Receptor-mediated tobacco toxicity: acceleration of sequential expression of α5 and α7 nicotinic receptor subunits in oral keratinocytes exposed to cigarette smoke Juan Arredondo * , Alexander I. Chernyavsky * , David L. Jolkovsky † , Kent E. Pinkerton ‡ and Sergei A. Grando * ,1 * Department of Dermatology, University of California, Irvine, California, USA; † Section of Periodontics, School of Dentistry, University of California, Los Angeles, California, USA; and ‡ Center for Health and the Environment, University of California, Davis, California, USA 1 Correspondence: Department of Dermatology, University of California, Irvine, C340 Medical Sciences I, Irvine, CA 92697, USA. E-mail: sgrando@uci.edu Tobacco products and nicotine alter the cell cycle and lead to squamatization of oral keratinocytes (KCs) and squamous cell carcinoma. Activation of nicotinic acetylcholine receptors (nAChRs) elicits Ca 2+ influx that varies in magnitude between different nAChR subtypes. Normal differentiation of KCs is associated with sequential expression of the nAChR subtypes with increasing Ca 2+ permeability, such as α5-containing α3 nAChR and α7 nAChR. Exposure to environmental tobacco smoke (ETS) or an equivalent concentration of nicotine accelerated by severalfold the α5 and α7 expression in KCs, which could be abolished by mecamylamine and α-bungarotoxin with different efficacies, suggesting the following sequence of autoregulation of the expression of nAChR subtypes: α3(β2/β4) > α3(β2/β4)α5 > α7 > α7. This conjecture was corroborated by results of quantitative assays of subunit mRNA and protein levels, using nAChR-specific pharmacologic antagonists and small interfering RNAs. The genomic effects of ETS and nicotine involved the transcription factor GATA-2 that showed a multifold increase in quantity and activity in exposed KCs. Using protein kinase inhibitors and dominant negative and constitutively active constructs, we characterized the principal signaling cascades mediating a switch in the nAChR subtype. Cumulative results indicated that the α3(β2/β4) to α3(β2/β4)α5 nAChR transition predominantly involved protein kinase C, α3(β2/β4)α5 to α7 nAChR transition—Ca 2+ /calmodulin-dependent protein kinase II and p38 MAPK, and α7 self-up-regulation—the p38 MAPK/Akt pathway, and JAK-2. These results provide a mechanistic insight into the genomic effects of ETS and nicotine on KCs and characterize signaling pathways mediating autoregulation of stepwise overexpression of nAChR subtypes with increasing Ca 2+ permeability in exposed cells. These observations have salient clinical implications, because a switch in the nAChR subunit composition can bring about a corresponding switch in receptor function, leading to profound pathobiologic effects observed in KCs exposed to tobacco products. Arredondo, J., Chernyavsky, A. I., Jolkovsky, D. L., Pinkerton, K. E., Grando, S. A. Receptor-mediated tobacco toxicity: acceleration of sequential expression of α5 and α7 nicotinic receptor subunits in oral keratinocytes exposed to cigarette smoke. Key Words: nicotinic acetylcholine receptors • Akt • PKC • p38 • JAK-2 • GATA-2

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