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Molecular and Cellular Biology, July 1999, p. 5073-5082, Vol. 19, No. 7
0270-7306/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.
Cell Cycle Withdrawal Promotes Myogenic Induction
of Akt, a Positive Modulator of Myocyte Survival
Yasushi
Fujio,1
Kun
Guo,1,2
Toshiaki
Mano,1
Yasuhiro
Mitsuuchi,3
Joseph R.
Testa,3 and
Kenneth
Walsh1,4,*
Division of Cardiovascular Research, St.
Elizabeth's Medical Center of Boston, Tufts University School of
Medicine, Boston, Massachusetts 021351;
Department of Cardiovascular Diseases, Rhone-Poulenc Rorer,
Inc., Collegeville, Pennsylvania 194262;
Department of Medical Oncology, Fox Chase Cancer Center,
Philadelphia, Pennsylvania 191113; and
Program in Cell, Molecular and Developmental Biology,
Sackler School of Biomedical Studies, Tufts University School of
Medicine, Boston, Massachusetts 021114
Received 25 November 1998/Returned for modification 11 January
1999/Accepted 7 April 1999
 |
ABSTRACT |
During myogenesis, proliferating myoblasts withdraw from the cell
cycle, acquire an apoptosis-resistant phenotype, and differentiate into
myotubes. Previous studies indicate that myogenic induction of the
cyclin-dependent kinase inhibitor p21 results in an inhibition of
apoptotic cell death in addition to its role as a negative cell cycle
regulator. Here we demonstrate that the protein encoded by the
Akt proto-oncogene is induced in C2C12 cells during
myogenic differentiation with a corresponding increase in kinase
activity. In differentiating cultures, expression of dominant-negative
forms of Akt increase the frequency of cell death whereas expression of
wild-type Akt protects against death, indicating that Akt is a positive
modulator of myocyte survival. Antisense oligonucleotides against p21
block cell cycle withdrawal, inhibit Akt induction, and enhance cell
death in differentiating myocyte cultures. Adenovirus-mediated transfer
of wild-type or constitutively active Akt constructs confer partial
resistance to cell death under conditions where cell cycle exit is
blocked by the antisense oligonucleotides. Collectively, these data
indicate that cell cycle withdrawal facilitates the induction of Akt
during myogenesis, promoting myocyte survival.
 |
INTRODUCTION |
During myogenesis, proliferating
myoblasts irreversibly withdraw from the cell cycle and differentiate
into myotubes. The cyclin-dependent kinase (CDK) inhibitor p21 and the
retinoblastoma protein (pRb) appear to be critical in establishing the
postmitotic state during myogenesis (55). p21 is markedly
induced in differentiating C2C12 cells and in 10T1/2 fibroblasts that
are induced to differentiate following transformation with
MyoD (23, 24, 40, 42). Bromodeoxyuridine-labeling experiments have shown that upregulation of p21 correlates with the
initiation of cell cycle exit, an early event in the myogenic differentiation pathway (4). Myocytes lacking pRb, a
downstream target of CDK inhibitors, are incapable of irreversible cell
cycle exit upon differentiation (41, 46). The transcription
of muscle-specific genes can be inhibited by the forced expression of
cyclins and CDKs, or E2F1, and this inhibition is largely reversed by
the expression of constitutively active mutants of pRb (22).
It is reported that the myocyte differentiation and cell
cycle-regulatory functions of pRb and E2F1 require different domains
within these proteins (22, 48).
A number of early studies described embryonic muscle precursor cells
that undergo temporally regulated disintegration (reviewed in reference
21), a process that has more recently been referred to as programmed cell death or apoptosis. In previous studies, we found
that a significant fraction of myoblasts undergo apoptosis during the
differentiation of the C2C12 myogenic cell line, while differentiated
C2C12 myotubes are relatively resistant to apoptosis (56,
57). Coimmunolocalization experiments with temporal markers of
myogenesis revealed that acquisition of the apoptosis-resistant phenotype coincided with induction of the p21 CDK inhibitor but not
with the appearance of myogenin, an earlier marker of myogenic differentiation (4). In addition, forced expression of the CDK inhibitors p21 or p16 blocked apoptosis during C2C12
differentiation (56, 57). The effects of CDK inhibitors on
myocyte proliferation and survival are likely determined by their
ability to modulate the state of pRb phosphorylation and cell growth.
Consistent with this hypothesis, the CC42 pRb-deficient myogenic cell
line undergoes a relatively high frequency of apoptosis during
differentiation (56). These pRb
/
myocytes
display a normal time course of p21 induction during differentiation,
and forced expression of the p21 or p16 CDK inhibitors has no effect on
the frequency of apoptosis. However, forced expression of pRb
suppresses apoptosis in both pRb
/
and wild-type cell
lines during differentiation. Consistent with these observations,
transgenic mice expressing low levels of pRb display substantial cell
death in muscle masses occurring prior to the onset of terminal
differentiation (59). In these mice, surviving myocytes
accumulate large polyploid nuclei, indicating a defect in the permanent
withdrawal from the cell cycle. Collectively, these studies suggest
that cell cycle activity markedly influences the susceptibility of
differentiating myoblasts to apoptosis. However, the mechanisms by
which perturbations in cell cycle activity induce apoptosis are
essentially unknown for any cell type.
Akt is a proto-oncogene encoding a serine-threonine kinase
whose amino terminus contains a pleckstrin homology (PH) domain (53). Various extracellular stimuli activate Akt through the phosphoinositide 3-kinase (PI 3-kinase) pathway (12, 20,
30). The lipid products of the PI 3-kinase reaction may activate
Akt either by binding to the Akt PH domain (19, 33) or by
activating a protein kinase that phosphorylates Akt (34,
52). Activation of Akt inhibits apoptosis induced by growth
factor withdrawal or irradiation in neural cells, fibroblasts, and
lymphocytes (11, 25). Recently, it has been shown that Akt
phosphorylates the proapoptotic proteins Bad and caspase 9 leading to
their inactivation and cell survival (8, 13, 43).
In the present study, we demonstrate that Akt protein and kinase
activities are markedly upregulated during myogenic differentiation. We
also show that myocytes die at a high frequency when cell cycle exit is
blocked by treatment with antisense oligonucleotides to p21 mRNA. Under
these conditions, endogenous Akt induction is suppressed, but forced
Akt expression protects mitotic cells from death under conditions that
promote myogenic differentiation. Thus, we propose that myocyte
survival can be controlled through the ability of cell cycle activity
to modulate Akt induction during myogenesis.
 |
MATERIALS AND METHODS |
Cell culture.
C2C12 myoblasts (American Type Culture
Collection) were cultured as described elsewhere (4). Cells
were maintained in growth medium (Dulbecco's modified Eagle medium
[DMEM] supplemented with 20% fetal bovine serum). To induce
differentiation, cells at 40 to 50% confluence were shifted to
differentiation medium (DMEM supplemented with 2% heat-inactivated
horse serum). In some experiments, cells were switched to DMEM
containing 0.5% heat-inactivated horse serum or no serum. Higher
frequencies of cell death were achieved with the lower serum levels in
the media.
Western immunoblot analysis.
Cells were washed with
phosphate-buffered saline (PBS) twice on ice and harvested by scraping.
Cell lysates were prepared in cell lysis buffer (1% Nonidet P-40, 10%
glycerol, 137 mM NaCl, 20 mM Tris-HCl [pH 7.4], 20 mM NaF, 2 µg of
leupeptin per ml, 1 mM phenylmethylsulfonyl fluoride) by rotating for
15 min at 4°C, followed by centrifugation at 14,000 rpm for 10 min.
Protein concentration was determined with a bicinchoninic acid kit
(Pierce). Twenty micrograms of protein was separated on a sodium
dodecyl sulfate (SDS)-polyacrylamide gel and transferred to a
polyvinylidene difluoride membrane (Millipore). The membrane was
blocked with T-PBS (1× PBS, 0.2% Tween) containing 5% dry milk and
incubated with primary antibody. After three washes with T-PBS, the
blots were incubated with secondary antibody (donkey anti-rabbit
[Amersham] or donkey anti-goat [Santa Cruz Biotechnology]
immunoglobulin G conjugated with horseradish peroxidase) and developed
with the Amersham enhanced chemiluminescence detection system.
Anti-Akt, anti-p21, anti-Cdc2, anti-Cdk4, and antimyogenin antibodies
were purchased from Santa Cruz. Phospho-Akt-specific antibody was
purchased from New England Biolabs, anti-
-galactosidase (
-Gal)
antibody was from Sigma, and rhodamine-labeled antibody was from Pierce.
Akt half-life determinations.
C2C12 cultures were incubated
in growth medium or shifted to differentiation medium for 2 days. At
this time, cultures were exposed to 35.5 µM cycloheximide, and cells
were harvested at 2, 4, or 6 h for Western immunoblot analysis as
described above. Levels of Akt were analyzed relative to those of Cdc2,
which is not degraded under these conditions (50). Akt and
Cdc2 expression levels were determined by using Scanalytics software.
N-acetyl-leucyl-leucyl-norleucinal (ALLN) was from Sigma.
In vitro kinase assay.
Akt kinase assays were performed as
described previously (20), with minor modifications.
Briefly, 100 µg of protein in 500 µl of the cell lysis buffer
described above was preincubated with protein G-agarose for 30 min at
4°C. After centrifugation, anti-Akt or anti-hemagglutinin epitope
(HA) antibody and protein G-agarose (Boehringer) were added to the
supernatant in the presence of bovine serum albumin (2 mg/ml).
Immunoprecipitation was performed at 4°C for 2 h. In control
experiments, 8 µg of immunogenic Akt peptide was included in the
immunoprecipitation reaction to determine the specificity of the H2B
kinase reaction. After being washed twice with cell lysis buffer, once
with H2O, and twice with kinase buffer (20 mM HEPES [pH
7.2], 10 mM MgCl2, 10 mM MnCl2),
immunoprecipitates were incubated in 50 µl of kinase buffer
containing 2 µg of histone H2B (Boehringer) and
[
-32P]ATP (5 µM, 10 µCi; Dupont) at room
temperature for 30 min. Kinase reactions were terminated by adding
SDS-sample solution. After electrophoresis on 15% polyacrylamide gels,
gels were dried and exposed to X-ray film.
Northern blot analysis.
Northern blotting was performed as
described elsewhere (2). In brief, total RNA was prepared
with acid guanidium thiocyanate-phenol-chloroform method
(10). Total RNA (25 µg) was separated in formaldehyde gel and transferred to Hybond N membrane (Amersham). After
cross-linking by irradiation with UV light, the membrane was
prehybridized in Rapid-hyb buffer (Amersham) for 2 h at 65°C,
followed by hybridization overnight. The probe was a cDNA fragment
corresponding to the PH domain of mouse Akt, which was
radiolabeled with a random primer labeling kit (Multiprime; Amersham)
and purified with a Nick column (Pharmacia Biotech). The membrane was
washed twice in 2× SSC (1× SSC is 0.15 M NaCl plus 0.015 M sodium
citrate) solution containing 0.1% SDS at room temperature for 10 min,
twice 2× SSC solution containing 0.1% SDS at 50°C for 10 min, twice
in 0.5× SSC solution containing 0.1% SDS at 65°C for 10 min, and
twice in 0.2× SSC solution containing 0.1% SDS at 65°C for 10 min.
The membrane was exposed to X-ray film at
70°C.
Antisense oligonucleotide experiments.
Antisense
phosphorothioate oligonucleotides against p21 (5'-TGT CAG GCT GGT CTG
CCT CC-3') and the control (5'-TGG ATC CGA CAT GTC AGA-3') were
designed and were transfected into the cells with Lipofectin (Gibco) as
described elsewhere (44). Cells were cultured overnight in
growth media at a density of 3 × 105 cells in
100-mm-diameter dishes. Cells were washed in differentiation medium
after the growth medium was removed and exposed to oligonucleotide solution. The oligonucleotide solution was prepared by incubating oligonucleotides with 75 µg of Lipofectin in 1.5 ml of OptiMEM for 15 min at room temperature. Then the oligonucleotide-Lipofectin mixture
was diluted with differentiation medium and added to the cells. For
cell survival analysis, cells were plated at a density of
104 cells per well in a 24-well plate. Treatment with
oligonucleotides was performed as described above. Flow cytometry
analyses were performed as described previously (56). In
brief, C2C12 cells were cultured in differentiation medium with the
antisense or control oligonucleotides mixed with Lipofectin, as
described previously, for 24 h. Cells were washed with PBS and
fixed with 70% ethanol. Samples were stained with propidium iodide.
DNA content was measured using a FACScan flow cytometer (Becton
Dickson) as described elsewhere (56).
Adenovirus vector construction and infection.
Replication-defective adenovirus vectors expressing mouse Akt proteins
under the control of the cytomegalovirus promoter were constructed
(Fig. 1). An HA tag was fused in frame to
the N termini of the Akt coding sequences. The dominant-negative mutant
Adeno-Akt(AA) expressing the mutant Akt [T308A, S473A] construct
cannot be activated by phosphorylation (1). The
constitutively active Akt construct (Adeno-myrAkt) has the c-Src
myristoylation sequence fused in frame to the N terminus of the HA-Akt
(wild-type) coding sequence. DNA fragments of each Akt fusion gene were
inserted into the EcoRI/XbaI site of pACCMVpLpA,
and the resulting plasmid was cotransfected with pJM17 into 293 cells
to allow for homologous recombination (7). Recombinant
adenovirus constructs expressing
-Gal (Adeno-
gal) and p27
(Adeno-p27) were described previously (9, 49). All constructs were amplified in 293 cells and purified by
ultracentrifugation in the presence of CsCl. For transfection, C2C12
cells were incubated with the adenovirus at a multiplicity of infection
(MOI) of 250 in growth medium for 15 h. Virus was removed when the
medium was replaced. Under these conditions, transfection efficiency
was greater than 90%.

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FIG. 1.
Structures of replication-defective adenoviral vectors
that express wild-type and mutated Akt. CMV, cytomegalovirus
promoter/enhancer; SV40 pA, simian virus 40 polyadenylation site.
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Plasmid transfection and cell viability analysis.
The empty
expression vector (pcDNA3) or an expression vector encoding wild-type
Akt tagged with HA or a dominant-negative form of Akt (Akt [K179M] or
Akt [T308A, S473A]) was cotransfected with an expression vector
encoding enhanced green fluorescent protein (GFP) (Clontech) at a ratio
of 9:1 by the LipofectAmine method (Gibco) according to the
manufacturer's protocol. In brief, C2C12 cells were plated in 24-well
plates overnight and incubated in a mixture of each individual plasmid
(2 µg per well) and LipofectAmine (1:5 [wt/wt]) in growth medium
for 6 h. After an 18-h incubation in growth medium, cells were
changed to low-mitogen medium. After incubating for 24 h, cells
were fixed with 3.7% formaldehyde and stained with Hoechst 33342. Floating and adherent GFP-positive cells with pyknotic or normal nuclei
were determined by visual examination, and the fraction of the cells
with pyknotic nuclei was calculated.
Alternatively, immunofluorescent microscopic analysis was performed as
described by Andrés and Walsh (
4). Briefly, cells
were
fixed with 3.7% formaldehyde in PBS for 20 min. Cells were
washed with
PBS twice and permeabilized with 0.2% Triton X-100
in PBS for 3 min.
After three washes with PBS, cells were incubated
with the first
antibody in PBS containing bovine serum albumin
(10 mg/ml) at 30°C
for 1 h. After three more washes with PBS,
cells were incubated
with secondary antibody labeled with rhodamine
at 37°C for 1 h.
TUNEL (terminal deoxynucleotidyltransferase-mediated
dUTP-biotin nick
end labeling) staining was performed as specified
by the manufacturer
(Boehringer Mannheim). Briefly, cells were
fixed with 3.7%
formaldehyde in PBS for 20 min. Cells were washed
with PBS twice and
permeabilized with 0.2% Triton X-100 in PBS
for 3 min. After three
washes with PBS, cells were incubated in
a solution of terminal
deoxynucleotidyltransferase with nucleotide
mixture at 37°C for
1
h.
Statistical analyses.
Data are presented as means ± standard errors of the means (SEM). Differences between data groups
were assessed for statistical significance by using an unpaired
t test.
 |
RESULTS |
Akt upregulation during muscle differentiation.
Changes in Akt
protein expression during murine C2C12 myogenesis were examined by
Western immunoblot analysis. C2C12 myoblasts cultured in high-mitogen
growth medium expressed low levels of Akt protein, but Akt was induced
following exposure of cultures to low-mitogen differentiation medium
(Fig. 2A). Consistent with previous
reports (23, 24, 40), the CDK inhibitor p21 was induced by
differentiation, while the levels of Cdk4 did not change.

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FIG. 2.
Akt is induced upon myocyte differentiation. (A) Akt
protein upregulation during myogenesis induced by mitogen deprivation.
C2C12 cells were cultured in growth medium (GM) or in differentiation
medium (DM) for 24 h (1d) or for 48 h (2d). Cell lysates
containing 20 µg protein were subjected to Western immunoblot
analysis using anti-Akt, p21, and Cdk4 antibodies. (B) Akt protein
upregulation induced by prolonged cultivation of confluent cultures in
high-mitogen medium. C2C12 cells were cultured in growth medium (GM)
for 2, 4, and 6 days. Cell lysates were prepared, and 20 µg of
extract protein was immunoblotted with anti-Akt, myogenin, and Cdk4.
(C) Akt protein expression is sustained in terminally differentiated
cells following serum restimulation. C2C12 cells were induced to
differentiate into myotubes by incubating cultures for 4 days in
differentiation medium. These cultures were then cultured in fresh
differentiation medium (DM) or growth medium (GM) for 24 h. Cell
lysates (20 µg) were immunoblotted with anti-Akt and Cdk4
antibodies.
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Experiments were performed to examine whether Akt induction was a
consequence of myogenic induction or due solely to changes
in the
mitogen content of the media. Though high-mitogen growth
medium
inhibits myogenesis, a low rate of differentiation can
be detected in
highly confluent cultures of C2C12 cells (
6,
58). Induction
of Akt was also detected under these conditions,
but it occurred more
slowly than in differentiation medium (compare
Fig.
2A and
2B).
Furthermore, once Akt was expressed by C2C12
myotubes (derived from
incubation in differentiation medium),
restimulation with growth medium
did not suppress Akt levels (Fig.
2C). Similar regulatory behavior has
also been described for p21
and myogenin induction during C2C12
differentiation (
4), and
these data indicate that Akt
induction is not a simple consequence
of differences in the mitogen
content of the media but a feature
of irreversible myogenic
differentiation.
Akt activity was assessed by measuring H2B kinase activity in anti-Akt
immunoprecipitates of extracts prepared from cultures
exposed to growth
and differentiation media (Fig.
3A). Akt
activity
was low in proliferating myoblasts but was induced in cultures
exposed to low-mitogen differentiation media. Inclusion of immunogenic
peptide during the Akt immunoprecipitation step reduced histone
H2B
kinase activity to background levels in extracts from differentiated
cells, indicating the specificity of the assay. To elucidate the
role
of PI 3-kinase in Akt activation during myogenesis, differentiating
cultures of C2C12 cells were incubated with wortmannin (Fig.
3B).
Wortmannin suppressed Akt-associated histone H2B kinase activity.
Wortmannin treatment also reduced the level of Akt phosphorylation,
assessed with an antibody that is specific for Akt phosphorylation
at
residue 473 and indicative of the status of Akt activation
(
1).

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FIG. 3.
Akt kinase activity in differentiating myocyte cultures
is sensitive to inhibition by wortmannin. (A) Cell lysates were
prepared from C2C12 cells cultured in growth medium (GM) or
differentiation medium (DM) for 48 h. Kinase activity was
determined in anti-Akt immunoprecipitates, using histone H2B as a
substrate. Specificity of the kinase reaction was analyzed by inclusion
of 8 µg of Akt peptide (comp.) in the immunoprecipitation reaction
with the extract prepared from differentiating cells. (B) Akt activity
in differentiating myocytes is inhibited by wortmannin. C2C12 cells
were cultured in differentiation medium (DM) for 48 h. Wortmannin
(Wort) was added to the medium at final concentration of 200 nM, and
cells were harvested after 1 h of incubation. Dimethyl sulfoxide
was used as a vehicle at final concentration 0.1%. In the upper panel,
Akt kinase activity immunoprecipitated (IP) with anti-Akt antibody was
analyzed with histone H2B as a substrate. Immunoblot analysis with
anti-Akt was also performed on anti-Akt-immunoprecipitated materials.
In the lower panel, cell lysates were immunoblotted with anti-Akt and
anti-phospho-Akt (anti-P-Akt) antibodies. IgG, immunoglobulin G.
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Northern blot analyses were performed to elucidate the mechanism of Akt
upregulation. These assays revealed no significant
changes in
Akt mRNA levels between cultures of proliferative myoblast
and differentiating cells (Fig.
4A).
Akt mRNA was also not upregulated
in MyoD-transformed 10T1/2
cells exposed to differentiation medium
(data not shown). In contrast,
the
Akt-related gene
Akt2 is upregulated
by
myogenic differentiation at the level of mRNA (
2,
3).
Upregulation of Akt2 protein was also detected in the differentiating
C2C12 cultures, but in contrast to Akt, Akt2 upregulation appeared
less
pronounced and was not sustained at later time points (not
shown).
Thus, we focused on understanding the functional significance
of Akt
induction during myogenic differentiation.

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FIG. 4.
Myogenic induction of Akt occurs through protein
stabilization. (A) Akt mRNA is not upregulated during
myogenesis. Total RNAs were prepared from the C2C12 cells in growth
medium (GM) or in differentiation medium (DM) for 24 h (1d) or for
48 h (2d). Northern blot analysis was performed with a cDNA probe
to the PH domain of Akt. The 28S RNA band is shown to
indicate equal loading of the gel. (B) Akt protein stability increases
upon myogenic differentiation. Cycloheximide was added to cultures
exposed to growth medium (GM) or differentiation medium (DM) (2 days),
and Western immunoblot analysis was performed on Akt and Cdc2 at the
indicated time points (t). Cdc2 levels do not change significantly
under the conditions of this assay (50), and it is used to
control for differences in sample loading. The ratio of Akt to Cdc2
signal in the absence of cycloheximide is assigned a value of 1.0. (C)
Proteasome inhibitor ALLN promotes Akt protein expression. C2C12 cells
were cultured with the indicated concentrations of ALLN in growth
medium for 12 h. Dimethyl sulfoxide was used as a vehicle at a
final concentration of 0.1%. Cell lysates were immunoblotted with
anti-Akt antibody.
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To further delineate the mechanism of Akt upregulation, Akt protein
half-life was examined in cultures exposed to cycloheximide
in growth
medium or differentiation medium (Fig.
4B). Akt protein
levels remained
stable in cultures exposed to differentiation
medium over the 6-h time
course of the assay, while Akt half-life
was approximately 3 h in
the cultures exposed to high-mitogen
growth medium. Thus, an increase
in the stability of the Akt peptide
appears to contribute to the
induction of Akt during myogenic
differentiation. To determine whether
the short half-life of Akt
in myoblast is dependent on proteasome
activity, cultures were
incubated with the proteasome inhibitor ALLN
(
47,
50). Incubation
with ALLN led to a dose-dependent
accumulation of Akt (Fig.
4C),
suggesting that Akt turnover is
dependent on the action of the
26S
proteasome.
Akt promotes myocyte viability.
Plasmid vectors expressing
wild-type and dominant-negative forms of Akt were used to assess the
role of Akt in myocyte survival during differentiation. Akt expression
plasmids were initially cotransfected with a plasmid expressing GFP
into C2C12 cells in growth medium, and cultures were shifted to medium
containing 0.5% horse serum or no serum to induce differentiation. In
these assays, serum levels were lowered to enhance the rate of
differentiation and frequency of apoptosis. Apoptosis was assessed in
the differentiating cultures by analyzing the fraction of floating and
adherent GFP-positive cells with condensed chromatin following staining
with Hoechst 33342 (15) (Fig.
5A). Most cells with condensed chromatin
were floating, but adherent cells with condensed chromatin were also noted. For quantitative analyses, all GFP-positive cells, both floating
and attached, were analyzed for each experimental condition.

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FIG. 5.
Effects of expression of wild-type or mutant Akt on the
frequency of myocytes displaying nuclear condensation during
differentiation. Differentiating C2C12 cells were cotransfected with
plasmids encoding dominant-negative (dn.) or wild-type Akt
along with a plasmid encoding GFP as a transfection marker at a ratio
of 9:1. (A) Representative photomicrographs showing adherent (attached)
and floating cells in myocyte cultures transfected with the GFP
expression plasmid and plasmids encoding wild-type Akt or
the K179M Akt mutant. Note the condensed Hoechst
33342-stained nuclei that correspond to the floating GFP-positive cells
in cultures transfected with K179M Akt. In contrast, cultures
cotransfected with an expression plasmid encoding wild-type
Akt revealed a high frequency of adherent GFP-positive cells
with normal-appearing nuclei. (B) Dominant-negative Akt expression
plasmids promote myocyte apoptosis during differentiation. Cells were
cotransfected with empty vector (pcDNA3) or plasmids expressing the
dominant-negative forms of Akt, using the LipofectAmine method. After
transfection, cells were incubated in growth medium for 18 h and
then in DMEM containing 0.5% horse serum. Low concentrations of serum
were used for these assays to increase the frequency of apoptosis.
After 24 h of incubation, cells were fixed and stained with
Hoechst 33342 as described in Materials and Methods. The adherent and
floating transfected GFP-positive cells were scored for normal or
pyknotic nuclei. Data are shown as mean ± SEM (*, P < 0.01). (C) Wild-type Akt promotes myocyte survival. Cells were
cotransfected with the indicated expression plasmids and the GFP
expression plasmid. After transfection and incubation in growth medium
for 18 h, the medium was changed to DMEM without serum. Serum-free
medium was used to maximize the number of cells undergoing apoptosis,
such that the protective effects of wild-type Akt could be determined
more accurately. After 24 h of incubation, the transfectants were
scored as described for panel B. Data are shown as mean ± SEM
(*, P < 0.01).
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The mutant Akt [K179M] has a mutation in the ATP-binding site and is
catalytically inactive (
5), while the mutant Akt [T308A,
S473A] has alanine substituted for serine/threonine at the indicated
residues and cannot be activated by phosphorylation (
1).
Cotransfection
with either dominant-negative Akt construct markedly
increased
the fraction of GFP-positive cells that were floating and
displayed
chromatin condensation when differentiating cultures were
incubated
in 0.5% horse serum (Fig.
5B). In contrast, forced
expression
of wild-type Akt in the cotransfection assay reduced the
fraction
of floating GFP-positive cells with condensed chromatin when
differentiating
cultures were incubated in serum-free medium (Fig.
5C).
Collectively,
these data suggest that Akt upregulation is essential for
full
myocyte viability during serum deprivation-induced myocyte
differentiation
and that elevated Akt levels are sufficient to confer
partial
resistance to apoptosis under these
conditions.
To further document the effect of Akt on cell survival, cultures were
transfected with plasmids expressing HA-tagged, wild-type,
constitutively active, or dominant-negative Akt constructs, and
frequencies of apoptosis were assessed by comparing the percentages
of
HA-positive cells that were positive for TUNEL staining. TUNEL-positive
cells typically displayed chromatin condensation in the Hoechst
stain
(Fig.
6A). Cells positive for
plasmid-encoded wild-type
or constitutively active Akt displayed a
reduced frequency of
TUNEL-positive nuclei than the control plasmid
expressing
lacZ (Fig.
6B). In contrast, cells positive for
expression of either
dominant-negative Akt construct displayed higher
frequencies of
TUNEL-positive nuclei. In these assays, the effects of
active
and inactive Akt constructs were compared in parallel and under
identical medium conditions, demonstrating that Akt can be sufficient
and essential for myocyte survival independent of culture conditions.

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FIG. 6.
Effects of expression of wild-type or mutant Akt on the
frequency of TUNEL-positive cells during myogenic differentiation.
Differentiating myocytes were transfected with plasmids encoding
wild-type, constitutively active, or dominant-negative Akt tagged with
HA. The plasmid encoding -Gal ( -gal) was used as a control. After
transfection, cells were incubated in growth medium for 18 h and
then in DMEM containing 0.5% horse serum for 24 h. Transfected
cells were identified by immunostaining with anti-HA or -Gal
antibodies. Apoptotic cells were detected by TUNEL (TNL). (A)
Representative photomicrographs showing TUNEL-positive cells (arrows).
Cells were treated as described above and stained by TUNEL (TNL;
green), Hoechst 33342 (Hoechst; blue), and anti-HA or -Gal antibody
(HA or -gal; red). (B) Percentage of cells that stained positive for
plasmid-encoded transgene expression. For each condition, four separate
cultures were transfected with the indicated plasmid, and at least 50 HA- or -Gal-positive cells were counted on each plate. Data are
shown as mean ± SEM.
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p21-mediated cell cycle withdrawal is coordinated with Akt
induction and cell survival.
To investigate the relationship
between p21 and Akt in myocytes, we investigated the effects of
p21-antisense oligonucleotides on Akt induction, cell cycle, and
apoptosis. C2C12 cultures were treated with p21-antisense or control
oligonucleotides and induced to differentiate. Western immunoblot
analysis of cultures harvested after 24 h of treatment revealed
that the p21-antisense oligonucleotides markedly inhibited the
induction of p21 (Fig. 7A). The
p21-antisense oligonucleotides had no effect on Cdk4 levels, but there
was a reproducible reduction in Akt expression. A statistically
significant reduction in Akt expression, normalized to Cdk4 expression,
was noted in multiple experiments (Fig. 7B).

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FIG. 7.
Antisense oligonucleotides against p21 inhibit the
induction of p21 and Akt during myogenic differentiation. (A) C2C12
cells were cultured in standard differentiation medium ( ) or in
differentiation medium containing Lipofectin with 0.5 µM
p21-antisense (p21-AS) or control (Cont) oligonucleotides for 24 h. After 24 h of incubation, cells were harvested and cell lysates
(20 µg protein) were immunoblotted with anti-Akt, anti-p21, and
anti-Cdk4 antibodies. Representative data from one of five assays are
shown. (B) Quantitative analysis of reduced Akt expression. The
intensities of the Akt and Cdk4 bands in immunoblots from five
independent experiments were quantified by gel densitometry. The ratios
of Akt band intensity relative to Cdk4 band intensity were calculated
and normalized to the ratios of band intensities in parallel cultures
that were incubated in differentiation medium with no oligonucleotide
or Lipofectin. Data are shown as mean ± SEM.
|
|
Flow cytometric analyses were performed to determine the effect of the
p21-antisense oligonucleotides on cell cycle progression
during
differentiation. As shown in Table
1,
cultures treated
with p21-antisense oligonucleotides for 24 h had
a greater percentage
of cells in the S and G
2/M phases of
the cell cycle than cultures
treated with control oligonucleotides or
with differentiation
medium alone. These data provide causal evidence
that p21 induction
mediates cell cycle exit during myogenic
differentiation.
Previously, it has been shown that induction of p21 coincides with the
acquisition of an apoptosis-resistant phenotype and
that forced
expression of p21 can block apoptosis in differentiating
cultures of
C2C12 myocytes (
56,
57). Thus, we analyzed the
effects of
the p21-antisense oligonucleotides on myocyte survival.
As shown in
Fig.
8A, markedly enhanced cell death was
observed
in differentiating cultures treated with p21-antisense
oligonucleotides
than in control cultures. The frequency of cell death
was dependent
on the dose of antisense oligonucleotides, and cell death
was
most notable between 24 and 48 h in differentiation medium
(Fig.
8B). Cultures treated with p21-antisense oligonucleotide
contained
high frequencies of mononuclear cells displaying cytoplasmic
shrinkage
and chromatin condensation (Fig.
8C), indicators of apoptotic
death. These data suggest that cell cycle withdrawal is essential
for
the suppression of apoptotic cell death during myogenesis.

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FIG. 8.
Antisense oligonucleotides against p21 promote cell
death during differentiation. The cells were plated and transfected
with the oligonucleotides. C2C12 cells were cultured in standard
differentiation medium or in differentiation medium containing
Lipofectin with the indicated oligonucleotides for 24 or 48 h. (A)
Representative light photomicrographs of cultures exposed to
differentiation medium in the absence (none) or presence of 0.5 µM
p21-antisense (p21-AS) or control oligonucleotides for 48 h were
obtained by a Nikon Diaphot light microscope at a magnification of
×100. (B) Cultures were washed with PBS and harvested by
trypsinization. Cell number was determined with a hemacytometer. Data
are shown as mean ± SEM of four parallel cultures that were
treated according to the indicated conditions (*, P < 0.01). (C) Representative photomicrographs showing Hoechst
33342-staining patterns of differentiating myocyte cultures exposed to
0.5 µM control or p21-antisense oligonucleotides for 24 h in
medium containing 2% horse serum. Note the condensation of chromatin
in cells exposed to p21-antisense oligonucleotides (arrowheads).
|
|
Adenovirus-mediated Akt gene transfer can protect mitotic cells
from death during myogenic differentiation.
To examine the
functional significance of suppressed Akt expression in p21-deficient
myocytes, p21-antisense oligonucleotide-treated cultures were infected
with replication-defective adenoviral vectors expressing wild-type Akt
(Adeno-Akt) or dominant-negative Akt(AA) [Adeno-Akt(AA)], and the
frequency of cell death during differentiation was assessed. These
vectors express the Akt transgene fused to HA to distinguish
virus-encoded and endogenous proteins (Fig. 1). Adenovirus transduction
efficiencies in C2C12 cell culture exceeds 90% under the conditions of
these assays. Myoblast cultures infected with Adeno-Akt or
Adeno-Akt(AA) express transgene proteins, as detected by Western
immunoblot analysis using either anti-Akt or anti-HA antibodies (Fig.
9A). H2B kinase activity was detected in
anti-HA immunoprecipitates of myoblasts infected with Adeno-Akt but not
Adeno-Akt(AA). Immunoprecipitation-coupled immunoblot analyses with
anti-HA or anti-Akt antibodies confirmed the presence of
transgene-encoded Akt proteins in the anti-HA immunoprecipitates. Collectively, these assays show that Adeno-Akt encodes a functional protein kinase, while Adeno-Akt(AA) encodes a kinase-deficient protein.

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FIG. 9.
Adenovirus-mediated Akt gene transfer partially inhibits
apoptosis in differentiating myocytes following p21 ablation. (A)
Adeno-Akt expresses functional Akt, but the Adeno-Akt(AA)-encoded
protein is kinase deficient. C2C12 cells were infected in growth medium
(GM) with the adenoviral vectors expressing -Gal or HA-tagged Akt or
Akt(AA) at an MOI of 250 for 24 h prior to harvest. Cell lysates
(10 µg of protein) were subjected to Western immunoblot analysis
using anti-Akt, anti-HA, or anti-Cdk4 antibody. Histone H2B kinase
activity in anti-HA immunoprecipitates (IP) was determined as described
in Materials and Methods. Immunoblot analysis, with anti-Akt or anti-HA
antibody was performed on the anti-HA-immunoprecipitated material to
confirm the presence of transgene-encoded protein. (B) Akt
overexpression following infection with Adeno-Akt. C2C12 cultures in
growth medium were infected in parallel with Adeno-Akt or Adeno- gal
at an MOI of 250. After 15 h, the media was replaced with fresh
growth medium (GM) or differentiation medium (DM) containing 2% horse
serum for 24 h. Cell lysates (20 µg) were then analyzed by
Western immunoblotting using anti-Akt antibody. (C) Akt expression
partially inhibits p21-antisense-induced cell death. C2C12 cells were
cultured in growth medium and infected with Adeno-Akt, Adeno-Akt(AA),
Adeno-p27, or Adeno- gal at an MOI of 250 for 15 h. Cultures
were then transferred to 2% horse serum differentiation medium in the
presence of 0.5 µM p21-antisense (p21-AS) or control (cont)
oligonucleotide for 24 h. Frequency of apoptosis was determined by
staining with Hoechst 33342 and scoring for nuclei with normal or
condensed chromatin. Data are shown as mean ± SEM (n = 4). (*, P < 0.01; NS, nonsignificant compared
to Adeno- gal-treated cultures exposed to p21-antisense
oligonucleotides).
|
|
Western immunoblot analysis with anti-Akt antibodies revealed that the
level of Akt overexpression resulting from Adeno-Akt
infection was
fivefold in myoblast cultures and threefold in cultures
exposed to
differentiation media (Fig.
9B). In these experiments,
we noted that
virus-encoded Akt protein, expressed from a cassette
containing
heterologous 5' and 3' noncoding sequences, was also
induced upon
exposure to differentiation medium. These data further
suggest that
myogenic differentiation increases the stability
of the Akt peptide,
and they are consistent with the results of
protein half-life and
proteasome inhibition experiments reported
above (Fig.
4B and
C).
To test whether Adeno-Akt can protect against p21-antisense-induced
death, myocyte cultures were infected with adenoviral
constructs and
exposed to differentiation medium containing 2%
horse serum and 0.5 µM p21-antisense oligonucleotides for 24 h
(Fig.
9C). Control
cultures were infected with an adenoviral vector
expressing

-galactosidase (Adeno-

gal), which does not affect
C2C12 cell
viability (
56). Treatment of control cultures with
the
p21-antisense oligonucleotide increased the fraction of cells
undergoing apoptosis by a factor of 4, as assessed by analyses
of
chromatin condensation. Infection with Adeno-Akt significantly
reduced
the frequency of apoptosis in differentiating cultures
exposed to
p21-antisense oligonucleotides, suggesting that Akt
can protect mitotic
cells against death under conditions that
promote differentiation. Of
note, the adenoviral construct expressing
the Akt(AA) mutant, which
enhances death in the absence of p21-antisense
oligonucleotides (Fig.
5B and
6B), did not cause further death
in the p21-deficient cells
(Fig.
9C). Since p21 ablation and Akt(AA)
do not have an additive
effect on cell death, these results suggest
that Akt participates in
the antiapoptotic signaling pathway that
is activated upon cell cycle
withdrawal.
Adenovirus-mediated overexpression of the CDK inhibitor p27 (Adeno-p27)
almost completely reversed the apoptosis induced by
a p21-antisense
oligonucleotide (Fig.
9C). These data further
suggest that the cell
death induced by the p21-antisense oligonucleotides
is a consequence of
its effect on cell cycle activity and not
due to nonspecific
cytotoxicity by this agent. Infection with
Adeno-p27 also abrogated Akt
downregulation by p21-antisense oligonucleotides
(data not shown),
consistent with the hypothesis that Akt expression
is negatively
regulated by cell cycle
activity.
The experiments described above demonstrate that adenovirus-encoded p27
more effectively suppressed cell death induced by
the p21-antisense
oligonucleotides than adenovirus-encoded wild-type
Akt (Fig.
9C)
despite its ability to overexpress Akt between three-
and fivefold
(Fig.
9B). These data suggested that either upstream
signaling pathways
may become limiting with respect to Akt activation
(particularly in the
low-mitogen medium) or other cell cycle-dependent
survival pathways
independent of Akt may be required for full
myocyte viability. To
address this issue further, an adenoviral
vector expressing
constitutively active Akt (Adeno-myrAkt) was
constructed (Fig.
1).
Adeno-myrAkt expressed similar levels of
HA-tagged recombinant protein
as the other adenoviral Akt vectors
(Fig.
10A). However, in marked contrast to
wild-type Akt, the protein
encoded by Adeno-myrAkt displayed high
levels of activity in the
absence of mitogen stimulation (not shown).
We calculated 3- and
15-fold higher levels of Akt-associated H2B kinase
activity in
Adeno-myrAkt-infected cultures of differentiating C2C12
cells
relative to the activities seen following infection with
Adeno-Akt
or the endogenous activity, respectively. Differentiating
cultures
of C2C12 cells infected with Adeno-myrAkt also displayed lower
frequencies of apoptosis, as assessed by TUNEL staining for DNA
fragmentation or Hoechst staining for chromatin condensation (Fig.
10B
and C). However, infection with Adeno-myrAkt did not provide
significantly more protection from cell death than infection with
Adeno-Akt.

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FIG. 10.
Constitutively active Akt partially inhibits apoptosis
in differentiating myocytes following p21 ablation. (A) Adeno-myrAkt
expresses functional Akt. C2C12 cells were infected in growth medium
(GM) with the adenoviral vectors expression -Gal or HA-tagged myrAkt
at an MOI of 250 for 24 h prior to harvest. Histone H2B kinase
activity in anti-HA immunoprecipitates (IP) was determined as described
in Materials and Methods, and immunoblot analysis with anti-Akt and
anti-HA antibodies was performed on the anti-HA-immunoprecipitated
material to confirm the presence of transgene-encoded protein. (B)
Analysis of apoptosis by TUNEL staining (TNL) in differentiating
cultures of C2C12 cells following infection with adenoviral vectors.
Note that many TUNEL-positive cells also display chromatin condensation
when stained with Hoechst 33342. (C) Akt expression partially inhibits
p21-antisense-induced cell death. C2C12 cells were cultured in growth
media and infected with Adeno-myrAkt, Adeno-Akt, or Adeno- gal at an
MOI of 250 for 15 h. Cultures were then transferred to 2% horse
serum differentiation medium in the presence of 0.5 µM p21-antisense
(p21-AS) or control oligonucleotide for 24 h. Frequency of
apoptosis was determined by scoring for nuclei that were TUNEL
positive. Data are shown as mean ± SEM (n = 4).
(*, P < 0.01 compared to Adeno- gal-infected
cultures exposed to p21-antisense oligonucleotides.)
|
|
 |
DISCUSSION |
In many systems, aberrant cell cycle activity can induce
apoptosis, and cell cycle activity can markedly influence the
susceptibility of cells to apoptosis as induced by a variety of stimuli
(29). However, the mechanisms by which cells sense
perturbations in cell cycle activity and induce apoptosis have not been
defined. Myogenic precursor cells irreversibly withdraw from the cell
cycle as they differentiate into multinucleated myotubes. As
differentiation progresses, myogenic cells display a reduced propensity
to undergo apoptotic cell death in low-mitogen differentiation media
(56, 57), possibly through induction of a survival factor.
In this study, we have defined one component of the mechanism by which proliferation and apoptosis are coordinated during myogenic
differentiation in vitro. We show that kinase Akt is induced during
myogenic differentiation, with consequences on myocyte survival. The
functional significance of Akt induction in differentiating cultures is
indicated by the observations that dominant-negative Akt mutants
promote apoptotic cell death while apoptosis is suppressed by the
forced expression of wild-type or constitutively active Akt.
Constitutively active Akt suppressed apoptosis by 83% relative to
cells transfected with dominant-negative Akt (Fig. 6), indicating the
importance of Akt as a regulator of cellular survival during myogenic
differentiation. In addition to its protective effects, myogenic
activation of Akt may also facilitate the differentiation process
(28).
Previously, phosphorylation of Akt has been shown to mediate the
antiapoptotic activity of mitogen survival factors in neuronal cells,
lymphocytes, fibroblasts, and other cell types (11). Here,
it is shown that developmental regulatory signals can also control Akt
expression through stabilization of the Akt peptide in postmitotic
myocytes. Protein stabilization may represent a common mechanism
through which cell cycle activity regulates the expression of key
myogenic factors. Similarly to Akt, MyoD has recently been shown to
have a short half-life in proliferating myoblasts, but it is stabilized
by cell cycle exit during differentiation (32, 50).
Stability of the Myf-5 protein, another myogenic factor, is also
governed by cell cycle activity in myocytes (38).
In many cell types it is established that Akt activity is regulated by
mitogen-dependent signals via the PI 3-kinase pathway (18, 34,
52). As shown here, the PI 3-kinase inhibitor wortmannin also
inhibits Akt activity in differentiating myocyte cultures. Though
differentiation is typically induced by incubating proliferative myoblast cultures with low-mitogen medium, differentiating myocytes produce insulin-like growth factor I (IGF-I) and IGF-II, activators of
the PI 3-kinase pathway (16, 17, 35, 45, 54). Thus, in
addition to Akt protein induction, autocrine stimulation by factors
that activate PI 3-kinase signaling may be required to complete a
regulatory circuit that favors myocyte survival. Consistent with this
hypothesis, IGF-II has been reported to function as an autocrine
survival factor during myogenic differentiation (51).
Multiple lines of correlative evidence suggest that CDK inhibitor
induction initiates cell cycle withdrawal during myogenic differentiation and that cell cycle exit promotes myocyte survival (reviewed in reference 55). Here it is shown that
ablation of p21 induction with antisense oligonucleotides blocks the
cell cycle exit that usually occurs early in myogenic differentiation, providing causal evidence that this CDK inhibitor is critical for the
establishment of the postmitotic state in vitro. Cultures treated with
p21-antisense oligonucleotides also exhibited high rates of apoptotic
cell death that was particularly notable at later time points during
the differentiation time course. Conversely, cell cycle inhibition by
the forced expression of pRB, p16, or p21 suppresses apoptosis during
myogenesis (56, 57). These data provide strong evidence that
apoptosis and mitotic activity are coupled during myogenic
differentiation in vitro. Similar regulatory pathways may also be
operational during myogenesis in vivo, as mice expressing reduced
levels of pRb contain muscle groups that undergo a high frequency of
apoptosis at an early stage in the differentiation process and display
cell cycle defects (59). On the other hand, mice lacking
individual CDK inhibitors develop normally, with no obvious muscle
defects. Presumably, CDK inhibitors are functionally redundant during
embryonic development (60). Consistent with this hypothesis,
we show here that forced expression of p27 can compensate for p21 in
suppressing apoptosis when p21 is ablated by the antisense oligonucleotide.
To elucidate the relationship between cell cycle withdrawal and
Akt-mediated cell survival, Akt levels were assessed in differentiating myocytes blocked from cell cycle withdrawal by treatment with p21-antisense oligonucleotides. Akt levels are suppressed in the p21-deficient cells, indicating a functional interaction between cell
cycle progression and Akt expression during myocyte differentiation. Akt gene transfer experiments were performed on these
p21-deficient cells to determine the functional significance of Akt
suppression by mitotic activity. Adenovirus-mediated Akt
gene transfer reduced the high frequency of apoptosis induced by
p21-antisense oligonucleotides, suggesting that elevated Akt expression
can partially compensate for the deficiency arising from the absence of
efficient cell cycle exit. In contrast, adenovirus-mediated expression
of a dominant-negative Akt did not increase the frequency of cell death
above what occurs when differentiating cells are exposed to
p21-antisense oligonucleotides alone. Since these agents are not
additive, these data suggest that Akt functions in the antiapoptotic
pathway induced by cell cycle exit.
Although Akt appears to function downstream from cell cycle exit to
protect against death during myogenesis, forced expression of Akt
cannot fully suppress apoptosis in mitotic myocytes. In contrast,
adenovirus-mediated overexpression of p27 was much more effective at
inhibiting apoptosis caused by the p21 deficiency. The lack of complete
protection by Akt overexpression could result from other components of
the Akt pathway that become limiting under these conditions. To test
whether activation of Akt is limiting in mitotic cells during myogenic
differentiation, cultures were infected with an adenoviral construct
expressing constitutively active Akt. No enhancement of cell survival
was observed despite a 15-fold increase in overall Akt activity
relative to endogenous levels. These data suggest that other cell
cycle-regulated pathways may work in conjunction with Akt to ensure
myocyte survival during differentiation. Consistent with this
hypothesis, it has recently been shown that IGF-I promotes survival of
Rat-1 cells through Akt-dependent and -independent pathways
(37). The identity of this alternative survival pathway is
unknown, but it could involve Akt2, a homologue of Akt that displays a
highly tissue-specific pattern of expression and is expressed in muscle
(2). The apoptosis-regulatory properties of Akt2 are unknown
at this time. Alternatively, mechanisms that involve the direct
association of cell cycle proteins with apoptosis-regulatory factors
may exist, as has recently been described for pRb, MDM2, and p53
(27). Of note, it has been shown that Bcl-2 can impart a
selective advantage to proliferative myoblasts, leading to their clonal
expansion (14), although levels of Bcl-2 are downregulated
at middle or late stages of myogenesis when cell cycle exit and Akt
protein stabilization occur.
Here we document an upregulation of Akt in a developmental system with
consequences on apoptosis. While it is well established that cell cycle
exit is required for the activation of contractile protein genes during
myogenesis, we propose that cell cycle exit is required for efficient
induction of Akt and cell survival. The experimental observations
described here provide a foundation for understanding the mechanisms
that coordinate apoptosis and cell cycle activity during myogenesis and
may broadly relate to other systems where proliferating cells undergo
apoptosis. Links between cell cycle and apoptosis have also been
observed in differentiating neuronal cells, which undergo apoptosis at
a high frequency when exposed to antisense oligonucleotides to p21
(44) and are protected from death by the overexpression of
the CDK inhibitor p16 (36). Mesangial cells deficient in p27
also undergo elevated rates of apoptosis and viability can be restored
by cell cycle exit (26). Finally, it has been shown that
terminally differentiated cardiomyocytes express lower levels of
tissue-specific proteins and undergo apoptosis in response to cell
cycle progression induced by forced expression of E2F1 or E1a (31,
39). Thus, in several differentiation systems, cell cycle
activity may suppress antiapoptotic genes, such as Akt,
required for survival as cellular differentiation progresses.
 |
ACKNOWLEDGMENTS |
This work was supported by NIH grants HD23681, HL50692, and
AG15052 to K.W.
We thank Roy C. Smith for carefully reading the manuscript. We thank
Linda Whittaker for preparing the manuscript.
 |
FOOTNOTES |
*
Corresponding author. Mailing address: Division of
Cardiovascular Research, St. Elizabeth's Medical Center, 736 Cambridge St., Boston, MA 02135. Phone: (617) 562-7501. Fax: (617) 562-7506. E-mail: kwalsh{at}opal.tufts.edu.
 |
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Molecular and Cellular Biology, July 1999, p. 5073-5082, Vol. 19, No. 7
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Copyright © 1999, American Society for Microbiology. All rights reserved.
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