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The Journal of Clinical Endocrinology & Metabolism Vol. 84, No. 2 611-617
Copyright © 1999 by The Endocrine Society


Original Studies

Regulation of Soluble Insulin-Like Growth Factor II/Mannose 6-Phosphate Receptor in Human Serum: Measurement by Enzyme-Linked Immunosorbent Assay1

Michael Costello, Robert C. Baxter and Carolyn D. Scott

Kolling Institute of Medical Research, University of Sydney, Royal North Shore Hospital, St. Leonards, New South Wales 2065, Australia

Address all correspondence and requests for reprints to: Dr. C. D. Scott, Kolling Institute of Medical Research, University of Sydney, Royal North Shore Hospital, St. Leonards, New South Wales 2065, Australia.


    Abstract
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
The soluble form of the insulin-like growth factor II/mannose 6-phosphate (IGF-II/M6-P) receptor has been detected in serum from a variety of mammalian species. We report the development of a highly sensitive quantitative human IGF-II/M6-P receptor immunoassay. Antibodies raised to receptor purified from a human hepatoma cell line by phosphomannan affinity chromatography were used to develop a specific enzyme-linked immunosorbent assay. In this assay, the serum level of soluble receptor for healthy adult subjects was 0.70 ± 0.23 mg/L. We have shown that soluble receptor is developmentally regulated, with levels in infant (1.12 ± 0.28 mg/L) and prepubertal (1.18 ± 0.6 mg/L) subjects dropping by 40% during adolescence (0.73 ± 0.61 mg/L) and remaining constant throughout adulthood. Further, the receptor is gestationally regulated, with a highly significant association between gestational age and maternal serum receptor levels (r = 0.947; P < 0.0001). Noninsulin-dependent diabetes mellitus (0.98 ± 0.25 mg/L) and insulin-dependent diabetes mellitus (0.98 ± 0.25 mg/L) mildly elevated soluble receptor levels, whereas end-stage renal failure (0.75 ± 0.23 mg/L) and acromegaly (0.79 ± 0.25 mg/L) did not affect receptor levels. Additionally, we have shown that soluble receptor is present in amniotic fluid, but at a 100-fold lower concentration than serum levels. The ability to quantitate soluble IGF-II/M6-P receptor levels in serum and other fluids provides a valuable tool that will help to further elucidate the role of the receptor in human physiology and disease states.


    Introduction
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
THE HUMAN insulin-like growth factor II/mannose 6-phosphate (IGF-II/M6-P) receptor is a multifunctional protein with a molecular mass of approximately 220 kDa that exists in both membrane-associated and soluble forms. The membrane receptor has a large extracellular domain, a short transmembrane region, and a small intracellular domain (1). Truncation of the membrane receptor at the transmembrane region leads to the formation of the soluble form of the receptor (2, 3), which has been reported in rat (4), ovine (5), bovine (6), monkey (7), and human serum (8). The receptor binds with high affinity two structurally and functionally distinct ligands, IGF-II (9) and proteins with M6-P moieties on their carbohydrate side-chains, such as lysosomal enzymes (10), transforming growth factor-ß (TGFß) precursor (11), and proliferin (12). Recently, a possible third ligand, retinoic acid, has been reported for the receptor (13). The IGF-II/M6-P receptor gene is imprinted in rats, but generally not in humans, and has been mapped to the human chromosome 6q25-q27 (14, 15).

The ability of the IGF-II/M6-P receptor to interact with several ligands is reflected by the many functions that have been attributed to it. The receptor has been shown to transport lysosomal enzymes such as ß-D-glucuronidase and ß-D-galactosidase from the Golgi apparatus to the prelysosomes (16, 17). Our group has shown that in rat hepatocytes the soluble receptor inhibits DNA synthesis by modulation of IGF-II action and by an IGF-independent mechanism (18). The importance of the receptor in fetal and tumor development is shown by its ability to bind, internalize, and degrade IGF-II. Disruption of this process in fetal mice leads to cardiac hypertrophy and subsequent perinatal death (19), whereas in tumor cells it has the potential to increase tumor cell proliferation. Hankins and De Souza have presented data suggesting that receptor allelic loss is an early event in breast and hepatocellular tumor etiology (20, 21, 22). Both of these IGF-II-stimulated overgrowth mechanisms rely on the loss of receptor function. TGFß, a potent cytokine, has been shown to require the IGF-II/M6-P receptor for its activation. It is thought that by binding to the latent form of TGFß, the IGF-II/M6-P receptor facilitates TGFß activation (11, 23, 24, 25). Additionally, the receptor has been shown to be involved in the endocytosis of extracellular enzymes (26, 27).

Despite the varied functions of the IGF-II/M6-P receptor, there is currently no simple immunological method for quantitating receptor levels in human biological fluids. We now report the development of a human IGF-II/M6-P receptor enzyme-linked immunosorbent assay (ELISA) and describe its use to study the regulation of the soluble form of the receptor in human serum.


    Materials and Methods
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
General reagents

D-Mannose 6-phosphate (Ba2+), ethanolamine, bovine ß-glucuronidase (type B-10), bovine {gamma}-globulins (Cohn fraction II), SDS, Triton X-100, Tween-20, BSA (RIA grade), and DMEM were purchased from Sigma Chemical Co. (St. Louis, MO). The bicinchoninic acid protein assay kit, the EZ-link NHS-LC-biotinylation kit, bis(sulfosuccinimidyl) suberate (BS3), and the Supersignal Chemiluminescence Substrate Solutions kit for enhanced chemiluminescence were obtained from Pierce (Rockford, IL). FCS was purchased from Trace Biosciences (Castle Hill, Australia). Epoxy-activated Sepharose 4B and protein A-Sepharose were obtained from Pharmacia Biotech (Uppsala, Sweden). F96 Certmaxisorp Nunc immunoplates were purchased from Nalge Nunc International (Rochester, NY). Bovine plasma {alpha}2-macroglobulin and 3,3',5,5'-tetra-methyl benzidine were obtained from Boehringer Mannheim (Mannheim, Germany). Aprotinin [10,000 kallikrein inhibitor units (KIU)/mL; Trasylol] was purchased from Bayer Australia Ltd. (Sydney, Australia). Streptavidin-horseradish peroxidase, donkey antirabbit horseradish peroxidase, and Hybond-C Extra were purchased from Amersham Life Science Australia (Castle Hill, Australia). Centricon-100 microconcentrators were purchased from Amicon (Beverly, MA). Recombinant human IGF-II and O-phosphomannan were gifts from Kabi Peptide Hormones (Stockholm, Sweden), and Dr. M. E. Slodki (USDA, Peoria, IL), respectively. All other reagents used were of analytical grade.

M6-P affinity column

Phosphomannan was hydrolyzed and separated into its core phosphomannan and pentamannose phosphate sugars as previously described (28, 29). Epoxy-activated Sepharose 4B was prepared as described by the manufacturers and mixed with the core phosphomannan in 0.1 mol/L sodium phosphate, pH 12, for 22 h at 45 C. The resin was washed extensively as described by the manufacturer, and unbound resin was blocked by incubation with 1 mol/L ethanolamine, pH 8, for 22 h at 45 C. The resin was washed and transferred to a 30 x 1-cm chromatography column.

IGF-II/M6-P receptor purification

Human hepatoma cells (HepG2) were grown to confluence in 17 tissue culture flasks (surface area/flask, 525 cm2), maintained in DMEM supplemented with 5% FCS and 2 mmol/L glutamine. Cells were harvested and homogenized by six passes with a Teflon-glass homogenizer in 0.25 mol/L sucrose containing 500 KIU/mL Trasylol and 5 µg/mL {alpha}2-macroglobulin. Microsomal membranes were isolated by differential centrifugation (30); resuspended in 25 mmol/L HEPES, pH 7.4, containing 500 KIU/mL Trasylol, and 5 µg/mL {alpha}2-macroglobulin; and solubilized in 1% Triton X-100. After solubilization, membranes were diluted 10-fold to give a final Triton X-100 concentration of 0.1%. The membrane solution (140 mL) was loaded onto a M6-P affinity column at 8.75 mL/h over 16 h at 4 C. The column was washed with 1 L 25 mmol/L HEPES, pH 7.4, containing 0.15 mol/L NaCl, 500 KIU/mL Trasylol, 5 µg/mL {alpha}2-macroglobulin, 0.1% Triton X-100, and 4 mmol/L D-glucose 6-phosphate followed by 300 mL 25 mmol/L HEPES, pH 7.4, and 0.1% Triton X-100. The protein was eluted with 10 mmol/L D-M6-P, 25 mmol/L HEPES (pH 7.4), and 0.1% (vol/vol) Triton X-100. Fractions were assayed for binding of [125I]IGF-II (31), and those fractions containing peak activity were concentrated by ultrafiltration (Centricon-100) and assayed for purity by SDS-PAGE (nonreducing conditions) and silver stained (Phast System, Pharmacia Biotech). Membrane and purified receptor protein concentrations were determined using the Pierce bicinchoninic acid protein assay kit and {gamma}-globulin as standard.

Immunization of rabbit

Purified human membrane IGF-II/M6-P receptor (100 µg) in 0.5 mL 136 mmol/L NaCl containing 2.7 mmol/L KCl, 1.5 mmol/L KH2PO4, and 18.5 mmol/L Na2HPO4, pH 7.4 (PBS), was emulsified with an equal volume of Freund’s adjuvant (0.5 mL) and injected via six sc paralumbal sites into an 8-week-old female New Zealand White rabbit. Two weeks later the rabbit was boosted with 100 µg purified receptor in Freund’s incomplete adjuvant. A second, third, and fourth boost (50 µg each) were injected 3, 8, and 12 weeks later into the hind leg muscles in saline without adjuvant. Test bleeds were taken at 5 and 7 weeks, and serum was assayed by Western immunoblot for immunological activity against purified IGF-II/M6-P receptor (200 ng). The titer was monitored intermittently over the following months. The rabbit was killed at 33 weeks, and blood was collected by cardiac puncture.

SDS-PAGE, Western immunoblotting, and autoradiography

Samples were applied under nonreducing conditions to a 4–15% gradient (Phast Gel System, Pharmacia Biotech) or 6% homogeneous SDS-polyacrylamide gels overlaid with 4% stacking gels and subjected to electrophoresis (32), then electroeluted from the gels at 17 V for 2 h onto nitrocellulose (Hybond-C Extra). The nitrocellulose was blocked with 10 mmol/L Tris, pH 7.4, containing 4.2 mmol/L NaCl, 0.1% Tween-20, and 10 g/L BSA for 22 h at 4 C and then incubated with this buffer containing a 1:1,000 dilution of IGF-II/M6-P receptor antiserum for 22 h at 4 C. The nitrocellulose was washed and incubated with donkey antirabbit IgG conjugated to horseradish peroxidase for 1 h at 22 C, and the immunoreactive species was detected by enhanced chemiluminescence (Pierce) and exposed to film for 0–5 min. Quantitation of developed Western blots was carried out using a Bio-Rad model 620 Video Densitometer (Bio-Rad Laboratories, Inc., Richmond, CA) attached to a chart recorder. Purified human IGF-II/M6-P receptor (0.5 µg) was affinity labeled by incubation with [125I]IGF-II (100,000 cpm; 200 cpm/pg) for 16 h at 4 C in 25 mmol/L HEPES, pH 7.4, containing 1 g/L BSA and 0.1% Triton X-100. The sample was then incubated with 1 mmol/L BS3 for 30 min at 22 C, the reaction was stopped with 1 mol/L Tris (pH 8), and the samples were applied to a 6% SDS-polyacrylamide gel.

IGF-II/M6-P receptor ELISA

IGF-II/M6-P receptor antibody from the terminal bleed was affinity purified using protein A-Sepharose. Biotinylated receptor antibody was prepared by incubating affinity-purified antibody (2 mg) with 74 µg sulfo-NHS-LC-biotin (Pierce) for 30 min at 22 C, according to the manufacturer’s instructions. The unreacted biotin was separated via extensive dialysis against PBS. Affinity-purified antibody (0.6 µg/well) in 10 mmol/L sodium carbonate, pH 9.6, was absorbed to the 96-well immunoplates by a 22-h incubation at 4 C. The unbound antibody was removed, and the wells were blocked by incubation with PBS, 0.1% (vol/vol) Triton X-100 (buffer B) containing 10 g/L BSA for 35 min at 37 C, then washed four times with buffer B. Purified solubilized membrane IGF-II/M6-P receptor in sample dilution buffer (buffer B containing 2 g/L BSA) was used to generate standard curves. Standard and samples (100 µL/well) were incubated for 22 h at 4 C. The plate was washed, then incubated with biotinylated receptor antibody (80 ng/well) for 22 h at 4 C. After washing, the plate was incubated with streptavidin horseradish-peroxidase (1:500) for 30 min at 22 C, followed by substrate [0.1 g/L 3,3',5,5'-tetramethyl benzidine in 0.2 mol/L sodium acetate, pH 6, containing 0.06% (wt/wt) H2O2] for 30 min at 22 C. The reaction was stopped by the addition of 2 mol/L H2SO4, and the absorbance was measured at 450 nm using a Bio-Tek microplate reader (Bio-Tek Instruments, Inc., Winooski, VT). Assay data were analyzed using the Multi Calc program (Wallac Oy, Turku, Finland).

Superose-12 gel chromatography

Serum samples (100 µL) were loaded onto a Superose-12 gel permeation column (Pharmacia Biotech) eluting at 1 mL/min in PBS. Fractions (0.5 mL) were collected, and the column was washed between runs. The column was calibrated with a purified [125I]IGF-II/M6-P receptor isolated from rat liver (31) peaking in fractions 19–20, bovine {gamma}-globulins (150 kDa) peaking in fractions 22–23, and BSA (67 kDa) peaking in fraction 24. The recovery of IGF-II/M6-P receptor was typically 64.4 ± 2.8% (mean ± SEM; n = 10).

Serum, urine, and amniotic fluid samples

Blood and urine samples and amniotic fluid collected for previous studies were obtained for analysis, with ethics committee approval. All samples were stored at -20 C before use. Serum IGF-II levels (in duplicate) were determined by RIA as previously described (33).

Statistical analysis

Each sample was assayed in duplicate. The data presented represent the mean ± SD for n samples. Statistics were calculated using the StatView 4.02 software package (Abacus Concepts, Inc., Berkeley, CA). Group comparisons were calculated by factorial ANOVA followed by Fisher’s protected least significant difference test. P < 0.05 was considered significant. Linear regression coefficients were calculated using a bivariate regression test.


    Results
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Human membrane IGF-II/M6-P receptor (30–100 µg) was routinely purified from 300 mg solubilized Hep G2 membranes. The purity of the purified protein was assessed by SDS-PAGE and silver staining, with the receptor appearing as a single band of 220 kDa (Fig. 1AGo), with occasional additional bands of approximately 300 and 80 kDa (not shown). Antiserum raised from purified receptor reacted with a single 220-kDa species in 100 ng purified receptor and with a single 200 kDa band in 5 µL adult human serum (Fig. 1BGo).



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Figure 1. SDS-PAGE of purified human IGF-II/M6-P receptor. Samples were prepared as described in Materials and Methods and subjected to electrophoresis on a 4–15% gradient polyacrylamide gel (A) or a 6% homogeneous polyacrylamide gel (B and C). Lane 1, Purified membrane IGF-II/M6-P receptor (200 ng) silver stained. Lane 2, Western immunoblotted purified membrane IGF-II/M6-P receptor (100 ng). Lane 3, Western immunoblotted adult human serum (5 µL). Lanes 4–6, Purified IGF-II/M6-P receptor affinity labeled with [125I]IGF-II in the presence of no added IGF-II (lane 4), unlabeled IGF-II (10 µg; lane 5), or unlabeled insulin (10 µg; lane 6). Lines indicate the location of mol wt standards expressed in kilodaltons: myosin, 200; ß- galactosidase, 116; phosphorylase B, 97.4; serum albumin, 66.2; ovalbumin, 45; carbonic anhydrase, 31.

 
Affinity labeling of membrane IGF-II/M6-P receptor (0.5 µg in 100 µL) with [125I]IGF-II followed by transfer to nitrocellulose and autoradiography showed a single band at 220 kDa (Fig. 1CGo). Confirmation of the [125I]IGF-II binding specificity was observed by the abolition of radiolabeled ligand binding with IGF-II (10 µg). A minor effect was observed at high doses of insulin (10 µg; >15,000 times physiological concentration), which may be due to a low degree of IGF contamination in the preparation (Fig. 1CGo).

A two-site ELISA was established in which affinity- purified IGF-II/M6-P receptor polyclonal antibody is used to both capture and detect the receptor. The ELISA had an analytical range of 0.56–28 ng purified membrane receptor (Fig. 2Go). Storage of purified receptor (standard) at 4 C for more than 1 month resulted in a 90% loss of activity, whereas freeze-dried standard was stable over at least a 1-yr period. Determined in 31 assays, a half-maximal response (ED50) was seen at 7.25 ± 1.38 mg/L.



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Figure 2. Standard curve and serum dose curve for the IGF-II/M6-P receptor ELISA. Curves are corrected for nonspecific binding. Points represent the means of duplicates. Results are representative of three experiments.

 
Human serum diluted over the range of 0.5–10 µL/well showed an increase in absorbance that paralleled that of the purified receptor standard (Fig. 2Go). Serum sample volumes greater than 10 µL caused an increase in background signal due to high levels of serum proteins (results not shown). For three quality control samples covering the range of the assay, the interassay means and SDs from 10 replicate assays were 13.8 ± 1.23, 5.20 ± 0.80, and 0.64 ± 0.10 ng/well, respectively. The intraassay coefficients of variation in 10 replicate assays on the same serum samples were 9%, 13%, and 15%, respectively. Rat, mouse, marsupial (wallaroo), ovine, and bovine serum were assayed for cross-reactivity and were found to have no detectable activity. The ELISA was tested for interference by both receptor ligands, and at concentrations of up to 1 µg/mL IGF-II and 1 µg/mL ß-glucuronidase, the ELISA exhibited no signal interference (data not shown).

The size of the soluble receptor detected by the ELISA was determined by two methods. First, 100 µL nonpregnancy and pregnancy sera were fractionated on a Superose 12 column, and eluted fractions were assayed by ELISA for IGF-II/M6-P receptor. The detected soluble receptor displayed an elution profile similar to that of rat membrane IGF-II/M6-P receptor (Fig. 3AGo). Further confirmation of the size and immunoreactivity of the eluted proteins was obtained by Western immunoblotting the eluted fractions (Fig. 3BGo). Two proteins were detected, the soluble IGF-II/M6-P receptor comigrating with the 200-kDa standard and a smaller receptor fragment migrating to approximately 120 kDa. Comparison of ELISA and densitometry of the immunoblot showed a similar distribution of receptor across the fractions (Fig. 3CGo), with the bulk of detected protein being full-sized soluble receptor.



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Figure 3. A, Healthy nonpregnant adult and pregnant subject sera (100 µL) were fractionated on a Superose-12 column as described in Materials and Methods, and fractions were assayed for IGF-II/M6-P receptor. The arrows represent the elution position of rat membrane receptor (rIGF-II/M6-P R; ~220 kDa), {gamma}-globulin (150 kDa), and BSA (67 kDa). B, Superose-12 fractions were subjected to electrophoresis on a 6% homogeneous polyacrylamide gel and Western immunoblotted. The standards shown are myosin (200 kDa) and ß-galactosidase (116 kDa). C, Densitometric analysis of Western immunoblot signal. Results are representative of three similar experiments.

 
Soluble IGF-II/M6-P receptor concentrations (mean ± SD) in healthy subjects, aged 21–50 yr (mean age, 33 ± 9 yr; n = 32), fasted overnight and nonfasted were 0.69 ± 0.22 and 0.70 ± 0.23 mg/L, respectively. No significant difference was observed between these two groups. Further, heparinized plasma from eight subjects was compared to corresponding serum samples, and no differences were observed (data not shown). No correlation was found between subject gender and receptor levels.

Samples obtained from healthy infant (age, 0.46 ± 0.70 yr; n = 44), prepubertal (age, 10.1 ± 0.64 yr; n = 28), and adolescent (age, 14.7 ± 0.46 yr; n = 27) subjects were assayed for soluble receptor levels. Infant (1.12 ± 0.28 mg/L) and prepubertal (1.18 ± 0.6 mg/L) receptor levels were significantly increased (P < 0.0001) above healthy adult values, whereas in adolescence, levels (0.73 ± 0.61 mg/L) were similar to adult levels (Fig. 4AGo).



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Figure 4. The effects of age and pregnancy on soluble IGF-II/M6-P receptor levels. A, Sera from subjects aged 0–2 yr (n = 44), 9–11 yr (n = 28), 14–15 yr (n = 27), and 21–50 yr (nonfasted; n = 32). B, Serum from pregnant subjects: normal, 15 weeks (n = 16); normal, 22–40 weeks (n = 10); and preeclamptic, 22–40 weeks (n = 9). *, Significant change compared to healthy nonfasted adult subject serum (P < 0.0001). The error bars represent the 10–90% range, the box represents the 25–75% range, the line represents the median, and the closed square represents the mean value.

 
Serum and plasma samples were obtained from healthy early gestation (gestational age, 15 ± 0 weeks; n = 16), late gestation (gestational age, 32 ± 5 weeks; n = 10), and preeclamptic (gestational age, 32 ± 5 weeks; n = 10) pregnant subjects. Serum soluble receptor concentrations for healthy pregnant subjects at late gestation (1.59 ± 0.32 mg/L) were significantly elevated (P < 0.0001) above nonpregnant values, but were not significantly changed in early gestation (0.47 ± 0.15 mg/L; Fig. 4BGo). Preeclampsia (1.67 ± 0.26 mg/L) had no effect on soluble receptor levels during pregnancy (Fig. 4BGo). Additionally, heparinized plasma from these subject groups displayed receptor levels similar to those in serum (data not shown). A highly significant association was seen between gestational age and the level of soluble receptor, as shown in Fig. 5Go (r = 0.947; P < 0.0001).



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Figure 5. Relationship between gestational age and soluble IGF-II/M6-P receptor levels. Individual data from Fig. 4Go were plotted showing a strong gestational age dependence of serum receptor level (r = 0.947; P < 0.0001).

 
Samples were also obtained from subjects with noninsulin-dependent diabetes mellitus (NIDDM; age, 52 ± 15 yr; n = 20), insulin-independent diabetes mellitus (IDDM; age, 41 ± 17 yr; n = 12), end-stage renal failure (age, 71 ± 11 yr; n = 11), and acromegaly (n=10). The renal failure (0.75 ± 0.23 mg/L) and acromegalic (0.79 ± 0.25 mg/L) subjects displayed soluble receptor levels equivalent to those of healthy adults, whereas the soluble receptor levels in IDDM (0.98 ± 0.25 mg/L) and NIDDM (0.98 ± 0.25 mg/L)) subjects were slightly elevated (P = 0.0012 and 0.0002, respectively; Fig. 6Go).



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Figure 6. Soluble IGF-II/M6-P receptor levels in adults: nonfasted (n = 32), fasted (n = 20), end-stage renal failure (n = 11), acromegalic (n = 10), NIDDM (n = 20), and IDDM (n = 12) serum samples. *, Significance greater than nonfasted adult subjects (P < 0.001).

 
Receptor levels in diabetic subjects with complications were also assessed. IDDM and NIDDM subjects were subgrouped depending on the type of complication. In the NIDDM grouping there were subjects with retinopathy (age, 65 ± 10 yr; n = 5), albuminuria (age, 56 ± 11 yr; n = 7), and obesity (age, 54 ± 14 yr; n = 4). Soluble receptor levels were 1.01 ± 0.23, 1.02 ± 0.27, and 1.04 ± 0.22 mg/L, respectively. In the IDDM subjects with retinopathy (age, 42 ± 11 yr; n = 7) and obesity (age, 44 ± 13 yr; n = 6), soluble receptor levels were 1.03 ± 0.29 and 1.12 ± 0.26 mg/L, respectively. These values were significantly elevated above those in the control healthy subjects, but there was no significant difference between diabetic subjects with and without complications. Serum glucose levels, glycosylated hemoglobin levels, age, sex, and disease duration showed no correlation with receptor levels. All subjects exhibited good glycemic control.

Amniotic fluid (n = 13) was assayed for soluble receptor and contained 6.89 ± 6.21 µg/L. Saliva (n = 3) and urinary (n = 4) soluble receptor levels were detectable, but were below the lowest quantifiable level of 5.6 µg/L. Serum IGF-II levels were determined for healthy adult (n = 10), infant (n = 10), diabetic (n = 10), end-stage renal failure (n = 5), pregnancy (15 weeks), and preeclamptic subject groups, and no correlation observed between IGF-II and IGF-II/M6-P receptor serum levels (data not shown).


    Discussion
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
To date, the IGF-II/M6-P receptor has been purified from numerous sources, including rat chrondrosarcoma (34) and liver cells (31), opossum liver (35), and bovine serum (6). The main methods of receptor purification involve either IGF-II or phosphomannan affinity chromatography (34, 36, 37). An IGF-II/M6-P receptor RIA has been previously reported for the rat (31). In this study the human IGF-II/M6-P receptor has been purified to homogeneity by a single step M6-P affinity chromatography method. SDS-PAGE of the purified receptor under nonreducing conditions showed a major band at 220 kDa, occasionally a larger, possibly more heavily glycosylated, band at 300 kDa, and a smaller fragment at 80 kDa. Reported values for the molecular mass of the human membrane IGF-II/M6-P receptor vary from 220 kDa (38, 39) to 300 kDa (40). Additionally, there have been reports of a smaller human soluble (40) and rat membrane receptor fragment (31). The ability of the purified 220-kDa receptor to bind IGF-II was confirmed by affinity labeling with [125I]IGF-II.

Immunization of a rabbit with purified human membrane IGF-II/M6-P receptor resulted in the production of a highly specific polyclonal antibody, which is immunoreactive to both membrane and soluble forms of the receptor. In this study we have developed a species specific two-site sandwich ELISA using a polyclonal antibody, with an analytical range from 0.56–28 ng purified human membrane receptor. Furthermore, the ELISA has been shown to detect soluble IGF-II/M6-P receptor.

In the rat and bovine systems, the IGF-II/M6-P receptor has been shown to be developmentally regulated (41, 42, 43). Fetal rat serum receptor levels increase during gestation, peak at term, then decrease dramatically in the neonate and remain very low through adulthood (42). It has been postulated that fetal IGF-II/M6-P receptor acts as an IGF-II sink, by binding and internalizing excess IGF-II to prevent fetal overgrowth (19). To date, regulation of the human IGF-II/M6-P receptor has not been studied extensively. Funk et al. (39) studied the gene expression of human IGF-II/M6-P receptor in various fetal tissues and found it to be developmentally regulated, but to a much lesser degree than in the rat. A recent study looking at serum and amniotic fluid soluble receptor by semiquantitative Western immunoblot (44) concluded that soluble IGF-II/M6-P receptor was developmentally regulated in the fetus, and that amniotic fluid contained low levels of receptor.

Our studies examined the developmental regulation of serum soluble IGF-II/M6-P receptor by specific ELISA. We found that infant and prepubertal serum receptor levels were approximately twice healthy adult levels and dropped by 40% during adolescence, confirming previous semiquantitative findings by Western immunoblotting that expression of soluble receptor is down-regulated in human adult serum (44). We found no GH effect on the soluble IGF-II/M6-P receptor as exhibited by the normal receptor levels in acromegalic patient serum. Maternal soluble receptor was gestationally regulated, with a strong positive correlation between gestational age and receptor levels. Additionally, receptor levels were detected in amniotic fluid, but were below quantifiable levels in urine or saliva.

From our findings the concentration of human adult soluble IGF-II/M6-P receptor is approximately 700 µg/L or 3.5 nmol/L, contrasting with a circulating IGF-II concentration of 50–100 nmol/L (33). This huge excess of ligand would rule out soluble receptor as a significant carrier of total IGF-II, most of which is known to be complexed to IGF-binding protein-3 and acid-labile subunit (45). However, soluble receptor may still be important in carrying the fraction of IGF-II not associated with IGF-binding protein-3 and may thus prevent free IGF-II circulating in the blood.

Other possible roles for the receptor may involve its ability to bind ligands such as lysosomal enzymes. To investigate this, we have examined clinical conditions in which plasma lysosomal enzyme levels are known to be elevated. Studies have shown that the IGF-II/M6-P receptor binds lysosomal enzymes (46), including ß-D-glucuronidase (47, 48, 49, 50) and ß-D-galactosidase (6, 36, 51, 52, 53) with high affinity. Lysosomal enzymes such as ß-D-glucuronidase have been shown to be elevated in pregnancy and preeclampsia sera (54, 55, 56). Furthermore, it has been reported that lysosomal enzymes, including ß-D-glucuronidase and ß-D-galactosidase, are elevated in diabetes (IDDM), and this increase is not affected by complications associated with diabetes, such as retinopathy (57, 58). A variety of explanations for the increase in lysosomal enzyme levels have been suggested, including a variation in enzyme activity in the arterial walls (54) and a loss of glycemic control (hyperglycemia) (57). Our study has determined that soluble IGF-II/M6-P receptor is similarly increased in pregnancy (normal and preeclamptic) and diabetes (with or without complications) above healthy nonpregnant adult levels, suggesting that receptor levels may correlate with lysosomal enzyme levels and play a role in transporting them in the circulation. Future studies into disease states with lysosomal enzyme level abnormalities may help to further establish this relationship.


    Acknowledgments
 
We thank Drs. M. Sinosich, E. Gallery, and G. Fulcher for providing human serum samples; Dr. P. Johnson for providing the wallaroo serum sample; and Mrs. Sridevi Meka for her technical assistance.


    Footnotes
 
1 This work was supported by the RNSH and Community Health Services Centenary Foundation Scholarship, the University of Sydney Medical Foundation, and the National Health and Medical Research Council of Australia. Back

Received June 8, 1998.

Revised October 27, 1998.

Accepted November 9, 1998.


    References
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 

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