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REVIEW ARTICLE
Structural andfunctionalspecificitiesofPDGF-C and
PDGF-D, thenovelmembersoftheplatelet-derived growth
factors family
Laila J. Reigstad
1,2
, Jan E. Varhaug
2,3
and Johan R. Lillehaug
1
1 Department of Molecular Biology, University of Bergen, Norway
2 Department of Surgical Sciences, University of Bergen, Norway
3 Haukeland University Hospital, Bergen, Norway
Introduction
The platelet-derivedgrowthfactors PDGF-A and -B
have since the late 1970s been recognized as important
factors regulating embryonic development, differenti-
ation, cell growthand many diseases including malig-
nancies. The PDGFs have been classified as members
of the superfamily ofgrowthfactors characterized by
the strongly conserved pattern of six cysteine residues
making up intra- and intermonomer disulfide bridges,
the cystine knot familyof proteins [1–3]. Examples of
cystine knot subfamilies are the glycoprotein hormone
family [4], the cyclotide family [5,6], andthe TGFb
family and NGF family [2]. Extended information
about subfamilies can be obtained in the Cystine Knot
Database (http://hormone.stanford.edu/cystine-knot).
This review focuses on the structure and function of
the two novel members, PDGF-Cand -D, of the
PDGF subfamily ofthe cystine knot superfamily. The
PDGFs show high sequence identity with the vascular
Keywords
PDGF; cystine knot; CUB; growth factor
domain
Correspondence
J. R. Lillehaug, Department of Molecular
Biology, University of Bergen, Post Box
7800, 5020 Bergen, Norway
Fax: +47 55 58 96 83
Tel: +47 55 58 64 21
E-mail: johan.lillehaug@mbi.uib.no
(Received 15 July 2005, revised 19
September 2005, accepted 22 September
2005)
doi:10.1111/j.1742-4658.2005.04989.x
The platelet-derivedgrowth factor (PDGF) family was for more than
25 years assumed to consist of only PDGF-A and -B. The discovery of the
novel familymembersPDGF-Cand PDGF-D triggered a search for novel
activities and complementary fine tuning between themembersof this fam-
ily ofgrowth factors. Since the expansion ofthe PDGF family, more than
60 publications on thenovelPDGF-Cand PDGF-D have been presented,
highlighting similarities and differences to the classical PDGFs. In this
paper we review the published data on the PDGF family covering struc-
tural (gene and protein) similarities and differences among all four family
members, with special focus on PDGF-Cand PDGF-D expression and
functions. Little information on the protein structures ofPDGF-Cand -D
is currently available, but thePDGF-C protein may be structurally more
similar to VEGF-A than to PDGF-B. PDGF-C contributes to normal
development ofthe heart, ear, central nervous system (CNS), and kidney,
while PDGF-D is active in the development ofthe kidney, eye and brain.
In adults, PDGF-C is active in the kidney andthe central nervous system.
PDGF-D also plays a role in the lung and in periodontal mineralization.
PDGF-C is expressed in Ewing family sarcoma and PDGF-D is linked to
lung, prostate and ovarian cancers. Both PDGF-Cand -D play a role in
progressive renal disease, glioblastoma⁄ medulloblastoma and fibrosis in
several organs.
Abbreviations
CNS, central nervous system; CUB, Clr ⁄ Cls, urchin EGF-like protein and bone morphogenic protein 1; CVB3, coxsackievirus B3;
EGF, endothelial growth factor; PDGF, platelet-derivedgrowth factor; VEGF, vascular endothelial growth factor.
FEBS Journal 272 (2005) 5723–5741 ª 2005 The Authors Journal compilation ª 2005 FEBS 5723
endothelial growthfactors (VEGF) andthefamily is
therefore often referred to as the PDGF ⁄ VEGF
family.
The PDGF familyofgrowth factors
The PDGF family consists of PDGF-A, -B, -C and -D
[7–12]. The cystine knot motif ofthe four PDGFs
contains two disulfide bridges linking the antiparallel
strands ofthe peptide chain forming a ring penetrated
by the third bridge [3]. This forces the protein to adapt
a three-dimensional arrangement that partly exposes
hydrophobic residues to the aqueous surroundings,
leading to the formation of either homo- or hetero-
dimers (PDGF-AA, -AB, -BB, -CC, -DD) [13,14]. In
addition to a conserved cystine knot motif, these four
growth factors show a high sequence identity. The four
PDGFs are inactive in their monomeric forms. They
share the same receptors; the PDGF receptor-a and -b.
These receptors dimerize when the dimeric PDGF
binds. The receptors may combine to generate homo-
or heterodimers, resulting in three possible combina-
tions, PDGFR-aa,-ab and -bb, having different
affinities towards the four PDGFs.
All PDGFs play important roles in embryogenesis
and adult maintenance, in addition to participating in
the phenotypes of various diseases and malignancies.
The novel PDGFs are both involved in progressive
renal diseases, glioblastomas, medulloblastomas and
fibrosis of a variety of tissues. PDGF-C appears to
play an important role in Ewing family sarcomas,
while PDGF-D is linked to lung, prostate and ovarian
cancers.
Discovery ofthe PDGFs
PDGF-A and PDGF-B have been extensively studied
since the 1970s, while PDGF-Cand PDGF-D were
discovered recently. ThePDGF-c gene was published
in 2000 by three independent groups and named
PDGF-C [8], Fallotein [15] and SCDGF [7]. In each
case, the discovery was based on the identification of a
cDNA sequence showing similarity to members in the
PDGF ⁄ VEGF familyofgrowth factors. PDGF-c and
PDGF-C are now the accepted name for this gene and
protein, respectively.
The last member ofthe PDGF family was published
in 2001, again by three independent groups, and
named PDGF-D and SCDGF-B [10–12]. The gene was
identified by BLAST search in the EST database for
homologues ofthe PDGF ⁄ VEGF family. PDGF-d and
PDGF-D are now the accepted names for this gene
and protein, respectively.
The pdgf genes
PDGF-c and PDGF-d were named and placed in the
PDGF ⁄ VEGF family because they encode the highly
conserved cystine knot motif characteristic of the
growth factor family. While the classical PDGF-a and
PDGF-b mainly encode thegrowth factor domain,
PDGF-c and PDGF-d encode a unique two-domain
structure with an N-terminal ‘Clr ⁄ Cls, urchin endo-
thelial growth factor (EGF)-like protein and bone
morphogenic protein 1’ (CUB) domain [16] in addition
to the C-terminal growth factor domain (Fig. 1A).
The pdgf genes are located on four different chromo-
somes; PDGF-a and -b on chromosomes 7 and 22
[17,18], andPDGF-cand -d on chromosomes 4 and 11
[19], respectively. The genomic organization ofthe pdgf
genes is quite similar, although PDGF-cand -d genes
are significantly longer due to large intron sizes and
cover about 200 kb compared to approximately 20 kb
for PDGF-a and -b [19–21].
Each ofthe four pdgf genes contains a long 5¢
untranslated region and a verified (PDGF-a and -b)or
putative (PDGF-c and -d) signal peptide in exon 1
(Fig. 1B). In thePDGF-cand -d genes, exons 2 and 3
encode the CUB domains, while in PDGF-a and -b
these exons encode precursor sequences residing 5¢ to
the cystine knot encoding sequence. The hinge regions
of PDGF-cand PDGF-d connecting the CUB and the
cystine knot domains are encoded by exons 4 and 5,
respectively. These hinge region sequences encode con-
served basic motifs and similar motifs are found in
PDGF-A and -B. The motifs are identified as proteo-
lytic cleavage sites for proteases used in post-transla-
tional protein processing. Exon 4 of PDGF-d encodes
a unique sequence not present in the other PDGFs. So
far, no function has been assigned to this sequence.
The exons in PDGF-c (exons 5 and 6) and PDGF-d
(exons 6 and 7) encoding the cystine knot motifs
resemble the corresponding exons in the PDGF-a and
-b (exons 4 and 5) genes. Both in PDGF-a and -b, exon
6 encodes a C-terminal basic retention sequence that
may be removed during the maturing and release of
the proteins. Analysis on the 3¢ untranslated mRNA
region ofPDGF-C identified five adenylate ⁄ uridylate-
rich elements, these being the best characterized mam-
malian determinant for highly unstable RNAs [15].
The pdgf promoters
PDGF-A and -C share common mechanisms of gene
regulation. Their expression is controlled by the zinc
finger transcription factors Egr1 and Sp1, which have
affinity for overlapping GC-rich binding sites in the
PDGF-C and -D, structure and function L. J. Reigstad et al.
5724 FEBS Journal 272 (2005) 5723–5741 ª 2005 The Authors Journal compilation ª 2005 FEBS
proximal region ofthe PDGF-a and PDGF-b promot-
ers [22,23]. So far, no information on the PDGF-d
promoter has been published, but functional character-
istics ofthe human PDGF-c promoter has been repor-
ted [24]. Comparison ofthePDGF-c promoter of
human smooth muscle cells with the characterized
human PDGF-a promoter identified a GC-rich
sequence ()35 to )1) in PDGF-c, with high similarity
to the )76 to )47 sequence ofthe PDGF-a promoter.
Both Egr1 and Sp1 were shown to bind the 35 bp
sequence ofthePDGF-c promoter. FGF-2 stimulates
Egr1 expression through the Erk ⁄ MAPK pathway,
and Egr1 translocates to the nucleus where it binds to
the proximal PDGF-c promoter resulting in increased
PDGF-C expression.
Alternative splicing ofthe PDGFs
No alternative splicing ofPDGF-c mRNA has been
demonstrated. However, alternative splicing is sugges-
ted because two shorter PDGF-C cDNAs have been
obtained [25]. Based on the variant PDGF-c sequences
isolated by PCR, the splice donor ⁄ acceptor sites are
located to nucleotides 719 ⁄ 720 and 988 ⁄ 989, resulting
in two alternative proteins; one short variant encom-
passing almost only the CUB domain, andthe longer
variant containing the CUB domain andthe final 30
residues in the C-terminal end ofthegrowth factor
domain. These splice variants are also present in
human thyroid papillary carcinomas (L. J. Reigstad,
J. E. Varhaug and J. R. Lillehaug, unpublished results).
Based on mRNA analysis ofPDGF-d, splice variants
have been reported to be present in mouse heart, liver
and kidney [26]. Interestingly, deletion of exon 6 cau-
ses a frame shift and an early stop codon in exon 7,
resulting in a protein lacking thegrowth factor domain
and without mitogenic activity (Fig. 1B). The PDGF-
D protein encoded by this splice variant could only be
detected in mouse tissues and not in human cell lines
or tissues. A second PDGF-d RNA splice variant lacks
A
B
Fig. 1. PDGF protein and gene structure.
(A) Schematic drawing ofthe four full-length
PDGF proteins. In PDGF-Cand -D, the
hydrophobic putative N-terminal signal pep-
tide (black) is separated from the N-terminal
CUB domain (110 residues, red) by a short
region (orange). A hinge region (blue) separ-
ates the CUB domain from the C-terminal
growth factor domain containing the cystine
knot motif (115 residues, yellow). PDGF-A
can be alternatively spliced and carries two
stop codons resulting in proteins of 198 and
211 amino acid residues. The numbers
show residue numbering in the PDGFs.
(B) Schematic drawing of gene structures
encoding the four PDGF polypeptide chains.
Exons are coloured and numbered: CUB
domain (red), hinge region (blue) and growth
factor domain (yellow). The introns are
shown in white. Start codons (ATG), stop
codons (Stop) andthe proteolytic cleavage
sites (black arrows) are denoted. Exons and
introns are not drawn in scale. The PDGF-A
and -B genes cover approximately 20 kb and
the PDGF-Cand -D cover approximately
200 kb. Alternative splicing has been shown
for PDGF-A andPDGF-D, in which exon 6 is
missing (see text).
L. J. Reigstad et al. PDGF-Cand -D, structure and function
FEBS Journal 272 (2005) 5723–5741 ª 2005 The Authors Journal compilation ª 2005 FEBS 5725
18 bp within the CUB domain of both mouse and
human PDGF-D mRNA [26,27]. In the case of PDGF-a,
exon 6 may be present or not resulting in two splice
variants encoding a long and a short PDGF-A protein
(Fig. 1B) [28]. PDGF-B mRNA has not been reported
to be alternatively spliced.
The PDGF proteins
The PDGF-A and -B proteins contain only the growth
factor domains whereas PDGF-Cand -D have a
unique two-domain structure containing the N-ter-
minal CUB domain separated from the C-terminal
growth factor domain by a hinge region (Fig. 1A).
PDGF-C and -D share an overall sequence identity of
42% with highest similarity in the CUB and cystine
knot-containing growth factor domain, whereas the
hinge region andthe N-terminal region show less
identity [10,12].
While PDGF-A and -B can form both homo- and
heterodimers (PDGF-AA, -AB, -BB), PDGF-Cand -D
exist only as homodimers (PDGF-CC and -DD). The
full-length PDGF-Cand -D monomers are 54–55 kDa
and 49–56 kDa, respectively, differing from their theo-
retical sizes of 39 and 43 kDa based on their amino
acid sequences [8,12,29]. The divergence from the
theoretical values indicates that PDGF-Cand -D may
be post-translationally modified. In addition to being
secreted to the extracellular space, the PDGF-C
protein is shown to be constitutively expressed in the
cytoplasm in rat smooth muscle cells residing in
arteries and arterioles [30]. Additionally, our data
(L. J. Reigstad, J. E. Varhaug and J. R. Lillehaug,
unpublished results) show full-length PDGF-C to be
present in both the cytoplasm and nucleus, a feature
also described for PDGF-B [31,32]. The function of
these two PDGFs in the nucleus is unclear.
The region N-terminal ofthe CUB domain in
PDGF-C and PDGF-D
The N-terminal ends of both PDGF-Cand -D contain
a hydrophobic sequence predicted to be a signal pep-
tide with a putative peptidase cleavage site between
residues 22 and 23 [8,10,12]. When part ofthe putative
PDGF-C signal sequence was deleted no mitogenic
activity was detected, suggesting that PDGF-C is secre-
ted by the aid of this N-terminal region [7]. The
sequence between residues 23 and 50 of PDGF-C, and
residues 23–56 ofPDGF-D, contain no known motifs
or domains (Fig. 1).
The CUB domain ofPDGF-Cand PDGF-D
The CUB domain was first identified in complement
subcomponents Clr ⁄ Cls, urchin EGF-like protein and
bone morphogenic protein 1 [16]. These proteins are
often referred to as the prototype CUB domains. Like
the prototype CUB domains, thePDGF-Cand -D
CUB domains span approximately 110 residues and
show 27–37% and 29–32% sequence identity to the
prototypic CUB domains, respectively (Fig. 2) [8]. The
CUB domains ofPDGF-Cand -D share 55%
sequence identity. CUB domains are assembled as a
Fig. 2. The CUB domain. The CUB domains ofPDGF-Cand PDGF-D aligned with the prototype CUB domains of human neuropilin (acces-
sion no CAI40251) and human bone morphogenic protein-1 (BMP-1, accession no CAA69974). Red, squared areas highlight sequence iden-
tity among the sequences. The four cysteines conserved in the prototypical CUB domains are labelled in yellow. The two cysteines missing
in thePDGF-Cand PDGF-D are marked by red circles while the two cysteines present are marked in blue circles. The two cysteines of
PDGF-C (accession no AAF80597) correspond to Cys104 and 124, whereas in PDGF-D (accession no AAK38840) these cysteines are
Cys109 and 131.
PDGF-C and -D, structure and function L. J. Reigstad et al.
5726 FEBS Journal 272 (2005) 5723–5741 ª 2005 The Authors Journal compilation ª 2005 FEBS
compact ellipsoidal b-sandwich, with a hydrophobic
core essential for the overall domain folding. The
b-sandwich is built up of two five-stranded b-sheets of
antiparallel b-strands [33–36]. Most CUB domains are
reported to contain four conserved cysteines that form
two disulfide bridges between nearest-neighbour cyste-
ines, resulting in disulfide bridges located on opposite
edges ofthe domain. As both thePDGF-Cand -D
CUB domains contain only two cysteines [7] which,
compared to the classical CUB domains, are the two
most-C-terminally located cysteines, the CUB domains
of PDGF-Cand -D may have only one disulfide
bridge. At present it is unclear how this may influence
their 3D structure. In the two crystallised CUB
domains of a serine protease associated with serum
mannose-binding proteins (MAPS), the N-terminally
located CUB domain contains only one disulfide
bridge, while the second CUB domain of MAPS has
two bridges. One disulfide bridge instead of two may
result in a slightly less tight b-sandwich in the N-ter-
minally located CUB domain, but thestructural and
functional significance of only one bridge remains
unknown [35].
The CUB domain is found in several extracellular
proteins, many involved in development, and they are
thought to mediate protein–protein and protein–carbo-
hydrate interactions, in addition to binding to low-
molecular-mass ligands [16,37]. Several reports state
that the CUB domains ofPDGF-Cand -D have to be
cleaved extacellularly to make the C-terminal growth
factor domains active [8,10,12]. The CUB domains are
believed to prevent PDGF-Cand -D binding to their
receptors by structurally blocking receptor-binding res-
idues ofthegrowth factor domain. In contrast, two
reports state that full-length PDGF-Cand -D exhibit
in vitro mitogenic activity towards coronary artery
smooth muscle cells and fibroblasts [25,26]. Addition-
ally, the CUB domain ofPDGF-C exhibits mitogenic
activity on human coronary artery cells independent of
the presence of its growth factor domain, suggesting a
possible biological activity ofthe CUB domains them-
selves [25]. Interestingly, when Cys124 ofthe PDGF-C
CUB domain was mutated to serine, the mitogenic
activity of CUB was reduced by approximately 50%.
The mitogenic CUB activity could not be confirmed in
transgenic mouse hearts overexpressing CUB and over-
expression gave no pathological effect in the heart [38].
CUB domains may facilitate unique, undiscovered
functions of full-length PDGF-Cand -D. This is reflec-
ted in a report on full-length PDGF-D of eye lens tis-
sue, in which the secreted PDGF-D does not appear to
be proteolytically cleaved [39]. The CUB may mediate
interactions between PDGF-C or PDGF-D and
elements ofthe extracellular or pericellular matrix.
Furthermore, a role for the PDGF CUB domains in
receptor binding is suggested based on studies of the
transmembrane receptor, neuropilin-1, which consists
of two CUB domains and a coagulation factor
domain, acting as coreceptors for VEGF-A and sem-
aphorins (reviewed in [40]). Crystallography studies of
the MAPS protein containing two CUB domains sug-
gests that CUB domains may also participate in pro-
tein heterodimer formations [35].
The hinge region and proteolytic cleavage for
growth factor activation
The hinge regions ofPDGF-Cand -D, separating the
CUB andthegrowth factor domains (Fig. 1), show no
homology to known sequences [41] but contain dibasic
cleavage sites for proteolytic removal ofthe CUB
domains and thereby activation ofthegrowth factor
domains. PDGF-Cand -D contain both the CUB and
growth factor domains when they are secreted and pro-
teolytic cleavage is therefore suggested to take place
extracellularly. Plasmin cleaves PDGF-C at RKSR234
[8,41], and PDGF-D at RKSK257 [12]. Tissue plasmi-
nogen activatior (tPA) cleaved PDGF-C at RKSR234
in vivo [42,43] and urokinase plasminogen activator
(uPA) was found to cleave PDGF-D at RGRS250,
thereby activating this growth factor [44]. PDGF-A is
cleaved by furin at RRKR86 [45], while PDGF-B is
cleaved at RGRR81 by a still unidentified protease [46].
The PDGF growth factor domain
The determination ofthe crystal structure of nerve
growth factor [47], transforming growth factor b2 [48],
PDGF-BB [49] and chorionic gonadotropin [4]
revealed unexpected topological similarities among
these four proteins belonging to separate families of
growth factors. Despite very little sequence similarity,
they all contain an unusual arrangement of cysteines
linked in disulfide bridges to form a conserved cystine
knot motif [1,2,50]. The cystine knot is located in a
conserved b-sheet structure referred to as the growth
factor domain. Although the four growth factor super-
families have a common topology, they differ in the
number of disulfide bonds, the interfaces used to form
the dimers, andthe way in which the monomers dimer-
ize [1,2].
In the PDGF ⁄ VEGF family, the crystal structures
of PDGF-BB [49], VEGF-AA [51,52], VEGF-AA
together with elements of its Flt1 receptor [53], and
PlGF-1 dimer [54] have been solved at 3.0, 1.9, 1.7
and 2.0 A
˚
, respectively. Characteristic for these growth
L. J. Reigstad et al. PDGF-Cand -D, structure and function
FEBS Journal 272 (2005) 5723–5741 ª 2005 The Authors Journal compilation ª 2005 FEBS 5727
factor domains are two long, highly twisted antiparal-
lel pairs of b-strands in an antiparallel side-by-side
mode. They all contain eight (I–VIII) highly conserved
cysteines. The monomeric antiparallel b-strands are
connected by three loops, referred to as loops 1, 2 and
3 (Fig. 3A), and due to the head-to-tail arrangement,
loop 2 of one monomer will be close to loops 1 and 3
of the other monomer when the dimer is formed
(Fig. 3B). Six ofthe conserved cysteines are engaged in
three intrachain disulfide bonds (Cys I-VI, III-VII,
V-VIII) stabilizing the cystine knot structure, while
two cysteines (Cys II and IV) are involved in inter-
chain disulfide bonds (Fig. 3C,D) [55,56]. The three
intrachain disulfide bonds makes the cystine knot very
Fig. 3. ThePDGF-Cgrowth factor domain.
Ribbon presentations ofthe proposed
PDGF-C model [57] displaying the twisted
b-sheets andthe N-terminal a-helix of the
PDGF-C monomer (A) andthe PDGF-CC
dimer (B). The N-terminal (N) and C-terminal
(C) ends for the monomer are marked. The
three loops (loop 1-2-3) connecting the
b-strands are labelled. (C, D) Sequence
alignments ofthegrowth factor domains of
PDGF-A (accession no P15692), PDGF-B
(accession no. 1109245 A), PDGF-C (acces-
sion no AAF80597), PDGF-D (accession
no AAK38840), VEGF-A (accession no
NP003367) and PIGF-1 (accession no.
1FZV). Red, squared areas show sequence
identity among the sequences. The eight
conserved cysteines are shown in yellow.
The extra cysteines ofPDGF-Cand -D are
labelled in blue. The green squares highlight
the area of disagreement in sequence align-
ment (see text). (C) Sequence alignment of
PDGF ⁄ VEGF familymembers where the
green square highlights the area containing
the insert of three residues between con-
served cysteines III and IV in both PDGF-C
and -D, and that PDGF-D is missing the con-
served cysteine V. (D) Sequence alignment
of PDGF ⁄ VEGF familymembers showing
PDGF-C and -D to contain all eight con-
served cysteines and have an insert of three
residue between cysteine V and VI (green
area).
PDGF-C and -D, structure and function L. J. Reigstad et al.
5728 FEBS Journal 272 (2005) 5723–5741 ª 2005 The Authors Journal compilation ª 2005 FEBS
stable as the first (Cys I-VI) and second (Cys III-VII)
disulfide bonds link two adjacent b-strands, making a
ring which is penetrated by the third (Cys V-VIII)
disulfide bond, covalently connecting two further
b-strands [49,54]. Additional stability to the dimer
structure is the extensive hydrophobic core formed by
residues from both monomers.
The PDGF-Cgrowth factor domain shares 27–35%
sequence identity with the rest ofthe PDGF ⁄ VEGF
family [8], and with specific reference to the other three
PDGFs the identity is nearly 25% [20]. The growth
factor domains of PDGF-A and -B show approxi-
mately 50% sequence identity, while the identity
between the domains ofPDGF-Cand -D is also nearly
50%.
Compared to the eight conserved cysteines in PDGF-
A and -B, PDGF-C contains four and PDGF-D
two additional cysteines. These extra cysteines and the
lack of solved PDGF-Cand -D 3D structures makes
identification ofthe cysteines that participate in the
conserved disulfide bridges difficult. Because of this,
two different sequence alignments ofPDGF-Cand -D
covering the area of conserved cysteines III to VI are
included here (Fig. 3C,D). Figure 3C shows the align-
ment ofPDGF-Cand -D to allow three residues
(NCA and NCG, respectively) between conserved
cysteines III and IV, an insert not present in the other
members ofthe PDGF ⁄ VEGF family. This alignment
also indicates that PDGF-D lacks the conserved cys-
teine V [7,8,10,12,15,25,57]. The alignment in Fig. 3D
has a different three-residue insert, which is located
between conserved cysteines V and VI. In this align-
ment, PDGF-D contains all eight conserved cysteines
of the cystine knot motif [20,21,41]. Crystallization or
NMR studies ofPDGF-Cand -D proteins will resolve
this debate, but our published 3D model of the
PDGF-C growth factor domain indicates the disulfide
bridges in PDGF-C to consist of Cys250 and 294,
Cys280 and 335, and Cys287 and 337, andthe inter-
monomeric bonds to consist of Cys274 and 286 [57].
At present, analysis of PDGF ⁄ VEGF domains show
that PDGF-C is more similar to VEGFs than PDGFs
[8,15,57], all in all favouring the alignment in Fig. 3C.
The region C-terminal ofthegrowth factor
domain
In PDGF-A and -B, the C-terminal regions contain a
basic sequence with a dual function. First, the
sequence mediates electrostatic interactions with com-
ponents ofthe extracellular matrix such as heparin [58]
and collagens [59]. Second, the basic sequence may
cause retention ofthegrowthfactors within the produ-
cer cell [60]. PDGF-C is shown to have a heparin-
binding domain in the C-terminal region ofthe growth
factor domain but the exact residues responsible for
the binding have not been identified [25]. PDGF-D has
not been shown to bind heparin.
Post-translational modifications and regulations
of PDGFs
Several membersofthe PDGF family are predicted to
have potential N-glycosylation sites. PDGF-C has
three predicted N-glycosylation sites (N25, 55, 254),
the last residing in thegrowth factor domain [8]. Due
to the difference in expected (39 kDa) and observed
(55 kDa) relative molecular mass as determined by
SDS ⁄ PAGE electrophoretic mobility, it has been sug-
gested that PDGF-C may be glycosylated. One report
gives experimental indication of glycosylation, recom-
binant full-length PDGF-C protein, secreted from
insect cells, slightly changed mobility when treated
with N-glycosidase F, but the mobility change did not
result in the expected 39 kDa protein size [25]. PDGF-
D has one predicted N-glycosylation site at N276
located in thegrowth factor domain [12] and PDGF-B
has a verified N-glycosylation site at N63 [61]. PDGF-
A has one predicted N-glycosylation site at N134 but
is not reported to be N-glycosylated [62], despite a
report from 1981 in which PDGF was stated to be
glycosylated [63]. In the case of PDGF-C, the post-
translational modification remains unidentified but
SUMOylation or ubiquitinylation may be candidates.
Receptor binding of PDGFs
The PDGFs bind to the protein tyrosine kinase
receptors PDGF receptor-a and -b. These two recep-
tor isoforms dimerize upon binding the PDGF
dimer, leading to three possible receptor combina-
tions, namely -aa,-bb and -ab. The extracellular
region ofthe receptor consists of five immunoglo-
bulin-like domains while the intracellular part is a
tyrosine kinase domain. The ligand-binding sites of
the receptors are located to the three first immuno-
globulin-like domains (reviewed in [64]). The residues
in PDGF-A and -B responsible for receptor binding
reside in loop 2, in addition to RKK161 in PDGF-
AA and R27 and I30 in PDGF-BB. The residues
involved in PDGF-CC and -DD receptor binding
remain to be identified, but our published 3D model
of PDGF-C suggests, when compared to the crystal
structure of VEGF-AA complexed to domain 2 of
its receptor, that the region containing residues
W271 and LR312 might be involved [57].
L. J. Reigstad et al. PDGF-Cand -D, structure and function
FEBS Journal 272 (2005) 5723–5741 ª 2005 The Authors Journal compilation ª 2005 FEBS 5729
PDGF-CC specifically interacts with PDGFR-aa and
-ab, but not with -bb, and thereby resembles PDGF-
AB [8,41]. PDGF-DD binds to PDGFR-bb with high
affinity, and to PDGFR-ab to a markedly lower extent
and is therefore regarded as PDGFR-bb specific [10,12].
PDGF-AA binds only to PDGFR-aa, while PDGF-BB
is the only PDGF that can bind all three receptor
combinations with high affinity [65]. Both PDGF-CC
and -DD activate PDGFRs resulting in downstream
phosphorylation of extracellular signal-regulated pro-
tein kinase ⁄ mitogen-activated protein kinase (Erk⁄
MAPK) and Akt ⁄ PKB pathways [57,66,67].
Fine tuning of PDGF and PDGFR isoform
expression and regulation
Expression of both receptors and each ofthe four
PDGFs is under independent control, giving the
PDGF ⁄ PDGFR system a high degree of combinatorial
flexibility. To understand how the four PDGFs may
generate different biological signals, five observations
may be relevant. First, different cell types vary greatly
in the ratio of PDGF isoforms and PDGFRs expressed.
Second, the PDGFR expression levels are not constant.
Different external stimuli such as inflammation, embry-
onic development or differentiation modulate cellular
receptor expression allowing binding of some PDGFs
but not others. Additionally, some cells display only one
of the PDGFR isoforms while other cells express both
isoforms, simultaneously or separately. Third, different
splice forms ofthe PDGFs appear to be expressed dif-
ferently, as shown for the two PDGF-A proteins in rest-
ing and active monocytes [68] and as indicated for the
two PDGF-D proteins identified in mouse but not
humans [26]. Fourth, regulation ofthe classical PDGFs
after secretion includes covalent binding to the extracel-
lular secreted protein, acidic and rich in cysteine
(SPARC), which only binds PDGF-AB and -BB,
decreasing their reactive concentrations and favouring
PDGF-AA signalling [69]. Data on possible PDGF-CC
or -DD binding to SPARC have not been reported. The
major reversible PDGF-A and -B binding to extracellu-
lar protein is a
2
-macroglobulin [70]. The PDGF–a
2
-
macroglobulin complex serves multiple functions. It
makes PDGF-AA, -AB and -BB unable to bind their
receptors, it protects the PDGFs against proteolytic
degradation, and may remove the PDGFs from circula-
tion via a
2
-macroglobulin receptors. There are no data
currently available about interactions between the novel
PDGFs and a
2
-macroglobulin, but several other growth
factors, such as FGF-2, TGF-b and TNF-a, also bind
a
2
-macroglobulin. Fifth, the expression of highly speci-
fic proteases that proteolytically activate the PDGFs
will also influence the availability and activity ofthe dif-
ferent isoforms. This can be exemplified by the proteo-
lytic cleavage of PDGF-D. While the human prostate
carcinoma cell line LNCaP produces a specific protease
to process the full-length PDGF-D [66], there is no pro-
tease capable of cleaving the full-length PDGF-D secre-
ted by cells and tissues in the eye [39].
Gene knockout studies on the PDGFs
For the PDGF-a gene knockout mouse, there are two
restriction points concerning animal survival; one pren-
atally at E10 and one postnatally at about two weeks
[71]. The postnatally surviving mice had a symmetrical
reduction ofthe size of most organs, developed lung
emphysema due to lack of alveolar myofibroblasts,
resulting in the loss of parenchymal elastin fibres and
no formation of alveolar septa. The mice died about
two weeks old due to respiratory problems. The phe-
notype reveals a role for PDGF-A in embryonic devel-
opment, as well as a highly specific and critical role for
PDGF-A in lung alveolar myofibroblast differentiation
and lung development.
When the PDGF-b gene is knocked out the mice die
perinatally, displaying several anatomical and histolog-
ical abnormalities [72]. The glomerular tufts of the
kidneys do not form as there is complete absence of
mesangial cells, and instead one single or a few disten-
ded capillary loops fill the glomerular space. Further-
more, the heart and some large arteries dilate in
late-stage embryos and fatal haemorrhages occur just
prior to birth. Based on these findings, PDGF-B is
assigned a crucial role in establishing certain renal and
circulatory functions.
Comparing the PDGF-a and PDGF-b knockout
mice, there are similarities in the resulting phenotypes.
Both the alveolar myofibroblasts andthe mesangial
cells express a-smooth muscle actin and have a con-
tractile phenotype, functioning as anchors for an
involuted epithelial sheet, the alveolar sac or the glom-
erulus. By losing this anchor in the knockout mice,
there is a failure of involution andthe physiological
functions are impaired, as a result of decreased surface
area for gas exchange or glomerular filtration, in
PDGF-A and PDGF-B mutants, respectively.
Knockout studies on PDGF-c in mice clearly dem-
onstrate a role for PDGF-C in embryonal development
[73]. The knockout ofPDGF-c results in mice dying
perinatally owing to difficulties in feeding and brea-
thing, as they have a complete cleft ofthe secondary
palate because the palate bones do not meet. Addition-
ally, the dorsal spinal cord was deformed in the
lower spine. The null mutant PDGF-C embryos had
PDGF-C and -D, structure and function L. J. Reigstad et al.
5730 FEBS Journal 272 (2005) 5723–5741 ª 2005 The Authors Journal compilation ª 2005 FEBS
subcutaneous oedema in the flank ofthe body between
the limbs lacking connective tissue, and showed several
blood-filled blisters in frontnasal and lateral forehead.
In the early embryo development, the features of the
knockout PDGF-c mice largely overlap with knockout
PDGF-a mice. PDGF-c ⁄ PDGF-a mice showed growth
retardation, pericardial effusion, a wavy neural tube
and subepidermal blisters, dying before E17. In total,
PDGF-C has specific roles in palatogenesis and in
morphogenesis ofthe skin tissue. PDGF-d knockouts
have not been reported.
Functions ofthePDGF-Cand PDGF-D proteins
The role of PDGF-A and -B proteins in normal pro-
cesses, malignancies and diseases have been character-
ized in a wide diversity of cells, organs and species
(reviewed in [62]). This part ofthe review will therefore
focus on thePDGF-Cand PDGF-D proteins, as their
functions are starting to be revealed.
PDGF-C in normal processes
The expression ofPDGF-C mRNA in embryonic
mouse tissue is located in the kidney, lung, brain,
heart, spinal cord and several other tissues, and partic-
ularly at sites of developing epidermal openings such
as the mouth, nostrils, ears and eyelids [7–9,74]. In the
adult mouse, PDGF-C is mainly expressed in kidney,
testis, liver, brain and heart. Adult humans addition-
ally express PDGF-C in the pancreas, adrenal gland,
skeletal muscles, ovary, prostate, uterus and placenta
[8,10,15,20,27,74]. PDGF-C mRNA and protein
expression is also detected in normal human thyroid
tissue (L. J. Reigstad, J. E. Varhaug and J. R. Lilleh-
aug, unpublished results).
PDGF-C in tissue remodelling
PDGF-C appears to be involved in all three phases
(inflammation, proliferation and remodelling ⁄ matur-
ing) of wound healing [75]. Extensive expression and
secretion of full-length PDGF-C from a-granules of
isolated platelets indicate that it plays a role in the
inflammatory phase [76]. In the proliferative phase of
wound healing capillary growth is triggered by low
oxygen, andPDGF-C was recently shown to revascu-
larize ischemic mouse heart and limb in vivo as effi-
ciently as VEGF and PlGF-1 [77]. PDGF-C mediates
increased mRNA and protein levels of metalloprotein-
ase-1 (MMP-1) and its inhibitor (TIMP-1), both being
important in the remodelling phase of tissues [78].
These results are further verified by in vivo experiments
showing that PDGF-C enhanced the repair of a full-
thickness skin excision in a delayed diabetic wound
healing mouse model by stimulation of fibroblast pro-
liferation, epithelial migration, extensive vasculariza-
tion and neutrophil infiltration [41].
PDGF-C in angiogenesis
The high PDGF-C expression in the angiogenic tissues
of placenta, ovary and embryo has led to several in vitro
and in vivo experiments defining PDGF-C as a potent
angiogenic factor, similar to VEGF andthe classical
PDGFs. The underlying mechanisms are still to be
understood. In the aortic ring outgrowth assay, PDGF-
C mediated significant increased outgrowth of fibro-
blasts and smooth muscle cells, to a degree comparable
to that of VEGF, PDGF-AA and -BB [41]. PDGF-C
efficiently stimulated the formation of new blood vessels
with high vessel density growing towards the implanted
dish ofthe chorioallantoic membrane (CAM) assay
[79]. In addition, PDGF-C stimulated formation of new
branches and vessel sprouts from those initially formed.
Several reports show in vivo angiogenic PDGF-C
effects. When PDGF-C-coated micropellets were added
to mouse corneal micropockets, PDGF-C potently
induced neovascularization ofthe avascular corneal tis-
sue. In these experiments, PDGF-C was as potent as
PDGF-BB and more potent than PDGF-AA. PDGF-
C affects the endothelial cells lining the blood vessels
by mobilizing the endothelial progenitor cells, promo-
ting the differentiation of bone marrow progenitor
cells into mature endothelial cells, and by stimulating
the chemotaxis of different mature endothelial cells in
ischemic heart and limb muscles. In these experiments,
PDGF-C also gave enhanced vessel maturing (arterio-
genesis) by inducing the differentiation of bone mar-
row cells into smooth muscle cells which coat the
endothelial cell layer ofthe vessels.
PDGF-C in embryonic development and adults:
kidney, central nervous system (CNS) and ears
PDGF-C has important functions both in embryonic
development and in adult tissues (Fig. 4) and there
appears to be expression differences between species.
High constitutive PDGF-C expression is present in the
adult kidneys of mouse, rat and humans [8,30,80,81].
In human adult kidneys, PDGF-C is detected in vascu-
lar endothelial cells and smooth muscle cells of arter-
ies, in parietal glomerular cells but not in the
glomerular tuft. In the tubulointerstitium, PDGF-C is
located in collecting ducts andthe loop of Henle [81].
PDGF-C protein localization in adult rodent kidneys
L. J. Reigstad et al. PDGF-Cand -D, structure and function
FEBS Journal 272 (2005) 5723–5741 ª 2005 The Authors Journal compilation ª 2005 FEBS 5731
was similar to the adult human kidney, but the rodent
kidneys did not contain PDGF-C protein in the pari-
etal glomeruli cells [30,74,76]. In contrast to kidney
development in rodents, the developing human glo-
meruli express PDGF-C in the metanephric epithelial
mesenchyme and in the parietal epithelial cells [30,81].
During kidney development, PDGFR-a is expressed
in the glomerular epithelial mesenchyme, suggesting a
paracrine signalling pathway for both PDGF-A and
-C in kidney vascular and interstitial development [74].
In the embryonal rat CNS, PDGF-C mRNA was
expressed in the notochord (prestage ofthe spinal
cord) and subsequently in the maturing spinal cord,
while the adult spinal cord does not express PDGF-
C [27]. The presence ofPDGF-C in the developing
spinal cord has also been shown in chicken [7].
PDGF-C mRNA is detected in the floor plate and
the ventricular zones of cortex and adjacent to the
floor plate ofthe embryonic brain, whereas in the
adult brain weak PDGF-C expression was observed
only in the olfactory nucleus and pontine nuclei [27].
Quantitative RT-PCR analysis did not detect PDGF-
C in human embryonic or adult brain tissues [82],
although this has been shown through northern blot
analyses [8,74].
PDGF-C mRNA has been detected in the develop-
ing ears of mouse and rat [9,74,83]. During rat
embryonic development, significant mRNA levels of
PDGF-C, PDGF-A and both PDGFRs are expressed
in cochlear progenitor hair cells ofthe inner ear [83].
PDGF-D in normal processes
Since its discovery four years ago, PDGF-D has been
linked to important functions both in embryogenesis
and in adult tissues (Fig. 4). In human adult tissue,
PDGF-D is highly expressed in heart, kidney, pan-
creas, ovary, adipose tissue, stomach, bladder, trachea,
testis and mammary gland [10,12,84]. In organs such
as the kidney and lung, there are several differences in
expression patterns between species.
PDGF-D in embryonic development and adults:
kidney, lung, CNS and eye
Most information on PDGF-D biology has been
obtained from studies using the kidney as a model.
Starting with embryogenesis, PDGF-D protein in the
human kidney is expressed mainly in visceral glomer-
ular epithelial cells and in smooth muscle cells in
renal arteries and also in some fibroblast-like intersti-
tial cells but not in the fibrous capsule surrounding
the embryonic kidney [29]. In mouse, PDGF-D is
expressed in the highly vascularized fibrous capsule,
the most peripheral part ofthe cortex metanephric
mesenchyme, and in the basal aspect ofthe branch-
ing ureter [12]. PDGF-D colocalizes with the
PDGFR-b in the differentiating metanephric mesen-
chyme, whereas PDGF-B expression is restricted to
endothelial cells, indicating the possibility of PDGF-
D ⁄ PDGFR-b constituting an autocrine loop, and
PDGF-B acting in a paracrine manner to promote
proliferation and migration of mesangial and intersti-
tial cells in the kidney. In the developing human
kidney, PDGF-D expression does not colocalize with
PDGFR-b, as PDGF-D is expressed in the visceral
epithelial cells and PDGFR-b in the mesangial cells.
Thus here a paracrine role for PDGF-D in prolifer-
ation and migration ofthe mesangial cells can be
indicated [29]. In the human adult kidney, PDGF-D
protein expression was also detected in smooth mus-
cle cells of arteries, arterioles and vasa rectae. In
contrast to human and mouse adult kidney, the rat
adult kidney shows no PDGF-D protein in the
glomeruli [85]. As in the kidneys, lungs show spe-
cies-different PDGF-D expression. Cells in normal
human lungs do not express PDGF-D protein at
detectable levels [10], while in murine lungs PDGF-D
mRNA is constitutively expressed [84].
In the embryo, PDGF-D mRNA is hardly detect-
able in the spinal cord, but in the adult spinal cord
prominent expression is located to the motor neurons
[27]. In the brain, PDGF-D mRNA was registered
in the thalamus and in a ventricular zone of the
Kidney (9,30,74,81)
CNS (5,27,74)
Heart (74,100)
Ear (9,74,83)
Kidney (30,80,81)
CNS (27,74)
Embryonic development
Adult tissue
PDGF-C
PDGF-D
Kidney (27,29,80,85)
Eye (27,39)
CNS and brain (27)
Lung (84,101)
Peri. mineral. (86)
Kidney (27,29)
Eye (27)
Brain (27,110)
Fig. 4. Defined functions ofPDGF-Cand PDGF-D in specific organs
during embryonic development and adult tissue. See text and refer-
ences (numbers given) for detailed descriptions. Peri. mineral, peri-
odontal mineralization.
PDGF-C and -D, structure and function L. J. Reigstad et al.
5732 FEBS Journal 272 (2005) 5723–5741 ª 2005 The Authors Journal compilation ª 2005 FEBS
[...]... determination ofthe 3D structures of both PDGFC and -D is lacking The current information on their activities points to a wide scope of biological effects; however further understanding of how these factors interplay with other membersofthe cystine knot familyand in particular the PDGF-A, -B, and VEGF growth factors, must be the focus of future investigations PDGF-Cand -D, structure and function... This high level of circulating PDGF-D is also detected in mice infected with adenovirus-containing PDGF-D, resulting in perivascular lymphoid cell infiltrates ofthe lung and fibrosis in the liver [110] Conclusions Thenovel members, PDGF-Cand -D, ofthe PDGF subfamily ofthe cystine knot familyofgrowthfactors are potent cytokines important for normal embryogenesis and maintenance of adult tissues... strains developing fibrosis These findings suggest a role for thePDGF-C in the development of lung fibrosis One ofthe characteristics of pancreatic cancer is the overproduction of extracellular matrix by interstitial cells This results in a tumour mass usually consisting of 60–80% interstitial cells and only 20–40% of pancreatic carcinoma cells [108] PDGF-B and several other growthfactors have previously... embryonic brain and in the adult brain it was expressed in several anatomical nuclei PDGF-D mRNA is expressed in the developing rat eyes and also adult eyes of rat, cow, monkey and rabbit In the adult rat eye, PDGF-D is localized to the stroma of iris and ciliar body in the anterior segment, and to the outer plexiform layer ofthe retina containing the photoreceptor axons, but not in the mature lens... PDGFR-a and -b, TGFb1, and TIMP-1 and -2 in the liver of transgenic mice PDGF-C treatment increased both mRNA and protein levels ofthe metalloproteinase inhibitor, TIMP-1, in dermal fibroblasts in vitro [78] ThePDGF-C induction of fibrosis starts with activation and intense proliferation ofthe hepatic stellate cells, producing robust pericellular and perivenular collagen type I deposits [106] PDGF-C. .. anchoragedependant growth, and is a potent transforming growth factor of NIH ⁄ 3T3 cells [88] The in vivo tumourigenesis may partially be explained by PDGFC-mediated VEGF expression, promoting indirect stimulation of tumour angiogenesis The apparent roles ofPDGF-C in diseases and malignancies are discussed below and are summarized in Fig 5 PDGF-C in Ewing family sarcomas The first link between PDGF-Cand malignancy... same pattern was detected for the mRNA expression of both PDGF-A and PDGFR-a Medulloblastoma tumours express both PDGFRs [103] andthe PDGF-A, -B and -D [89,104] but an 5734 Fig 5 Involvement ofPDGF-Cand PDGF-D in diseases and malignancies Both PDGF-Cand PDGF-D are linked to progressive renal diseases, fibrosis and brain tumours PDGF-C is furthermore involved in Ewing family sarcoma whereas PDGF-D... protease-activated ligand for the PDGF beta-receptor Nat Cell Biol 3, 512–516 Heldin CH & Westermark B (1990) Signal transduction by the receptors for platelet-derivedgrowth factor J Cell Sci 96, 193–196 Heldin CH, Eriksson U & Ostman A (2002) New membersoftheplatelet-derivedgrowth factor familyof mitogens Arch Biochem Biophys 398, 284–290 Tsai YJ, Lee RK, Lin SP & Chen YH (2000) Identification of a novel platelet-derived. .. Eriksson U (2004) The PDGF family: four gene products form five dimeric isoforms Cytokine Growth Factor Rev 15, 197–204 Li X & Eriksson U (2003) Novel PDGF family members: PDGF-Cand PDGF-D Cytokine Growth Factor Rev 14, 91–98 Khachigian LM, Williams AJ & Collins T (1995) Interplay of Sp1 and Egr-1 in the proximal platelet-derivedgrowth factor A-chain promoter in cultured vascular endothelial cells J Biol... Identification of a cell retention PDGF-Cand -D, structure and function 61 62 63 64 65 66 67 68 69 70 71 72 signal in the B-chain ofplatelet-derivedgrowth factor and in the long splice version ofthe A-chain Cell Regul 2, 503–512 Kaetzel DM Jr, Morgan D, 3rd Reid JDT & Fenstermaker RA (1996) Site-directed mutagenesis ofthe N-linked glycosylation site in platelet-derivedgrowth factor B-chain results . REVIEW ARTICLE
Structural and functional specificities of PDGF-C and
PDGF-D, the novel members of the platelet-derived growth
factors family
Laila J. Reigstad
1,2
,. the lung and fibro-
sis in the liver [110].
Conclusions
The novel members, PDGF-C and -D, of the PDGF
subfamily of the cystine knot family of growth factors
are