Review
Sex-specific cell signaling: the corticotropin-releasing factor receptor model

https://doi.org/10.1016/j.tips.2013.06.004Get rights and content

Highlights

  • Receptor signaling can be sex biased such that different pathways are engaged in males and females.

  • The CRF receptor is an example of a receptor that exhibits sex biased signaling.

  • Sex biased signaling may underlie sex differences in disease vulnerability and drug sensitivity.

  • Sex biased signaling underscores the importance of including both sexes in biomedical research.

Elucidating the biological basis for sex differences in diseases can reveal their pathophysiology and guide the development of individualized treatments. Here, we review evidence for the novel concept that receptor signaling can be sex biased such that the specific pathways engaged by ligand binding are determined by sex. As an example, this review focuses on the receptor for corticotropin-releasing factor (CRF), a stress-related peptide implicated in diverse psychiatric and medical disorders that are more prevalent in females. There is evidence for sex biases in CRF receptor coupling to G proteins and β-arrestin that render females more sensitive to acute stress and less able to adapt to chronic stress. Taken with evidence for sex biased signaling in other receptor systems, the studies demonstrate the broad potential impact of this characteristic in determining sex differences in disease and therapeutic efficacy and underscore the importance of studying females in medical and pharmacological research.

Section snippets

Biased signaling at seven-transmembrane receptors

Understanding of how seven-transmembrane receptor (7-TMR) function has undergone an evolution over the past decade and transformed approaches to drug development. Rather than the simple model in which ligand binding initiates a cascade of reactions that is determined by receptor coupling to specific guanine nucleotide binding proteins (G proteins), it is now recognized that 7-TMRs can associate with multiple G proteins. Moreover, evidence for the association of 7-TMRs with β-arrestin adaptor

CRF, stress, and disease

Sex differences in disease prevalence are reported for many diseases but are particularly apparent for stress-related psychiatric and medical diseases, including anxiety, depression, post-traumatic stress disorder (PTSD), irritable bowel syndrome (IBS), inflammatory disorders, and metabolic syndrome, many of which are nearly two times more prevalent in females (http://www.hcp.med.harvard.edu/ncs/ftpdir/NCS-R_Lifetime_Prevalence_Estimates.pdf) 10, 11. Certain disorders that have been associated

CRF1 signaling

CRF exerts its effects through two receptor subtypes, CRF1 and CRF2. Genes for CRF1 and CRF2 have been cloned 22, 23 and their distinct distribution, pharmacological specificity, signaling, and trafficking have been described (for a review, see [16]. This review focuses on CRF1, the receptor subtype that is the most prominent in the brain and that is thought to mediate most aspects of the stress response including ACTH release, arousal, and anxiogenic effects. Notably, the evidence for sex

Sex differences in CRF1 neuronal responses

A target of CRF neurotransmission in the brain is the pontine nucleus LC [38], which is the major source of norepinephrine in the brain. CRF containing axon terminals synapse with LC dendrites, and CRF microinfused directly onto LC neurons in vivo or in vitro increases discharge activity of the cells by inhibiting potassium currents 39, 40, 41. CRF-induced activation of the LC–norepinephrine system during stress is thought to be important for initiating arousal and promoting cognitive

Sex differences in CRF1–Gs-dependent signaling

CRF activation of LC neurons is differentially attenuated by the PKA antagonist, Rp-cAMP-S, which almost completely blocks the effect in females, while producing only a partial attenuation in male rats, consistent with differential CRF1 signaling [8]. Confirmatory evidence for sex differences in CRF1 signaling was derived from immunoprecipitation of CRF1 from the rat cortex, a tissue of high CRF1 expression and lacking CRF2 [44]. Immunoprecipitated CRF1 from the female rat cortex

Sex differences in CRF1 receptor trafficking

The initial descriptions of stress-induced CRF1 internalization in vivo were based on studies of LC neurons from male rats and are consistent with the observation of a decreased maximum response in the CRF dose–response curve for LC activation observed at the same time following stress [36]. In contrast to males, swim stress does not promote CRF1 internalization in LC neurons of female rats or decrease the CRF maximal response [8]. The cellular localization of CRF1 is remarkably opposite in

Consequences of sex differences in CRF1 signaling in conditions of CRF overexpression

Increased CRF1–Gs coupling together with decreased CRF1 internalization would render female neurons more sensitive to CRF and less able to adapt to excessive CRF (Figure 2). This is clinically relevant because excessive CRF has been implicated in many stress-related disorders that are more prevalent in females 18, 19, 20. The pathological condition of excessive CRF has been modeled using CRF overexpressing mice (CRF-OE) 45, 46. A well-characterized CRF-OE model is a transgenic line in which CRF

Sex biased CRF signaling

In addition to enabling receptor internalization, it is now well recognized that β-arrestin 2 can engage G protein-independent signaling cascades by scaffolding receptors to signaling molecules [1]. Given this function, the implications of sex differences in CRF1–β-arrestin association are much broader than can be attributed to differences in CRF1 internalization alone. β-Arrestin 2 signaling includes MAPK (e.g., ERK2, JNK3, and p38), tyrosine kinases (e.g., c-SRC), AKT, PI3 kinase, and RhoA

Sex biased signaling of other receptors

Given the shared characteristics of different GPCRs, sex biased signaling would be predicted to be a property of other GPCRs. Although this has not yet been systematically studied for receptors other than CRF1, evidence for differential signaling in males and females exists for several GPCRs and in some cases there is evidence for differential coupling of GPCRs to G proteins, as has been demonstrated for CRF1. For example, sex differences in βAR–Gs coupling have been demonstrated in rat

Clinical and therapeutic implications of sex biased receptor signaling

Sex biased receptor coupling and signaling has important ramifications for understanding disease and developing therapeutics. Focusing on the CRF system alone, it implies that the cellular reactions initiated by stressors will differ to some extent in males and females and this could account for a different expression of stress-related pathology. Given the many and diverse diseases that have been linked to stress, elucidating how differences in CRF1 signal transduction translate to different

Concluding remarks

This review integrates convergent findings supporting the novel concept of sex differences in receptor signaling and trafficking, using CRF1 as a model. Sex differences in Gs coupling would confer differences in agonist sensitivity and in the case of CRF, differences in acute responses to stressors. Differences in receptor association with β-arrestin influence receptor trafficking and the ability to adapt to the excessive CRF that is predicted to be present in diseases related to severe or

Acknowledgements

The authors wish to acknowledge Mr. Paul Palcko for artwork. Supported by PHS grants MH092438 and 040008.

References (60)

  • T. Yagami

    Sex difference in adrenergic receptor-mediated glycogenolysis in rat livers

    Jpn. J. Pharmacol.

    (1990)
  • G. Xing

    Cannabinoid receptor expression and phosphorylation are differentially regulated between male and female cerebellum and brain stem after repeated stress: implication for PTSD and drug abuse

    Neurosci. Lett.

    (2011)
  • S.K. Shenoy et al.

    Seven-transmembrane receptor signaling through β-arrestin

    Sci. STKE

    (2005)
  • A.C. Emery

    Ligand bias at metabotropic glutamate 1a receptors: molecular determinants that distinguish β-arrestin-mediated from G protein-mediated signaling

    Mol. Pharmacol.

    (2012)
  • G. Rivero

    Endomorphin-2: a biased agonist at the μ-opioid receptor

    Mol. Pharmacol.

    (2012)
  • D.A. Zidar

    Endogenous ligand bias by chemokines: implications at the front lines of infection and leukocyte trafficking

    Endocr. Metab. Immune Disord. Drug Targets

    (2011)
  • T.A. Slotkin

    Ontogenesis of β-adrenoceptor signaling: implications for perinatal physiology and for fetal effects of tocolytic drugs

    J. Pharmacol. Exp. Ther.

    (2003)
  • D.A. Bangasser

    Sex differences in corticotropin-releasing factor receptor signaling and trafficking: potential role in female vulnerability to stress-related psychopathology

    Mol. Psychiatry

    (2010)
  • A.L. Curtis

    Sexually dimorphic responses of the brain norepinephrine system to stress and corticotropin-releasing factor

    Neuropsychopharmacology

    (2006)
  • C.G. Helmick

    Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part I

    Arthritis Rheum.

    (2008)
  • J.B. Becker

    Sex differences in the neural mechanisms mediating addiction: a new synthesis and hypothesis

    Biol. Sex Differ.

    (2012)
  • W. Vale

    Characterization of a 41-residue ovine hypothalamic peptide that stimulates secretion of corticotropin and β-endorphin

    Science

    (1981)
  • H.Y. Li

    Distinct mechanisms underlie activation of hypothalamic neurosecretory neurons and their medullary catecholaminergic afferents in categorically different stress paradigms

    Proc. Natl. Acad. Sci. U.S.A.

    (1996)
  • T.S. Gray

    Amygdaloid CRF pathways. Role in autonomic, neuroendocrine, and behavioral responses to stress

    Ann. N. Y. Acad. Sci.

    (1993)
  • T.L. Bale et al.

    CRF and CRF receptors: role in stress responsivity and other behaviors

    Annu. Rev. Pharmacol. Toxicol.

    (2004)
  • J.D. Bremner

    Elevated CSF corticotropin-releasing factor concentrations in posttraumatic stress disorder

    Am. J. Psychiatry

    (1997)
  • C. Nemeroff

    Elevated concentrations of CSF corticotropin-releasing factor-like immunoreactivity in depressed patients

    Science

    (1984)
  • N.C. Vamvakopoulos et al.

    Evidence of direct estrogenic regulation of human corticotropin-releasing hormone gene expression. Potential implications for the sexual dimorphism of the stress response and immune/inflammatory reaction

    J. Clin. Invest.

    (1993)
  • T.W. Lovenberg

    Cloning and characterization of a functionally distinct corticotropin-releasing factor receptor subtype from rat brain

    Proc. Natl. Acad. Sci. U.S.A.

    (1995)
  • M.H. Perrin

    Comparison of an agonist, urocortin, and an antagonist, astressin, as radioligands for characterization of corticotropin-releasing factor receptors

    J. Pharmacol. Exp. Ther.

    (1999)
  • Cited by (0)

    View full text