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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Endocrinol.</journal-id>
<journal-title>Frontiers in Endocrinology</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Endocrinol.</abbrev-journal-title>
<issn pub-type="epub">1664-2392</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3389/fendo.2021.732456</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Endocrinology</subject>
<subj-group>
<subject>Original Research</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>PACAP&#x2013;PAC1 Signaling Regulates Serotonin 2A Receptor Internalization</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author" corresp="yes">
<name>
<surname>Hayata-Takano</surname>
<given-names>Atsuko</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff2">
<sup>2</sup>
</xref>
<xref ref-type="author-notes" rid="fn001">
<sup>*</sup>
</xref>
<xref ref-type="author-notes" rid="fn003">
<sup>&#x2020;</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/74998"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Shintani</surname>
<given-names>Yusuke</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="author-notes" rid="fn003">
<sup>&#x2020;</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/1449205"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Moriguchi</surname>
<given-names>Keita</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/1506504"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Encho</surname>
<given-names>Naoki</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/1506967"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Kitagawa</surname>
<given-names>Kohei</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/1461219"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Nakazawa</surname>
<given-names>Takanobu</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff3">
<sup>3</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/192626"/>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name>
<surname>Hashimoto</surname>
<given-names>Hitoshi</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff2">
<sup>2</sup>
</xref>
<xref ref-type="aff" rid="aff4">
<sup>4</sup>
</xref>
<xref ref-type="aff" rid="aff5">
<sup>5</sup>
</xref>
<xref ref-type="aff" rid="aff6">
<sup>6</sup>
</xref>
<xref ref-type="author-notes" rid="fn001">
<sup>*</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/47015"/>
</contrib>
</contrib-group>
<aff id="aff1">
<sup>1</sup>
<institution>Laboratory of Molecular Neuropharmacology, Graduate School of Pharmaceutical Sciences, Osaka University</institution>, <addr-line>Suita</addr-line>, <country>Japan</country>
</aff>
<aff id="aff2">
<sup>2</sup>
<institution>Molecular Research Center for Children&#x2019;s Mental Development, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui</institution>, <addr-line>Suita</addr-line>, <country>Japan</country>
</aff>
<aff id="aff3">
<sup>3</sup>
<institution>Department of Bioscience, Tokyo University of Agriculture</institution>, <addr-line>Setagaya-ku</addr-line>, <country>Japan</country>
</aff>
<aff id="aff4">
<sup>4</sup>
<institution>Division of Bioscience, Institute for Datability Science, Osaka University</institution>, <addr-line>Suita</addr-line>, <country>Japan</country>
</aff>
<aff id="aff5">
<sup>5</sup>
<institution>Transdimensional Life Imaging Division, Institute for Open and Transdisciplinary Research Initiatives, Osaka University</institution>, <addr-line>Suita</addr-line>, <country>Japan</country>
</aff>
<aff id="aff6">
<sup>6</sup>
<institution>Department of Molecular Pharmaceutical Science, Graduate School of Medicine, Osaka University</institution>, <addr-line>Suita</addr-line>, <country>Japan</country>
</aff>
<author-notes>
<fn fn-type="edited-by">
<p>Edited by: Hubert Vaudry, Universit&#xe9; de Rouen, France</p>
</fn>
<fn fn-type="edited-by">
<p>Reviewed by: Lee E. Eiden, National Institutes of Health (NIH), United States; Alessandro Castorina, University of Technology Sydney, Australia</p>
</fn>
<fn fn-type="corresp" id="fn001">
<p>*Correspondence: Hitoshi Hashimoto, <email xlink:href="mailto:hasimoto@phs.osaka-u.ac.jp">hasimoto@phs.osaka-u.ac.jp</email>; Atsuko Hayata-Takano, <email xlink:href="mailto:a-hayata@phs.osaka-u.ac.jp">a-hayata@phs.osaka-u.ac.jp</email>
</p>
</fn>
<fn fn-type="equal" id="fn003">
<p>&#x2020;These authors have contributed equally to this work and share first authorship</p>
</fn>
<fn fn-type="other" id="fn002">
<p>This article was submitted to Neuroendocrine Science, a section of the journal Frontiers in Endocrinology</p>
</fn>
</author-notes>
<pub-date pub-type="epub">
<day>25</day>
<month>10</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="collection">
<year>2021</year>
</pub-date>
<volume>12</volume>
<elocation-id>732456</elocation-id>
<history>
<date date-type="received">
<day>29</day>
<month>06</month>
<year>2021</year>
</date>
<date date-type="accepted">
<day>27</day>
<month>09</month>
<year>2021</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#xa9; 2021 Hayata-Takano, Shintani, Moriguchi, Encho, Kitagawa, Nakazawa and Hashimoto</copyright-statement>
<copyright-year>2021</copyright-year>
<copyright-holder>Hayata-Takano, Shintani, Moriguchi, Encho, Kitagawa, Nakazawa and Hashimoto</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/">
<p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</p>
</license>
</permissions>
<abstract>
<p>Mice lacking pituitary adenylate cyclase-activating polypeptide (PACAP) display psychomotor abnormalities, most of which are ameliorated by atypical antipsychotics with serotonin (5-HT) 2A receptor (5-HT<sub>2A</sub>) antagonism. Heterozygous <italic>Pacap</italic> mutant mice show a significantly higher hallucinogenic response than wild-type mice to a 5-HT<sub>2A</sub> agonist. Endogenous PACAP may, therefore, affect 5-HT<sub>2A</sub> signaling; however, the underlying neurobiological mechanism for this remains unclear. Here, we examined whether PACAP modulates 5-HT<sub>2A</sub> signaling by addressing cellular protein localization. PACAP induced an increase in internalization of 5-HT<sub>2A</sub> but not 5-HT<sub>1A</sub>, 5-HT<sub>2C</sub>, dopamine D<sub>2</sub> receptors or metabotropic glutamate receptor 2 in HEK293T cells. This PACAP action was inhibited by protein kinase C inhibitors, &#x3b2;-arrestin2 silencing, the PACAP receptor PAC1 antagonist PACAP<sub>6-38</sub>, and PAC1 silencing. In addition, the levels of endogenous 5-HT<sub>2A</sub> were decreased on the cell surface of primary cultured cortical neurons after PACAP stimulation and were increased in frontal cortex cell membranes of <italic>Pacap<sup>&#x2212;/&#x2212;</sup>
</italic> mice. Finally, intracerebroventricular PACAP administration suppressed 5-HT<sub>2A</sub> agonist-induced head twitch responses in mice. These results suggest that PACAP&#x2013;PAC1 signaling increases 5-HT<sub>2A</sub> internalization resulting in attenuation of 5-HT<sub>2A</sub>-mediated signaling, although further study is necessary to determine the relationship between behavioral abnormalities in <italic>Pacap<sup>&#x2212;/&#x2212;</sup>
</italic> mice and PACAP-induced 5-HT<sub>2A</sub> internalization.</p>
</abstract>
<kwd-group>
<kwd>pituitary adenylate cyclase-activating polypeptide (PACAP)</kwd>
<kwd>internalization</kwd>
<kwd>hallucination</kwd>
<kwd>&#x3b2;-arrestin</kwd>
<kwd>G protein-coupled receptor (GPCR)</kwd>
<kwd>serotonin 2A receptor (5-HT<sub>2A</sub>)</kwd>
</kwd-group>    <contract-sponsor id="cn001">Japan Society for the Promotion of Science<named-content content-type="fundref-id">10.13039/501100001691</named-content>
</contract-sponsor>    <contract-sponsor id="cn002">Ministry of Education, Culture, Sports, Science and Technology<named-content content-type="fundref-id">10.13039/501100001700</named-content>
</contract-sponsor>    <contract-sponsor id="cn003">Japan Agency for Medical Research and Development<named-content content-type="fundref-id">10.13039/100009619</named-content>
</contract-sponsor>    <contract-sponsor id="cn004">Takeda Science Foundation<named-content content-type="fundref-id">10.13039/100007449</named-content>
</contract-sponsor>
<counts>
<fig-count count="5"/>
<table-count count="0"/>
<equation-count count="0"/>
<ref-count count="55"/>
<page-count count="12"/>
<word-count count="5472"/>
</counts>
</article-meta>
</front>
<body>
<sec id="s1" sec-type="intro">
<title>Introduction</title>
<p>Pituitary adenylate cyclase-activating polypeptide (PACAP) is a multifunctional neuropeptide that regulates a wide array of physiological responses, including emotion, cognition and motor function. It acts upon three G protein-coupled receptor subtypes: a PACAP-preferring receptor (PAC1) and two vasoactive intestinal polypeptide (VIP) receptors (VPAC1 and VPAC2) (<xref ref-type="bibr" rid="B1">1</xref>, <xref ref-type="bibr" rid="B2">2</xref>). PAC1 signaling mediates cellular functions, such as transcriptional responses and cell survival, partly through its own internalization (<xref ref-type="bibr" rid="B3">3</xref>, <xref ref-type="bibr" rid="B4">4</xref>). We previously reported that PACAP-deficient (<italic>Pacap<sup>&#x2212;/&#x2212;</sup>
</italic>) mice show behavioral abnormalities such as locomotor hyperactivity in an open-field, deficits in prepulse inhibition (PPI) of the startle response, depression-like behavior and memory impairment (<xref ref-type="bibr" rid="B5">5</xref>&#x2013;<xref ref-type="bibr" rid="B10">10</xref>). The hyperlocomotion and PPI deficits in <italic>Pacap<sup>&#x2212;/&#x2212;</sup>
</italic> mice were reversed by risperidone, an atypical antipsychotic drug with antagonism of serotonin (5-HT)<sub>2</sub> receptors and dopamine D<sub>2</sub> receptors (D2) (<xref ref-type="bibr" rid="B10">10</xref>). The depression-like behavior in <italic>Pacap<sup>&#x2212;/&#x2212;</sup>
</italic> mice were ameliorated by risperidone and the selective 5-HT 2A receptor (5-HT<sub>2A</sub>) antagonist, ritanserin (<xref ref-type="bibr" rid="B7">7</xref>). In addition, <italic>Pacap<sup>&#x2212;/&#x2212;</sup>
</italic> mice (<xref ref-type="bibr" rid="B7">7</xref>) and heterozygous mutant mice (<italic>Pacap</italic>
<sup>+</sup>
<italic>
<sup>/&#x2212;</sup>
</italic>) (<xref ref-type="bibr" rid="B11">11</xref>) show exaggerated (&#xb1;)-2,5-dimethoxy-4-iodoamphetamine (DOI)-induced head-twitch responses compared with wild-type mice. <italic>Pacap<sup>&#x2212;/&#x2212;</sup>
</italic> mice also have increased 5-HT content and 5-HT-immunoreactive cell counts in the dorsal raphe (<xref ref-type="bibr" rid="B12">12</xref>) and slightly decreased levels of the 5-HT metabolite, 5-hydroxyindoleacetic acid, in the cortex and striatum (<xref ref-type="bibr" rid="B5">5</xref>). These findings indicate that 5-HT<sub>2A</sub> function may be involved in psychiatric conditions in which PACAP signaling is dysfunctional and that functional crosstalk may exist between PACAP and 5-HT<sub>2A</sub> signaling pathways. However, the underlying molecular mechanisms for this remain unclear.</p>
<p>5-HT<sub>2A</sub> has been implicated in many psychiatric disorders, such as schizophrenia and affective disorders (<xref ref-type="bibr" rid="B13">13</xref>). Clinical studies have indicated that impaired 5-HT<sub>2A</sub> signaling plays a major role in schizophrenic episodes (<xref ref-type="bibr" rid="B14">14</xref>). Almost all currently available atypical antipsychotic drugs possess antagonistic effects against D2 and 5-HT<sub>2A</sub> (<xref ref-type="bibr" rid="B15">15</xref>). Cellular internalization is known to play a critical role in the regulation of 5-HT<sub>2A</sub> functions (<xref ref-type="bibr" rid="B16">16</xref>, <xref ref-type="bibr" rid="B17">17</xref>). 5-HT, dopamine, DOI and clozapine induce 5-HT<sub>2A</sub> internalization and recycling, and the signaling processes through which each ligand induces its effect are differentially regulated (<xref ref-type="bibr" rid="B17">17</xref>). In addition, different classes of G-protein-coupled receptors (GPCRs) can form heteromeric complexes that potentially contribute to the regulation of receptor internalization or alteration of pharmacological signaling properties (<xref ref-type="bibr" rid="B18">18</xref>, <xref ref-type="bibr" rid="B19">19</xref>). 5-HT<sub>2A</sub>/metabotropic glutamate receptor 2 (mGlu2) and 5-HT<sub>2A</sub>/D2 form heteromeric complexes that induce unique hallucinogen-specific signaling (<xref ref-type="bibr" rid="B20">20</xref>&#x2013;<xref ref-type="bibr" rid="B23">23</xref>). Thus, the signaling pathways involved in 5-HT<sub>2A</sub> function are complicated, and the precise signaling pathways responsible for hallucinogenic and therapeutic effects remain unclear.</p>
<p>Our previous studies indicated that there are no significant differences in 5-HT content in the cortex and striatum or in 5-HT<sub>2A</sub> protein levels in the somatosensory cortex between <italic>PACAP</italic> mutant and wild-type mice (<xref ref-type="bibr" rid="B5">5</xref>, <xref ref-type="bibr" rid="B11">11</xref>, <xref ref-type="bibr" rid="B24">24</xref>). Therefore, here, we examined the effect of PACAP signaling on 5-HT<sub>2A</sub> internalization and revealed that the PACAP&#x2013;PAC1 signaling pathway regulates 5-HT<sub>2A</sub> internalization in a protein kinase C (PKC)- and &#x3b2;-arrestin2-dependent manner. These results further suggest the existence of functional crosstalk between PACAP and 5-HT<sub>2A</sub>-mediated signaling pathways in the brain.</p>
</sec>
<sec id="s2" sec-type="materials|methods">
<title>Materials and Methods</title>
<sec id="s2_1">
<title>Animals</title>
<p>ICR mice were purchased from Japan SLC (Shizuoka, Japan). Generation of <italic>Pacap<sup>&#x2212;/&#x2212;</sup>
</italic> mice by gene targeting was reported previously (<xref ref-type="bibr" rid="B5">5</xref>). <italic>Pacap<sup>&#x2212;/&#x2212;</sup>
</italic> mice and wild-type littermates on the ICR background were obtained by crossing <italic>Pacap<sup>+/&#x2212;</sup>
</italic> heterozygous mice.</p>
<p>All animal care and handling procedures were performed in accordance with protocols approved by the Animal Care and Use Committee of the Graduate School of Pharmaceutical Sciences, Osaka University. All efforts were made to minimize the number of animals used.</p>
</sec>
<sec id="s2_2">
<title>Drugs</title>
<p>PACAP (PACAP-38, 4221-v), PACAP<sub>6-38</sub> (4286-v) and VIP (4110-v) were purchased from Peptide Institute (Osaka, Japan). D-sphingosine (S7049), H89 (B1427) and 5-HT hydrochloride (H9523) were purchased from Sigma-Aldrich (St Louis, MO, USA). PD98059 (513000) was purchased from Calbiochem (CA, USA). H7 (BML-EI148) and HA1004 (BML-EI184) were purchased from ENZO Life Science (NY, USA).</p>
</sec>
<sec id="s2_3">
<title>Vector Construction</title>
<p>The vector, pFN21A (HaloTag technology, Promega, Madison, WI, USA), encoding the secretory IL-6 signal peptide fused to the N-terminus of Halo-tag was a gift from Dr. Nagase (Kazusa DNA Research Institute). To generate the Halo-PAC1 construct, the hop1 splicing variant of a human <italic>PAC1</italic> cDNA was subcloned into the pFN21A vector at <italic>Sgf</italic>I and <italic>Pme</italic>I restriction sites as described previously (<xref ref-type="bibr" rid="B4">4</xref>). Human <italic>5-HT<sub>1A</sub>
</italic>, <italic>5-HT<sub>2A</sub>
</italic>, <italic>D2</italic> and <italic>mGlu2</italic> cDNAs were obtained from the Kazusa Collection of Flexi ORF Clones (Kazusa DNA Research Institute, Chiba, Japan). These clones were also subcloned into the pFN21A vector at <italic>Sgf</italic>I and <italic>Pme</italic>I restriction sites.</p>
</sec>
<sec id="s2_4">
<title>Receptor Internalization in HEK293T Cells</title>
<p>Receptor internalization was quantitatively assessed using HaloTag technology (Promega) as described previously (<xref ref-type="bibr" rid="B4">4</xref>). HEK293T cells were maintained in Dulbecco&#x2019;s modified Eagle&#x2019;s medium (DMEM, 5919, Nissui, Tokyo, Japan) supplemented with 10% fetal bovine serum. The cells were transfected with Halo-expressing vector and labeled with the cell-impermeable Alexa Fluor 488 ligand (Promega) in Opti-MEM for 15 min at 37&#xb0;C. Each inhibitor or antagonist pretreatment was for 30 min. The cells were then treated with 1 &#xb5;M PACAP, 5-HT or saline, washed with phosphate-buffered saline and fixed in 4% paraformaldehyde. Cells were imaged using an FV1000D confocal microscope (Olympus, Tokyo, Japan) in sequential mode and membrane protein internalization was quantified using ImageJ software (NIH, MD, USA). To assess the internalization ratio, we defined the shape of a whole-cell (region of interest, ROI, A) and its cytoplasmic region (ROI B) by reducing the size by 5&#x2013;10 pixels and then determining the fluorescence in both ROIs. The internalization ratio (%) was defined by dividing the amount of luminescence in ROI B by that in ROI A.</p>
</sec>
<sec id="s2_5">
<title>&#x3b2;-Arrestin Silencing</title>
<p>siRNA-mediated silencing of &#x3b2;-arrestins was performed exactly as described in our previous study (<xref ref-type="bibr" rid="B4">4</xref>). &#x3b2;-arrestin1 (6218S; Cell Signaling Technology, Danvers, MA, USA), &#x3b2;-arrestin2 (sc-29743; Santa Cruz Biotechnology, Dallas, TX) or control siRNA (6568S; Cell Signaling Technology), each at 25 mM, were transfected using Lipofectamine RNAiMAX (Invitrogen) according to the manufacturer&#x2019;s protocol. We confirmed that the &#x3b2;-arrestin1 and &#x3b2;-arrestin2 siRNAs effectively decreased the respective &#x3b2;-arrestin levels to less than 35% in HEK293T cells in our previous study (<xref ref-type="bibr" rid="B4">4</xref>).</p>
</sec>
<sec id="s2_6">
<title>Antibodies</title>
<p>The following commercially available antibodies were used: rabbit polyclonal anti-PAC1 (ab54980, Abcam, Cambridge, UK), rabbit polyclonal anti-5-HT<sub>1A</sub> (ab44635, Abcam), rabbit polyclonal anti-5-HT<sub>2A</sub> (ab16028, Abcam), rabbit polyclonal anti-D2 (ab21218, Abcam), rabbit polyclonal anti-mGlu2/3 (06-676, Millipore, Darmstadt, Germany), mouse monoclonal anti-&#x3b2;-actin (MAB1501, Millipore), mouse monoclonal anti-alpha 1 sodium potassium ATPase (ab7671, Abcam). Horseradish peroxidase-conjugated anti-rabbit IgG and anti-mouse IgG were purchased from Cappel (Cochranville, PA, USA).</p>
</sec>
<sec id="s2_7">
<title>Surface Biotinylation Assay and Membrane Protein Isolation</title>
<p>A receptor biotinylation assay was performed using the Pierce cell surface protein isolation kit (Thermo Fisher Scientific, Waltham, MA, USA) as described previously (<xref ref-type="bibr" rid="B25">25</xref>). Primary cultures of cortical neurons were prepared as described previously (<xref ref-type="bibr" rid="B4">4</xref>). The surface proteins of mouse primary cultured cortical neurons at 14 days <italic>in vitro</italic> were biotinylated with EZ-Link Sulfo-NHS-SS-biotin for 30 min at 4&#xb0;C. To collect the surface proteins, cells were lysed with lysis buffer and biotinylated proteins were precipitated with NeutrAvidin agarose. The collected surface proteins were analyzed by western blotting.</p>
<p>Membrane protein isolation was performed using a plasma membrane protein isolation kit (Invent Biotechnologies, Plymouth, MN, USA) according to the manufacturer&#x2019;s instructions. The collected membrane proteins were analyzed by western blotting.</p>
</sec>
<sec id="s2_8">
<title>Western Blotting</title>
<p>Collected surface proteins were suspended in RIPA buffer (50 mM Tris-HCl, pH 7.4, 150 mM NaCl, 1 mM EDTA, 0.1% NP-40, 0.5% sodium deoxycholate, 0.1% sodium dodecyl sulfate), separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and then transferred electrophoretically onto polyvinylidene fluoride membranes (Millipore). After blocking with 2% BSA in TBS buffer (50 mM Tris-HCl, pH 7.4, 150 mM NaCl), the membranes were incubated with an anti-PAC1 antibody (1:1,000 dilution), anti-5-HT<sub>1A</sub> antibody (1:1,000 dilution), anti-5-HT<sub>2A</sub> antibody (1:1,000 dilution), anti-D2 antibody (1:1,000 dilution), anti-mGlu2/3 antibody (1:1,000 dilution), anti-&#x3b2;-actin antibody (1:2000 dilution) or anti-alpha 1 sodium potassium ATPase antibody (1:1000 dilution) overnight at 4&#xb0;C. After incubation with a horseradish peroxidase-conjugated anti-rabbit IgG (1:2,000 dilution) or anti-mouse IgG (1:2,000 dilution) secondary antibody for 1 h at room temperature, proteins were detected by chemiluminescence and visualized with an ImageQuant LAS 4000 system (GE Healthcare, Little Chalfont, UK). For quantification, the bands of specific immune-complexes were analyzed using ImageJ software.</p>
</sec>
<sec id="s2_9">
<title>Head Twitch Response and Intracerebroventricular Injections</title>
<p>Intracerebroventricular injections were performed as described previously (<xref ref-type="bibr" rid="B26">26</xref>). Head twitch responses were assessed as described previously (<xref ref-type="bibr" rid="B10">10</xref>). ICR mice were anesthetized and placed in a stereotaxic instrument (Narishige, Tokyo, Japan). A G-4 cannula (Eicom, Kyoto, Japan) was implanted, &#x2212;0.4 mm posterior, 1.0 mm lateral, and 2.3 mm ventral from the bregma. After cannula implantation, each mouse was given 1 mg/kg buprenorphine (Sigma-Aldrich) to relieve pain and housed individually for at least 10 days before performing head-twitch experiments. Thirty minutes before DOI (Sigma-Aldrich) treatment, PACAP (10 pmol) was diluted in Ringer&#x2019;s solution (1:100, Fuso Pharmaceutical Industries, Osaka, Japan) and a 3 &#x3bc;l volume was injected at an infusion rate of 1 &#x3bc;l/min using a microinjection pump (KD Scientific, MA, USA). For the pretreatment of the PAC1 antagonist, PACAP<sub>6-38</sub> (100 pmol) were diluted and injected in the same way 30 min before PACAP treatment. The mice were individually placed in observation cages (19 &#xd7; 10 &#xd7; 11 cm) for a 30 min habituation period. They were then intraperitoneally injected with either saline or DOI, which were prepared just before use, and recordings were made for a duration of 60 min. Scoring began immediately after injection by trained observers who were blind to the treatment. The head twitch response is a distinctive paroxysmal head-twitching behavior that is easily distinguished from head-bobbing, lateral movements of the head and grooming. The intracerebroventricular injection was judged successful if the third ventricle was stained by Evans blue.</p>
</sec>
<sec id="s2_10">
<title>Statistical Analysis</title>
<p>Experimental data were analyzed using Student&#x2019;s <italic>t</italic>-test, or one-way, two-way or two-way repeated measures analysis of variance (ANOVA). The Tukey-Kramer <italic>post hoc</italic> test was also performed after significant main effects for interaction were observed. The criterion for statistical significance was <italic>p</italic> &lt; 0.05. Statistical analyses were performed using StatView software (version 5.0; SAS Institute, Cary, NC, USA). All experiments were performed in a blinded manner. The observers were blinded to the group of samples during the analyses by random numbering.</p>
</sec>
</sec>
<sec id="s3" sec-type="results">
<title>Results</title>
<sec id="s3_1">
<title>PACAP-Induced Internalization of 5-HT<sub>2A</sub> in HEK293T Cells</title>
<p>To examine whether PACAP signaling modulates the internalization of 5-HT<sub>2A</sub> and related GPCRs in HEK293T cells, we constructed membrane-specific Halo-tagged receptors for PAC1, 5-HT<sub>2A</sub>, 5-HT<sub>1A</sub>, 5-HT<sub>2c</sub>, D2 and mGlu2. As a first step, we examined whether <italic>PAC1</italic>, <italic>VPAC1</italic>, <italic>VPAC2</italic>, and <italic>5-HT<sub>2A</sub>
</italic> mRNAs were expressed in HEK293T cells using reverse transcription (RT)-PCR analysis. In our HEK293T cell cultures, we detected the mRNA expression of <italic>PAC1</italic> and <italic>VPAC1</italic>; however, the expression of <italic>VPAC2</italic> and <italic>5-HT<sub>2A</sub>
</italic> was below the detection limit of our RT-PCR analysis (<xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Figure&#xa0;1A</bold>
</xref>). Quantitative RT-PCR analysis showed that PC12 cells and SH-SY5Y cells expressed relatively higher levels of <italic>PAC1</italic> mRNA as expected from the previous reports (<xref ref-type="bibr" rid="B27">27</xref>&#x2013;<xref ref-type="bibr" rid="B29">29</xref>), and both our HEK293T cell cultures and the HEK293T cells provided by RIKEN BRC Cell Bank (RCB2202; the National Bio-Resource Project of the MEXT/AMED, Japan) moderately expressed <italic>PAC1</italic> mRNA at similar levels. In Hela cells, <italic>PAC1</italic> expression was below the detection limit of our quantitative RT-PCR analysis (<xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Figure&#xa0;1B</bold>
</xref>). The nucleotide sequence of the cDNA fragment amplified from our HEK293T cell cultures was identical to that of the cDNA encoding the human PAC1 hop1 splice variant (NCBI Reference Sequence: NM_001199635.2).</p>
<p>We then examined whether PACAP, maxadilan, a potent and specific PAC1 agonist (<xref ref-type="bibr" rid="B30">30</xref>), and VIP increase intracellular cyclic adenosine monophosphate (cAMP) levels in our HEK293T cell cultures and confirmed that PACAP and maxadilan, both at &#x2265; 0.01 nM, significantly increased intracellular cAMP levels, while VIP at higher concentrations (&#x2265; 1 nM) increased intracellular cAMP levels (<xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Figure&#xa0;1C</bold>
</xref>).</p>
<p>To detect receptor internalization, only cell surface GPCR-Halo proteins were labeled with the cell-impermeable Alexa Fluor 488 HaloTag ligand and the signal ratio of internalized GPCR vs. total GPCR was determined in each cell after 30 min of PACAP treatment. PACAP (1 &#xb5;M) induced an increase in the internalization of 5-HT<sub>2A</sub> (saline, 10.64 &#xb1; 1.40; PACAP, 29.50 &#xb1; 2.07, <italic>p</italic> &lt; 0.001, Student&#x2019;s <italic>t</italic>-test) in HEK293T cells (<xref ref-type="fig" rid="f1">
<bold>Figures&#xa0;1A, B</bold>
</xref>). In accordance with previous reports (<xref ref-type="bibr" rid="B3">3</xref>, <xref ref-type="bibr" rid="B4">4</xref>, <xref ref-type="bibr" rid="B31">31</xref>, <xref ref-type="bibr" rid="B32">32</xref>), PACAP also induced the internalization of PAC1 (saline, 9.52 &#xb1; 1.45; PACAP, 33.08 &#xb1; 0.56, <italic>p</italic> &lt; 0.001, Student&#x2019;s <italic>t</italic>-test) (<xref ref-type="fig" rid="f1">
<bold>Figures&#xa0;1A, B</bold>
</xref>). In contrast, PACAP did not affect the internalization of 5-HT<sub>1A</sub> (saline, 6.19 &#xb1; 0.61; PACAP, 7.18 &#xb1; 0.64, not significant), 5-HT<sub>2c</sub> (saline, 49.35 &#xb1; 2.72; PACAP, 42.06 &#xb1; 2.09, not significant), D2 (saline, 20.95 &#xb1; 1.93; PACAP, 17.87 &#xb1; 1.81, not significant), or mGlu2 (saline, 11.64 &#xb1; 0.84; PACAP, 9.44 &#xb1; 0.95, not significant) (<xref ref-type="fig" rid="f1">
<bold>Figures&#xa0;1A, B</bold>
</xref>). We also analyzed the time course of PACAP-induced internalization. The internalization ratios of 5-HT<sub>2A</sub> and PAC1 were similarly increased within 15 min after PACAP treatment and remained elevated for at least 45 min (two-way repeated-measures ANOVA; 5-HT<sub>2A</sub>, treatment effect, <italic>F</italic>
<sub>(1, 82)</sub> = 65.77, <italic>p</italic> &lt; 0.001; time effect, <italic>F</italic>
<sub>(3, 246)</sub> = 11.77, <italic>p</italic> &lt; 0.001; interaction, <italic>F</italic>
<sub>(3, 246)</sub> = 11.75, <italic>p</italic> &lt; 0.001; PAC1, treatment effect, <italic>F</italic>
<sub>(1, 54)</sub> = 96.14, <italic>p</italic> &lt; 0.001; time effect, <italic>F</italic>
<sub>(3, 162)</sub> = 19.41, <italic>p</italic> &lt; 0.001; interaction, <italic>F</italic>
<sub>(3, 162)</sub> = 18.66, <italic>p</italic> &lt; 0.001) (<xref ref-type="fig" rid="f1">
<bold>Figure&#xa0;1C</bold>
</xref>). In accordance with previous reports (<xref ref-type="bibr" rid="B15">15</xref>, <xref ref-type="bibr" rid="B16">16</xref>), 5-HT increased 5-HT<sub>2A</sub> internalization in a time-dependent manner, the pattern of which was similar to that of PACAP-induced 5-HT<sub>2A</sub> internalization (<xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Figure&#xa0;2</bold>
</xref>).</p>
<fig id="f1" position="float">
<label>Figure&#xa0;1</label>
<caption>
<p>PACAP induces internalization of 5-HT<sub>2A</sub> in HEK293T cells. <bold>(A)</bold> Representative images of HEK293T cells transfected with the indicated HaloTag receptors. The cells were labeled with Alexa Fluor 488 HaloTag membrane impermeable ligand for 15 min and then treated with 1 &#x3bc;M PACAP or saline for 30 min. Scale bar, 10 &#x3bc;m. <bold>(B)</bold> Quantification of the indicated HaloTag receptor internalization. Values are the mean &#xb1; SEM of 40&#x2013;64 cells obtained from three independent experiments. **<italic>p</italic> &lt; 0.01 vs. saline, Student&#x2019;s <italic>t</italic>-test. <bold>(C)</bold> Time course of 5-HT<sub>2A</sub> and PAC1 internalization for 45 min after PACAP treatment. Values are the mean &#xb1; SEM of 23&#x2013;69 cells obtained from three independent experiments. **<italic>p</italic> &lt; 0.01 vs. saline, two-way repeated-measures ANOVA followed by the Tukey-Kramer test.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fendo-12-732456-g001.tif"/>
</fig>
</sec>
<sec id="s3_2">
<title>PAC1 Mediates PACAP-Induced 5-HT<sub>2A</sub> Internalization</title>
<p>To examine the subtypes of the three PACAP receptors (PAC1, VPAC1 and VPAC2) involved in PACAP-induced 5-HT<sub>2A</sub> internalization, we compared 5-HT<sub>2A</sub> internalization following administration of various doses of PACAP and VIP. PACAP (0.01, 0.1, and 1 &#xb5;M) dose-dependently increased 5-HT<sub>2A</sub> internalization (one-way ANOVA, <italic>F</italic>
<sub>(3, 321)</sub> = 29.44, <italic>p</italic> &lt; 0.001), but VIP (0.01, 0.1, and 1 &#xb5;M) did not (one-way ANOVA, <italic>F</italic>
<sub>(3, 304)</sub> = 3.62, <italic>p</italic> = 0.054) (<xref ref-type="fig" rid="f2">
<bold>Figures&#xa0;2A, B</bold>
</xref>). Pretreatment with PACAP<sub>6-38</sub>, a PAC1 antagonist, significantly inhibited the PACAP-induced 5-HT<sub>2A</sub> internalization (one-way ANOVA, <italic>F</italic>
<sub>(2, 246)</sub> = 17.54, <italic>p</italic> &lt; 0.001) (<xref ref-type="fig" rid="f2">
<bold>Figures&#xa0;2C, D</bold>
</xref>). In addition, shRNA-mediated PAC1 silencing in HEK293T cells, which effectively decreased <italic>PAC1</italic> mRNA levels to less than 5% of normal levels, blocked the PACAP-induced 5-HT<sub>2A</sub> internalization (two-way ANOVA, PACAP effect, <italic>F</italic>
<sub>(1, 156)</sub> = 79.51, <italic>p</italic> &lt; 0.001; shRNA effect, <italic>F</italic>
<sub>(1, 156)</sub> = 76.58, <italic>p</italic> &lt; 0.001; interaction, <italic>F</italic>
<sub>(1, 156)</sub> = 81.72, <italic>p</italic> &lt; 0.001) (<xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Figure&#xa0;3</bold>
</xref>). Taken together these results indicate that PAC1 is involved in PACAP-induced 5-HT<sub>2A</sub> internalization.</p>
<fig id="f2" position="float">
<label>Figure&#xa0;2</label>
<caption>
<p>PACAP induces 5-HT<sub>2A</sub> internalization <italic>via</italic> PAC1 in HEK293T cells. <bold>(A)</bold> Representative images of HEK293T cells transfected with HaloTag 5-HT<sub>2A</sub>. The cells were labeled with Alexa Fluor 488 HaloTag membrane impermeable ligand for 15 min and then treated with the indicated concentrations of PACAP or VIP for 30 min. Scale bar, 10 &#x3bc;m. <bold>(B)</bold> Quantification of 5-HT<sub>2A</sub> internalization. Values are the mean &#xb1; SEM of 46&#x2013;71 cells obtained from three independent experiments. **<italic>p</italic> &lt; 0.01 vs. 0 &#x3bc;M, one-way ANOVA followed by the Tukey-Kramer test. <bold>(C)</bold> Representative images of HEK293T cells transfected with 5-HT<sub>2A</sub>. The cells were pretreated with 2 &#x3bc;M PACAP<sub>6-38</sub> or saline for 30 min, labeled with Alexa Fluor 488 HaloTag membrane impermeable ligand for 15 min and then treated with 100 nM PACAP or saline for 30 min. Scale bar, 10 &#x3bc;m. <bold>(D)</bold> Quantification of 5-HT<sub>2A</sub> internalization. Values are the mean &#xb1; SEM of 80&#x2013;86 cells obtained from three independent experiments. **<italic>p</italic> &lt; 0.01, one-way ANOVA followed by the Tukey-Kramer test.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fendo-12-732456-g002.tif"/>
</fig>
</sec>
<sec id="s3_3">
<title>PKC Is Involved in PACAP-Induced 5-HT<sub>2A</sub> Internalization</title>
<p>We then addressed the signaling pathways involved in PACAP-induced 5-HT<sub>2A</sub> internalization. Pretreatment with the PKC inhibitor D-sphingosine (50 &#xb5;M), but not the protein kinase A inhibitor H89 (20 &#xb5;M), or the mitogen-activated protein kinase kinase (MEK) inhibitor PD98059 (50 &#xb5;M), blocked the PACAP-induced 5-HT<sub>2A</sub> internalization (two-way ANOVA, PACAP effect, <italic>F</italic>
<sub>(1, 372)</sub> = 44.34, <italic>p</italic> &lt; 0.001; inhibitor effect, <italic>F</italic>
<sub>(3, 372)</sub> = 18.41, <italic>p</italic> &lt; 0.001; interaction, <italic>F</italic>
<sub>(3, 372)</sub> = 8.04, <italic>p</italic> &lt; 0.001) (<xref ref-type="fig" rid="f3">
<bold>Figures&#xa0;3A, B</bold>
</xref>). Another PKC inhibitor 1-(5-isoquinolinesulfonyl)-2-methylpiperazine dihydrochloride (H7) also significantly blocked PACAP-induced 5-HT<sub>2A</sub> internalization, whereas HA1004, a structural analog of H7 and used as a control, did not significantly inhibit the PACAP-induced 5-HT<sub>2A</sub> internalization (two-way ANOVA, PACAP effect, <italic>F</italic>
<sub>(1, 448)</sub> = 33.37, <italic>p</italic> &lt; 0.001; inhibitor effect, <italic>F</italic>
<sub>(2, 448)</sub> = 8.98, <italic>p</italic> &lt; 0.001; interaction, <italic>F</italic>
<sub>(2, 448)</sub> = 4.53, <italic>p</italic> = 0.011) (<xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Figure&#xa0;4</bold>
</xref>).</p>
<fig id="f3" position="float">
<label>Figure&#xa0;3</label>
<caption>
<p>Effect of kinase inhibitors or &#x3b2;-arrestin silencing on PACAP-induced 5-HT<sub>2A</sub> internalization in HEK293T cells. <bold>(A)</bold> Representative images of HEK293T cells transfected with 5-HT<sub>2A</sub>. The cells were pretreated with 50 &#x3bc;M D-sphingosine (PKC inhibitor), 20 &#x3bc;M H89 (protein kinase A inhibitor), 50 &#x3bc;M PD98059 (MEK inhibitor) or saline for 30 min, labeled with Alexa Fluor 488 HaloTag membrane impermeable ligand for 15 min and then treated with 1 &#x3bc;M PACAP or saline for 30 min. Scale bar, 10 &#x3bc;m. <bold>(B)</bold> Quantification of 5-HT<sub>2A</sub> internalization. Values are the mean &#xb1; SEM of 34&#x2013;51 cells obtained from three independent experiments. **<italic>p</italic> &lt; 0.01, two-way ANOVA followed by the Tukey-Kramer test. <bold>(C)</bold> Representative images of HEK293T cells cotransfected with 5-HT<sub>2A</sub> plus &#x3b2;-arrestin1 siRNA, &#x3b2;-arrestin2 siRNA or the negative control siRNA. The cells were labeled with Alexa Fluor 488 HaloTag membrane impermeable ligand for 15 min and then treated with 1 &#x3bc;M PACAP or saline for 30 min. Scale bar, 10 &#x3bc;m. <bold>(D)</bold> Quantification of 5-HT<sub>2A</sub> internalization. Values are the mean &#xb1; SEM of 77&#x2013;87 cells obtained from three independent experiments. **<italic>p</italic> &lt; 0.01, two-way ANOVA followed by the Tukey-Kramer test.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fendo-12-732456-g003.tif"/>
</fig>
</sec>
<sec id="s3_4">
<title>&#x3b2;-Arrestin2 Is Involved in PACAP-Induced 5-HT<sub>2A</sub> Internalization</title>
<p>We recently reported that &#x3b2;-arrestin2, but not &#x3b2;-arrestin1, is involved in PACAP-induced internalization of PAC1 (<xref ref-type="bibr" rid="B4">4</xref>). We therefore examined whether &#x3b2;-arrestins are also involved in PACAP-induced 5-HT<sub>2A</sub> internalization. Although the &#x3b2;-arrestin1 and &#x3b2;-arrestin2 siRNAs effectively decreased respective &#x3b2;-arrestin levels to less than 35% of normal levels in HEK293T cells (<xref ref-type="bibr" rid="B4">4</xref>), &#x3b2;-arrestin2 siRNA, but not &#x3b2;-arrestin1 siRNA, blocked the PACAP-induced 5-HT<sub>2A</sub> internalization (two-way ANOVA, PACAP effect, <italic>F</italic>
<sub>(1, 490)</sub> = 37.78, <italic>p</italic> &lt; 0.001; silencing effect, <italic>F</italic>
<sub>(2, 490)</sub> = 5.85, <italic>p</italic> = 0.0031; interaction, <italic>F</italic>
<sub>(2, 490)</sub> = 7.61, <italic>p</italic> &lt; 0.001) (<xref ref-type="fig" rid="f3">
<bold>Figures&#xa0;3C, D</bold>
</xref>). A negative control siRNA showed no effect on PACAP-induced 5-HT<sub>2A</sub> internalization (<xref ref-type="fig" rid="f3">
<bold>Figures&#xa0;3C, D</bold>
</xref>).</p>
</sec>
<sec id="s3_5">
<title>PACAP Decreases Cell Surface Localization of Endogenously Expressed 5-HT<sub>2A</sub>
</title>
<p>To confirm the phenomenon of PACAP-induced 5-HT<sub>2A</sub> internalization in more neurologically relevant cells, we examined the effect of PACAP on the cell surface localization of endogenously expressed 5-HT<sub>2A</sub> in mouse primary cultured cortical neurons using a cell surface biotinylation assay. PACAP significantly decreased the levels of cell-surface biotinylated 5-HT<sub>2A</sub> (saline, 1.00 &#xb1; 0.14; PACAP, 0.46 &#xb1; 0.10; <italic>p</italic> = 0.0077, Student&#x2019;s <italic>t</italic>-test) (<xref ref-type="fig" rid="f4">
<bold>Figures&#xa0;4A, B</bold>
</xref>). As expected, cell-surface biotinylated PAC1 levels were also decreased by PACAP (saline, 1.00 &#xb1; 0.09; PACAP, 0.26 &#xb1; 0.055; <italic>p</italic> &lt; 0.001, Student&#x2019;s <italic>t</italic>-test) (<xref ref-type="fig" rid="f4">
<bold>Figures&#xa0;4A, B</bold>
</xref>). In contrast, levels of cell-surface biotinylated 5-HT<sub>1A</sub> (saline, 1.00 &#xb1; 0.17; PACAP, 1.50 &#xb1; 0.45; not significant), D2 (saline, 1.00 &#xb1; 0.058; PACAP, 1.37 &#xb1; 0.22; not significant) and mGlu2/3 (saline, 1.00 &#xb1; 0.10; PACAP, 0.68 &#xb1; 0.13; not significant) were not affected by PACAP (<xref ref-type="fig" rid="f4">
<bold>Figures&#xa0;4A, B</bold>
</xref>).</p>
<fig id="f4" position="float">
<label>Figure&#xa0;4</label>
<caption>
<p>PACAP significantly decreases cell surface localization of 5-HT<sub>2A</sub> in primary cultured cortical neurons. <bold>(A)</bold> Representative immunoblots of cell surface biotinylated PAC1, 5-HT<sub>2A</sub>, 5-HT<sub>1A</sub>, D2, mGlu2/3 and alpha 1 sodium potassium ATPase (Na/K-ATPase) in primary cultured cortical neurons at 14 days <italic>in vitro</italic> treated with 1 &#x3bc;M PACAP or saline for 30 min. The band size is indicated for each blot. <bold>(B)</bold> Quantification of cell surface levels of PAC1, 5-HT<sub>2A</sub>, 5-HT<sub>1A</sub>, D2 and mGlu2/3 normalized to the levels of Na/K-ATPase. Values are the mean &#xb1; SEM from three or four independent experiments. **<italic>p</italic> &lt; 0.01, ***<italic>p</italic> &lt; 0.001 vs. saline, Student&#x2019;s <italic>t</italic>-test.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fendo-12-732456-g004.tif"/>
</fig>
<p>In addition, 5-HT<sub>2A</sub> levels in the membrane fraction of the frontal cortex were increased in <italic>Pacap<sup>&#x2013;/&#x2013;</sup>
</italic> mice compared with wild-type mice (saline, 1.00 &#xb1; 0.10; PACAP, 1.64 &#xb1; 0.10; <italic>p</italic> = 0.002, Student&#x2019;s <italic>t</italic>-test), although no significant change was observed in total 5-HT<sub>2A</sub> protein levels between <italic>Pacap<sup>&#x2013;/&#x2013;</sup>
</italic> and wild-type mice (saline, 1.00 &#xb1; 0.03; PACAP, 0.94 &#xb1; 0.03; not significant, Student&#x2019;s <italic>t</italic>-test) (<xref ref-type="fig" rid="f5">
<bold>Figures&#xa0;5A, B</bold>
</xref>).</p>
<fig id="f5" position="float">
<label>Figure&#xa0;5</label>
<caption>
<p>Increased 5-HT<sub>2A</sub> levels in the membrane fraction of the frontal cortex in <italic>Pacap<sup>&#x2013;/&#x2013;</sup>
</italic> mice and PACAP-induced attenuation of DOI-induced head twitch response. <bold>(A)</bold> Representative immunoblots of 5-HT<sub>2A</sub> in the cell membrane fraction (membrane) or total cell lysate (total) of the frontal cortex from wild-type (WT) or <italic>Pacap<sup>&#x2013;/&#x2013;</sup>
</italic> (KO) mice. As internal controls, Na/K-ATPase (membrane) and &#x3b2;-actin (total) were used. <bold>(B)</bold> Quantification of 5-HT<sub>2A</sub> levels normalized to Na/K-ATPase (membrane) or &#x3b2;-actin (total). Values are the mean &#xb1; SEM (n = 5). **<italic>p</italic> &lt; 0.01 vs. saline, Student&#x2019;s <italic>t</italic>-test. <bold>(C, D)</bold> Mice intracerebroventricularly administered PACAP (10 pmol) or vehicle were treated with DOI and their head-twitch responses were counted. <bold>(C)</bold> Time course of DOI (1 mg/kg)-induced head twitch responses. <bold>(D)</bold> Head twitch responses during 60 min in mice injected with the indicated doses of DOI. Values are the mean &#xb1; SEM (n = 3 per group). *<italic>p</italic> &lt; 0.05, **<italic>p</italic> &lt; 0.01 vs. vehicle, two-way repeated measures ANOVA <bold>(C)</bold> and two-way ANOVA <bold>(D)</bold> followed by the Tukey-Kramer test. <bold>(E)</bold> Effect of the PAC1 antagonist PACAP<sub>6-38</sub> on the PACAP inhibition of DOI-induced head twitch response. Thirty minutes before PACAP administration, PACAP<sub>6-38</sub> (100 pmol) were preadministered intracerebroventricularly. Values are the mean &#xb1; SEM (n = 4 per group). **<italic>p</italic> &lt; 0.01 vs. vehicle, one-way ANOVA followed by the Tukey-Kramer test.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fendo-12-732456-g005.tif"/>
</fig>
</sec>
<sec id="s3_6">
<title>Intracerebroventricular PACAP Administration Ameliorates the Hallucinogenic Head Twitch Response</title>
<p>We then addressed PACAP signaling involvement in 5-HT<sub>2A</sub>-dependent behavioral responses by examining the head twitch response, which is a characteristic head-shaking movement induced by a hallucinogenic drug through the stimulation of 5-HT<sub>2</sub> receptors (<xref ref-type="bibr" rid="B33">33</xref>). DOI (1.0 mg/kg)-induced head twitch responses were significantly fewer in mice administered PACAP (10 pmol) compared with vehicle control mice in the first, third and fourth 10 min-bins of a 60-min observation period (<xref ref-type="fig" rid="f5">
<bold>Figure&#xa0;5C</bold>
</xref>). The numbers of head twitch responses induced by 0.3 and 1.0 mg/kg DOI during 60 min were significantly lower in mice administered PACAP compared with vehicle control mice (two-way ANOVA, PACAP effect, <italic>F</italic>
<sub>(1, 12)</sub> = 39.80, <italic>p</italic> &lt; 0.001; dose effect, <italic>F</italic>
<sub>(2, 12)</sub> = 50.90, <italic>p</italic> &lt; 0.001; interaction, <italic>F</italic>
<sub>(2, 12)</sub> = 11.03, <italic>p</italic> = 0.0019) (<xref ref-type="fig" rid="f5">
<bold>Figure&#xa0;5D</bold>
</xref>). In addition, we examined whether the inhibitory effect of PACAP on DOI-induced head twitch response is mediated by PAC1 by using the PAC1 antagonist PACAP<sub>6-38</sub>. Intracerebroventricular preadministration of PACAP<sub>6-38</sub> (100 pmol) significantly blocked the inhibitory effect of PACAP on DOI-induced head twitch response (one-way ANOVA, <italic>F</italic>
<sub>(3, 12)</sub> = 47.77, <italic>p</italic> &lt; 0.001) (<xref ref-type="fig" rid="f5">
<bold>Figure&#xa0;5E</bold>
</xref>).</p>
</sec>
</sec>
<sec id="s4" sec-type="discussion">
<title>Discussion</title>
<p>In the present study, we investigated the mechanisms underlying the relationship between PACAP and 5-HT<sub>2A</sub> signaling pathways. We found that PACAP time- and dose-dependently increased the internalization of 5-HT<sub>2A</sub>, but not 5-HT<sub>1A</sub>, 5-HT<sub>2c</sub>, D2 or mGlu2, in HEK293T cells and that the effect of PACAP was mediated by PAC1, PKC and &#x3b2;-arrestin2. In addition, we showed that PACAP decreased the cell surface levels of endogenously expressed 5-HT<sub>2A</sub> in mouse primary cultured cortical neurons and that 5-HT<sub>2A</sub> levels in the membrane fraction of the frontal cortex were increased in <italic>Pacap<sup>&#x2013;/&#x2013;</sup>
</italic> mice compared with wild-type mice. Finally, we observed that intracerebroventricular administration of PACAP suppressed DOI-induced head twitch responses in mice. These results suggest that PACAP&#x2013;PAC1 signaling increases 5-HT<sub>2A</sub> internalization, resulting in attenuation of 5-HT<sub>2A</sub>-meadiated signaling.</p>
<p>In the present study, it is still uncertain whether PACAP-induced 5-HT<sub>2A</sub> internalization can be a mechanism for behavioral abnormalities including hyperactivity, PPI deficits, depressive-like behavior and memory impairment, reversal of the depressive-like behavior by the 5-HT<sub>2A</sub> antagonist ritanserin, and exaggerated DOI-induced hallucinogenic behaviors in <italic>Pacap<sup>&#x2013;/&#x2013;</sup>
</italic> mice. In order to address this, it is necessary to examine if increased cell surface expression of 5-HT<sub>2A</sub> in the frontal cortex (and possibly other brain regions as well) is relevant to behavioral impairments including exaggerated DOI-induced hallucinogenic behaviors and the effects of 5-HT<sub>2A</sub> antagonists on reversal of the impairments in <italic>Pacap</italic>
<sup>&#x2013;/&#x2013;</sup> mice (<xref ref-type="bibr" rid="B5">5</xref>&#x2013;<xref ref-type="bibr" rid="B10">10</xref>). Given that increased cell surface expression of 5-HT<sub>2A</sub> leads to supersensitivity of the 5-HT<sub>2A</sub>-mediated 5-HT response, it is reasonable that 5-HT<sub>2A</sub> antagonists effectively reverse the behavioral impairments in <italic>Pacap</italic>
<sup>&#x2013;/&#x2013;</sup> mice. The issue should also be addressed by examining whether 5-HT<sub>2A</sub> antagonists affect PAC1 and 5-HT<sub>2A</sub> interactions.</p>
<p>We examined 5-HT<sub>2A</sub> levels in the membrane fraction of the frontal cortex in <italic>Pacap<sup>&#x2013;/&#x2013;</sup>
</italic> mice, since both 5-HT<sub>2A</sub>, PACAP and PAC1 are expressed in this brain region (<xref ref-type="bibr" rid="B34">34</xref>&#x2013;<xref ref-type="bibr" rid="B37">37</xref>), suggesting a potential colocalization of 5-HT<sub>2A</sub> and PAC1 in the frontal cortex. In addition, 5-HT<sub>2A</sub> expressed in the frontal cortex plays an important role in the pathophysiology and therapeutic effects of schizophrenia (<xref ref-type="bibr" rid="B12">12</xref>, <xref ref-type="bibr" rid="B14">14</xref>). However, further analyses in other brain regions are needed, which will be investigated in our future work.</p>
<p>5-HT<sub>2A</sub> internalization is involved in diverse signaling pathways depending on different ligands. Recent studies indicate that 5-HT<sub>2A</sub> internalization signaling may be separated into hallucinogenic and antipsychotic specific pathways, because hallucinogenic and non-hallucinogenic 5-HT<sub>2A</sub> ligands induce distinct immediate early gene expression patterns (<xref ref-type="bibr" rid="B38">38</xref>&#x2013;<xref ref-type="bibr" rid="B41">41</xref>). Hallucinogenic DOI-induced 5-HT<sub>2A</sub> internalization is independent on &#x3b2;-arrestins and antipsychotic clozapine-mediated internalization is independent on PKC (<xref ref-type="bibr" rid="B16">16</xref>, <xref ref-type="bibr" rid="B42">42</xref>). Urs et&#xa0;al. (<xref ref-type="bibr" rid="B43">43</xref>) reported that &#x3b2;-arrestin-biased D2 ligands exert unique brain region-specific antipsychotic actions (<xref ref-type="bibr" rid="B43">43</xref>). The present observation that PACAP&#x2013;PAC1 signaling regulates 5-HT<sub>2A</sub> internalization in a PKC- and &#x3b2;-arrestin2-dependent manner provides a new molecular mechanism for this peptidergic signaling that cross-talks with serotonergic signaling in the brain.</p>
<p>We also examined the protein-protein interaction between PAC1 and 5-HT<sub>2A</sub> by co-immunoprecipitation using an anti-5-HT<sub>2A</sub> antibody; however, co-immunoprecipitation of PAC1 with 5-HT<sub>2A</sub> was not detected (data not shown). Therefore, it remains unclear how PACAP&#x2013;PAC1 signaling induces 5-HT<sub>2A</sub> receptor internalization. We previously reported that PACAP&#x2013;PAC1 signaling markedly reduces the association between DISC1 and DBZ in PC12 cells (<xref ref-type="bibr" rid="B44">44</xref>). DISC1 forms a protein complex of DISC1/Kalirin-7/PSD-95 (<xref ref-type="bibr" rid="B45">45</xref>). The Kalirin-7/PSD-95 complex is also directly associated with the 5-HT<sub>2A</sub> receptor and regulates 5-HT<sub>2A</sub> signaling and trafficking in HEK293 cells (<xref ref-type="bibr" rid="B46">46</xref>, <xref ref-type="bibr" rid="B47">47</xref>). In addition, we previously showed that &#x3b2;-arrestin2, but not &#x3b2;-arrestin1, was involved in PACAP-induced internalization of PAC1 (<xref ref-type="bibr" rid="B4">4</xref>). PACAP&#x2013;PAC1 signaling may regulate 5-HT<sub>2A</sub> internalization through these adaptor proteins.</p>
<p>In the present study, we observed, in our HEK293T cell cultures, expression of PAC1 transcript, maxadilan-induced cAMP elevation, PACAP-induced 5-HT<sub>2A</sub> internalization as well as inhibition of the PACAP-induced 5-HT<sub>2A</sub> internalization by PACAP<sub>6-38</sub> and shRNA-mediated PAC1 silencing. In addition, we observed that the HEK293T cells which was newly obtained from RIKEN BRC Cell Bank expressed <italic>PAC1</italic> mRNA at a similar level with our HEK293T cell cultures used in the present 5-HT<sub>2A</sub> internalization study. However, previous studies have shown that HEK293T cells did not express PAC1 (<xref ref-type="bibr" rid="B3">3</xref>, <xref ref-type="bibr" rid="B28">28</xref>, <xref ref-type="bibr" rid="B48">48</xref>, <xref ref-type="bibr" rid="B49">49</xref>) and therefore PAC1 was exogenously expressed to investigate the signal transduction system. In contrast, it was also reported that HEK293T cells expressed the PAC1 protein as observed by western blot analysis (<xref ref-type="bibr" rid="B50">50</xref>, <xref ref-type="bibr" rid="B51">51</xref>). The reason for the disagreement in PAC1 expression in HEK293T cells is currently unknown but might be related with passage number and culture conditions.</p>
<p>Serotonin syndrome is caused by adverse side effects of serotonergic drugs and is associated with increased serotoninergic activity (<xref ref-type="bibr" rid="B52">52</xref>). By indirectly antagonizing 5-HT<sub>2A</sub> function, PACAP signaling may have the potential to ameliorate serotonin syndrome. Accumulating evidence suggests that PACAP&#x2013;PAC1 signaling in the brain provides clues to elucidating the pathomechanisms of neurological and psychiatric disorders (<xref ref-type="bibr" rid="B53">53</xref>&#x2013;<xref ref-type="bibr" rid="B55">55</xref>). The present study furthers understanding of PACAP&#x2013;PAC1 signaling and shows that this pathway is a promising target for the development of neurotherapeutics.</p>
</sec>
<sec id="s5" sec-type="data-availability">
<title>Data Availability Statement</title>
<p>The raw data supporting the conclusions of this article will be made available by the authors.</p>
</sec>
<sec id="s6">
<title>Ethics Statement</title>
<p>This animal study was reviewed and approved by the Animal Care and Use Committee of the Graduate School of Pharmaceutical Sciences, Osaka University.</p>
</sec>
<sec id="s7" sec-type="author-contributions">
<title>Author Contributions</title>
<p>AH-T: design, experimentation, statistics, visualization, and writing. YS: experimentation and statistics. KM: experimentation and statistics. NE: experimentation and statistics. KK: experimentation. TN: writing and supervision. HH: conception, writing, and supervision. All authors contributed to the article and approved the submitted version.</p>
</sec>
<sec id="s8" sec-type="funding-information">
<title>Funding</title>
<p>This work was supported in part by the Japan Society for the Promotion of Science (JSPS) KAKENHI, grant numbers JP16K08269 (AH-T), JP19K07121 (AH-T), JP20H00492 (HH), JP20H03429 (HH, AH-T), JP20K07736 (HH, AH-T), JP21K19335 (HH), MEXT KAKENHI, grant number JP18H05416 (HH), AMED, grant numbers JP21dm0207117 (HH), and JP21am0101084 (HH), and a grant from the Takeda Science Foundation (HH).</p>
</sec>
<sec id="s9" sec-type="COI-statement">
<title>Conflict of Interest</title>
<p>The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
</sec>
<sec id="s10" sec-type="disclaimer">
<title>Publisher&#x2019;s Note</title>
<p>All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.</p>
</sec>
</body>
<back>
<ack>
<title>Acknowledgments</title>
<p>We are grateful to Dr. Atsuro Miyata at the Graduate School of Medical and Dental Sciences, Kagoshima University for his indispensable support. We are also grateful to the Center for Medical Research and Education, Graduate School of Medicine, Osaka University, for confocal microscopy analyses.</p>
</ack>
<sec id="s11" sec-type="supplementary-material">
<title>Supplementary Material</title>
<p>The Supplementary Material for this article can be found online at: <ext-link ext-link-type="uri" xlink:href="https://www.frontiersin.org/articles/10.3389/fendo.2021.732456/full#supplementary-material">https://www.frontiersin.org/articles/10.3389/fendo.2021.732456/full#supplementary-material</ext-link>
</p>
  <supplementary-material xlink:href="DataSheet_1.pdf" id="SM1" mimetype="application/pdf"/>
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