Encyclopedia of Signaling Molecules

2018 Edition
| Editors: Sangdun Choi


Reference work entry
DOI: https://doi.org/10.1007/978-3-319-67199-4_622


Historical Background

MKK6 is a dual specificity mitogen-activated protein kinase that was first cloned by PCR using degenerate primers for the conserved kinase domain of MKKs (Han et al. 1996). MKK6 amino-acid sequence shares about 80% of similarity with MKK3 and 40% with MKK4 (Stein et al. 1996). Two MKK6 isoforms have been described in mouse and human (Cuenda et al. 1996; Han et al. 1996). The bigger isoform contains 334 amino acids and is highly expressed in heart, skeletal muscle, pancreas, and liver, while the smaller isoform of 278 amino acids has been detected only in skeletal muscle (Han et al. 1996).

Regulation of MKK6 Activity

Several extracellular stimuli initiate a signaling cascade of kinases that activate MKK6 by phosphorylating it at two residues (serine 207 and threonine 211) located in the activation loop domain (Fig. 1). The interaction of activation kinases with MKK6 is mediated by a domain for versatile docking (DVD domain) located in the C-terminal region of MKK6 (Takekawa et al. 2005).
MKK6, Fig. 1

Activation of MKK6 by upstream kinases. Several extracellular stimuli activate MAPKKKs (MTK1, ASK1, TAK1, TAO2K) that phosphorylate MKK6, thereby activating it. Active MKK6 phosphorylates and activates p38 kinases alpha, beta, delta, and gamma

Osmotic stress, ultraviolet light, and anisomycin activate MAP three kinase-1 (MTK1), which in turn phosphorylates MKK6 in a dose-dependent manner in COS and HeLa cells (Takekawa et al. 1997).

Transforming growth factor beta–activated protein kinase 1 (TAK1) has been shown to phosphorylate and activate MKK6 in vitro and in vivo (Moriguchi et al. 1996) and to be required to activate MKK6-p38 pathway during myogenic differentiation (Bhatnagar et al. 2010). Thousand and one amino acid kinase-2 (TAO2) coimmunoprecipitates and phosphorylates MKK6 during myogenic differentiation in the presence of stress stimuli such as sorbitol, sodium chloride, taxol, and nocodazole (Chen and Cobb, 2001). Apoptosis signal-regulating kinase 1 (ASK1) activates MKK6-p38 in response to proinflammatory cytokines and apoptotic stress (Ichijo et al. 1997). Noteworthy, phosphorylation mediated by ASK1 and TAO2 is characterized by a sequential order; first they phosphorylate MKK6 on Thr211 residue and subsequently on Ser207 (Humphreys et al. 2013). PKNα (a fatty-acid-activated and rho-activated serine/threonine protein kinase) has been shown to play an activating role in the MKK6-p38 pathway as an upstream activator of MTK1 and as a scaffold protein, associating with each member of the p38γ MAPK signaling pathway (p38γ, MKK6, and MTK1) (Takahashi et al. 2003). MKK6 activation has also been shown to be mediated by microtubules and Dctn1, a component of the dynein-dynactin complex involved in organelle transportation along the microtubules (Cheung et al. 2004).

Regarding MKK6 inactivation, the serine/threonine protein phosphatase type 2C alpha (PP2Cα) has been shown to dephosphorylate MKK6 in vitro and in vivo (Takekawa et al. 1998). Acetylation of serine 207 and threonine 211 by acetyltransferase YopJ (Yersinia outer protein J) inhibits MKK6 activity, indicating that phosphorylation and acetylation states of the activation loop domain are crucial to regulate MKK6 kinase activity. Importantly, the crystal structure of nonphosphorylated human MKK6 helped to reveal that MKK6 has a unique auto-inhibitory mechanism (different from the ones present in MKK4 or MKK1) which involves three short α-helices configured in the activation loop region (Matsumoto et al. 2012; Min et al. 2009).

In addition to modulation of MKK6 activity by direct enzymatic reactions, regulation of its protein and mRNA abundance have been shown to impact on MKK6 levels and thus in the magnitude of MKK6-p38 signaling. For instance, a negative feedback has been described in vitro and in vivo where one of MKK6 substrates, p38alpha, destabilizes MKK6 mRNA by promoting the dissociation of HuR from MKK6 3’UTR (Ambrosino et al. 2003). In accordance with this data, MKK3 deficient mice, which show lower p38 activation than WT mice, present higher amounts of MKK6 protein (Ma et al. 2007); however, whether p38α absence was indeed responsible for the observed increased MKK6 levels was not studied.

Upon activation, MKK6 phosphorylates  p38α, p38β, p38γ, and p38δ on their regulatory threonine and tyrosine residues within a tripeptide motif (Thr-Gly-Tyr) located in the activation loop of p38 (Raingeaud et al. 1995). The specific recognition of MKK6-p38 binding is mediated by a consensus docking domain (Lys/Arg–Xaa3–Leu/Ile–Xaa–Leu/Ile) present in the N-terminal region of MKK6 (Enslen et al. 2000).

MKK3 and MKK4, who share highly similar catalytic domains to MKK6, can also phosphorylate and activate p38 mitogen-activated protein kinase (MAPK) family members (Derijard et al. 1995; Raingeaud et al. 1996). Genetic and biochemical evidence demonstrates nonredundant and selective functions for these MAPKKs in regulating the activity of p38 kinases in response to specific stimuli. For instance, p38α is activated by MKK6 and MKK3 in response to TNFα stimuli, while in response to UV light p38α is phosphorylated and activated by MKK6, MKK3, and also MKK4. Environmental stress activates MKK6 and  MKK3, which in turn activate p38β and p38γ. However, MKK6 activation by TNFα results in activation of p38γ, while MKK3 activation by TNFα, UV light, osmotic shock, and anisomycin results in activation of p38δ (Remy et al. 2010). The complexity of MAPKs’ activation may reflect the ability to respond to multiple stimuli.

While phosphorylation of MKK6 in serine 207 and threonine 211 is an activatory event, MKK6 acetylation of these same residues by YopJ (Yersinia Outer protein J) has been shown to inhibit MKK6 activity. Therefore, MKK6 acetylation may be the mechanism by which YopJ blocks the innate immune response (Mukherjee et al. 2006).

Functional Roles of MKK6 Activity

Role of MKK6 in Cell Fate

MKK6-p38 pathway has been shown to promote differentiation of several cell types; the most studied being the myogenic lineage. MKK6 knockout mice are viable, fertile, and do not show developmental or tissue abnormalities. This data indicates that other kinases, most likely MKK3 and MKK4 who share highly homologous kinase domains, could compensate MKK6 loss in most important biological processes. Nevertheless, absence of MKK6 (or its activation impairment) as well as MKK6-forced activation have revealed important specific roles for MKK6 during cell fate decisions. For instance, MKK6−/− mice show impairment in double positive thymocyte apoptosis, indicating that MKK6 plays a role in thymocyte maturation (Tanaka et al. 2002).

MKK6 plays a crucial role in promoting myogenesis through the activation of p38 pathway (Zetser et al. 1999). Myogenic differentiation stimuli such as cell-to-cell contact activate the CDO-JLP immunoglobulin-scaffold protein complex, which in turn activates the MKK6-p38-α/β pathway (Takaesu et al. 2006). Other ligands, such as TNFα and amphoterin/RAGE, have been shown to induce myogenic differentiation through MKK6-p38 activation (Sorci et al. 2004). MKK6 exerts its promyogenic functions mainly through the p38 alpha kinase isoform (Perdiguero et al. 2007), which mediates the assembly of an active myogenic transcriptional complex by direct phosphorylation of its components: MEF2 myogenic transcriptional factors (Zhao et al. 1999; Rampalli et al. 2007),  SWI/SNF (SWItch/Sucrose NonFermentable) chromatin remodeling subunits (Simone et al. 2004, Forcales et al. 2012), and E47 (Lluís et al. 2005). p38 beta and gamma have been reported to promote and inhibit muscle gene expression by different groups (Wang et al. 2008; Gillespie et al. 2009).

Importantly, the MKK6-p38 pathway has been shown to play a role in the survival of differentiated neurons. In response to calcium influx, the activation of MKK6-p38 pathway induces MEF2C phosphorylation in serine 387 and this event may activate the expression of survival genes and repress the expression of apoptotic genes (Mao et al. 1999).

Intriguingly, MKK6 activation can reprogram neutrophils towards the monocytic lineage in mice and human cells (Köfel et al. 2014). Upon MKK6-p38 activation by transducing mouse and human peripheral blood neutrophils with a dominant activated MKK6, the granulopoietic C/EBPa transcriptional factor is degraded, which facilitates monocytic differentiation. GM-CSF/TNFα/IL-1β inflammatory cytokines promoted MKK6 phosphorylation with concomitant c-Jun induction and C/EBPa degradation; this event was accompanied with the neutrophil to monocyte transdifferentiation. Surprisingly, MKK6-p38 inhibitors were not used in order to monitor whether this pathway is not only sufficient but also required for neutrophil to monocyte reprogramming.

MKK6 and Inflammation

MKK6 activation occurs in inflammatory diseases such as rheumatoid arthritis (RA) and osteoarthritis (OA) (Chabaud-Riou and Firestein 2004). Blocking MKK6-p38 activity has been shown to attenuate these inflammatory diseases. For instance, a dominant negative MKK6 impairs the production of inflammatory cytokines (IL-6, IL-8) and the protease MMP-3 in IL-1 stimulated fibroblasts-like synoviocytes (Inoue et al. 2005). Furthermore, in a passive K/B × N mouse serum transfer model of arthritis, MKK6−/− mice show attenuation of arthritis, cartilage destruction, and bone erosion (Yoshizawa et al. 2009). In this study, MKK6 would be contributing to the colocalization of p38 with its substrate MK2 (MAPKAPK2).

In macrophages, LPS induces MKK6 phosphorylation and its binding with IRAK2. This event is required for the posttranscriptional control of cytokine and chemokine expression involved in the innate immune response (Wan et al. 2009).

Chronic inflammatory reactions are present in Alzheimer disease where glial cells release cytokines that are toxic to neurons and induce their degeneration (Akiyama et al. 2000). Importantly, activated MKK6 has been shown to localize with pathological structures such as neurofibrillary tangles, senile plaques, neuropil threads, and granular structures, only in the hippocampal and cortical regions of individuals with Alzheimer disease (Zhu et al. 2001). The authors suggest that activated MKK6-p38 pathway could promote cell death of damaged neurons and contribute like this to neurodegeneration, a hallmark of Alzheimer disease.

MKK6-p38 pathway plays an important cardioprotective role in the heart. In an in vivo model of infarction, transgenic mice hearts overexpressing MKK6 show a better functional recovery and less injury than nontransgenic mice (Martindale et al. 2005). One possible mechanism could be that MKK6-p38 activation in these MKK6-transgenic mice induced the expression of the heat shock protein αB-crystallin and the antiapoptotic Bcl-2 protein, which have been shown to play important cardioprotective roles.

All these works suggest that in an inflammatory environment, whether MKK6 is activated in cytokine producing cells or in cells receiving those inflammatory signals could result in opposite biological outcomes that include apoptosis versus cell survival.

MKK6 Role in Cancer

A tumor suppressor role has been described by different groups for the MKK6-p38 pathway, in part due to the observation that MKK6-p38 activation induces apoptosis in several cell lines, and this effect can be blocked by specifically inhibiting p38 with the SB203580 drug (Olson and Hallahan 2004). In addition, MKK6-p38 pathway is a critical regulator in G2-checkpoint, inducing cell cycle arrest in response to DNA damage (Wang et al. 2000). Fibroblasts isolated from MKK6−/− mice show an increased proliferation rate in serum-free medium compared to WT fibroblasts, correlating with the maintained expression of D-cyclins and the presence of phosphorylated Rb. Importantly, subcutaneous injection of these MKK6−/− fibroblasts into nude mice induces larger tumors compared to the WT fibroblasts (Brancho et al. 2003). Furthermore, a deficient MKK6-p38 signaling has been shown in certain types of rhabdomyosarcomas, where restoring a persistent activation of p38 MAPK pathway by the constitutively active mutant MKK6EE leads to tumor growth arrest and terminal differentiation (Puri et al. 2000). A similar approach was used in nude mice that were injected with HeLa (human cervical carcinoma) cells expressing a constitutively active MKK6 and showed reduced tumor formation (Timofeev et al. 2005). MKK6 levels were shown to be lower in 20 cases of liver cancer (Iyoda et al. 2003), suggesting that reduced MKK6-p38 signaling could represent an antiapoptotic mechanism giving growth advantages to these cells.

Thus, all these experiments indicate that absence of MKK6 signaling results in tumor progression, whereas activation of the MKK6-p38 pathway is sufficient to suppress in vivo tumorigenesis. In addition, an anti-metastatic effect has been attributed to the MKK6-p38 pathway; ectopic expression of MKK6 in an ovarian carcinoma cell line prevented the metastatic process when these cells were injected intraperitoneally (Hickson et al. 2006).

Nevertheless, the opposite functional output regarding MKK6 activation and cancer has also been reported. For instance, increased levels of MKK6 protein have been shown in esophagus, stomach, and colon cancers (Parray et al. 2014); importantly, data from The Cancer Genome Atlas (TCGA) show MKK6 amplification in several cancer types (Fig. 2). Accordingly, MKK6 activation has been shown to promote survival in MDA-MB-231 breast cancer cell line by increasing cyclin D1 levels (Huth et al. 2016). Therefore, MKK6 not only acts as a tumor suppressor but also seems to promote tumor survival. In the same manner, reports on p38 kinases contribution to cancer are highly debated with many experimental approaches supporting tumor-promotion or tumor-suppression effects (Igea and Nebreda 2015).
MKK6, Fig. 2

TCGA data on MKK6 alterations in several types of cancer. Amplification of MKK6 seems to be the most common alteration in several cancer types. (This graph was obtained using the cBioportal platform to analyze TCGA data Cerami et al. (2012)

All these works reveal that cancer disease is highly heterogenic; a multistep process involving many players in a complex combinatorial system. Thus, it is not surprising to find MKK6-p38 kinase pathway involved in what may seem at first contradictory outcomes. Regarding this issue, some light has been shed by a recent work that demonstrated a dual role for p38a kinase in colorectal cancer, by displaying tumor suppression activity at early stages of the disease and promoting cell survival and thus fueling the oncogenic process at later phases (Gupta et al. 2014); however, whether MKK6 was the responsible kinase for p38 activation in colorectal cancer was not addressed.


Mitogen-activated protein kinase kinase-6 (MKK6) belongs to the MAPK kinase (MAPKK) family of enzymes, which specifically activates p38 MAPK. MKK6 has a similar sequence to MKK3 (80%) and to MKK4 (40%). Cellular stresses such as osmotic shock, UV irradiation, hypoxia, cytokine stimulation, and cell-to-cell contact activate the MKK6-p38 pathway by activating upstream kinases (MAPKKKs) including Ask1 (apoptosis signal-regulating kinase 1), Tak1 (transforming growth factor beta–activated kinase 1), Tao2 (1001 amino acids kinases 2), and Mtk1 (Mekk4/MAP three kinase 1). All of these protein kinases phosphorylate MKK6 on serine 207 and threonine 211 resulting in MKK6 activation. Active MKK6 phosphorylates p38α, β, δ, and γ MAPKs, on their regulatory threonine and tyrosine residues, activating p38 MAPK signaling. MKK6 is widely expressed in mammalian tissues with higher accumulation in skeletal muscle, where it plays a crucial role during myogenic differentiation. In cancer, several loss of function and gain of function assays support a tumor suppressor role for MKK6 activity; however, some reports are also showing protumorigenic features of MKK6. MKK6 activation in an inflammatory environment also seems to lead to antagonistic results.

In summary, MKK6 has major distinct roles in several biological processes. The specificity of its action depends on multiple factors such as the diversity of its activators, the selectivity of the available substrates, the concomitant signaling pathways being activated or repressed in a particular situation, the duration and magnitude of the activation, and the assembly with scaffold proteins among others. Because of its prominent signaling role in differentiation, inflammatory diseases, and cancer, the exploration of drugs targeting MKK6 activity is a challenging field to develop new therapeutic approaches.


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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Germans Trias i Pujol Health Sciences Research Institute (IGTP), Program of Predictive and Personalized Medicine of Cancer (PMPPC)Badalona, BarcelonaSpain