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RAGE and TLRs: Relatives, friends or neighbours?

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Molecular Immunology 56 (2013) 739–744 Contents lists available at ScienceDirect Molecular Immunology jo ur nal home p age: www.elsevier.com/locate/molimm Review RAGE and TLRs: Relatives, friends or neighbours? Zaridatul Aini Ibrahim a,b,c , Carol L. Armour a , Simon Phipps d , Maria B. Sukkar a,b,a Woolcock Institute of Medical Research, Sydney Medical School, The University of Sydney, NSW 2006, Australia b School of Pharmacy, The University of Technology, Sydney, NSW 2007, Australia c Department of Pharmacology, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia d School of Biomedical Sciences and Australian Infectious Diseases Research Centre, The University of Queensland, Queensland 4072, Australia a r t i c l e i n f o Article history: Received 2 July 2013 Accepted 8 July 2013 Available online 14 August 2013 Keywords: Receptor for advanced glycation end products (RAGE) High mobility group box-1 (HMGB1) S100 proteins Toll-like receptors (TLRs) Lipopolysaccharide (LPS) Pattern-recognition receptors (PRRs) a b s t r a c t The innate immune system forms the first line of protection against infectious and non-infectious tissue injury. Cells of the innate immune system detect pathogen-associated molecular patterns or endogenous molecules released as a result of tissue injury or inflammation through various innate immune recep- tors, collectively termed pattern-recognition receptors. Members of the Toll-like receptor (TLR) family of pattern-recognition receptors have well established roles in the host immune response to infection, while the receptor for advanced glycation end products (RAGE) is a pattern-recognition receptor predominantly involved in the recognition of endogenous molecules released in the context of infection, physiological stress or chronic inflammation. RAGE and TLRs share common ligands and signaling pathways, and accu- mulating evidence points towards their co-operative interaction in the host immune response. At present however, little is known about the mechanisms that result in TLR versus RAGE signalling or RAGE–TLR cross-talk in response to their shared ligands. Here we review what is known in relation to the physico- chemical basis of ligand interactions between TLRs and RAGE, focusing on three shared ligands of these receptors: HMGB1, S100A8/A9 and LPS. Our aim is to discuss what is known about differential ligand interactions with RAGE and TLRs and to highlight important areas for further investigation so that we may better understand the role of these receptors and their relationship in host defense. © 2013 Elsevier Ltd. All rights reserved. 1. Introduction RAGE and TLRs play a critical role in the innate immune sys- tem as they can recognize and interact with microbial products (i.e. pathogen-associated molecular patterns or PAMPs) as well as endogenous molecules released in the context of tissue injury and inflammation (i.e. damage-associated molecular patterns or DAMPs). Ligation of RAGE and TLR signalling results in the acti- vation of immune and inflammatory responses involved in host defence (Botos et al., 2011; Chang, 2010). Recently, it has been suggested that RAGE and some members of the TLR family functionally interact to coordinate and regulate immune and inflammatory responses. RAGE co-operation with cer- tain TLRs results in amplification of inflammatory responses and there is increasing evidence to support their potential synergism. Abbreviations: CpG-A, class A cytosine-guanine-rich; DAMP, damage-associated molecular pattern; HMGB1, high mobility group box-1; LPS, lipopolysaccharides; PAMP, pathogen-associated molecular pattern; PRR, pattern recognition receptor; RAGE, receptor for advanced glycation end products; TLR, Toll-like receptor. Corresponding author at: School of Pharmacy, The University of Technology, Sydney, Australia. Tel.: +61 2 9514 8302; fax: +61 2 9514 8300. E-mail address: [email protected] (M.B. Sukkar). RAGE and TLRs share several common ligands including HMGB1 (Hori et al., 1995; Huttunen et al., 2002; Ivanov et al., 2007; Jordana and Evdokia, 2012; Liu et al., 2009; Park et al., 2004; Yang et al., 2010a; Yang et al., 2012), the S100A8/A9 heterodimeric protein complex (Turovskaya et al., 2008; Vogl, 2007), the bacterial cell wall component LPS (Visintin et al., 2003; Yamamoto et al., 2011) and -sheet fibrils like serum amyloid A (Cheng et al., 2008; Yan et al., 2000) and amyloid (Deane et al., 2003; Udan et al., 2008; Yan et al., 1996; Yan et al., 1998). RAGE also appears to interact with TIRAP and MyD88, both of which are intracellular adaptor proteins used by TLRs to activate downstream signalling pathways (Hreggvidsdottir et al., 2009; Ivanov et al., 2007; Qin et al., 2009; Sakaguchi et al., 2011; Tian et al., 2007). So far, much of the evidence in the literature relating to RAGE and TLR co-operation or synergy has focused on signalling path- ways down-stream of these receptors and the outcome of these interactions on the inflammatory response. However, understand- ing of the mechanism of RAGE–TLR cross-talk at the receptor level is extremely limited and important questions remain to be addressed particularly whether RAGE–TLR synergy is due to physical association of the receptors. Here we discuss what is known about the structural and biochemical basis of ligand inter- actions with RAGE and TLRs, with a view to highlighting possible mechanisms of RAGE and TLR co-operation at the receptor level 0161-5890/$ see front matter © 2013 Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.molimm.2013.07.008
Transcript
Page 1: RAGE and TLRs: Relatives, friends or neighbours?

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Molecular Immunology 56 (2013) 739– 744

Contents lists available at ScienceDirect

Molecular Immunology

jo ur nal home p age: www.elsev ier .com/ locate /mol imm

eview

AGE and TLRs: Relatives, friends or neighbours?

aridatul Aini Ibrahima,b,c, Carol L. Armoura, Simon Phippsd, Maria B. Sukkara,b,∗

Woolcock Institute of Medical Research, Sydney Medical School, The University of Sydney, NSW 2006, AustraliaSchool of Pharmacy, The University of Technology, Sydney, NSW 2007, AustraliaDepartment of Pharmacology, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, MalaysiaSchool of Biomedical Sciences and Australian Infectious Diseases Research Centre, The University of Queensland, Queensland 4072, Australia

r t i c l e i n f o

rticle history:eceived 2 July 2013ccepted 8 July 2013vailable online 14 August 2013

eywords:eceptor for advanced glycation endroducts (RAGE)igh mobility group box-1 (HMGB1)100 proteins

a b s t r a c t

The innate immune system forms the first line of protection against infectious and non-infectious tissueinjury. Cells of the innate immune system detect pathogen-associated molecular patterns or endogenousmolecules released as a result of tissue injury or inflammation through various innate immune recep-tors, collectively termed pattern-recognition receptors. Members of the Toll-like receptor (TLR) family ofpattern-recognition receptors have well established roles in the host immune response to infection, whilethe receptor for advanced glycation end products (RAGE) is a pattern-recognition receptor predominantlyinvolved in the recognition of endogenous molecules released in the context of infection, physiologicalstress or chronic inflammation. RAGE and TLRs share common ligands and signaling pathways, and accu-mulating evidence points towards their co-operative interaction in the host immune response. At present

oll-like receptors (TLRs)ipopolysaccharide (LPS)attern-recognition receptors (PRRs)

however, little is known about the mechanisms that result in TLR versus RAGE signalling or RAGE–TLRcross-talk in response to their shared ligands. Here we review what is known in relation to the physico-chemical basis of ligand interactions between TLRs and RAGE, focusing on three shared ligands of thesereceptors: HMGB1, S100A8/A9 and LPS. Our aim is to discuss what is known about differential ligandinteractions with RAGE and TLRs and to highlight important areas for further investigation so that wemay better understand the role of these receptors and their relationship in host defense.

. Introduction

RAGE and TLRs play a critical role in the innate immune sys-em as they can recognize and interact with microbial productsi.e. pathogen-associated molecular patterns or PAMPs) as wells endogenous molecules released in the context of tissue injurynd inflammation (i.e. damage-associated molecular patterns orAMPs). Ligation of RAGE and TLR signalling results in the acti-ation of immune and inflammatory responses involved in hostefence (Botos et al., 2011; Chang, 2010).

Recently, it has been suggested that RAGE and some membersf the TLR family functionally interact to coordinate and regulate

mmune and inflammatory responses. RAGE co-operation with cer-ain TLRs results in amplification of inflammatory responses andhere is increasing evidence to support their potential synergism.

Abbreviations: CpG-A, class A cytosine-guanine-rich; DAMP, damage-associatedolecular pattern; HMGB1, high mobility group box-1; LPS, lipopolysaccharides;

AMP, pathogen-associated molecular pattern; PRR, pattern recognition receptor;AGE, receptor for advanced glycation end products; TLR, Toll-like receptor.∗ Corresponding author at: School of Pharmacy, The University of Technology,

ydney, Australia. Tel.: +61 2 9514 8302; fax: +61 2 9514 8300.E-mail address: [email protected] (M.B. Sukkar).

161-5890/$ – see front matter © 2013 Elsevier Ltd. All rights reserved.ttp://dx.doi.org/10.1016/j.molimm.2013.07.008

© 2013 Elsevier Ltd. All rights reserved.

RAGE and TLRs share several common ligands including HMGB1(Hori et al., 1995; Huttunen et al., 2002; Ivanov et al., 2007; Jordanaand Evdokia, 2012; Liu et al., 2009; Park et al., 2004; Yang et al.,2010a; Yang et al., 2012), the S100A8/A9 heterodimeric proteincomplex (Turovskaya et al., 2008; Vogl, 2007), the bacterial cellwall component LPS (Visintin et al., 2003; Yamamoto et al., 2011)and �-sheet fibrils like serum amyloid A (Cheng et al., 2008; Yanet al., 2000) and amyloid � (Deane et al., 2003; Udan et al., 2008;Yan et al., 1996; Yan et al., 1998). RAGE also appears to interactwith TIRAP and MyD88, both of which are intracellular adaptorproteins used by TLRs to activate downstream signalling pathways(Hreggvidsdottir et al., 2009; Ivanov et al., 2007; Qin et al., 2009;Sakaguchi et al., 2011; Tian et al., 2007).

So far, much of the evidence in the literature relating to RAGEand TLR co-operation or synergy has focused on signalling path-ways down-stream of these receptors and the outcome of theseinteractions on the inflammatory response. However, understand-ing of the mechanism of RAGE–TLR cross-talk at the receptorlevel is extremely limited and important questions remain to beaddressed – particularly whether RAGE–TLR synergy is due to

physical association of the receptors. Here we discuss what isknown about the structural and biochemical basis of ligand inter-actions with RAGE and TLRs, with a view to highlighting possiblemechanisms of RAGE and TLR co-operation at the receptor level
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740 Z.A. Ibrahim et al. / Molecular Immunology 56 (2013) 739– 744

Table 1Summary of RAGE and TLRs interaction with their common ligands.

Ligands Receptors Affinity Important feature mediating the interaction

HMGB1 RAGE (Hori et al., 1995; Huttunen et al., 2002;Jordana and Evdokia, 2012; Liu et al., 2009)

5–10 nM RAGE V-domain and C-terminal of HMGB1B-box domain

TLR4 (Yang et al., 2010b; Yang et al., 2012) 1.5–22 �M Cys23 and Cys45 disulphide bond and reducedCys106 within HMGB1 structure

TLR2 and TLR9 (Ivanov et al., 2007; Park et al.,2004)

Not determined Not determined

S100A8/A9 complex RAGE (Turovskaya et al., 2008) 34.4 ± 13 nM RAGE N-glycansTLR4 (Vogl, 2007) 1.1–2.5 × 10−8 M S100A8 protein and MD2/TLR4 complex

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or future investigation. We have focused the discussion on RAGEnd TLR interactions with three of their shared ligands: HMGB1,he S100A8/A9 protein complex and LPS (summarized in Table 1).

.1. RAGE and TLRs structure at a glance

The receptor for advanced glycation end products (RAGE) is aember of the immunoglobulin superfamily of cell surface recep-

ors. Its structure consists of an extracellular domain comprised ofn N-terminal sequence and three Ig-like regions including one V-ype domain and two C-type domains, C1 and C2. The V-type and1-domains are joined together forming an integrated structuralnit important for ligand recognition. RAGE has a single transmem-rane domain and a short cytoplasmic domain which is essentialor signal transduction (Dattilo et al., 2007; Fritz et al., 2010).

TLRs are a group of type 1 transmembrane proteins consist-ng of ten identified members in humans (TLR1 through to TLR10).heir structures are comprised of an extracellular domain, a trans-embrane domain and a cytoplasmic domain. The extracellular

omain contains leucine-rich repeat (LRR) motifs that mediateigand recognition, while the cytoplasmic domain contains Toll/IL-

receptor (TIR) domain which is important for signal transductionBotos et al., 2011; Chang, 2010).

. RAGE and TLR interactions with their shared ligands

.1. HMGB1

HMGB1 is a DNA binding protein which is released from theucleus during tissue injury, infection and inflammation. Severalost-translational modifications such as acetylation, phosphoryla-ion, methylation and poly (ADP) – ribosylation are required forMGB1 nuclear-cytoplasmic translocation and its ultimate release

nto the extracellular environment (Stros, 2010). In the extracellu-ar space, HMGB1 activates immune and inflammatory responseshrough binding to a number of receptors including RAGE and sev-ral members of the TLR family (Hori et al., 1995; Yu et al., 2006).

The first evidence demonstrating HMGB1 as a RAGE bindingigand came from a study by Hori et al. who were at the timeearching for RAGE ligands in bovine lung extracts. After a seriesf sequencing studies with proteins isolated by a RAGE affinity col-mn, it was revealed that the binding protein was HMGB1. Sincehen, the HMGB1-RAGE interaction has been validated by radioli-and binding assays which demonstrated HMGB1-RAGE binding toe specific, saturable, dose-dependent and of higher affinity thandvanced glycation end-products (AGEs), the first reported RAGEigands (Hori et al., 1995). Further insight into the physicochemicalasis of the HMGB1-RAGE interaction has come from recent stud-

es which show that the binding is mediated through the V-domainf RAGE and the C-terminal of the HMGB1 B-box domain (aminocids position 150–183). The negatively charged RAGE V-domainnteracts with the positively charged acidic residues located in the

∼35 nM RAGE V-domainNot determined Lys128 and Lys132 within MD2 structure

C-terminal region of HMGB1 leading to the formation of a sta-ble ligand-receptor complex (Fritz, 2011; Huttunen et al., 2002;Jordana and Evdokia, 2012; Liu et al., 2009). More recently, a studyhas shown that the RAGE-HMGB1 interaction also depends on hep-aran sulfate, a cell-surface proteoglycan. RAGE and heparan sulfatereadily form a complex at the cell surface prior to HMGB1 bindingand the presence of HMGB1 further increases RAGE-heparan sul-fate association as a result of receptor complex stabilization. Thisfinding has shed new light on the critical role of heparan sulfatein mediating the interaction between HMGB1 and RAGE (Xu et al.,2011).

A group of researchers from Protelica and Bio3 Researchare developing a novel protein scaffold-based inhibitor usingfibronectin type III domain, a polypeptide made up of a smallmonomeric �-sandwich protein. This molecule (called R2F8), nowpatented in several countries, has been demonstrated to inhibitHMGB1-RAGE interactions in vitro in a dose-dependent manner.Current efforts are aimed at extending its biological half-life sothat it can be used to disrupt HMGB1-RAGE interactions in vivo.If successfully developed, this molecule will expand the opportu-nity to further explore HMGB1-RAGE interactions in disease models(Universal Fibronectin Type III Binding Domain Libraries, PatentApplication, Protelica and Bio3 Research).

While HMGB1 has also been reported to signal via a number ofTLRs, including TLR2, TLR4 and TLR9, very little is known about thephysicochemical mechanism of binding between HMGB1 and thesereceptors (Hreggvidsdottir et al., 2012; Ivanov et al., 2007; Parket al., 2004; van Zoelen et al., 2009). HMGB1 binding to TLR4 andHMGB1-mediated cytokine activity depend on specific redox modi-fications within the HMGB1 molecule; specifically a disulfide bondbetween Cys23 and Cys45 and reduced Cys106 (thiol). However,under different molecular states where all cysteine residues arefully reduced, HMGB1 loses its TLR4-binding ability. Fully reducedHMGB1 function as a chemoattractant but the receptor pathwaysmediating its chemotactic activity are yet to be identified (Yanget al., 2010b; Yang et al., 2012). While there is evidence demon-strating that reducible HMGB1 can bind to RAGE, this interaction isnot associated with HMGB1 chemoattractive function (Tang et al.,2010). Moreover, carboxylated glycans such as heparan sulfate mayplay an important role in mediating the HMGB1-RAGE interaction,although it is not known whether this is the case with respectto HMGB1-TLR interactions (Xu et al., 2011). Further studies areneeded to explore HMGB1-TLR binding mechanisms, and particu-larly charaterization of the TLR binding region(s) within the HMGB1molecule.

Interestingly, a number of TLR ligands such as the extracellu-lar DNA material class A cytosine-guanine-rich (CpG-A)-DNA andthe bacterial cell wall component lipopolysaccharide (LPS) form

complexes with HMGB1. These complexes elicit stronger inflam-matory responses compared to HMGB1 or the partner moleculealone via mechanisms that appear to involve co-activation of TLRand RAGE signalling (Hreggvidsdottir et al., 2009; Qin et al., 2009;
Page 3: RAGE and TLRs: Relatives, friends or neighbours?

Z.A. Ibrahim et al. / Molecular Immunology 56 (2013) 739– 744 741

Fig. 1. HMGB1 binding to its receptors. (A) HMGB1 binds to RAGE in the presence of the cell surface proteoglycan heparan sulfate. The complex formation between RAGE,HMGB1 and heparan sulfate induces the activation of cellular signaling which ultimately results in cell migratory responses. (B) HMGB1 can also interact with TLRs such asT ith TLl underc

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LR2, TLR4 and TLR9 to induce cytokine release. (C) HMGB1 can form complexes wigand and this elicits stronger inflammatory responses. However, the mechanismross-talk.

ian et al., 2007). A recent study excluded RAGE-TLR cooperationn the inflammatory response induced by HMGB1 complexes withither the TLR4 ligand LPS or the TLR2 ligand Pam3CSK4, showinghat this is mediated only by the activation of TLR2 or −4, respec-ively (Hreggvidsdottir et al., 2012). However, since this was onlyetermined at the signalling level, structural studies using nuclearagnetic or surface plasmon resonance assays will be necessary to

efinitively exclude a role for RAGE (Fig. 1).Finally, while we have some information regarding the

hysiochemical basis of HMGB1-RAGE/TLR interactions in vitro,nderstanding of their interaction in vivo remains extremely vague.ecause HMGB1 interacts with multiple receptors, this obviously

imits the use of receptor gene knockout mice to discern HMGB1-eceptor interactions in immune and inflammatory responses inivo. One approach to address this would be to employ doublenockout mice (e.g. RAGE-TLR4 deficient mice) or another approachould be to conduct parallel studies that employ recombinantMGB1 molecules lacking the TLR-binding site or RAGE-bindingomain in their structure to allow specific interaction with onlyne receptor.

.2. S100A8/A9

S100A8 and S100A9 are members of the S100 protein family.100 proteins interact with various effector molecules in the cyto-lasm following binding of Ca2+ or other elements such as Zn2+ oru2+ via the helix-loop-helix structural domain known as EF-hand

R ligands such as PAM3CSK4, a TLR2 agonist; LPS, a TLR4 ligand and CpG-A, a TLR9lying this is not well understood, especially with respect to the role of RAGE–TLR

motifs. Extracellular release has been demonstrated for S100A8and S100A9 protein, which are secreted in a heterodimeric formby activated immune cells such as monocytes, granulocytes andneutrophils (Altwegg et al., 2007). The extracellular S100A8/A9 pro-tein complex serves as an alarmin, triggering immune responsesby engaging with pattern-recognition receptors such as RAGE andTLR4.

S100A8/A9 heterodimeric complexes have been identified asligands of RAGE in a co-immunoprecipitation study in isolatedcardiac myocytes from mice (Boyd et al., 2008). In this study,tissue lysates containing S100A8 and S100A9 proteins wereimmunoprecipitated with specific antibodies against both pro-teins and the immunoprecipitated proteins were separated byelectrophoresis and probed with anti-RAGE antibodies. RAGE co-immunoprecipitated with S100A8 and S100A9 proteins in thetissue lysates, demonstrating a strong interaction between RAGEand these proteins.

Although there have been several studies reporting thatS100A8/A9 protein interacts with RAGE, many of them focus onlyon the signalling pathways, for instance activation of kinases likep38 MAPK and transcription factors such as NF-�B, as well as down-stream cellular effects following the S100A8/A9-RAGE interactionrather than ligand-receptor recognition and binding (Gebhardt

et al., 2006; Ghavami et al., 2008; Hermani et al., 2006). However,accumulating evidence suggests that N-glycans present in RAGE,which in this case is a carboxylated glycan, is important in mediat-ing their ligand-receptor binding. This is in agreement with earlier
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tudies that demonstrate S100A8/A9 proteins bind to carboxylatednd other modified glycans such as heparan sulfate glycosamino-lycans expressed on the surface of chondrocytes and endothelialells (Robinson et al., 2002; Srikrishna et al., 2001; van Lent et al.,008b). A study by Turovskaya and colleagues further character-

zed the S100A8/A9-RAGE binding interaction by demonstratinghat S100A8/A9 protein directly binds immobilized RAGE with ad of 34.4 ± 13 nM. The presence of glycans is required to mediate

heir ligand-receptor interaction as deglycosylation of RAGE (a pro-ess that eliminates glycans from the receptor) almost completelybolished S100A8/A9 binding (Turovskaya et al., 2008).

S100A8/A9 is also an endogenous ligand for TLR4. In an in vitrourface plasmon resonance study, it was demonstrated that thisrotein complex binds directly to TLR4 with a binding affinity ofd 1.1–2.5 × 10−8 M (Vogl, 2007). The interaction was found to bepecifically mediated via S100A8 binding to MD2, a component ofhe TLR4 signalling complex. Further evidence that the S100A8/A9rotein signals via TLR4 come from studies which show that block-

ng TLR4 with a small molecule inhibitor such as TAK-242 or usingene knockout mice almost completely suppress S100A8/A9 cellu-ar responses (Schelbergen et al., 2012; van Lent et al., 2008a).

Despite evidence for TLR4 as a signalling receptor for the100A8/A9 complex, little is known about the physiochemical basisf this ligand-receptor interaction. Structural studies are neededo characterize the physicochemical interaction, and to identifyLR-binding sites in the heterodimeric structure of S100A8/A9 pro-ein. Furthermore, since glycans seem to be essential in mediating100A8/A9 binding to RAGE, it is also important to investigatehether glycans expressed on TLR4 also mediate ligand-receptor

inding between S100A8/A9 protein and TLR4.Of note, a recent in vitro study directly compared the S100A8/A9

nteraction with TLR4 and RAGE and found that RAGE but notLR4 associates with S100A8/A9 protein in colon tumour cells, buthe mechanisms underlying this selective ligand-receptor bindingere not determined (Ichikawa et al., 2011). RAGE has a three-foldigher binding affinity to S100A8/A9 protein than TLR4 suggest-

ng this may be one factor, but it is also possible that bindingnd preferential activation of specific receptors depends on theathophysiological conditions, cell type and ligand concentrationsTurovskaya et al., 2008; Vogl, 2007). Indeed, there is evidence that100A8/A9 interaction with RAGE is associated with inflammation-ediated carcinogenesis whereas its interaction with TLR4 is

ssociated with inflammatory processes in autoimmune disordersnd infection (Schelbergen et al., 2012; van Lent et al., 2008a; Vogl,007). However, there is a study which shows that TLR4-deficientice are protected against S100A8/A9-induced tumours, suggest-

ng this is not so clear cut (Fukata et al., 2007; Hiratsuka, 2008).urther studies are needed to determine whether there is conver-ence between RAGE and TLR4 in response to S100A8/A9 proteinn different pathophysiological conditions.

.3. Lipopolysaccharides (LPS)

LPS, the major constituent of the cell wall of Gram-negativeacteria is composed of polysaccharides attached to a lipid com-onent known as lipid A, which mediates its biological activity.PS was first demonstrated to signal via TLR4 in the late 1990s.he evidence came from a study using C3H/HeJ and C57BL/10ScCRice which were observed to be insensitive to the effects of

PS. Inquiry into the genetic basis revealed that C3H/HeJ and57BL/10ScCR mice had a single point mutation in the TLR4 genet amino acid residue 712 (pro712his) or a complete absence of

LR4 mRNA expression (Poltorak et al., 1998). Consistent withhese results, TLR4-deficient mice also failed to respond to LPS,Hoshino et al., 1999), while a potent synthetic lipid A antagonistnhibited TLR4-mediated NF-�B activation and subsequent cellular

unology 56 (2013) 739– 744

responses in vitro (Chow et al., 1999). Structural and biochemi-cal analyses have demonstrated that several molecules, includingLPS binding protein (LBP), glycoprotein CD14 and an extracellu-lar adaptor protein MD2 are all required to assist LPS transfer andrecognition by TLR4. MD2 binds to TLR4 on the cell surface beforeLPS binding takes place and this binding occurs via extracellularleucine–rich repeats in TLR4 (Visintin et al., 2003). CD14, togetherwith the lipid transfer molecule, LBP, then bring LPS into closeproximity and facilitates LPS transfer to the pre-formed TLR4-MD2complex (da Silva Correia et al., 2001; Jiang et al., 2000). LPS specif-ically interacts with MD2 via positive amino acid residues (Lys 128and 132) in the MD2 structure, leading to the formation a stablecomplex, which in turn promotes TLR4 aggregation and activationof the receptor.

There is evidence to suggest that the 3D-conformation ofthe LPS molecule determines the receptor binding and associ-ated cellular responses. LPS with conically shaped lipid A derivedfrom Escherichia coli and Salmonella spp. binds TLR4, inducingstrong inflammatory responses. Interestingly, however, cylindri-cally shaped lipid A derived from several bacteria including P.gingivalis can bind and activate TLR2, but induces less potentinflammatory responses (Netea et al., 2002). Indeed, while somestudies have shown that LPS interacts with TLR2, it is not clearwhether this plays an important role in the biological response toLPS in vivo (Beutler, 2000; da Silva Correia et al., 2001; Hirschfeldet al., 2000).

Of note, recent studies demonstrate that LPS can also interactwith RAGE. Using surface plasmon resonance assays, it was shownthat LPS isolated from E. coli can bind directly to RAGE with a meanKd of ∼35 nM (Yamamoto et al., 2011). The binding was furtherconfirmed in a plate competition assay and LPS was found to dosedependently and competitively inhibit the binding of another RAGEligand, AGE-BSA to the receptor. LPS associates with RAGE throughthe V-domain of the RAGE ligand-binding domain, and interest-ingly, this interaction does not require other partner molecules as isthe case with TLR4. Importantly, LPS binding to RAGE induced sim-ilar cellular responses as that seen with TLR4 binding both in vitroand in vivo. While it is unknown whether TLR4 and RAGE cooperatewith each other in response to LPS or whether only one receptor isactivated at one time, a study demonstrates that LPS when in com-plex with another ligand such as HMGB1, requires co-activation ofboth RAGE and TLR4 (Qin et al., 2009).

3. Conclusion and future perspectives

It is clear from the evidence at hand, that common TLR/RAGEligands may bind preferentially to one receptor versus the otherunder certain physiological or pathological conditions, but thefactor(s) which determine this – be it the cell type, ligand con-centration or molecular state of the ligand or receptor is stilllargely unknown. Certainly, structural and biochemical studieshave guided us towards a better understanding of the physico-chemical basis mediating RAGE and TLR interactions with theirligands. However, examination of the current literature exposessignificant gaps in knowledge. That is, to what extent do the physio-chemical properties of pathogen- or damage-associated molecularpatterns determine their preferential interaction with TLRs versusRAGE; and by the same token, to what extent do physiochemicalproperties of RAGE and TLRs promote selective or co-interactionwith their common ligands.

Moving forward, there is much that is still yet to be donein terms of understanding TLR and RAGE interactions with their

common ligands, and the mechanisms of their cross-talk or syn-ergy when engaged by common ligands. Specifically, the factorsthat allow discrimination or promote collaboration between RAGEand TLR signalling need to be determined. It is not until we have
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chieved this that it will be possible to fully understand the rolef these receptors in homeostasis and host defence. While muchf the research to date has focussed on the signalling pathwaysctivated down-stream of TLR/RAGE ligation, future efforts in thiseld should focus on the physiochemical determinants of TLR/RAGEignalling under both physiological and pathological conditions.

Further biochemical and structural studies are clearly necessaryo uncover TLR and RAGE binding regions within the moleculartructure of their common and distinct ligands. This would assisturther elucidation of unresolved RAGE- or TLR-ligand interactionsnd provide new direction for pharmacological interventions thatay discriminate between these receptor pathways in the context

f certain diseases.

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