Originally published online as doi:10.1189/jlb.0608387 on October 3, 2008
Published online before print October 3, 2008
(Journal of Leukocyte Biology. 2009;85:136-145.)
© 2009
by Society for Leukocyte Biology
Prostaglandin H2 induces the migration of human eosinophils through the chemoattractant receptor homologous molecule of Th2 cells, CRTH2
Rufina Schuligoi,
Miriam Sedej,
Maria Waldhoer,
Anela Vukoja,
Eva M. Sturm,
Irmgard T. Lippe,
Bernhard A. Peskar and
Akos Heinemann1
Institute of Experimental and Clinical Pharmacology, Medical University Graz, Graz, Austria
1 Correspondence: Institute of Experimental and Clinical Pharmacology, Medical University of Graz, Universitaetsplatz 4. A-8010 Graz, Austria. E-mail: akos.heinemann{at}meduni-graz.at

ABSTRACT
The major mast cell product PGD
2 is released during the allergic
response and stimulates the chemotaxis of eosinophils, basophils,
and Th2-type T lymphocytes. The chemoattractant receptor homologous
molecule of Th2 cells (CRTH2) has been shown to mediate the
chemotactic effect of PGD
2. PGH
2 is the common precursor of
all PGs and is produced by several cells that express cyclooxygenases.
In this study, we show that PGH
2 selectively stimulates human
peripheral blood eosinophils and basophils but not neutrophils,
and this effect is prevented by the CRTH2 receptor antagonist
(+)-3-[[(4-fluorophenyl)sulfonyl] methyl amino]-1,2,3,4-tetrahydro-9H-carbazole-9-acetic
acid (Cay10471) but not by the hematopoietic PGD synthase inhibitor
4-benzhydryloxy-1-[3-(1H-tetrazol-5-yl)-propyl]piperidine (HQL79).
In chemotaxis assays, eosinophils showed a pronounced migratory
response toward PGH
2, but eosinophil degranulation was inhibited
by PGH
2. Moreover, collagen-induced platelet aggregation was
inhibited by PGH
2 in platelet-rich plasma, which was abrogated
in the presence of the D-type prostanoid (DP) receptor antagonist
3-[(2-cyclohexyl-2-hydroxyethyl)amino]-2,5-dioxo-1-(phenylmethyl)-4-imidazolidine-heptanoic
acid (BWA868c). Each of these effects of PGH
2 was enhanced in
the presence of plasma and/or albumin. In eosinophils, PGH
2-induced
calcium ion (Ca
2+) flux was subject to homologous desensitization
with PGD
2. Human embryo kidney (HEK)293 cells transfected with
human CRTH2 or DP likewise responded with Ca
2+ flux, and untransfected
HEK293 cells showed no response. These data indicate that PGH
2 causes activation of the PGD
2 receptors CRTH2 and DP via a dual
mechanism: by interacting directly with the receptors and/or
by giving rise to PGD
2 after catalytic conversion by plasma
proteins.
Key Words: allergy D-type prostanoid HEK293 D-type prostanoid receptor platelet aggregation degranulation

INTRODUCTION
PGD
2 is the main prostanoid released from activated mast cells
as part of the allergic response [
1
,
2
]. Like other prostanoids,
PGD
2 arises from the phospholipase A
2/arachidonic acid/cyclooxygenase
pathways. PGD
2 is finally isomerized from the primary cyclooxygenase
product, PGH
2, by two specific cytosolic enzymes: lipocalin-type
PGD synthase (PGDS) and hematopoietic PGDS. The latter is expressed
in immune cells such as mast cells, APCs, microglia, and Th2-type
lymphocytes [
3
,
4
]. In contrast, lipocalin-type PGDS is most
abundant in the CNS but can also be found in osteoblasts, male
genital organs, the heart, and vascular endothelium [
5
6
7
8
].
Upon damage of these tissues, lipocalin-type PGDS becomes up-regulated
[
6
,
7
] and is also being secreted into cerebrospinal liquor,
seminal fluid, and blood plasma, respectively [
5
]. In agreement
with the expression patterns and localization of PGDS, PGD
2 has been implicated in allergic disease, sleep, nociception,
male fertility, and vascular function.
Two G-protein-coupled receptors for PGD2 have been described to date: chemoattractant receptor homologous molecule expressed on Th2 cells (CRTH2) and D-type prostanoid receptor (DP). CRTH2 was discovered as a seven transmembrane-spanning protein expressed by Th2 cells, eosinophils, and basophils [9
]. In fact, PGD2 is chemotactic for Th2 cells, eosinophils, and basophils. However, CRTH2 has been shown to have a broader spectrum of ligands, as it is also activated by several PGD2 metabolites, including 13,14-dihydro-15-keto-PGD2, PGJ2, 15-deoxy-
12,14-PGJ2,
12-PGJ2 [10
, 11
], as well as 9
,11β-PGF2 and its stereoisomer PGF2
[12
] and a thromboxane (TX) metabolite, 11-dehydro-TXB2 [13
].
CRTH2 activation can lead to a plethora of biological effects that include the induction of the chemotaxis of eosinophils, basophils, and Th2 cells [9
, 14
], the respiratory burst of eosinophils [11
, 15
], and enhancement of histamine release from basophils [16
]. Interestingly, osteoblasts and osteoclasts express CRTH2, which modulates their migration and activity [8
, 17
]. Moreover, we have shown that CRTH2 agonists prime eosinophils for chemotaxis toward other chemoattractants [11
, 18
] and are capable of mediating the rapid mobilization of eosinophils from the isolated hind limb of guinea pigs [11
]. In rats, CRTH2 mediates eosinophil infiltration into the lungs and skin [19
, 20
], and studies in murine models of allergic disease revealed that the PGD2-CRTH2 system plays a significant role in chronic allergic skin inflammation [21
22
23
], pollen-induced rhinitis [24
], and allergic airway inflammation [21
, 25
, 26
].
The alternate PGD2 receptor DP is expressed more widely, including platelets, several types of leukocytes, osteoblasts, the vasculature, the CNS, retina, nasal mucosa, lungs, and intestine [8
, 9
, 27
28
29
30
]. Functionally, DP-mediated responses include inhibition of platelet aggregation, induction of vasorelaxation, mucin secretion, and lowering intraocular pressure [30
31
32
]. DP agonists have been suggested to inhibit neutrophil, basophil, and dendritic cell function [33
34
35
36
]. Eosinophils also express the DP receptor [37
, 38
] and show delayed apoptosis after treatment with a selective DP agonist [37
]. Recently, we described that the DP receptor plays an important modulator role in the trafficking of eosinophils [38
]. In vivo, DP has been shown to mediate antigen-induced rhinitis, conjunctivitis, and pulmonary inflammation in the guinea pig [39
], and DP-deficient mice exhibit reduced pulmonary inflammation in response to allergen [40
].
The accumulating body of data suggesting a pathogenic role of PGD2 in allergic disease has prompted the interest in CRTH2 and DP as potentially useful therapeutic targets. Accordingly, synthesis of several CRTH2 and DP antagonists has been reported in the meanwhile [15
, 39
, 41
42
43
44
45
46
47
48
49
]. In addition, the selective inhibition of PGD2 biosynthesis by means of PGDS inhibitors is being considered [22
, 50
51
52
]. In this case, PGH2 would not be isomerized to PGD2 but be metabolized by an alternate PG synthase present in the cell or released unmodified from the cell. In fact, release of PGH2 from cells under normal and/or inflammatory conditions has been reported [53
, 54
]. PGH2 has been shown to be a highly potent agonist on the TX receptor, TP [55
], but its effect on PGD2 receptors has not been investigated. Here, we describe that PGH2 mimics the effect of PGD2 on CRTH2 and DP receptors and may, therefore, play a role in allergic inflammation, even in the absence of functional PGDS.

MATERIALS AND METHODS
Reagents
All laboratory reagents were from Sigma (Vienna, Austria), unless
specified. Assay buffer, as used in the shape-change experiments,
was made from Dulbeccos modified PBS (with 0.9 mM Ca
2+ and 0.5 mM Mg
2+, Invitrogen, Vienna, Austria), 0.1% BSA (10
mM HEPES and 10 mM glucose, pH 7.4). Human recombinant eotaxin
was from Peprotech (London, UK). PGD
2, 4-benzhydryloxy-1-[3-(1H-tetrazol-5-yl)-propyl]piperidine
(HQL79), (+)-3-[[(4-fluorophenyl)sulfonyl] methyl amino]-1,2,3,4-tetrahydro-9H-carbazole-9-acetic
acid (Cay10471), [1S-[1

,2

(Z),3

|,4

]]-7-[3-[[2-[(phenylamino)carbonyl]hydrazine]methyl]-7-oxabicylo[2.2.1]
hept-2-yl]-5-heptenoic acid (SQ29548), and 3-[(2-cyclohexyl-2-hydroxyethyl)amino]-2,5-dioxo-1-(phenylmethyl)-4-imidazolidine-heptanoic
acid (BWA868c) were purchased from Cayman (Ann Arbor, MI, USA).
CellFix® and FACS-Flow® were from Becton Dickinson (Vienna,
Austria). Fixative solution was prepared by adding 9 mL distilled
water and 30 mL FACS-Flow® to 1 mL CellFix®. Collagen
was obtained from Probe&Go (Endingen, Germany). Drugs were
dissolved in ethanol or DMSO and diluted further in assay buffer
to give a final concentration of the solvents <0.1%.
Cloning and expression of human CRTH2 and DP receptors
The DNA coding for the human DP receptor was cloned into a modified eukaryotic expression vector SSFLAG-pcDNA3.1(+) [56
] and verified by sequencing. Dr. Evi Kostenis (Institute of Pharmaceutical Biology, University of Bonn, Germany) provided the human CRTH2 receptor cloned into the eukaryotic expression vector pcDNA3.1 (+) and the constructs hemagglutinin (HA)-
6-Gqi4-myr-pcDNA3.1 Zeo and HA-
6-Gqs5-myr-pcDNAI.
Human embryonic kidney (HEK)293 cells (American Type Culture Collection, Manassas, VA, USA) were maintained in culture in DMEM (Invitrogen), supplemented with 10% FCS at 37°C in a 5% CO2-humidified atmosphere. Stable cell lines expressing recombinant receptors were generated by clonal selection in drug-containing media: HEK293 cells stably expressing DP or CRTH2 were cultured in DMEM containing 10% FCS and 0.1 mg/ml Zeocin (Invitrogen) or 0.2 mg/ml Geneticin 418 (Invitrogen), respectively. For transient coexpression of
6-Gqs5-myr and DP or
6-Gqi4-myr and CRTH2, 40,000 cells were transfected with 200 ng of the respective DNA by using Lipofectamin2000 (Invitrogen), according to the manufacturers instructions.
Leukocyte shape-change assay
The Ethics Committee of the Medical University of Graz (Austria) approved this study. Prior to blood sampling from healthy volunteers, all donors signed an informed consent form. Aliquots (90 µL) of citrated whole blood were stimulated with 10 µl agonists for 4 min at 37°C. The samples were then transferred to ice and fixed with 250 µl fixative solution followed by NH4Cl–induced lysis of RBC [57
]. Cells were then washed and resuspended in 250 µL fixative solution. To record shape-change responses in the absence of plasma, preparations of polymorphonuclear leukocytes (PMN; containing eosinophils and neutrophils) were obtained by dextran sedimentation of whole blood and centrifugation on Histopaque gradients as described [11
]. Samples were analyzed immediately on a FACSCalibur flow cytometer (Becton Dickinson, Mountain View, CA, USA). Eosinophils were distinguished from other cells according to their autofluorescence in the fluorescence 1 (FL-1) and FL-2 channels (see Fig. 1A
) [11
].
Chemotaxis
Eosinophils were purified further from polymorphonuclear populations
by negative magnetic selection using an antibody mixture and
colloidal magnetic particles from StemCell Technologies (Vancouver,
Canada). Resulting populations of eosinophils were typically
>97%, and the majority of contaminating cells was neutrophils.
Purified eosinophils were suspended in assay buffer at 2
x 10
6/ml,
and 50 µl of the suspension was placed onto the top of
a 48-well microBoyden chemotaxis chamber with a 5-µm pore-size
polycarbonate filter (NeuroProbe, Gaithersburg, MD, USA), with
30 µl agonists in the bottom wells of the plate. Baseline
migration was determined in wells containing only assay buffer.
The plates were incubated at 37°C in a humidified incubator
for 1 h, and the membrane was removed carefully. Cells that
had migrated to the lower chamber were enumerated by flow cytometric
counting for 30 s, as described previously [
58
].
Calcium ion (Ca2+) flux
Intracellular Ca2+ levels in eosinophils were analyzed by flow cytometry as described [10
, 11
, 59
]. PMN (107 cells/ml) were treated with 2 µM of the acetoxymethyl ester of Fluo-3 in the presence of 0.02% pluronic F-127 for 60 min at room temperature and washed in PBS without Ca2+/Mg2+. The leukocytes were then labeled with anti-CD16 (PE) for 6 min at room temperature, washed, and resuspended in assay buffer without Ca2+/Mg2+ to give a concentration of 3 x 106 leukocytes/ml. Aliquots (950 µl) of the leukocyte suspension were removed and treated with 50 µl PBS containing Ca2+ (36 mM) and Mg2+ (20 mM) for 5 min. Changes in intracellular-free Ca2+ levels were detected at room temperature by flow cytometry as increases in fluorescence intensity of the Ca2+-sensitive dye Fluo-3 in the FL-1 channel. In some experiments, a first agonist was added to the cell sample followed by a second agonist 6 min later. Maximal Ca2+ responses were determined by the addition of the Ca2+ ionophore A23187 (10 µM) at the end of each experiment.
In addition, agonist-induced Ca2+ signaling was measured in HEK293 cells coexpressing
6-Gqs5-myr and DP or
6-Gqi4-myr and CRTH2, respectively. Twenty-four hours post-transfection, cells were loaded for 60 min with a Ca2+ fluorophore (FLIPR® Calcium 4 Assay Kit, Molecular Devices, Sunnyvale, CA, USA). Intracellular Ca2+ mobilization was measured immediately after agonist application and recorded for 2 min in a FlexStationTM II system (Molecular Devices). EC50 values were determined by nonlinear regression analysis using the GraphPad Prism 4.0 software.
Eosinophil degranulation
To determine the release of eosinophil peroxidase (EPO) and myeloperoxidase (MPO) from activated granulocytes, purified human eosinophils or neutrophils were resuspended in assay buffer at 1 x 106 cells/ml, mixed with cytochalasin B (10 µg/ml), and 50 µl aliquots were loaded into the wells of a 96-well microplate. Cells were stimulated with 20 µl of various concentrations of C5a for 20 min at 37°C. Thereafter, 60 µl H2O2 (1 mM) was added to each well to start the peroxidase reaction. To detect the reaction, 70 µl 2.8 mM tetramethylbenzidine was added. Following incubation for 1 min at room temperature, the peroxidase reaction and the color development were terminated with 4 M acetic acid [60
]. Microplates were analyzed on a bench reader at a wavelength of 630 nm. Data were expressed as percent of the maximal control response (C5a at 300 nM).
Platelet aggregation
Human platelet-rich plasma and platelet-poor plasma were prepared from citrated whole blood by centrifugation. Platelet aggregation was recorded at 37°C with constant stirring (1000 rpm) in a four-channel Aggrecorder II aggregometer (KDK Corp., Kyoto, Japan) as described [13
, 61
]. Platelet aggregation was measured as the increase in light transmission for 5 min, starting with the addition of collagen (1.25–10 µg/ml) as a proaggregatory stimulus. CaCl2 at a final concentration of 1 mM was added 2 min before collagen. To record inhibition of collagen-induced aggregation, PGD2 or PGH2 was added 2 min before collagen. The antagonists or their vehicle were added 10 min before PGD2. Data were expressed as percent of maximum light transmission, and nonstimulated, platelet-rich plasma was 0% and platelet-poor plasma, 100%.
Statistical analyses
Data are shown as mean ± SEM for n observations. Comparisons of groups were performed using two-way ANOVA for repeated measurements, and probability values of P < 0.05 were considered as statistically significant.

RESULTS
The ability of PGH
2 to stimulate human eosinophils was first
tested in flow cytometric shape-change assays. Stimulation of
leukocytes with chemoattractants results in a rapid rearrangement
of the cytoskeleton to facilitate cell polarization, which can
be readily detected by flow cytometry as changes in forward-scatter
[
11
]. Therefore, samples of human whole blood were incubated
for 4 min at 37°C with PGD
2, PGH
2, eotaxin, or arachidonic
acid.
Figure 1A
shows the marked increase in forward-scatter
of eosinophils stimulated with PGH
2 (75 nM) as compared with
its vehicle. The PGH
2-induced changes in the shape of eosinophils
were concentration-dependent
(Fig. 1B)
. In this respect, PGH
2 was 10 times less potent than PGD
2 but almost as potent as eotaxin.
In contrast, arachidonic acid did not stimulate eosinophil shape
change. In addition, basophils responded with shape change to
stimulation with PGH
2, PGD
2, and eotaxin, with similar sensitivity
as eosinophils (data not shown,
n=5). In contrast, neutrophils
did not respond to PGH
2 or PGD
2 (data not shown,
n=6). Pretreatment
of whole blood with the hematopoietic PGDS inhibitor HQL79 (6.6
µM) did not alter the shape-change responses of eosinophils
to PGH
2 (Fig. 1B)
. To investigate the role of plasma proteins,
these experiments were repeated with isolated polymorphonuclear
preparations in the absence of BSA or with 1% BSA. In the absence
of plasma and BSA, the potency of PGH
2 to induce eosinophil
shape change was ten- to 30-fold reduced, and that of PGD
2 was
left largely unaltered
(Fig. 1C)
. Supplementing the assay buffer
with 1% BSA again shifted the sensitivity of eosinophils to
PGH
2 tenfold to the left without fully restoring maximal response
effectiveness of PGH
2 to that observed in whole blood
(Fig. 1C)
.
To test the involvement of CRTH2 in the eosinophil shape-change responses to PGH2, cells were pretreated with the CRTH2 antagonist Cay10471 (100 nM) or vehicle for 10 min at 37°C. In fact, Cay10471 abolished the shape-change responses of eosinophils to PGH2 and PGD2 (Fig. 1C)
but had no effect on eosinophil responses to eotaxin (data not shown, n=4). The conjecture of PGH2 acting through the same receptor as PGD2 was also confirmed in Ca2+ flux assays: PGH2 elicited effective Ca2+ responses in eosinophils in a concentration-dependent manner (Fig. 2A
) and completely desensitized eosinophils to a subsequent challenge with PGD2 but not eotaxin (Fig. 2B)
. PGH2 exhibited similar efficacy as PGD2 but was 30-fold less potent at inducing Ca2+ flux in eosinophils (Fig. 2A)
. None of these chemoattractants induced Ca2+ flux in neutrophils (data not shown, n=4).
In eosinophil chemotaxis, PGH
2 likewise mimicked the effect
of PGD
2, as purified eosinophils migrated effectively toward
PGH
2 (
Fig. 3
). As in the shape-change assay, addition of plasma
(1% final concentration) to the assay buffer enhanced the effect
of PGH
2 but had little effect on eosinophil chemotaxis toward
PGD
2 (Fig. 3)
. As PGH
2 stimulated the mobilization of Ca
2+ in eosinophils, and elevation of free cytoplasmic Ca
2+ is a
prerequisite of leukocyte degranulation [
62
], we tested the
effect of PGH
2 on EPO release. Unexpectedly, PGH
2 itself did
not stimulate eosinophil degranulation at concentrations up
to 500 nM (data not shown,
n=5) but potently inhibited the C5a-induced
EPO release with an IC
50 of 15 nM (
Fig. 4A
). In contrast, neutrophil
degranulation (i.e., the release of MPO activity into the supernatants)
was only inhibited to a minor degree
(Fig. 4A)
. Pretreatment
of eosinophils with the CRTH2 antagonist Cay10471 completely
reversed the inhibitory effect of PGH
2 on C5a-induced eosinophil
degranulation but had no effect on EPO release by itself
(Fig. 4B)
,
which suggests that the inhibitory effect of PGH
2 is mediated
by CRTH2.
In further experiments, we addressed the question of whether
PGH
2 was also a ligand for the second PGD
2 receptor, DP, using
platelet aggregation as a model system. Two experimental protocols
were used: platelet-rich plasma and isolated, washed platelets.
Treatment of platelets in plasma with 30–300 nM PGH
2 for
2 min markedly inhibited the subsequent collagen-induced platelet
aggregation (
Fig. 5A
). This effect of PGH
2 closely mimicked
the inhibition of platelet aggregation by PGD
2 (Fig. 5B)
. Moreover,
pretreatment of the samples with the DP antagonist BWA868c (100
nM) for 10 min abolished the inhibitory effects of PGD
2 as well
as that of PGH
2, whereas the hematopoietic PGDS inhibitor HQL79
(6.6 µM) did not prevent the antiaggregatory effect of
PGH
2 (Fig. 5)
. Previous reports suggested that PGH
2 was an
agonist on TP receptors and stimulated the aggregation of platelets
by itself [
55
]. Here, we observed that only high concentrations
of PGH
2 (

1 µM) were able to induce platelet aggregation
of a moderate extent, and as expected, this effect was abolished
after pretreatment for 10 min with 100 nM of the TP receptor
antagonist SQ29548 (
Fig. 6A
). However, the efficacy of PGH
2 to induce platelet aggregation was increased markedly after
pretreatment of platelets with the DP antagonist BWA868c (100
nM) for 10 min
(Fig. 6A)
. Similarly, the potency of PGH
2 to
induce platelet aggregation was tenfold and its efficacy twofold,
increased in the absence of plasma, i.e., in washed platelet
preparations, as compared with platelet-rich plasma
(Fig. 6B)
.
This was not a result of nonspecific enhancement of the sensitivity
of the platelets, as the aggregatory effect of collagen was
similar in washed platelet preparations and platelet-rich plasma
(Fig. 6C)
.
These observations suggest that PGH
2 can activate CRTH2 and
DP receptors, but the cellular responses to PGH
2 depend on the
presence of plasma and/or albumin. Therefore, we investigated
the pharmacological properties of PGH
2 more closely in the absence
of plasma proteins in HEK293 cells transfected with human CRTH2
and DP, respectively. To minimize the possibility of PGH
2 being
modified in the assay buffer or at the cellular surface, a Ca
2+ flux assay was used that provides an immediate, functional read-out
after ligand binding to the receptor. To this end, DP-expressing
cells were cotransfected with the chimeric G protein G

6Gqs5myr,
which is capable of transforming the activation G
s-coupled receptors
into G
q-induced Ca
2+ signals [
63
]. For the same reason, CRTH2-expressing
cells were cotransfected with the chimeric G protein G

6Gqi4myr.
Untransfected HEK293 cells did not respond with Ca
2+ flux to
PGH
2 or PGD
2 (data not shown,
n=3). In contrast, cells transfected
with human DP and G

6Gqs5myr were highly sensitive to PGD
2 and
responded to PGH
2 (
Fig. 7A
). The EC
50 values for PGD
2 and PGH
2 for the induction of Ca
2+ flux in DP-expressing cells were 0.0002
± 0.21 and 0.04 ± 0.21 nM, respectively. Similarly,
PGH
2 and PGD
2 potently elicited Ca
2+ flux in HEK293 transfected
with human CRTH2 and G

6Gqi4myr (Fig. 7B)
. In this case, the
EC
50 values for PGD
2 and PGH
2 were 0.24 ± 0.20 and 6.24
± 0.16 nM, respectively. The DP antagonist BWA868c and
the CRTH2 antagonist Cay10471 (1 µM each) largely abolished
the Ca
2+ responses to PGH
2 in DP- and CRTH2-expressing cells,
respectively
(Fig. 7 C and D)
. In contrast, the TP antagonist
SQ29548 had no effect, demonstrating that TP receptors endogenously
expressed by HEK293 cells are not involved in the response to
PGH
2 (Fig. 7D)
.

DISCUSSION
Here, we show that PGH
2 potently induces the chemotaxis of human
eosinophils, elicits a shape change, and stimulates intracellular
Ca
2+ flux. These effects appear to be mediated by CRTH2, although
we observed that PGH
2 can also stimulate DP receptors. This
suggests that CRTH2 and/or DP receptor activity may be generated
in vivo in the absence of functional PGDS. Therefore, the range
of cells and tissues that are capable of producing active ligands
for CRTH2 and DP might be considerably wider than assumed to
date. Most cells that express cyclooxygenases also express PG
synthases, so that only little PGH
2 is expected to be released
from the cell in an untransformed form. However, examples from
other cells and tissues that release larger amounts of genuine
PGH
2 are also known, including platelets, mesangial cells, and
lung tissue [
53
,
64
,
65
]. Particularly among these are endothelial
cells, which have been shown in numerous studies to release
PGH
2 in response to mechanical stimuli, acetylcholine, endothelin-1,
and IL-1β [
54
,
66
67
68
]. These studies suggest that
activation of endothelial cells results in enhanced metabolization
of arachidonic acid to PGH
2, which cannot be metabolized further
by prostacyclin synthase or other PG synthases as a result of
limited capacity. Therefore, PGH
2 is released untransformed
from cells [
69
]. The resulting effects have been described
as induction of platelet aggregation and vasoconstriction, mediated
by the TX receptor TP, for which PGH
2 is a potent agonist [
55
,
66
]. The current study, however, reveals that PGH
2 can activate
two further prostanoid receptors, CRTH2 and DP, thus extending
the possible biological consequences of PGH
2 released in an
untransformed manner. As these receptors play a role in the
regulation of inflammatory cells that are involved in the allergic
response, our findings point to a novel role of PGH
2 in leukocyte-endothelial
cell interaction in allergic disease.
In detail, in agreement with previous studies, we observed that PGH2 was able to induce platelet aggregation [55
], and this was prevented by the TP receptor antagonist SQ29548. However, under physiological conditions (i.e., in the presence of plasma), its proaggregatory potency and efficacy were low (EC50=1–3 µM; maximal efficacy, 42% aggregation). At considerably lower concentrations (IC50=100 nM), however, PGH2 exhibited potent inhibitory action against collagen-induced platelet aggregation. This antiaggregatory effect was mediated by DP receptors, as inferred from BWA868c preventing it. These observations, therefore, suggest that PGH2 activates DP and TP receptors in platelets, but under physiological conditions, DP receptor activation and ensuing inhibition of platelet aggregation are predominant.
The effect of PGH2 on CRTH2 was tested in eosinophils. We have shown previously that CRTH2 activation in these cells causes flow cytometric shape change that is mediated by G
q proteins, phospholipase C, and actin rearrangement [58
]. In fact, PGH2 induced the shape change of human peripheral blood eosinophils in a CRTH2-dependent manner, but in the absence of plasma, the potency of PGH2 was low, i.e., 100-fold lower than that of PGD2. In whole blood, however, PGH2 was highly potent and effective, almost as potent as the CCR3 ligand eotaxin, which is among the most potent eosinophil chemoattractants known to date. Similar results were obtained with basophils, where PGH2 induced shape change with a similar potency as in eosinophils. Consistent with its effect to cause eosinophil shape change, PGH2 also induced the elevation of intracellular-free Ca2+ in eosinophils to similar levels as PGD2 and eotaxin. The involvement of CRTH2 in this mechanism was demonstrated by homologous receptor desensitization, as PGD2 and PGH2 mutually desensitized eosinophils to each other but not to eotaxin, suggesting that the two PGs were acting via the same receptor.
The primary role of PGD2 and CRTH2 in eosinophil function is the regulation of eosinophil trafficking, as activation of CRTH2 results in eosinophil mobilization from bone marrow, direct stimulation of chemotaxis, and priming of eosinophils for migration toward other chemoattractants [9
, 11
, 18
, 41
]. Accumulation of eosinophils at sites of allergic reactions, such as eczema or asthma, is a hallmark of tissue injury and lung dysfunction [70
]. Asthmatic patients that receive treatment based on eosinophil counts in sputum have significantly fewer severe asthma exacerbations than patients treated according to standard management therapy [71
]. Moreover, genetically modified mice lacking eosinophils are protected against allergen-induced lung injury and asthma [72
, 73
]. In keeping with the ability of PGH2 to activate CRTH2, eosinophils migrated toward PGH2 in chemotaxis assays. As also observed for inhibition of platelet aggregation, the addition of plasma (1%) to the assay buffer markedly enhanced the chemotactic efficacy of the prostanoid. This observation and the fact that the PGH2-induced shape change of eosinophils and inhibition of platelet aggregation were substantially more prominent in whole blood and plasma, respectively, prompt the question of whether PGH2 is being transformed to active metabolites, such as PGD2, in the presence of plasma proteins. On the other hand, the fact that PGH2 was also chemotactic in protein-free assay buffer is remarkable and suggests that short-term exposure of eosinophils to a CRTH2 ligand for a few minutes is sufficient to initiate and maintain directed movement of the cells.
Previous studies showed that the isomerization of PGH2 into PGD2 can be catalyzed by serum albumin [74
] and that lipocalin-type PGDS is present in plasma [75
, 76
]. This would support the possibility that rapid conversion of PGH2 to PGD2 in plasma accounts for the CRTH2- and DP-stimulating activity of PGH2. To test the hypothesis that PGH2 directly binds to CRTH2 and DP and to minimize the possibility of PGH2 being transformed to PGD2, we used HEK293 cells transfected with CRTH2 or DP and recorded agonist-induced Ca2+ flux as an indirect but immediate (within less than 3 s) measure of receptor binding in protein-free assay buffer. This approach was preferred over conventional binding studies, which imply incubation times of at least 1 h, hence, allowing decomposition of labile ligands. The fact that HEK293 cells transfected with CRTH2 or DP responded with Ca2+ flux within 3 s following PGH2 stimulation argues for a direct binding of PGH2 to these prostanoid receptors. In contrast, the half-life of PGH2 in aqueous media has been described to be 4–5 min [77
]. Moreover, in the absence of proteins, PGH2 isomerizes almost exclusively to PGE2 [74
, 77
], which in turn lacks any agonistic activity on DP or CRTH2. The effects of PGH2 on platelet aggregation, however, probably involve conversion of PGH2 to PGD2, as the DP-dependent activity of PGH2 could only be observed in the presence of plasma, and the TP-mediated stimulation of platelet aggregation was obliterated by plasma. Similarly, eosinophil chemotaxis toward PGH2 was enhanced in the presence of plasma, which suggests the generation of the more potent CRTH2 ligand, PGD2.
The binding of chemoattractants to plasma proteins and also cellular components can fundamentally alter their potency. With respect to the current data, it might be of importance that eotaxin binds to the Duffy antigen of erythrocytes, which reduces its potency more than tenfold [78
]. Similarly, the potency of another eosinophil chemoattractant, 5-oxo-6,8,11,14-eicosatetraenoic acid, is reduced by plasma proteins 30-fold [18
]. The same does not hold true for PGD2, as responses of eosinophils to PGD2 were not different in whole blood versus PBS [18
]. However, we also observed that there is a time-dependent metabolism of PGD2 in plasma with an estimated half-life of 35 min for PGD2 [61
]. These observations show that the dynamics and kinetics of chemoattractants are altered by blood components.
Finally, we tested the effect of PGH2 on eosinophil degranulation, i.e., the release of EPO activity into the supernatants of eosinophils. As we have shown previously for PGD2 [41
], PGH2 did not stimulate EPO release by itself but effectively inhibited the C5a-induced EPO release from eosinophils. PGH2 mimicked the inhibitory effect of PGD2 on eosinophil degranulation in two ways: First, this effect was selective for eosinophils, as neutrophil degranulation was left largely unaltered by PGH2, and second, the inhibitory effect of PGH2 was reversed by the CRTH2 antagonist Cay10471. This observation further supports the role of CRTH2 ligands as initial chemoattractants in the hierarchy of chemoattractants, governing the evasion of eosinophils from the vascular space but restraining their degranulator activity. This stands in contrast to endpoint chemoattractants, such as eotaxin or C5a, which are effective degranulators of eosinophils [18
].
In summary, we have demonstrated that PGH2 is a potent agonist on the PGD2 receptors CRTH2 and DP. Given that PGH2 is released in substantial amounts from activated endothelial cells and lung tissue, our data suggest that PGH2 might be involved in the recruitment of CRTH2-expressing inflammatory cells, such as eosinophils, basophils, and Th2 cells, to sites of allergic reactions. The interaction of PGH2 with CRTH2 and DP appears to take place directly and by means of PGH2 isomerization to PGD2 in plasma.

ACKNOWLEDGEMENTS
This work was supported by the Jubiläumsfonds of the Austrian
National Bank (grants 10287, 10934, and 11967), the Austrian
Science Fund FWF (grants P19424-B05 and P18723-B05), and the
Franz Lanyar Foundation (grants 315 and 316). The expert technical
assistance of Martina Ofner and Wolfgang Platzer is highly appreciated.
Received June 25, 2008;
revised August 22, 2008;
accepted September 11, 2008.

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