Proteolytic Activation Cascade of the Netherton Syndrome–Defective Protein, LEKTI, in the Epidermis: Implications for Skin Homeostasis Paola Fortugno,

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Proteolytic Activation Cascade of the Netherton Syndrome–Defective Protein, LEKTI, in the Epidermis: Implications for Skin Homeostasis Paola Fortugno, Alberto Bresciani, Chantal Paolini, Chiara Pazzagli, May El Hachem, Marina D'Alessio, Giovanna Zambruno Journal of Investigative Dermatology Volume 131, Issue 11, Pages 2223-2232 (November 2011) DOI: 10.1038/jid.2011.174 Copyright © 2011 The Society for Investigative Dermatology, Inc Terms and Conditions

Figure 1 LEKTI proteolytic fragments in the epidermis, human keratinocytes, and transfected HEK293. (a) Schematic representation of lympho-epithelial Kazal-type-related inhibitor (LEKTI) isoforms with location of the antigenic polypeptides used to generate the indicated antibodies. (b) Immunoblotting detection of LEKTI in: conditioned medium (CM) of HEK293 transfected with pLEKTIFL (1) or empty vector (2), total extract from human epidermis of two healthy donors (3, 4), CM of proliferating natural human keratinocytes (NHKs) (5), CM of differentiated NHK (6), and Netherton syndrome (NS) keratinocytes (7). Note that the experimental conditions used did not allow separation of the 65- and 68-kDa fragments, and that the band corresponding to the 65-kDa fragment displays a higher molecular weight in HEK293 expressing LEKTIFL because of the C-terminal tag. Ponceau S staining was used to ensure even protein loading among similar samples (lower panel). Different exposures of the same blot (lanes 1–2, 3–4, 5–7) were juxtaposed. (c) Immunoblotting detection of LEKTI in CM of HEK293 transfected with pLEKTIFL, pLEKTIL, or pLEKTISh using the antibodies 1C11G6 (1), anti-D7D12 (2), anti-D13D15 (3), anti-D14D15 (4), or anti-His6 (5). Lower panels: 1C11G6 and anti-D7D12 immunoblot longer exposures revealing the 23- and 7-kDa fragments. Sizes of immunoreactive bands are indicated. Journal of Investigative Dermatology 2011 131, 2223-2232DOI: (10.1038/jid.2011.174) Copyright © 2011 The Society for Investigative Dermatology, Inc Terms and Conditions

Figure 2 Mapping of LEKTI proteolytic fragments. (a) Graphic illustration of predicted proprotein convertase cleavage sites in lympho-epithelial Kazal-type-related inhibitor (LEKTI) protein. (b) Partial N-terminal amino-acid sequence of the 42-kDa fragment isolated from conditioned medium (CM) of pLEKTISh transfected HEK293 in alignment with the three human LEKTI isoform sequences. (c) Immunoblotting detection of LEKTI fragments in CM from HEK293 or Netherton syndrome (NS) keratinocytes transfected with LEKTIFL, LEKTI R625A mutant, or the empty vector. The asterisk indicates nonspecific signals. (d) Immunoblotting detection of LEKTI fragments in CM from HEK293 transfected with either wild type or mutant LEKTI. Samples were separated on 12% (upper panel) or 15% (lower panel) SDS-PAGE. On the left, schematic representation of LEKTI processing as deduced from N-terminal sequencing and mutagenesis results. Sizes of immunoreactive bands are indicated. Different exposures of the same blot were juxtaposed. Journal of Investigative Dermatology 2011 131, 2223-2232DOI: (10.1038/jid.2011.174) Copyright © 2011 The Society for Investigative Dermatology, Inc Terms and Conditions

Figure 3 Dose-dependent inhibition of KLK activity by recombinant LEKTI fragments. (a) Dose–response inhibition curves of GST-D6 (•), GST-D7 (♦), GST-D6D9 (○), GST-D7D9 (▴), and GST-D8D9 (□) toward the trypsin-like serine proteases kallikrein (KLK)5 and KLK14. (b) Dose–response inhibition curves of D10D15FL-His (▵), D10D15L-His (▪), and D10D15Sh-His (⋄) toward the chymotrypsin-like KLK7. (a,b) KLKs were preincubated with increasing concentrations of inhibitors before addition of the specific substrates described inSupplementary Table S3 online. Residual KLK activity is expressed relative to control with no inhibitors (Vi/V0). Each data point represents means±SD of three independent assays.Ki values are indicated on the right.aThe single domain fragment D6 inhibited at most 35% of KLK5 activity (Vi/V0>0.65 at [D6]=25 nM) and the relativeKi value could not be determined (ND).bNI, no inhibition. Journal of Investigative Dermatology 2011 131, 2223-2232DOI: (10.1038/jid.2011.174) Copyright © 2011 The Society for Investigative Dermatology, Inc Terms and Conditions

Figure 4 KLK-mediated hydrolysis of LEKTI fragments. (a–c) Immunoblotting detection of lympho-epithelial Kazal-type-related inhibitor (LEKTI) fragments in natural human keratinocyte (NHK) conditioned medium (CM) incubated for up to 24 hours in presence of kallikrein (KLK)5 (a), KLK14 (b), or KLK7 (c), and analyzed at various time points. Asterisks indicate sub-products derived from KLK-mediated cleavage. Journal of Investigative Dermatology 2011 131, 2223-2232DOI: (10.1038/jid.2011.174) Copyright © 2011 The Society for Investigative Dermatology, Inc Terms and Conditions

Figure 5 Inhibition of KLK-mediated DSG1 degradation by LEKTI fragments. Immunoblotting detection of desmoglein-1 (DSG1) in epidermal extracts incubated with kallikrein (KLK)5 (upper panel) or KLK14 (lower panel). Proteases were preincubated with the indicated recombinant polypeptides. Journal of Investigative Dermatology 2011 131, 2223-2232DOI: (10.1038/jid.2011.174) Copyright © 2011 The Society for Investigative Dermatology, Inc Terms and Conditions

Figure 6 LEKTI fragments in human epidermis. (a) Immunohistochemical analysis for lympho-epithelial Kazal-type-related inhibitor (LETKI) and kallikrein (KLK)5 in human epidermis (left panels) and epidermal specimens enriched for granular/horny layers (right panels). Bar=40 μm. (b) Quantitative analysis of LEKTI fragments and KLK5 in epidermis enriched for granular/horny layers by immunoblotting. Increasing amounts of protein extracts (expressed as microgram of uppermost epidermis dry weight) are compared with defined amounts of the corresponding recombinant proteins (expressed in ng). Note that the LEKTI weight values are relative to the sole polypeptides and not to the entire fusion proteins. The tables on the right show the protein content in the epidermis, measured as ng per mg of uppermost epidermis dry weight.1The values indicate the mean of three independent experiments±standard deviation. (c) Model of LEKTI proteolytic activation cascade as deduced from bioactive peptide mapping. Generation of the D1D5 fragment is inferred on the basis of previously published data. Journal of Investigative Dermatology 2011 131, 2223-2232DOI: (10.1038/jid.2011.174) Copyright © 2011 The Society for Investigative Dermatology, Inc Terms and Conditions