary and bystander cell
death is caspase-mediated. Often cell processes were labeled, indicating that
cleaved caspase-3 was located throughout the cytoplasm
(Fig. 3e, double
arrowheads). Scrape-loading with RD alone rarely induced caspase-3 cleavage in
RD-labeled cells, and only occasional immunolabeled cells were observed
(Fig. 3g-i).
Scrape-loading with Cc induced morphological features of cell death
as evidenced by pyknotic nuclei in DAPI-stained tissue
(Fig. 4a,b) in both
RD-labeled cells (arrows) and in cells not loaded with Cc and RD
(Fig. 4a,b,
arrowheads). Horizontal cells often were labeled with RD; however, their
nuclei were rarely pyknotic (Fig.
4a,b, double arrowheads), indicating that they were
resistant to Cc-induced cell death. RD alone rarely induced pyknosis
in labeled cells (Fig.
4c,d, arrow). Whereas only 1% of cells scrape-loaded with
RD showed apoptotic morphology, 97% of cells scrape-loaded with RD and
Cc were pyknotic 1 hr after scrape loading
(Fig. 4e), consistent
with a previous study showing induced cell death in 95% of cells after
pressure injection of Cc in cell lines
(Brustugun et al., 1998
).

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Figure 4. The propagation of cell death was decreased by the inhibition of gap
junction coupling in vitro. a, b, Radial sections of P13 rat retina
scrape-loaded with RD and Cc. RD labeling (a) identified the
primary cells loaded with Cc, and DAPI staining (b) showed
pyknotic nuclei in cells labeled with RD (arrows) and also in many bystander
cells unlabeled with RD (arrowheads). Note in a and b that
the RD-loaded horizontal cells (double arrowheads) were not pyknotic. c,
d, Retina scrape-loaded with RD alone. c, RD-labeled cells were
occasionally pyknotic (arrow) in DAPI staining (d) of the same field.
Scale bars in a-d, 20 µm. e, Percentage of scrape-loaded
cells killed for control (RD), Cc, and Cc with drug
treatments. RD was significantly different from Cc (p <
0.01; one-way ANOVA, Duncan's multiple range test), but treatment with gap
junction inhibitors did not decrease the death of cells loaded with Cc.
f, The Bystander Killing Index for retinas treated with Cc
demonstrates that gap junction inhibitors (carbenoxolone and octanol) as well
as cAMP and NO generators (SNAP) decreased the bystander killing effect
significantly when compared with Cc alone (asterisks indicate
significant differences from Cc; p < 0.01; one-way ANOVA,
Duncan's multiple range test). ODQ significantly attenuated the effects of
carbenoxolone, indicating a role for cGMP as well. None of these agents
decreased cell death in primary cells (e), indicating that the rescue
effect was specific for the bystander cells. Cc, Cytochrome
c; Cbx, carbenoxolone; ODQ,
1H-[1,2,4]oxadiazolo[4,3a]quinoxalin-1-one; SNAP,
S-nitroso-DL-penicillamine; Oct, octanol.
|
|
Inhibition of bystander killing
A "bystander index" was calculated by dividing the number of
pyknotic cells not labeled with RD (bystander cells) by the total number of
pyknotic cells for each field. In the presence of Cc, the Bystander
Index was 0.66 ± 0.02 (mean ± SEM), showing that two of three
dying cells are bystanders (Fig.
4f). To determine whether bystander cell killing was
mediated via gap junction intercellular communication, we scrape-loaded
retinas with Cc and RD in the presence of agents that decrease gap
junctional communication: 10 µM carbenoxolone
(Davidson and Baumgarten, 1988
)
and 100 µM octanol (Spray et
al., 1986
). In carbenoxolone treatments the animals were injected
(20 mg/kg, s.c., in dH2O) 1 hr before death, as described above.
This combined injection and in vitro incubation protocol has been
shown previously to reduce dye coupling in the forebrain of rats
(Menezes et al., 2000
). Both
of these agents significantly decreased bystander cell death
(Fig. 4f).
Because carbenoxolone may exert its actions via inhibition of cAMP and cGMP
phosphodiesterases (Vapaatalo et al.,
1978
), the role of these molecules in the bystander effect was
determined. cAMP and cGMP have been shown to decrease coupling in the retina,
cAMP directly and cGMP via nitric oxide (NO) stimulation
(Mills and Massey, 1995
). The
addition of 1 mM 8-Br-cAMP and 100 µM SNAP, a NO
generator (Singh et al.,
1996
), also significantly decreased the bystander effect
(Fig. 4f). Further,
the rescue by carbenoxolone was reversed partially by the addition of 30
nM ODQ, a potent inhibitor of soluble guanylyl cyclase
(Moro et al., 1996
), further
indicating a role for cGMP in the blockage of bystander cell death. None of
these agents changed the percentage of RD-labeled cells killed by the
scrape-loading procedure (Fig.
4e), indicating that the rescue was specific for
bystander cells. NO has been shown to bind caspases reversibly by
S-nitrosylation (J. Li et al.,
1997
). However, the finding that 100 µM SNAP
decreased the bystander killing without decreasing the death of RD-labeled
cells indicates that this concentration of SNAP is exerting its effects via a
different mechanism, potentially via the inhibition of gap junctions.
Dye coupling
To confirm that cells are coupled in our in vitro model, we
scrape-loaded the retina with RD and NB. Cy2-conjugated streptavidin revealed
intercellular spread of NB in cells in the GCL and INL
(Fig. 5a,b), whereas
carbenoxolone treatment (the same protocol described above for bystander death
studies) decreased coupling (Fig.
5c,d). As in previous dye-coupling experiments, the
number of cells labeled with NB alone was divided by the total number of
labeled cells to generate a Coupling Index (comparable to the Bystander
Killing Index), which was reduced significantly by carbenoxolone
(Fig. 5e) from 0.63
± 0.07 to 0.24 ± 0.03 (two-tailed t test, p
< 0.01). This decrease in Coupling Index by carbenoxolone coincides well
with the decrease in Bystander Killing Index by carbenoxolone (0.66 ±
0.02 to 0.19 ± 0.02; Fig.
4f).

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Figure 5. Carbenoxolone decreased dye coupling in the scrape-loading model. Shown is
control P13 rat retina scrape-loaded with RD (a) and Neurobiotin
(b), which was visualized with Cy2-streptavidin. In a and
b note that many Neurobiotin-labeled cells were not labeled with RD
(arrowheads), indicating that they were coupled to the scrape-loaded cells
(arrows). c, d, P13 retina treated with carbenoxolone (20 mg/kg,
s.c., followed by 10 µM), scrape-loaded with RD and Neurobiotin.
d, Neurobiotin labeling of same field as in c; only
occasional cells were single labeled for Neurobiotin (arrowheads), indicating
decreased coupling as compared with control (a, b). The same
concentration of carbenoxolone that decreased bystander cell killing inhibited
coupling to similar levels. Scale bars in a-d, 20 µm. e,
The Coupling Index for retinas treated with carbenoxolone demonstrates that
this gap junction inhibitor decreased the Coupling Index significantly as
compared with control (asterisk indicates group significantly different from
control; two-tailed t test, p < 0.01). Con, Control; Cbx,
carbenoxolone.
|
|
Single-cell injections
To induce bystander cell death and confirm that dying cells are coupled via
gap junctions, we coinjected single cells in the ganglion cell layer of live,
whole-mounted rat retina (P13-P21) with 1 mM Alexa Fluor 488
(AF488), a gap junction-permeable dye, and 1 mM Cc, which
is too large (12.6 kDa) to pass through gap junction channels. Control
injections of AF488 alone and injections of AF488 and Cc showed that
similar numbers of cells were coupled to at least one other cell (45 ±
5.4%; n = 48 injected cells in 4 retinas for AF488 alone vs 47
± 4.8%; n = 32 cells from 4 retinas for AF488 and
Cc), indicating that dye spread is not decreased by Cc
injection. To confirm that dye spread was the result of gap junctional
coupling, we performed injections in the presence of 75 µM
carbenoxolone, which decreased coupling to at least one other cell by 66%
(15.4 ± 3.8%; n = 33 cells from 3 retinas). This concentration
of carbenoxolone was used in an attempt to increase the efficacy of gap
junction blockade over that obtained in previous experiments and previously
has been shown to decrease dye coupling in other cell types
(Rozental et al., 2001
).
In other retinas the bystander cell death was quantified after control and
Cc injections. After multiple injections the retinas were maintained
in vitro for 1 hr after the last cell was injected, fixed, and
immunolabeled for cleaved caspase-3. Quantification was limited to cells that
showed dye-spread, and data were pooled from multiple retinas. Bystander death
was considered to have occurred if multiple apoptotic cells were found within
a cluster of AF488-labeled cells (Fig.
6a-d). Cc induced cell death in 60.5% of
injected cells (26 of 43 cells from 9 retinas), whereas only one cleaved
caspase-3-labeled cell was seen in control injections of AF488 alone (1 of 16
cells from 4 retinas). In AF488-labeled clusters containing at least one dying
cell, death spread from primary to at least one bystander cell in 57.6% of
cases (15 of 26 cells from 9 retinas) as determined by immunolabeling for
cleaved caspase-3 (Fig.
3b). Spread of cell death was seen in only one case in
the presence of carbenoxolone (4%; n = 25 cells from 3 retinas), a
treatment that reduced coupling of the injected cells to other cells to 8% in
this series of injections. Occasional dying cells were seen in the GCL of
control retinas (Fig.
6e,f), indicating that the lack of labeling was
attributable to failure to induce caspase cleavage in control injections
rather than failure to immunolabel cleaved caspase-3. Likewise, the fact that
many injections (both control and Cc) did not lead to
caspase-3-immunopositive cells indicates that the labeling pattern was not the
result of fluorescence bleedthrough in instances when bystander death was
observed.

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Figure 6. Dying bystander cells were coupled via gap junctions to primary cells.
a-d, Single-cell injections of AF488 (a gap junction-permeable dye)
and Cc in the GCL showed that multiple coupled cells were
immunolabeled for cleaved caspase-3. a, AF488 labeled cells coupled
to the injected cell. Asterisks show location of injected cell that was no
longer present 1 hr after the injection; presumably, it died and detached or
was cleared by engulfment. b, Cleaved caspase-3 labeled many of the
coupled cells in a. c, d, AF488 (c) and cleaved caspase-3
(d) labeling showed that the injected cell (arrowhead) and other
coupled cells were immunopositive. e, f, Control injections of AF488
(e) into a single cell (arrowhead) did not induce caspase-3 cleavage
(f) in the injected or coupled cells. Scale bars in a-f, 20
µm.
|
|
Control injections of biotin-Cc and AF488 showed that only single
cells were labeled with Cc despite spread of AF488 to other nearby
cells (data not shown), indicating that Cc did not enter cells other
than the injected cell and thereby ruling out an extracellular route for the
bystander cell killing.
 |
Discussion
|
|---|
The fundamental findings of this study are that dying cells are clustered
in the normal, developing retina (Fig.
1), that this clustered cell death is reduced by a gap junction
inhibitor (Fig. 2), that
bystander cell death may be induced by targeted deletion of cells (Figs.
3,
4,
6), and that the propagation of
cell death is decreased by inhibition of gap junction coupling in
vitro (Figs. 4,
5). These findings lead to the
conclusion that bystander killing via gap junctions contributes to cell death
in the normal developing nervous system, supporting the hypothesized role of
this novel mechanism (Linden,
2000
).
The data from both the distribution of TUNEL-labeled cells and the NN
analysis in the mouse (Fig. 1)
suggest that the probability of cells dying together is greater than the
probability of dying singly. The reduction of the number of cells that die
within short distances of other dying cells by carbenoxolone, in conjunction
with the decrease in dye-coupling, suggests that gap junctions mediate the
clustering of dying cells (Fig.
2).
We also demonstrate bystander killing by scrape-loading retinas with
Cc (Figs.
3d-f,
4a,b,f). At P13 the
bulk of cell death in the rat retina already has occurred, and few pyknotic
cells are found (Horsburgh and Sefton,
1987
). The occasional dying cells found in control retinas in this
study (Figs. 3g-i,
4c,d,f) were
infrequent enough to suggest that they may be the result of naturally
occurring cell death rather than induced cell death.
One possible mechanism by which cell death may be propagated is via the
transfer of cytotoxic metabolites from dying cells to other cells via gap
junctions. Recent evidence has shown that gap junctions remain open during
apoptosis (Lin et al., 1998
;
Wilson et al., 2000
), and gap
junction-mediated bystander effects previously have been shown in cell lines
(Mesnil et al., 1996
;
Vrionis et al., 1997
;
Lin et al., 1998
). The
bystander effect induced by Cc was decreased by preinjection of 20
mg/kg carbenoxolone and preincubation of the retina in 10 µM
carbenoxolone (Fig.
4f). Carbenoxolone is a gap junction inhibitor
(Davidson and Baumgarten, 1988
)
but has other known functions, including effects on steroid metabolism in the
eye (Rauz et al., 2001
). This
same protocol significantly decreased dye coupling in retinas scrape-loaded
with RD and NB (Fig.
5c-e), and the reduction in coupling was comparable to
the decrease in bystander killing, further evidence that the effect was
mediated by carbenoxolone-induced inhibition of gap junctional coupling rather
than nonspecific carbenoxolone effects. NO, octanol, and a cAMP analog also
decreased the bystander effect (Fig.
4f). Each of these agents has multiple actions, but all
have been shown to inhibit cell coupling in the retina
(McMahon et al., 1989
;
Mills and Massey, 1995
). Taken
together, these results indicate that gap junctional coupling is involved in
the propagation of cell death in the retina.
Single-cell injections of Cc and AF488 directly showed that
bystander killing is mediated by the activation of caspase-3
(Fig. 6a-d).
Incubation of retinas in 75 µM carbenoxolone decreased both the
dye coupling and propagation of cell death. Because Cc is too large
to pass through gap junctions, it is likely that a byproduct of the cell death
pathway passed into coupled cells and induced caspase activation. The fact
that the dying cells were dye-coupled clearly demonstrates that gap junctions
participate in bystander killing. Our efficacy at killing cells by Cc
injection was much lower than by scrape-loading, suggesting that the
concentration of Cc necessary to induce cell death is achieved more
readily by scrape-loading than by injection. It has been reported recently
that Cc injection of isolated nerve growth factor (NGF)-dependent
neurons yields very low levels of cell death, with NGF protecting cells from
the downstream effects of cytoplasmic Cc
(Deshmukh and Johnson, 1998
;
Deshmukh et al., 2002
). It is
not clear whether retinal cells also have a neurotrophin-dependent protection
against low levels of cytoplasmic Cc; however, we did observe little
cell death in horizontal cells scrape-loaded with Cc
(Fig. 4a,b), a cell
type that has been shown to be dependent on autocrine NGF
(Karlsson et al., 2001
).
Other possible mechanisms may contribute to the tendency of cells to die
near to one another in both space and time. Extracellular signals such as
withdrawal of trophic support may impact multiple cells simultaneously, the
bystander cells may depend directly on the primarily dying cells for their
survival, or dying cells may release substances into their immediate
environment that initiate apoptosis in surrounding cells. Although the extent
to which these extracellular signaling mechanisms directly operate in the
bystander effect or act via the regulation of cell coupling is not known, it
is clear that gap junctions play an important role in this process.
It has been theorized recently that gap junction-mediated cell killing may
provide a mechanism of cone photoreceptor cell death secondary to the loss of
rod photoreceptors in degenerative diseases caused by mutation of rod-specific
genes (Ripps, 2002
). However,
this intriguing possibility remains to be tested experimentally. Although the
present study does not address the intercellular spread of cell death in
photoreceptors directly, it suggests that gap junction-mediated bystander cell
killing may have important consequences in degenerative diseases or traumatic
injuries to the retina.
 |
Footnotes
|
|---|
Received Dec. 26, 2002;
revised May. 16, 2003;
accepted May. 16, 2003.
This work was supported by National Institutes of Health Grants HL07675
(K.C.), MH65495 (D.C.S.), and EY11087 (B.E.R.); Conselho Nacional de
Desenvolvimento Cientifico e Tecnológico (A.B. and R.L.);
Fundação de Amparo à Pesquisa do Estado de Rio de Janeiro
(R.L.); Pronex-MCT (R.L.); the John Simon Guggenheim Foundation (R.L.); the
Kirby Foundation (R.R.); and Alcon Laboratories, Fort Worth, TX (R.R.). We
thank José Nilson dos Santos for technical assistance. K.C. and A.B.
performed some of these studies at the Instituto de Biofisica Carlos Chagas
Filho, Universidade Federal do Rio de Janeiro.
Correspondence should be addressed to Dr. Karen Cusato, Department of
Neuroscience, Albert Einstein College of Medicine, 1300 Morris Park Avenue,
Rose F. Kennedy Center 712, Bronx, NY 10461. E-mail:
kcusato{at}aecom.yu.edu.
C. Guimarães's present address: Department of Biological Chemistry,
The Hebrew University, Jerusalem, Israel.
Copyright © 2003 Society for Neuroscience
0270-6474/03/236413-10$15.00/0
* R.L. and D.C.S. contributed equally to this work. 
 |
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