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Mol Cell Biol, January 1998, p. 198-205, Vol. 18, No. 1
Division of Molecular Biology, The
Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands
Received 10 September 1997/Accepted 15 October 1997
African trypanosomes undergo antigenic variation of their variant
surface glycoprotein (VSG) coat to avoid being killed by their
mammalian hosts. The active VSG gene is located in one of many
telomeric expression sites. Replacement of the VSG gene in the active
site or switching between expression sites can give rise to a new VSG
coat. To study Trypanosoma brucei VSG expression site
inactivation rather than VSG gene switching, it is useful to have an in
vitro negative-selection system independent of the VSG. We have
achieved this aim by using a viral thymidine kinase (TK) gene.
Following integration of the TK gene downstream of the 221a
VSG expression site promoter, transformant cell lines became sensitive
to the nucleoside analog
1-(2-deoxy-2-fluoro-8-D-arabinofuranosyl)-5-iodouracil. These TK trypanosomes were able to revert to resistance at a rate approaching 10 The protozoan parasite
Trypanosoma brucei lives within the bloodstream of its
mammalian host. In order to avoid destruction by the host immune
response, T. brucei periodically changes its variant surface
glycoprotein (VSG) coat, a process termed antigenic variation (see
references 6 and 10 for recent
reviews). The expressed VSG gene is invariably found close
to the telomere in a long polycistronic transcription unit called the
expression site. There are around 20 VSG expression sites (13,
26) which are highly homologous and include a number of
expression site-associated genes (ESAGs) besides the VSG
gene (30). Some of the ESAGs encode proteins required for
the uptake of host macromolecules, for example, ESAGs 6 and 7, which
comprise the heterodimeric transferrin receptor (reviewed in references
6 and 27). Normally, only one
expression site is transcribed at a time, giving rise to a single set
of ESAGs and a VSG coat composed of a single protein species (for a
review, see reference 6). In addition to the
expression sites, there are about 1,000 different VSG genes
located in large arrays in the interior of the larger chromosomes and
at the telomeres of approximately 100 minichromosomes (39).
VSG switching can occur through DNA rearrangements such as gene
conversion and reciprocal recombination (see Fig. 4; see reference 2 for a recent review). In the former, a copy of a
silent VSG gene replaces the previously active
VSG gene. If the donor VSG is part of another
expression site, then the gene conversion can include a number of ESAGs
as well. A similar outcome can arise from a reciprocal recombination
reaction, although in this case there is no duplication or loss of the
genes involved. In addition to these mechanisms of switching, the
trypanosome can activate a new expression site and silence the old one,
a process termed an in situ switch. This is different from the other
mechanisms in that it can occur in the absence of any detectable DNA
rearrangement (19, 41). How the switch in transcription
between VSG expression sites occurs and how all expression sites but
one are silenced are not known, although it has been suggested that
some form of epigenetic mechanism might be involved (16, 18,
31).
Previous studies of VSG switching have relied heavily upon the use of
animals to select the rare VSG switch variants from a population of
trypanosomes. With this approach, it is difficult to manipulate the
conditions of selection. Quantitative study of factors which may
influence VSG switching and switch variant selection is also far from
easy. To overcome these limitations, in vitro selection by
complement-mediated lysis using antisera raised against the parental
VSG type (trypanolysis) has been used (24). However, this
procedure has proved unreliable, as trypanosomes trapped in clumps
survive the antibody treatment. In addition, methods which select
purely against the VSG antigen type are not suitable for the study of
VSG expression site switching. This is because a large proportion of
switch variants can arise through replacement of the VSG
gene alone, leaving the rest of the active expression site unchanged
(2).
Following the development of stable-transfection techniques, it has
recently become possible to tag an individual VSG expression site with
drug resistance genes (5, 18, 31). This allows positive
selection for expression of that site in liquid culture, providing the
opportunity to examine specific expression site activation events and
to monitor consecutive on-off-on switches (19, 26, 32).
However, this type of experiment does not simulate the situation in
vivo, where immune attack against the parent population selects for a
switch in expression to any one of the 20 VSG expression sites the
trypanosome has to offer. To this end, we set about testing a
negative-selection system for T. brucei, making use of the
thymidine kinase (TK)-thymidylate kinase gene from herpes simplex virus
type 1 (HSV-1). This enzyme can phosphorylate a wide variety of
nucleoside analogs which subsequently act as competitive inhibitors of
DNA polymerase or as DNA chain terminators, leading to cell death. We
and others have previously demonstrated that TK can be used as a
negatively selectable marker in the procyclic insect stage of T. brucei (22, 36). Here, we report the use of TK in the
bloodstream stage of the parasite to successfully select in vitro
trypanosomes which had switched expression of the VSG expression site.
Trypanosomes, plasmid constructs, and transformation.
T.
brucei 221a bloodstream-form trypanosomes (MiTat 1.2a) of strain
427 (11) were used and were grown in vitro at 37°C in HMI-9 culture medium (17) with the following modifications: no Serum Plus or extra thymidine was added, and 20% instead of 10%
fetal bovine serum was used. Growth of 221a trypanosomes under these
conditions appeared no different from growth in standard HMI-9 medium.
For growth assays, trypanosomes were seeded at 5 × 104 cells/ml in the presence or absence of 20 µg of
1-(2-deoxy-2-fluoro-8-D-arabinofuranosyl)-5-iodouracil (FIAU).
0270-7306/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.
Frequent Loss of the Active Site during Variant
Surface Glycoprotein Expression Site Switching In Vitro in
Trypanosoma brucei
and
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ABSTRACT
Top
Abstract
Introduction
Materials & Methods
Results
Discussion
References
5 per cell per generation. The majority of
revertants expressed a new VSG gene even though there had
been no selection against the VSG itself. Analysis of these switched
variants showed that some had shut down TK expression via
an in situ expression site switch. However, most variants had the
complete 221 expression site deleted and another VSG expression site
activated. We speculate that a new VSG expression site cannot switch on
without inactivation of the old site.
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INTRODUCTION
Top
Abstract
Introduction
Materials & Methods
Results
Discussion
References
![]()
MATERIALS AND METHODS
Top
Abstract
Introduction
Materials & Methods
Results
Discussion
References
3'): the 190-bp
SalI-SphI fragment from the 221 VSG expression
site, the 240-bp 
intergenic region of the tubulin array as a
splice acceptor site, the HYG gene, the 402-bp intergenic region between actin genes 1 and 2 as a polyadenylation-splice acceptor
site, the HSV-1 TK gene, the 330-bp 
intergenic region of the tubulin array as a polyadenylation site, and the 685-bp SphI-StuI fragment from the 221 VSG expression
site. A detailed description of how this plasmid was constructed can be
obtained from the authors upon request.
Negative selection of HTK trypanosomes for VSG switch variants. HTK trypanosomes were routinely cultivated in the presence of 20 µg of hygromycin per ml. For switching experiments, the cells were washed in medium containing no hygromycin and used to inoculate a fresh culture, again containing no hygromycin, at a density of 2.5 × 103 to 5 × 103 cells/ml. Cells were harvested when the culture had grown to 1 × 106 to 2 × 106 cells/ml and were distributed over 96-well plates at 104/well in 100 µl of medium containing 20 µg of FIAU per ml. After 6 or 7 days, clonal outgrowth of wells was scored and FIAUr trypanosome cell lines were tested for sensitivity to 20 µg of hygromycin per ml. Cell lines displaying a FIAUr Hygs phenotype were then immediately expanded in vitro for preparation of crude cell lysates and DNA (see below).
Luria-Delbrück fluctuation test.
The rate of reversion
to FIAU resistance was measured with the Luria-Delbrück
fluctuation test (21). HTK3 cells were distributed over two
96-well plates at 10/well in 200 µl of culture medium. After 5 days
of growth, cells in the 48 central wells from each plate were counted
and taken for further analysis. Replica cultures in which the contents
of the wells were transferred to 2 ml of fresh medium supplemented with
20 µg of FIAU per ml with or without hygromycin (20 µg/ml) in
24-well plates were set up. Outgrowth of wells was scored after 7 days.
The frequency of reversion (a) was then assessed by
substituting experimental results into the equation a = (
lnP0 · ln2)/N, where
P0 is the proportion of wells without cell
growth and N is the number of trypanosomes per culture upon
addition of FIAU.
Analysis of VSG switch variants. Crude cell lysates of HTK cell lines selected for the FIAUr Hygs phenotype were prepared from 1 × 106 to 2 × 106 cells which had been washed twice with PSG (59.4 mM Na2HPO4, 3.1 mM NaH2PO4, 43.2 mM NaCl, 55.5 mM glucose [pH 8]), resuspended in 10 µl of sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) loading buffer, and boiled for 5 min. Proteins were separated on an 8% polyacrylamide-SDS gel and visualized by staining with Coomassie brilliant blue. Small-scale genomic DNA preparations and dot blot hybridization were done as described elsewhere (23). The probes used were the coding regions of the HYG and TK genes and a 590-bp PstI fragment of pTcV221.5 specific for the 221 VSG gene (3). To control for DNA loading, a fragment containing the calmodulin intergenic repeat region was used (23).
Pulsed-field gel electrophoresis. Chromosome separations were performed by contour-clamped homogeneous electric field (CHEF) electrophoresis with a Bio-Rad CHEF-DR II system. The gel (0.8% FMC Fastlane agarose) was run for 72 h at 12°C at 2 V/cm with a switching time of 900 s. TAFE buffer (1×) (10 mM Tris, 0.5 mM EDTA-free acid [Titriplex II], 4.4 mM glacial acetic acid) was used and was changed once halfway through the run. Each gel lane contained 1.25 × 107 trypanosomes embedded in low-melting-point agarose (Gibco BRL) as described previously (38). Hansenula wingei chromosomes (Boehringer) were used as DNA size markers. Following staining with ethidium bromide, the gel was blotted onto a Zeta-Probe GT nylon membrane (Bio-Rad) by the alkaline transfer method and hybridized as described by the manufacturer. The probes used were VSG V02 (33), VSG 1.8 (24), and 50-bp repeats (41).
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RESULTS |
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Integration of a TK gene in the 221 VSG expression site confers sensitivity to nucleoside analogs. We and others have previously reported that procyclic trypanosomes engineered to express the HSV-1 TK gene are sensitive to nucleoside analogs added to the culture medium (22, 36). As this system could be used to select cells which had ceased expression of active TK protein, it appeared suitable for the study of VSG expression site switching in vitro. By placing TK in a VSG expression site, it should be possible through the lethal combination of TK and nucleoside analog to mimic the negative selection imposed by the host immune response against a VSG antigenic type. We designed a construct with the HSV-1 TK gene downstream of the hygromycin phosphotransferase gene such that both markers would become integrated 272 bp downstream of the promoter of the 221 VSG expression site (Fig. 1). This location was chosen since an inserted marker at that position did not affect the ability of the expression site to switch off (31) and because it would allow us to focus on events whereby the entire expression site had become inactivated. Electroporation of bloodstream-form 221a trypanosomes with this construct yielded six clones from three experiments. Two clones, HTK3 and HTK16, were analyzed in detail. Correct targeting of the construct to the 221 expression site in each cell line was confirmed by Southern hybridization (data not shown).
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phenotype. This phenomenon was also observed with
other nucleoside analogs (bromovinyldeoxyuridine and ethyldeoxyuridine
[data not shown]). It has previously been reported that reversion of
TK-expressing procyclic trypanosomes is due to inactivating point
mutations in the TK gene (36). This could also
explain reversion of the bloodstream HTK cells. However, in this case,
VSG expression site switching should also lead to FIAU resistance.
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The majority of FIAU-resistant cells appear to express a VSG
different from 221.
On the basis of sensitivity to hygromycin, it
is possible to discriminate between HTK revertants which arise due to
mutation of the TK gene and those which have inactivated the
221 expression site. This is because in trypanosomes in which the
TK gene has been mutated, the HYG gene in the
active 221 expression site is still transcribed, resulting in
hygromycin resistance. In contrast, if the 221 expression site has been
inactivated, then no hygromycin phosphotransferase is produced and the
cells are sensitive to hygromycin. In order to allow VSG expression
site switch variants to arise and survive, HTK trypanosomes were grown
in the absence of hygromycin for 3 days prior to negative selection.
FIAU was then added to the culture, which was distributed over 96-well microtiter dishes under conditions in which clonal outgrowth of revertants occurred (see Materials and Methods). FIAU-resistant clones
were picked and screened for hygromycin resistance. We found from over
10 experiments that the frequency of FIAUr Hygr
clones (most likely TK
mutants) was on the
order of 10
6, although on rare occasions this rose to
10
4. We have no simple explanation for this variation.
TK
mutants do not appear to have any growth
advantage over TK+ cells in culture, nor do they
preferentially survive stresses such as cryopreservation (data not
shown). The frequency of FIAUr Hygs clones
ranged from 1 × 10
5 to 3 × 10
5.
Thus, in most experiments the majority of revertants showed the
hygromycin-sensitive phenotype. An estimation of the rates of VSG
expression site switching and mutation is presented below.
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Measurement of VSG expression site switching and TK
inactivation rates.
It is difficult to derive a reliable estimate
for the VSG switching rate in vivo due to the inherent variation
exhibited by such biological phenomena. This is not the case with an in
vitro system, however, in which it is possible to determine the rate of
a particular event by the Luria-Delbrück fluctuation test (21). The rate of reversion to a TK
phenotype
in the presence of hygromycin gives an estimate for the mutation rate
of the gene TK. In the absence of hygromycin, the rate of
reversion reflects the rate of mutation plus the rate of expression
site switching. Thus, it is possible to calculate the switching rate
from these two values. The results of the fluctuation tests are shown
in Table 1. This analysis indicated that
the mutation rate of TK in the 221 expression site is
3.8 × 10
7 cell
1
generation
1. This rate is similar to that observed for
reversion to FIAU resistance in procyclic trypanosomes which express
HSV-1 TK from the ribosomal DNA array (1.2 × 10
7 cell
1 generation
1
[36]). By subtracting the TK inactivation
rate from the rate of reversion in the absence of hygromycin, we
estimate the rate of VSG expression site switching to be 7.2 × 10
6, almost 20-fold higher than the rate of mutation.
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Characterization of the events leading to VSG expression site switching in the HTK trypanosomes. There are a number of different mechanisms by which the TK-expressing trypanosomes could become resistant to FIAU and sensitive to hygromycin, as outlined in Fig. 4. It is possible to discriminate between these events by examining the VSG coat expressed, the presence or absence of the HYG, TK, and VSG 221 marker genes, and the chromosomal locations of these marker genes in the different switch variants. A total of 32 FIAUr Hygs clones derived from four independent experiments were analyzed for their VSG coat by SDS-PAGE and Coomassie staining and by Western blotting and for their marker genotype by DNA dot blot hybridization. The results are summarized in Table 2. Although the relative frequencies of different switch events varied somewhat from experiment to experiment, as can be expected from natural fluctuation within distinct populations, a broad trend was observed. The majority of clones (87%) were found to express a VSG different from 221. Of the cells still expressing 221, all had lost both the HYG and the TK genes. The most likely explanation for this result is that the region of the 221 expression site which contains the integrated construct had been replaced by sequences from another VSG expression site via gene conversion (event 2 in Fig. 4). Although this type of event is not regarded as an expression site switch in the strict sense (i.e., there is no antigenic switch), the gene conversion could encompass a large portion of the expression site and therefore switch the expression of a number of different ESAGs.
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Most variants have lost the 221 expression site and activated another VSG expression site. The experiments described above suggested that the majority of switch variants had inactivated the TK gene by deleting the entire 221 expression site. To investigate this further, we performed a chromosomal analysis of clones which showed this type of switch event. We focused upon those variants which had switched to expression of the VSG V02 gene, since this was the most common switch variant type and since we had probes with which to detect V02 sequences. Chromosomal DNAs from 11 V02 switch variants were size fractionated by pulsed-field gel electrophoresis. Conditions were chosen to optimize separation of the ca. 3.2-Mbp chromosome that contains the telomeric VSG 221 gene, which in this strain is present as a single copy. Following electrophoresis, the gel was stained with ethidium bromide and then blotted onto a nylon membrane and hybridized with a panel of DNA probes (Fig. 5).
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DISCUSSION |
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In this report, we demonstrate that a viral TK gene can
be used as a negatively selectable marker in bloodstream-form T. brucei suitable for studying VSG expression site switching in
vitro. We think that this TK system will prove a useful addition to the tools available for investigation of the mechanisms of antigenic variation. Indeed, TK-expressing trypanosomes have already been used to
see how changing the level of DNA modification J can affect VSG
expression site switching (40). We have estimated the rates of switching and mutation of the VSG expression site by the
Luria-Delbrück fluctuation test. Although we have not directly
demonstrated that inactivation of TK in bloodstream trypanosomes can
arise from point mutation of the TK gene, this seems likely,
since this mechanism had been observed previously in procyclic
trypanosomes (36). On the basis of the inactivation of TK in
the absence of an expression site switch, we calculate the mutation
rate in bloodstream trypanosomes to be 3.8 × 10
7
per cell per generation. This is similar to what we observed for
TK in the ribosomal DNA of procyclic trypanosomes.
We found that the rate of inactivation of the 221 VSG expression site
approaches 10
5 per cell per generation in the
TK-transformed cells. Almost 90% of inactivation events resulted in
the expression of a new VSG gene. The rate of switching is
greater than what we observe with other 427 221a trypanosome lines, for
which switch variants were selected in vivo in immunized mice. Rudenko
et al. (31) reported rates of switching in vivo of between
10
6 and 10
7 for both the wild type and
transformants containing a HYG gene integrated near the 221 expression site promoter. McCulloch et al. (23) observed
switching rates of between 1.2 × 10
6 and 1 × 10
7 (with an average of 6 × 10
7) for
three different 427 221a transformant lines in nine experiments, with
wild-type switching occurring at a rate of 3 × 10
7.
Since VSG switch variants were generated in vitro for both types of
experiment, the difference in switching frequency is probably a
consequence of the method of selection. For example, the majority of
switch variants arise late in the growth of the initial culture, when
cell numbers are highest. Due to the slow turnover of VSG, these late
switchers can have a mixed coat long enough to be a target for immune
destruction. In contrast, the combination of relatively rapid dilution
of TK activity to a sublethal level and slow action of the selection
system would greatly favor survival of the late switchers in vitro. The
elevated rate of switching is not simply due to the presence of the
TK gene, since 427 221a trypanosomes containing only a
HYG gene in the 221 expression site also switch in vitro at
rates approaching 10
5 (32).
We observed at least six different types of VSG switch variant. We think that these variants represent different expression sites switched on following inactivation of the TK-marked 221 expression site. The criterion we used to distinguish between different expression sites is migration of VSG protein during SDS-PAGE. This assay is rather crude, in that different VSGs can migrate similarly, so it is possible that the actual number of sites which can be activated could be nearer the 20 or so in the trypanosome's repertoire. However, some expression sites might be activated at a low frequency or might be nonfunctional. Another possibility is that some expression sites are not suitable for growth under particular culture conditions. We have found that variability in ESAGs 6 and 7, which encode the trypanosome transferrin receptor, may be required primarily to allow T. brucei to cope with the diversity of transferrins in a range of mammalian hosts (6). Support for this idea comes from switching experiments using different sera in the culture medium, which we find can greatly influence the number and type of variants that survive the selection (12).
When we analyzed the type of events which led to VSG switching, we found that 18% were in situ switches, while the remainder involved loss of the 221 expression site. For the latter, we expected that the active expression site had been replaced via gene conversion by another VSG expression site, as described previously (26, 29, 35, 37). However, in the sample of 11 V02 VSG switch variants we analyzed, only 2 contained a new copy of the V02 gene in the 3.2-Mbp chromosome. The majority of events therefore appear to be complex switches involving chromosome rearrangement and V02 expression site activation. One possibility is a gene conversion of the 221 expression site by another expression site, which subsequently becomes silenced upon activation of V02. Such events have been suggested before (25). We found, however, that the 50-bp repeats were absent from the 3.2-Mbp chromosome in all but one of the remaining switch variants. As these repeats are invariably found upstream of the expression site promoter (41), we conclude that 8 of 11 clones have undergone an unknown rearrangement that did not involve another VSG expression site.
Although complex VSG switches following immune selection in animals have been noted before (25, 35), they have been considered to be rare events. The experiments reported here indicate that they can be rather frequent. We suspected that chromosomal rearrangement may be a consequence of using TK and nucleoside analogs which can interfere with DNA replication. However, two lines of evidence argue against this. First, the majority of switch variants arise during expansion of trypanosomes in the absence of FIAU. Second, and more compelling, is the occurrence of similar chromosomal rearrangements during switching from the 221 or the V02 expression site in 427 transformant cell lines which do not contain the TK gene (32). The very low level of transcription from a silenced 221 promoter (26, 31) did not produce sufficient TK activity to be lethal to the cell, since we did obtain clones which had switched off the 221 site. Besides, we find that expression of TK integrated in the tubulin array, where the level of transcription is much higher than in a silent VSG expression site, does not make the trypanosome sensitive to FIAU under the conditions used in the selection procedure (4, 12).
It is difficult to make a valid comparison of the frequencies of switch event types in vivo with the in vitro switching experiments reported here, due to the nature of the selection system. To survive FIAU selection in vitro, the trypanosome has to prevent by some means the expression of the TK gene located near the active expression site promoter. Replacement of the VSG gene at the end of the expression site, an event often observed in vivo, simply won't do. However, it is interesting that in a study of switching events in animals, Myler et al. (25) reported that in 7 of 19 switches the previously active site had been lost and another VSG expression site on a different chromosome had been activated. This type of switch has all the hallmarks of the expression site loss event we describe here. As 5 of the 19 switches reported by Myler were the result of a simple VSG gene conversion, an event excluded by the TK selection system, the frequency of complex expression site loss switches in vivo is 50%. This is not significantly different from what we observe in vitro.
Although more work is required to establish the mechanism of deletion, several alternatives can be envisaged. Deletion could arise through aberrant interchromosomal recombination promoted by a repeated element, such as a retrotransposon (e.g., TRS/INGI [28]). This would account for the large size difference in the 3.2-Mbp chromosome of the switch variants. Chromosome breakage and healing, phenomena seen often in Plasmodium spp. (20), would also delete the telomeric VSG expression site. Another possibility is that destruction of the expression site may be the result of a normal switching event which has gone wrong. For instance, a cut in the expression site postulated to initiate a gene conversion reaction is followed by gap widening and a search for homology (reviewed in references 2 and 8). If this search fails, then the site may be destroyed by exonuclease activity followed by recombination events to heal the chromosome.
We consider it highly unlikely that VSG expression site deletion
contributes to survival of T. brucei in the wild. We think that the gross DNA rearrangements observed by us represent background genetic noise, made audible by a powerful selection system amplifying rare events. Trypanosome lines recently passaged through tsetse flies
switch coat at rates up to 10
2 per cell division, i.e., 3 to 4 orders of magnitude higher than the rates of the rodent-adapted
strains studied by molecular biologists (reviewed in reference
2). If this rapid switching includes in situ
switching (mechanism 5 in Fig. 4), a point that remains to be verified,
then the rare expression site deletions observed here would have no
physiological significance.
Nevertheless, we think that these rare events are of special interest because they provide insight into the mechanism of expression site switching. The frequent deletion of the previously active site during the switches analyzed here and in other switches using positive selection (32) strongly suggests that activation of a new site cannot readily occur without inactivation of the old one. It now appears that loss of the old site helps to activate the new one, rather than that different sites are activated and inactivated independently, as previously thought (1, 9; see reference 7 for discussion). There are other lines of evidence arguing against independent activation-inactivation of sites. Davies et al. (14) have recently reported very high switch rates following removal of a putative stabilizing element, and we have found that two expression sites cannot be maximally active at the same time, showing that in situ switches must involve some kind of interaction between the sites involved (7). The TK system described here should prove useful in dissecting this interaction.
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ACKNOWLEDGMENTS |
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We thank Magali Berberof, Pat Blundell, Ines Chaves, Anita Dirks-Mulder, Herlinde Gerrits, Rudo Kieft, Ronald Plasterk, Gloria Rudenko, and Fred van Leeuwen for helpful discussions and critical reading of the manuscript.
This work was supported by grants from the European Commission to M.C., from the Wellcome Trust to M.C.T., and from the Netherlands Organization for Scientific Research (NWO/SON) to P.B.
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FOOTNOTES |
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* Corresponding author. Mailing address: Division of Molecular Biology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands. Phone: 31 20 512 2880. Fax: 31 20 669 1383.
Present address: Applied Molecular Biology Unit, Department of
Medical Parasitology, London School of Hygiene and Tropical Medicine,
London WC1E 7HT, United Kingdom.
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