Respiratory epithelial cells are constantly under oxidative stress caused by exposure to molecular oxygen and inhaled oxidizing pollutants. Despite strong evidence that Bcl-XL, an antiapoptotic protein encoded by the Bcl-X gene, protects cultured cell lines against hyperoxia-induced cell death, its role in proper lung development and protection against oxidative stress in vivo is not known. Here we provide evidence Bcl-XL is the predominant isoform expressed in the lung, and confirm through Cre-mediated recombination that it functions to protect the respiratory epithelium in vivo against hyperoxia-induced cell death. Although loss of Bcl-XL did not noticeably disrupt lung function or development, perinatal lethality was observed in some mice, leading us to consider that Bcl-XL may protect against the oxidative damage caused by exposure to ambient air at birth. Indeed, exposure to room air at birth oxidizes DNA, much like the exposure of adults to hyperoxia. Our findings confirm that Bcl-XL protects the respiratory epithelium against hyperoxia, and provide new evidence that it may serve to protect against oxidative damage created as the lung transitions to ambient air at birth.
The
Bcl-X gene encodes multiple isoforms created by alternative splicing of RNA transcripts generated from multiple promoters (
21). Whereas Bcl-X
S, Bcl-X
β, and Bcl-Xγ promote apoptosis, Bcl-X
L and Bcl-X
ΔTM possess antiapoptotic activities. Although it remains unclear how promoter choice and alternative splicing control the expression of individual isoforms, they are required for the proper development of some tissues. For instance, germline ablation of the
Bcl-X gene causes massive apoptosis of postmitotic neurons of the brain, spinal cord, and dorsal root ganglion (
22). Shortened lifespans of immature lymphocytes are also seen, and the mice die by Embryonic Day 13. Erythroid-specific ablation using mouse mammary tumor virus-long terminal repeat/Cre driver mice causes the hyperproliferation of megakaryocytes and immature erythroid cells, and hemolytic anemia by age 3 months (
24). These deficits could be rescued by simultaneously ablating Bax. The conditional deletion of
Bcl-X in mammary epithelium caused accelerated apoptosis of the epithelium during involution, but increased apoptosis could not be reduced by deleting Bax (
25). The inability to rescue mammary gland development by deleting Bax implies that erythroid and mammary cells express different isoforms of the
Bcl-X gene, or that Bcl-X
L acts to block Bax in some cell types and not in others. Regardless, we found that normal lung development and function was unaffected by ablation of the
Bcl-X gene in the respiratory epithelium. Because Bcl-X
L was the only isoform detected in respiratory epithelium, this suggests that apoptosis (e.g., the low levels of apoptosis seen in postnatal rats) may not be absolutely required for specifying proper lung development and function (
35). Alternatively, the apoptosis of epithelial cells is important for lung maturation, but the process does not involve Bcl-X
L.
On the other hand, loss of Bcl-X
L increases the sensitivity of respiratory epithelium to hyperoxia, as defined according to TUNEL staining and histologic features of cell necrosis. Because biotin was not used to amplify staining, the number of TUNEL-positive cells reported here was much lower than in previous studies (
31,
34,
36). Because TUNEL staining during hyperoxia is associated with oxygen-induced DNA strand breaks, the omission of biotin allowed us to identify those cells with the most severe DNA damage as they died (
31). The increased number of TUNEL-positive but not 8-oxoguanine–positive cells in hyperoxic mice lacking Bcl-X
L suggests that Bcl-X
L protects against signals coming from DNA damage (e.g., p53, Puma, Noxa, or Bak) that promote cell death and hence the degradation of DNA (
37–
39). Our findings in mice lacking Bcl-X
L confirm studies in mouse-lung epithelial MLE12 cells, Rat1a fibroblasts, and
p21-deficient HCT116 colon carcinoma cells, showing that the overexpression of Bcl-X
L protects against hyperoxia-induced Bax activation and cell death (
7,
14,
40). The overexpression of Bcl-X
L does not protect A549 human lung adenocarcinoma cells against hyperoxia (
11). However, this is because A549 cells express the cell-cycle–inhibitor p21, which delays the loss of Bcl-X
L during exposure (
10,
41). Unlike findings in
p21-deficient mice exposed to hyperoxia (
42), increased alveolar–capillary membrane permeability and mortality were not evident in mice lacking the epithelial expression of Bcl-X
L. This finding implies that alveolar–capillary membrane permeability, at least for this length of exposure, is not affected by injury to the respiratory epithelium. This is consistent with histologic observations that microvascular endothelial cells are more sensitive to hyperoxia, and their loss leads to increased vascular permeability and mortality (
43–
45).
Although Bcl-X
L is not required for proper lung development, our study suggests that it protects the developing lung from oxidative damage as it becomes exposed to ambient air at birth. This is a critical period during which the lung undergoes oxidative stress as it transitions from a relatively hypoxic
in utero to an oxygen-rich
ex utero environment. Although oxidative damage attributed to exposure to room air at birth has not been extensively studied, plasma levels of F2-isoprostanes are high in early human infants, and decline by 6 months of age (
46). The elevated expression of antioxidant defense enzymes, as reported in newborn rats, is thought to protect against such oxidative stress (
47,
48). Consistent with this idea, the targeted overexpression of manganese-superoxide dismutase or extracellular-superoxide dismutase to the respiratory epithelium protects the developing lung against hyperoxia (
49,
50). However, mice lacking these enzymes are normal, implying a redundancy in antioxidant defense mechanisms required for adaptation of the lung to oxygen (
3). However, the present study indicates that these antioxidant defense mechanisms are insufficient to block oxidative stress fully, because increased 8-oxoguanine lesions were evident in newborn mice. Instead, antiapoptotic proteins such as Bcl-X
L appear to provide an additional line of defense by blocking apoptotic signals emanating from oxidized molecules such as DNA. Interestingly, 8-oxoguanine staining was both nuclear and cytoplasmic, because cytoplasmic staining was seen in newborn rats and adult mice exposed to hyperoxia (
31,
51). This may reflect the oxidation of mitochondrial DNA, because 8-oxoguanine staining in mice colocalized to cytochrome-C oxidase subunit 1. Intriguingly, mitochondrial dysfunction was recently associated with arrested lung development in newborn mice exposed to hyperoxia, and Bcl-X
L functioned to maintain mitochondrial homeostasis (
52,
53). Although levels of Bcl-X
L were similar in newborn and adult mice (data not shown), targeting additional levels to developing lungs exposed to hyperoxia may provide a novel therapy for preventing BPD.
The loss of Bcl-X
L by itself shifted the lung toward a proapoptotic state, as defined by a reduction in antiapoptotic Mcl-1 and an increase in proapoptotic Bak. These were selective changes, because the expression of Bcl-2 and Bax were unaffected. How the loss of Bcl-X
L affected the expression of Mcl-1 and Bak is unclear. Studies on the effects of germline or Cre-mediated ablation of Bcl-X
L in other tissues did not investigate how loss of Bcl-X
L affected the expression of other members of the Bcl-2 family (
22–
25). The silencing RNA knockdown of Bcl-X
L in cell lines (A549, H1299, and HCT116) does not affect the expression of Mcl-1 or Bak (unpublished observations). On the other hand, similar changes in expression of these Bcl-2–related proteins were seen when these cell lines were exposed to hyperoxia (
10,
11,
14,
41). This implies that the Bcl-2 rheostat of the respiratory epithelium was shifted in
Cre +:
Bcl-Xfl/fl mice as if they were already in a state of hyperoxia. Viewed this way, it may be less surprising to find that they are hypersensitive to hyperoxia or even oxygen exposure at birth. Although additional studies are needed to understand how Bcl-X
L maintains the expression of Mcl-1 and Bak, Bcl-X
L should be considered equivalent in importance to antioxidants for defending the respiratory epithelium against oxidative damage created by inhaled pollutants or oxygen at birth.
A limitation of this study was our inability to generate a line of mice lacking epithelial Bcl-X, and we have no explanation for this failure. The Sftpc–Cre and unfloxed Bcl-X lines of mice breed in a normal Mendelian manner, and produced the expected F1 progeny when bred together. Although viable F2 mice were obtained, we were unsuccessful at generating a line of mice using five independent mating pairs. One pair produced F3 progeny, but only once, and pregnancy was never observed in the other pairs. Thus, the present study was largely performed on a limited number of F2 mice obtained from F1 heterozygote matings. A remote but possible explanation is that Cre expression is “leaky” in the germline. Indeed, as these studies were nearing completion, we learned that some germline leakiness was observed (personal communication with Barry Stripp at Duke University). Although it remains to be determined whether that was responsible for our failure to create a line of mice, enough mice were created for us to conclude that Bcl-XL protects respiratory epithelial cells against oxidative damage when oxygen tensions increase, but is not required for proper lung development.