| Summary: | The urokinase plasminogen activator receptor (PLAUR) is a membrane anchored receptor that has been associated with a number of disease states. In these diseases, elevated receptor levels were associated with increased disease aggressiveness and higher mortality rates. Through genetic studies PLAUR has been identified as an asthma susceptibility gene. In these studies, coding and untranslated region single nucleotide polymorphisms showed association with asthma diagnosis and decline in lung function. In addition, association with baseline lung function in smokers and PLAUR SNPs was identified. This suggests that PLAUR plays a role in respiratory disease. Work presented in this thesis aimed to i) identify whether serum levels of PLAUR are associated with obstructive lung disease and lung function parameters, ii) identify novel regulatory mechanisms determining PLAUR levels, both at the genetic level in primary bronchial epithelial cells and at the protein level for serum PLAUR, iii) explore a role for the different isoforms in asthma and COPD and iv) determine novel variation in the PLAUR gene and 5` and 3` distal regions through next generation sequencing. Levels of the soluble cleaved form of PLAUR in serum were determined to be significantly elevated in COPD and asthma subjects compared to a control population. This identified an association between the soluble cleaved receptor and disease per se. However, PLAUR levels in serum could not be related to lung function parameters. With regards to receptor regulation, a genome-wide association study identified a novel post-translational PLAUR regulatory mechanism. This involved key SNPs in the human plasma kallikrein gene promoter that directed human plasma kallikrein enzymatic activity to cleave PLAUR in a post-translational mechanism. PLAUR gene regulation was also investigated via molecular biology, identifying that in primary bronchial epithelial cells, PLAUR regulation involves the gene’s 5 prime and 3 prime untranslated regions. Investigation of regulation under multiple stimulations pertinent to respiratory disease identified that cigarette smoke extract selectively elevated the soluble spliced variant of the receptor through a three prime untranslated region mechanism. This suggests that bronchial epithelial damage driven by cigarette smoke may be at least partially mediated by the soluble spliced form of PLAUR. Overexpression of PLAUR identified that the receptor has an important role in regulating primary bronchial epithelial cell function, including migration and rate of mitochondrial activity. Interestingly, results identified isoform specific roles for the different forms of the receptor suggesting that variant-specific over-expression of PLAUR could have diverse effects on cell function. Importantly this study was also the first to define a role for the soluble spliced form of PLAUR. Investigation into variation in the PLAUR gene and surrounding regions through next generation sequencing in asthma (n=200) and control (n=200) populations identified a number of novel variants including 4 variants unique to asthma population. In summary, the work described in this thesis has identified a novel association between serum soluble cleaved PLAUR and obstructive lung disease, as well defining novel genetic and post-translational regulatory mechanisms for PLAUR, importantly defining isoform specific PLAUR regulation for the first time. This work has also identified novel isoform specific roles for PLAUR, which have significant modulatory effects on bronchial epithelial cell function, and has through next generation sequencing furthered knowledge on universal and asthma specific PLAUR variation.
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