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Fig. 5. Proposed mechanism for cytotrophoblast survival at 2% O2.
Activated metalloproteinases (MP) at the cell surface cleave the extracellular
domain of proHBEGF (1). The released sHBEGF binds to HER1 or HER4 through its
EGF-like domain and to heparan sulfate proteoglycans (HSPG) through its
heparin-binding domain (2), and this is followed by receptor homo- or
heterodimerization with other members of the HER family. Subsequent
transphosphorylation of HER cytoplasmic domains at key tyrosine residues (Y-P)
initiates downstream signaling that increases proHBEGF accumulation (3) and
inhibits apoptosis (4). This positive feedback loop upregulates HBEGF
secretion to achieve extracellular HBEGF levels sufficient to maintain cell
survival at 2% O2.