Human Reproduction Update Advance Access originally published online on October 26, 2005
Human Reproduction Update 2006 12(2):145-157; doi:10.1093/humupd/dmi044
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System B0,+ amino acid transport regulates the penetration stage of blastocyst implantation with possible long-term developmental consequences through adulthood
1 Department of Biochemistry, 2 Department of Obstetrics and Gynecology, Midwestern University, Downers Grove, IL and 3 Department of Internal Medicine, Walter Reed Army Medical Center, Washington, DC, USA
4 To whom correspondence should be addressed at: Department of Biochemistry, Midwestern University, 555 31st Street, Downers Grove, IL 60515, USA. E-mail: lvanwi{at}midwestern.edu
Submitted on July 27, 2005; resubmitted on September 13, 2005; accepted on September 26, 2005
| Abstract |
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Amino acid transport system B0,+ was first characterized in detail in mouse blastocysts over two decades ago. Since then, this system has been shown to be involved in a wide array of developmental processes from blastocyst implantation in the uterus to adult obesity. Leucine uptake through system B0,+ in blastocysts triggers mammalian target of rapamycin (mTOR) signalling. This signalling pathway selectively regulates development of trophoblast motility and the onset of the penetration stage of blastocyst implantation about 20 h later. Meanwhile, system B0,+ becomes inactive in blastocysts a few hours before implantation in vivo. System B0,+ can, however, be activated in preimplantation blastocysts by physical stimuli. The onset of trophoblast motility should provide the physiological physical stimulus activating system B0,+ in blastocysts in vivo. Activation of system B0,+ when trophoblast cells begin to penetrate the uterine epithelium would cause it to accumulate its preferred substrates, which include tryptophan, from uterine secretions. A low tryptophan concentration in external secretions next to trophoblast cells inhibits T-cell proliferation and rejection of the conceptus. Suboptimal system B0,+ regulation of these developmental processes likely influences placentation and subsequent embryo nutrition, birth weight and risk of developing metabolic syndrome and obesity.
Key words: amino acid transport systems / embryo implantation / human development / metabolic syndrome / small for gestational age
| Introduction and scope |
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Blastocyst implantation in the mammalian uterus is a complex process with numerous, species-specific nuances. Similarly, development of obesity, type 2 diabetes mellitus and their associated chronic adult diseases are multifactorial events influenced by many genes and a multitude of environmental factors. For these reasons, it may seem at first curious to the reader to suggest that these types of long-term outcomes can all be linked to events that occur before and around the time of implantation. Specifically, we propose here that each of these adverse developmental events is tied to the relative activity of a single biological catalyst, the amino acid transport system B0,+, during the pre- and periimplantation period of blastocyst development.
System B0,+ was first described in detail in mouse blastocysts where it serves to transport amino acids across the trophectoderm apical membrane (Van Winkle et al., 1985
; Van Winkle, 2001
). Although system B0,+ has broad substrate specificity, it prefers the branched chain and benzenoid amino acids, leucine, isoleucine, tryptophan and phenylalanine, over other zwitterionic and cationic amino acids (Table I; where the lower the Km value, the better the substrate). System B0,+ is also Na+-dependent (Borland and Tasca, 1974
; Van Winkle et al., 1985
); a characteristic that renders it able both to form gradients of its preferred substrates (Figure 1) and to change the magnitudes of such gradients with changes in the Na+ and K+ concentrations. As we shall see, an increase in the Na+ concentration of uterine secretions, and the effect of the increase on system B0,+ transport, could trigger signalling in blastocysts needed for development of the penetration stage of embryo implantation.
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Blastocyst implantation in the uterus has been divided into three stages (Enders and Schlafke, 1967
; Enders and Schlafke, 1969
). The apposition stage is followed by attachment of the embryo in a manner that renders it unable to be isolated simply by flushing the uterine lumen with culture medium. In mice and probably other species, these first two stages of implantation are regulated in the embryo, in part, by 4-hydroxy-17ß-estradiol (4-OH-E2) (Paria et al., 1998
) and trafficking of ß1 integrins to the apical trophectoderm membrane (Sutherland et al., 1993
; Schultz et al., 1997
), respectively. Many mammals, including mice, rats and humans, also exhibit the third stage of implantation; namely, blastocyst penetration of the uterine epithelium (Schlafke and Enders, 1975
). Such penetration requires differentiation of trophectoderm cells into motile trophoblast cells (Sutherland, 2003
). Mouse and rat trophoblast cells do not appear to migrate much in vivo but instead use their protrusive activity to invade by phagocytizing apoptotic decidual cells (Welsh and Enders, 1987
; Bevilacqua and Abrahamsohn, 1989
). Not only is development of trophoblast motility regulated by amino acid transport system B0,+ initiated signalling beginning about 20 h before implantation (Martin et al., 2003
) but the onset of motility also reactivates system B0,+ during the penetration stage of implantation to protect blastocysts from immunologic rejection (see below). Interestingly, porcine blastocysts, which do not penetrate the uterine epithelium (e.g. Lee and DeMayo, 2004
), do not express the amino acid transport system B0,+ (Prather et al., 1993
).
Both trophoblast motility and suppression of immunologic rejection are needed successfully to establish placental function and pregnancy. More than half of all pregnancies appear to end during the periimplantation period, and implantation abnormalities likely help to cause miscarriage, pre-eclampsia, placental accreta and ectopic pregnancy (Nayak and Guidice, 2003
). The significance of amino acid transport system B0,+ in regulating development does not, however, cease with blastocyst implantation and its abnormalities.
Rather, some alleles of the SLC6A14 gene, which encodes the amino acid transporter B0,+, are associated with an increased risk of obesity in human adults and probably children (Suviolahti et al., 2003
; Durand et al., 2004
). As for humans, the same gene in mice maps to a region on the X chromosome (Kawai et al., 2001
) previously shown to be linked to body weight (Dragani et al., 1995
). Interestingly, this body weight gene in mice influences body mass only on the right genetic background (Dragani et al., 1995
), and it appears to be influenced by diet (West et al., 1992
), as is the case for most human obesity. The gene encoding the system B0,+ amino acid transporter is, however, expressed at the protein level predominantly in lung, colon and eye in adults (Sloan et al., 2003
; Hatanaka et al., 2004
). Hence, it is somewhat difficult to relate expression of the gene in adults to tissues and to metabolic abnormalities possibly causing obesity.
When one considers the importance of amino acid transport system B0,+ in establishing placental nutrition of the embryo, however, the connection between some alleles of the gene encoding amino acid transporter B0,+ and adult obesity appears clearer. Placental nutrition influences the size of offspring, and small for gestational age offspring have an increased risk of developing obesity, type 2 diabetes mellitus and other chronic adult conditions associated with the metabolic syndrome (Kanaka-Gantenbein et al., 2003
; Levy-Marchal and Jaquet, 2004
; Ten and Maclaren, 2004
). We discuss in detail below the evidence that amino acid transport system B0,+ regulates blastocyst implantation and immunologic rejection and thus may influence subsequent placentation, embryo nutrition and fetal size at birth. Such a scenario is consistent with the known association of obesity with some alleles of the system B0,+ gene, SLC6A14, in humans (Suviolahti et al., 2003; Durand et al., 2004
) and probably mice.
| System B0,+ amino acid transport activity is regulated to appear in abundance at the blastocyst stage of preimplantation mouse and rat embryo development |
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Transcripts encoding the amino acid transporter B0,+ (ATB0,+) were detected at all but the one cell stage of preimplantation mouse embryo development using microarrays (Zeng et al., 2004
| System B0,+-catalyzed leucine uptake regulates development of trophoblast motility and, thus, the penetration stage of blastocyst implantation |
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It has been known for many years that amino acid deprivation prevents formation of trophoblast outgrowths by mouse blastocysts in vitro (Gwatkin, 1966
Similarly, in previously unpublished studies we showed that leucine and, apparently to a lesser extent, arginine each alone support development of trophoblast motility and outgrowth (Figure 2). The proportion of blastocysts eventually forming outgrowths in the presence of leucine is similar to the proportion forming outgrowths when all 20 amino acids are present, although the time at which outgrowth begins in vitro is delayed a day or two when leucine is the only amino acid supplied in the culture medium (Van Winkle et al., 2003). Because concentrations above 50 µM arginine are toxic to blastocysts when present as the only amino acid supplied in the medium (Van Winkle et al., 2003), we could not determine whether it supports development of trophoblast motility at the same rate as leucine (Figure 2). Interestingly, leucine protects embryos from this arginine toxicity (Van Winkle et al., 2003).
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| Leucine uptake triggers development of trophoblast motility selectively: it does not regulate other aspects of trophectoderm differentiation |
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Although system B0,+ leucine uptake triggers development of trophoblast motility, it is not needed to foster other aspects of trophectoderm differentiation. For example, blastocysts begin to express placental lactogen-I (a marker for the giant-cell transformation in the trophectoderm) regardless of whether amino acids are supplied in the culture medium (Martin and Sutherland, 2001
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| How does leucine accumulation selectively regulate development of trophoblast motility in mouse blastocysts? |
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We reported that rapamycin inhibits development of trophoblast motility and outgrowth (Van Winkle, 2001
Martin and Sutherland (2001) not only verified that rapamycin blocks development of trophoblast motility but also showed that amino acid (leucine) uptake by the trophectoderm fosters phosphorylation of the mTOR substrate, p70S6 kinase, in blastocysts. Conversely, both amino acid deprivation and rapamycin prevent this phosphorylation. mTOR also phosphorylates PHAS/4EBP proteins and, thus, frees eIF4E selectively to initiate translation of mRNAs encoding proteins, such as ornithine decarboxylase (ODC), that help to regulate cellular growth and differentiation (Kimball et al., 1999
; Martin et al., 2003). In part, because mTOR signalling regulates ODC expression and, hence, polyamine synthesis, we propose that polyamines are the downstream signalling molecules more directly regulating development of trophoblast motility (see next section).
mTOR gene-knockout experiments support the conclusion that system B0,+ leucine transport fosters development of trophoblast motility through mTOR. mTOR (/) conceptuses fail to develop significantly into the penetration stage of implantation (Gangloff et al., 2004
; Murakami et al., 2004
). Only a small amount of motility develops in the trophectoderm of mTOR (/) blastocysts possibly owing to the presence in oocytes of some maternal mTOR mRNA that survives to the blastocyst stage (Gangloff et al., 2004
). (But see other possible explanations below.) We are studying whether mouse blastocysts lose this surviving maternal mTOR mRNA when the preimplantation period is prolonged through delay of implantation. Upon resumption of development of delayed implantation blastocysts, mTOR (/) conceptuses should neither penetrate the uterine epithelium in vivo nor form outgrowths in vitro.
| mTOR (/) embryos also will be useful for studying the signalling processes needed for implantation that are downstream from mTOR |
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In a previous report (Martin et al., 2003), we discussed evidence supporting the hypothesis that polyamines serve as downstream signalling molecules of system B0,+ leucine transport-stimulated mTOR. Polyamines likely foster development of trophoblast motility in blastocysts in a manner analogous to the mechanism by which these signalling molecules promote development of motility in intestinal epithelial cells (Rao et al., 2003
We showed previously that blastocysts fail to form outgrowths in vitro in the presence of inhibitors of polyamine synthesis (Van Winkle LJ and Campione, 1983
, 1984
). Similarly, embryos deficient in enzymes required for polyamine synthesis perish at about the time of implantation (Pendeville et al., 2001
; Nishimura et al., 2002
). The block to development of trophoblast motility by inhibitors of polyamine synthesis can, however, be overcome by polyamines in the medium. Hence, leucine transport-dependent mTOR signalling could conceivably stimulate downstream polyamine accumulation and signalling by promoting both polyamine synthesis and uptake by the trophectoderm.
In this regard, we found that polyamines partially reverse rapamycin inhibition of blastocyst outgrowth (P <0.01, Van Winkle and Campione, unpublished data). Polyamines are taken up by blastocysts through a process that appears to select the polyamines, spermidine (Spd) and spermine (Spm), over putrescine (Put) (Figure 4). Interestingly, amino acid-deprivation impairs development of polyamine transport activity in the blastocyst trophectoderm (Figure 3B). Hence, amino acid (leucine) transport promotes mTOR signalling and development of polyamine transport activity in the trophectoderm, but amino acid transport is not needed for other aspects of differentiation in this tissue (recall the above section concerning selective regulation of development of trophoblast motility by leucine uptake). For these reasons, we conclude that system B0,+-catalysed leucine transport triggers mTOR signalling and consequently polyamine accumulation. The polyamines then signal development of trophoblast motility ultimately owing to Rac 1 activation, as is the case for intestinal epithelial cells (Ray et al., 2003
).
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mTOR (/) embryos will allow us more definitively to study the relationship between polyamine and mTOR signalling during development of trophoblast motility. The studies showing polyamine reversal of inhibition of blastocyst outgrowth by rapamycin, described above, need verification because it is never certain that the effects of an inhibitor are exclusively on the intended target (in this case, mTOR). Because polyamines partially overcome inhibition of trophoblast outgrowth by rapamycin, it is likely that these substances are taken up in quantities adequate to support development of trophoblast motility even when mTOR is inhibited or inactive. Moreover, mTOR (/) blastocysts should not develop an increased capacity to take up polyamines like wild-type blastocysts do (Figure 3B). Thus, it should be possible to use mTOR (/) embryos to study the signalling processes emanating from mTOR that are needed to stimulate development of increased polyamine transport activity and, subsequently, trophoblast motility. Since most of the studies described here and in the preceding sections have been or will be performed in vitro, however, it is also necessary to learn what regulates system B0,+ leucine uptake, mTOR signalling and development of trophoblast motility in blastocysts in vivo.
| What regulates system B0,+-catalysed leucine uptake in blastocysts in vivo? |
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Wild-type blastocysts that develop from the two-cell stage in vitro in the absence of amino acids are poised to take up leucine (and isoleucine) but not other essential and non-essential amino acids (Van Winkle and Dickinson, 1995
Normally, a surge of estrogen secretion about 3.5 days after female mice mate initiates blastocyst development towards implantation. Implantation can be delayed, however, if the mice are ovariectomized before the estrogen surge. Blastocysts remain in delay of implantation in ovariectomized, progesterone-maintained mice until estrogen is administered along with the progesterone. Blastocyst implantation then begins about 25 h after estrogen administration (Yoshinaga and Adams, 1966
; Weitlauf and Greenwald, 1968
; Van Blerkom et al., 1978
; Van Winkle and Campione, 1987
; Mead, 1993
; Renfree and Shaw, 2000
; Dey et al., 2004
; Lee and DeMayo, 2004).
Blastocysts in delay of implantation will form outgrowths in vitro in the absence of prior estrogen administration if the culture medium contains leucine or a mixture of all 20 amino acids (Figure 2). However, these same blastocysts have no such requirement for amino acids to form outgrowths in vitro when the blastocysts are removed from the uterus 24 h after estrogen administration (Van Winkle and Campione, unpublished data). Hence, net leucine accumulation by blastocysts through system B0,+ likely occurs in vivo some time between 0 and 24 h after estrogen administration. This leucine accumulation by blastocysts in vivo triggers mTOR signalling and development of trophoblast motility regardless of whether amino acids are present subsequently in the blastocysts environment.
In this regard, the Na+ and K+ concentrations in uterine secretions increase significantly within 6 h after estrogen administration to progesterone-maintained, ovariectomized rats (Figure 5) and probably mice (Van Winkle et al., 1983). In fact, since the increases in the Na+ and K+ concentrations are accompanied by a similar rise in the Cl concentration in uterine secretions (Nilsson and Ljung, 1985
), the environment of blastocysts likely changes from hypo- or isotonic to hypertonic after estrogen administration (i.e. from less than 300 to over 400 mOsmolar assuming equal concentrations of monovalent anions and cations, Figure 5). The latter change might negatively influence mTOR since cell shrinkage inhibits such signalling (Fumarola et al., 2005
).
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Cell shrinkage would be counteracted, however, and mTOR signalling triggered by the net accumulation of leucine and other amino acids in the trophectoderm at higher extracellular Na+ and K+ concentrations (Figure 1). All amino acid substrates of system B0,+ would serve as osmolytes, whereas leucine alone would trigger mTOR signalling. The stoichiometry of Na+ : amino acid cotransport through system B0,+ appears to be about 2:1 (Sloan and Mager, 1999). Hence, the increase in the Na+ concentration in uterine secretions can be calculated to increase the intracellular amino acid concentration nearly three-fold if the trophectoderm is able to maintain the new Na+ concentration (or more precisely, the new Na+ total chemical potential) gradient (Van Winkle, 1999).
Significantly, the free energy needed to maintain a greater Na+ concentration gradient would be available to Na+K+ATPase in blastocysts (Figure 1). The K+ concentration increases enough in uterine secretions (Figure 5) to reduce the free energy needed to transport it against its total chemical potential gradient by about the same amount of free energy as is needed to maintain the new Na+ concentration gradient (Van Winkle, 1999). Moreover, Na+K+ATPase is present in the apical as well as the basolateral membrane of the trophectoderm (Van Winkle and Campione, 1991
), and, of course, the apical membrane faces the cations in uterine secretions.
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Somewhat surprisingly then, the penetration stage of implantation appears to be regulated in blastocysts primarily if not exclusively by a single signalling pathway. Estrogen stimulates increases in the Na+ and K+ concentrations in uterine secretions, and these changes in the Na+ and K+ concentrations power an increase in the trophectoderm leucine concentration (Figure 1). Only about a 10% increase in the intracellular leucine concentration can trigger some mTOR signalling, so the nearly three-fold increase in leucine that should occur in the blastocyst trophectoderm is more than enough to stimulate mTOR signalling. The greater increase in intracellular amino acid concentrations than needed to initiate mTOR signalling likely counteracts trophectoderm cell shrinkage which would otherwise impair mTOR signalling (Fumarola et al., 2005
Estrogen, of course, has other effects on blastocyst implantation. For example, it leads to production of the 4-OH-E2 apparently needed for blastocysts to undergo the apposition stage of implantation (Paria et al., 1998
). Apposition precedes blastocyst attachment and penetration of the uterine epithelium. Similarly, estrogen is needed for leukemia inhibitory factor (LIF) production, and LIF signalling is needed for the uterus to develop a phenotype that is receptive to implantation (Stewart et al., 1992
; Stewart and Cullinan, 1995
; Chen et al., 2000
). Nevertheless, development of trophoblast motility and penetration of the uterine epithelium on the part of the blastocyst appear to be regulated not by 4-OH-E2, LIF or numerous other signalling molecules that are involved in blastocysts implantation (Dey et al., 2004; Lee and DeMayo, 2004). (See also the section below concerning other signalling molecules.) Rather, system B0,+ leucine transport triggers the mTOR signalling needed for differentiation of motile trophoblasts and penetration of the uterine epithelium by the blastocyst (Figure 1).
| What functions may other amino acid transporters play in blastocyst implantation? |
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Another amino acid transport system first described in mouse blastocysts (Van Winkle et al., 1988a) also may function in implantation. This system is Na+ independent, so by convention (Bannai et al., 1984
The system b0,+ heavy chain accessory protein is usually rBAT (Palacin et al., 2005) but apparently sometimes the related protein CD98 (also termed 4F2hc) (Rajan et al., 2000). The Km values for transport are in general lower when CD98 rather than rBAT is associated with b0,+AT (Rajan et al., 2000). Transcripts encoding each of these amino acid transport-related proteins are present in mouse (Hamatani et al., 2004
; Qian, 2004
; Zeng et al., 2004; Maekawa et al., 2005
) and human (Van Winkle et al., 2001) blastocysts although the transcript encoding CD98 appears to be much more abundant in blastocysts than those encoding the other two proteins (National Center for Biotechnology Information BLAST Data Base). Consistent with the latter findings, CD98 also serves as the accessory protein for several other transporters expressed in mouse and human blastocysts including y+LAT1 (Zeng et al., 2004), y+LAT2 (Van Winkle et al., 2001; Qian, 2004
; Zeng et al., 2004), LAT1 (Hamatani et al., 2004
; Qian, 2004
; Maekawa et al., 2005) and LAT2 (Qian, 2004
; Hamatani et al., 2004). Based on the substrate selectivity of system b0,+ for arginine versus other amino acids (Table II), we conclude provisionally that system b0,+ in blastocysts is composed of the b0,+AT light chain and the CD98 heavy chain.
System b0,+ functions in the apical membrane of the blastocyst trophectoderm mainly to take up its preferred substrate, arginine (Figure 1). Arginine serves as a precursor for the synthesis of polyamines which are likely downstream signalling molecules of an mTOR signalling pathway (see above). In addition, arginine is a substrate of nitric oxide (NO) synthase, and NO appears also to help regulate pre- and periimplantation blastocyst development (Chwalisz and Garfield, 2000
; Khorram, 2002
; Martin et al., 2003; Thaler and Epel, 2003
). Similarly, arginine is probably needed as a precursor for proline and thus extracellular matrix synthesis in blastocysts (Biggers et al., 2000
; Martin et al., 2003). Perhaps because an arginine supply is essential to early development, other novel arginine-selective transport systems also operate in blastocysts (Van Winkle and Campione, 1990
; Van Winkle, 2001). The latter systems appear largely to compensate for an absence of system b0,+ activity in blastocysts, since b0,+AT deficient mice are in general healthy and fertile (Feliubadalo et al., 2003
). As for humans with similar mutations, however (Feliubadalo et al., 1999
; Palacin et al., 2005), b0,+AT (/) mice develop cystinuria (Feliubadalo et al., 2003
; Palacin et al., 2005).
Somewhat surprisingly then, CD98 deficient embryos fail to develop beyond the periimplantation period (Tsumura et al., 2003
). We are currently determining the precise time and mechanism by which development ceases in early CD98 (/) embryos. In this regard, CD98 modulates ß1 integrin function in the plasma membrane (Cai et al., 2005
; Feral et al., 2005
), and it fosters migration of ß1 integrins to the basolateral membranes of polarized epithelial cells (Cai et al., 2005). Contrariwise, blastocyst attachment to the substratum in vitro (Sutherland et al., 1993; Schultz et al., 1997) and probably the attachment stage of implantation in vivo (Martin et al., 2003) require ß1 integrin trafficking to the trophectoderm apical membrane. We suggest that a yet to be identified signal may redirect some CD98 from the basal to the apical membrane and consequently also send both ß1 integrins and b0,+AT to the latter membrane. As discussed above, ß1 integrins and b0,+AT have been observed to function in the trophectoderm apical membrane for attachment to the substratum (Sutherland et al., 1993; Schultz et al., 1997) and amino acid (arginine) transport (Van Winkle et al., 1988a), respectively.
CD98 also has been shown to be essential for normal migration and spreading of embryonic stem cells, fibroblasts and polarized epithelial cells (Cai et al., 2005; Feral et al., 2005
). Interestingly, this CD98-mediated ß1 integrin function depends on ß1 integrin signalling that activates Rac (Feral et al., 2005). The reader should recall that mTOR-dependent polyamine signalling appears to lead to development of trophoblast motility by fostering Rac 1 activation in the blastocyst trophectoderm (see above). For these reasons, we are currently investigating whether both CD98- and mTOR-mediated signalling are needed for optimal Rac 1 activation and subsequent development of trophoblast motility in blastocysts (Figure 6). Conceivably either CD98- or mTOR-mediated signalling alone could lead to some, albeit, insufficient Rac 1 activation in blastocysts. Both CD98- and mTOR-mediated signalling may, however, be needed for fully effective Rac 1 activation, development of trophoblast motility and penetration of the uterine epithelium during implantation. In the absence of either CD98- or mTOR-mediated signalling in CD98 (/) (Tsumura et al., 2003
) or mTOR (/) (Gangloff et al., 2004) blastocysts, respectively, only limited motility may develop in trophoblast cells. We are currently working to determine whether such is the case for CD98 (/) embryos, and such is known to be the case for mTOR (/) embryos in vitro and in vivo (Gangloff et al., 2004). (Other explanations are, of course, possible for the latter observation, as discussed in preceding sections.) Regardless of the explanations for these observations, however, both amino acid transport-related CD98 and amino acid transport-dependent mTOR-mediated signalling are essential for full development of trophoblast motility and the penetration stage of implantation. Many other signalling molecules contribute to but are not essential for development of these and other aspects of implantation.
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| If amino acid transport-related CD98 and amino acid transport-dependent mTOR-mediated signalling regulate development of trophoblast motility and the penetration stage of blastocyst implantation, then what role do numerous growth factors, cytokines and other more conventional signalling molecules play in these and related processes? |
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Although the actions of a few signalling molecules on blastocysts are required for implantation, many other such molecules are involved in but not essential for nidation (Aplin and Kimber, 2004
In contrast, we liken the impaired implantation sometimes accompanying knockout of expression of a signalling process in mice (Aplin and Kimber, 2004; Dey et al., 2004; Imakawa et al., 2004; Red-Horse et al., 2004
) to the impaired but not prevented outgrowth of blastocysts deprived of essential amino acids other than leucine and arginine in vitro (Spindle and Pedersen, 1973; Van Winkle et al., 2003) (Figure 2). In our view, leucine uptake triggers mTOR signalling and development of trophoblast motility in vitro and in vivo, whereas other essential amino acids and most other signalling molecules support primarily the growth of the conceptus needed simultaneously with the penetration stage of implantation. Even if the latter nutrients and signalling molecules are needed specifically to support implantation, they do not in most cases appear to be a single signalling process that alone regulates development of trophoblast motility. In contrast, system B0,+ leucine transport triggers the mTOR signalling that is required for development of enough trophoblast motility to establish pregnancy (Martin et al., 2003; Gangloff et al., 2004) during the penetration stage of implantation (Figure 1). The resultant trophoblast motility also likely regulates system B0,+ activity further to foster successful implantation and embryo nutrition, as described in the following section.
| While system B0,+ leucine transport triggers mTOR signalling in blastocysts about 20 h before implantation, system B0,+ activity is suppressed by the uterine environment as the time of implantation draws nearer |
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Increases in the Na+ and K+ concentrations in uterine secretions should cause leucine accumulation through system B0,+ in the trophectoderm no more than 6 h after estrogen administration to progesterone-maintained, ovariectomized rats (Nilsson and Ljung, 1985) and mice (Van Winkle et al., 1983) (Figure 1). The uterine environment suppresses blastocyst system B0,+ activity, however, between 12 and 25 h after estrogen administration (Figure 7A, filled symbols). The relatively inactive system B0,+ can then be activated by physical stimuli, such as removing periimplantation blastocysts from the uterus (Figure 7A, open symbols) or gently massaging the uterus containing the embryos (Figure 7B, open squares). No such activation occurs, however, in blastocysts one day before implantation (Van Winkle and Campione, 1987; Van Winkle et al., 1990a,b; Figure 7). The physiological physical stimulus most likely activating system B0,+ in blastocysts approaching implantation in vivo is the onset of trophoblast motility and initiation of the penetration stage of implantation.
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The penetration stage of implantation is associated with the need for a new function of system B0,+ in blastocysts; namely, its activation in the trophoblast helps to deplete surrounding secretions of another of its preferred substrates, tryptophan (Table 1). A few days after initial penetration of the uterine epithelium, the rate-limiting enzyme in tryptophan catabolism in trophoblast cells, indoleamine 2,3-dioxygenase (IDO), also begins to contribute to tryptophan depletion from the environment of the mouse conceptus (Munn et al., 1998
T-cell suppression through tryptophan depletion should, however, be needed at the time when the trophoblast first penetrates the uterine epithelium. At that time, trophoblast cells and uterine epithelial cells are separated by only a very small amount of fluid (Nilsson, 1977
). Consequently, Na+-dependent system B0,+ tryptophan transport into the trophoblast is likely sufficient initially to deplete tryptophan from secretions surrounding the trophoblast and, thus, to block T-cell proliferation. The physical stimulus associated with development of trophoblast motility would activate system B0,+ (Van Winkle and Campione, 1987) to more efficiently concentrate tryptophan in these cells and out of surrounding secretions. The relatively rapid net rate of protein synthesis and accumulation that begins in blastocysts during the 10 h preceding implantation (Weitlauf, 1973
) would serve as a reservoir to sequester tryptophan taken up by the trophoblast. In humans, removal of tryptophan appears also to be aided by the IDO-regulated pathway which is expressed in blastocysts before implantation (Kudo et al., 2004
). If the latter pathways for consumption of tryptophan in mouse and human blastocysts were able to maintain an intracellular tryptophan concentration of about 685 µM, then the steady state tryptophan concentration outside cells would be 0.1 µM under more or less standard cellular conditions and assuming a 2:1 stoichiometry of Na+ : tryptophan cotransport by system B0,+ (Sloan and Mager, 1999; Van Winkle, 1999). Since T-cell proliferation is maximally inhibited at tryptophan concentrations of 0.1 µM or less (Munn et al., 1999
), system B0,+ tryptophan transport into the trophoblast should indeed be able to suppress T-cell proliferation under the conditions present when the penetration stage of implantation is initiated in vivo.
| How could the integral role of system B0,+ in establishing pregnancy and embryo nutrition also allow it to influence health across the life span? |
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Recently, some alleles of the X-linked SLC6A14 gene, which encodes the system B0,+ amino acid transporter (ATB0,+), were shown to be associated with human obesity in adults and probably children (Suviolahti et al., 2003; Durand et al., 2004
For example, low levels of system B0,+ expression that do not fully suppress T-cell proliferation through tryptophan deprivation could conceivably impair placentation, embryo nutrition and consequent growth and development of the fetus. A variable and sometimes relatively low ability to activate system B0,+ has, in fact, been observed by us in implanting blastocysts (Figure 8). Similarly, impaired development of trophoblast motility owing to less than optimal system B0,+ leucine transport-activated mTOR signalling (Figure 1) also might compromise placentation and nutrition of embryos. In humans, the resultant small for gestational age offspring have an increased probability of developing metabolic syndrome and the obesity, type 2 diabetes mellitus, coronary heart disease and hypertension associated with it (Kanaka-Gantenbein et al., 2003; Levy-Marchal and Jaquet, 2004; Ten and Maclaren, 2004).
In this regard, the effects of administering inhibitors of system B0,+ leucine and tryptophan transport to pregnant rats have surprisingly predictable effects on embryo growth and development to term. It is worth noting that, like mice (Van Winkle et al., 1983; Van Winkle and Campione, 1987), rats exhibit both the increases in the Na+ and K+ concentrations in uterine secretions (Nilsson and Ljung, 1985) and the activatable system B0,+ in blastocysts (Van Winkle et al., 1990b) that are likely needed to initiate development of trophoblast motility and suppress T-cell mediated immunologic rejection, respectively. Under conditions in which protein and, thus, leucine are limited but marginally adequate to maintain pregnancy (i.e. 6% casein diet), addition of the system B0,+ inhibitor (and subsrate), methionine (Table I), to the diet beginning on day 1 of pregnancy leads to complete loss of conceptuses by day 14 (Viau and Leathem, 1973
; Matsueda and Niiyama, 1982
). Supplementation of the 6% casein diet with 4 or 5% methionine also decreases food intake and consequently impairs ovarian function (Nelson and Evans, 1954
; Viau and Leathem, 1973). Such pregnancies can be rescued by administration of estrone and progesterone to rats consuming 6% casein diets supplemented with various inhibitors (and substrates) of amino acid transport system B0,+.
Interestingly, under these conditions (in which pregnant rats consume a marginally sufficient 6% casein diet and receive estrone and progesterone), supplementation of the diet throughout pregnancy with each of the inhibitors of system B0,+; tyrosine, phenylalanine, threonine, lysine and methionine; causes the birth weights of offspring to be significantly reduced relative to the offspring of control animals that consume the same amount of food (Viau and Leathem, 1973; Matsueda and Niiyama, 1982). These results are as predicted above for partial inhibition of system B0,+-dependent development of trophoblast motility and suppression of immunologic rejection. In fact, supplementation of the 6% casein diet with 5% leucine increases (rather than decreases) the sizes of offspring relative to offspring of control rats that consume the same amount of food (Matsueda and Niiyama, 1982). The latter result is expected if, under conditions of limited availability of leucine in the 6% casein diet, system B0,+ leucine transport-dependent mTOR signalling becomes limiting to development of trophoblast motility and establishment of embryo nutrition during pregnancy. In such conditions, leucine also may foster mTOR signalling in developing muscle later in pregnancy and thus support development of larger offspring (Zhu et al., 2004
). (See also the following section.) Similarly as expected, supplementation of a 6% casein diet with 5% tryptophan decreases the size of offspring relative to offspring of control rats that consume the same amount of food (Matsueda and Niiyama, 1982). Added tryptophan would inhibit system B0,+-dependent leucine transport and mTOR signaling, and it would make more difficult the suppression of immunologic rejection that depends on depletion of tryptophan from the environment of T cells. Although other regimens of administration of system B0,+ inhibitors and substrates have been studied in pregnant rats (e.g. Mawatati et al., 2004
), most of these regimens do not include administration of the inhibitors before and during the critical periods of initiation of development of trophoblast motility and initial suppression of T-cell proliferation.
Offspring were sacrificed at term in the studies with system B0,+ inhibitors described above (Matsueda and Niiyama, 1982). Hence, it will be interesting to learn whether the smaller for gestational age offspring produced in such experiments are at increased risk of developing greater body mass, glucose intolerance, dyslipidemia and the chronic adult diseases associated with human metabolic syndrome. Such a scenario would help us further to connect system B0,+-regulated implantation, placentation and embryo nutrition with the observation that some alleles of the gene encoding the system B0,+ amino acid transporter are associated with obesity in humans (Suviolahti et al., 2003; Durand et al., 2004
) and most likely mice (Dragani et al., 1995
), rats and other species.
In this regard, however, somewhat different studies are pertinent here. In these studies (Kwong et al., 2000
), dietary protein (and leucine) were limited up to about the time of implantation and most importantly, during the time when leucine is needed by blastocysts to trigger mTOR signaling. Rats that are fed a low protein and thus low leucine diet between days 1 and 5.25 of pregnancy (day 1, day of vaginal plug detection) produce offspring with the lower birth weights we anticipate in our model and the greater body weights expected later on (Kwong et al., 2000
). In addition, male offspring of rats consuming a low protein diet on days 15.25 of pregnancy exhibit higher systolic blood pressures at weeks 4 and 11 of age and lower liver masses at week 12 of age than offspring of rats fed a control diet containing twice the protein concentration. Significantly, blood essential amino acid levels including specifically the leucine concentration are decreased just before implantation on day 5 of pregnancy in rats consuming a low protein diet (Kwong et al., 2000
). Decreased leucine availability could impair system B0,+ leucine transport-dependent mTOR signalling and development of the amount of trophoblast motility needed best to penetrate the uterine epithelium (Figures 1 and 6) and optimize placenta formation. Less than optimum placentation could impair embryo nutrition and thus cause lower birth weight and its undesirable consequences.
Viewed in this light, we see the transiently decreased blood insulin level on day 5 of pregnancy in rats consuming a low protein diet (Kwong et al., 2000
) as an adaptive response to decreased leucine availability to blastocysts during the periimplantation period. In fact, consumption of a low protein diet by rats for the first 14 days of pregnancy increases rather than decreases their insulin level (Fernandez-Twinn et al., 2003
). Although the transient decrease in the insulin concentration on day 5 of pregnancy in rats consuming a low protein diet produces a transient rise in blood glucose levels (Kwong et al., 2000
), it should also cause a transient increase in the blood leucine concentration (Brosnan et al., 1983
; Borghi et al., 1985
; Engelen et al., 2000
; Lattuada et al., 2004
) at the time leucine is needed by system B0,+ to initiate mTOR signalling in blastocysts. The leucine level observed on day 5 of pregnancy in rats consuming a low protein diet, although decreased relative to rats consuming a control diet, likely is higher than it would have been had the insulin level not decreased. Such an adaptation could rescue pregnancies in animals consuming low protein (and low leucine) diets albeit incompletely in regard to the adult health risks that develop later on.
| Summary and challenges |
|---|
We propose that the association of some alleles of the gene encoding amino acid transport system B0,+ with obesity in humans and probably other species has its origin in very early embryogenesis. Lower system B0,+ leucine transport activity in preimplantation blastocysts likely impairs development of trophoblast motility and initiation of the penetration stage of blastocyst implantation. Furthermore, relatively low system B0,+ activatability during penetration of the uterine epithelium could compromise tryptophan depletion from neighboring secretions and consequently impair suppression of T-cell proliferation. Sublethal immunologic rejection of the conceptus and reduced trophoblast motility during penetration of the uterine epithelium could adversely affect placentation and subsequent embryo nutrition. Embryo under-nutrition produces small for gestational age offspring that have an increased risk of developing obesity, metabolic syndrome and their associated chronic human diseases. It remains to be determined precisely how lower system B0,+ activity and the concomitant impairment of implantation might alter subsequent placental development such that processes for delivery of nutrients to the embryo are also impaired, although the studies cited above involving administration of inhibitors of system B0,+ indicate that such is indeed the case. In this regard, blastocyst development in vitro in relatively simple medium devoid of amino acids results in subsequent development of the conceptus in vivo in which proper genetic imprinting is preserved in the embryo itself but not in the placenta (Mann et al., 2004
Recent work indicates, however, that the latter risk originates from abnormal tissue and organ development because of the embryo under-nutrition. The altered interactions among these tissues likely leads to obesity and metabolic syndrome later on. For example, maternal nutrient restriction in sheep produces smaller fetuses with retarded muscle development and fewer secondary myofibers probably owing to decreased mTOR signalling in the muscle (Zhu et al., 2004
). In this regard, small for gestational age offspring of adequately nourished humans have reduced muscle mass that persists not only through early childhood (Hediger et al., 1998
) but apparently even into older age (i.e. 6575 years). In the latter case, exercise protects against development of glucose intolerance (Eriksson et al., 2004
). Similarly, liver and kidney growth is relatively more impaired than the body as a whole in small for gestational age humans (Latini et al., 2004
). The mechanism by which such tissue and organ imbalances influence adult metabolism are currently being investigated (Gallou-Kabani and Junien, 2005
; Ozanne et al., 2005
). Nevertheless, a process underlying development of these abnormalities despite adequate maternal nutrition appears to be suboptimal system B0,+ amino acid transport in blastocysts and its effects on development of trophoblast motility and suppression of immunologic rejection during implantation. The resultant poorer placental function and embryo under-nutrition would cause undesirable tissue and organ development in small for gestational age offspring. The altered interactions among these tissues then appear to cause metabolic abnormalities and development of metabolic syndrome in humans.
| Note added in proof |
|---|
After this paper was accepted for publication, we detected sequences encoding the human ATB0,+ in cDNA libraries prepared from preimplantation human embryos (Van Winkle et al., 2001).
| Acknowledgements |
|---|
The authors thank Drs Phillip Iannaccone and Richard Tasca for helpful discussions and critiques of an earlier version of the manuscript, and we thank Ms Barb LeBreton for helping to prepare it.
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