Cezanne Regulates Inflammatory Responses to Hypoxia in Endothelial Cells by Targeting TRAF6 for Deubiquitination

Le A. Luong, Maria Fragiadaki, Jennifer Smith, Joseph Boyle, Jens Lutz, Jonathan L. E. Dean, Sarah Harten, Margaret Ashcroft, Sarah R. Walmsley, Dorian O. Haskard, Patrick H. Maxwell, Henning Walczak, Charles Pusey, Paul C. Evans

Research output: Contribution to journalArticlepeer-review


Rationale: Hypoxia followed by reoxygenation promotes inflammation by activating nuclear factor kappa B transcription factors in endothelial cells (ECs). This process involves modification of the signaling intermediary tumor necrosis factor receptor-associated factor 6 with polyubiquitin chains. Thus, cellular mechanisms that suppress tumor necrosis factor receptor-associated factor 6 ubiquitination are potential therapeutic targets to reduce inflammation in hypoxic tissues.

Objective: In this study, we tested the hypothesis that endothelial activation in response to hypoxia-reoxygenation can be influenced by Cezanne, a deubiquitinating enzyme that cleaves ubiquitin from specific modified proteins.

Methods and Results: Studies of cultured ECs demonstrated that hypoxia (1% oxygen) induced Cezanne via p38 mitogen-activated protein kinase-dependent transcriptional and post-transcriptional mechanisms. Hypoxia-reoxygenation had minimal effects on proinflammatory signaling in unmanipulated ECs but significantly enhanced Lys63 polyubiquitination of tumor necrosis factor receptor-associated factor 6, activation of nuclear factor kappa B, and expression of inflammatory genes after silencing of Cezanne. Thus, although hypoxia primed cells for inflammatory activation, it simultaneously induced Cezanne, which impeded signaling to nuclear factor kappa B by suppressing tumor necrosis factor receptor-associated factor 6 ubiquitination. Similarly, ischemia induced Cezanne in the murine kidney in vascular ECs, glomerular ECs, podocytes, and epithelial cells, and genetic deletion of Cezanne enhanced renal inflammation and injury in murine kidneys exposed to ischemia followed by reperfusion.

Conclusions: We conclude that inflammatory responses to ischemia are controlled by a balance between ubiquitination and deubiquitination, and that Cezanne is a key regulator of this process. Our observations have important implications for therapeutic targeting of inflammation and injury during ischemia-reperfusion.

Original languageEnglish
Pages (from-to)1583-1591
Number of pages20
JournalCirculation Research
Issue number12
Publication statusPublished - 7 Jun 2013


  • endothelium
  • hypoxia
  • inflammatory activation
  • A20

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