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The Journal of Neuroscience, January 1, 1999, 19(1):147-158
Nitric Oxide Acutely Inhibits Neuronal Energy Production
James R.
Brorson1,
Paul
T.
Schumacker2, and
He
Zhang3
1 Department of Neurology and the Committees on
Neurobiology and Cell Physiology, 2 Department of Medicine
and the Committee on Comparative Medicine and Pathology, and
3 Section of Neurosurgery, Department of Surgery, The
University of Chicago, Chicago, Illinois 60637
 |
ABSTRACT |
Disruption of mitochondrial respiration has been proposed as an
action of nitric oxide (NO) responsible for its toxicity, but the
effects of NO on the energetics of intact central neurons have not been
reported. We examined the effects of NO on mitochondrial function and
energy metabolism in cultured hippocampal neurons. The application of
NO from NO donors or from dissolved gas produced a rapid, reversible
depolarization of mitochondrial membrane potential, as detected by
rhodamine-123 fluorescence. NO also produced a progressive
concentration-dependent depletion of cellular ATP over 20 min
exposures. The energy depletion produced by higher levels of NO (2 µM or more) was profound and irreversible and proceeded
to subsequent neuronal death.
In contrast to the effects of NO, mitochondrial protonophores produced
complete depolarizations of mitochondrial membrane potential but
depleted the neuronal ATP stores only partially. Inhibitors of
mitochondrial oxidative phosphorylation (rotenone or 3-nitropropionic
acid) or of glycolysis (iodoacetate plus pyruvate) also produced only
partial ATP depletion, suggesting that either process alone could
partially maintain ATP stores. Only by combining the inhibition of
glycolytic energy production with the inhibition of mitochondria could
the effects of NO in depleting energy and inducing delayed toxicity be duplicated.
These results show that NO has rapid inhibitory actions on
mitochondrial metabolism in living neurons. However, the severe ATP-depleting effects of high concentrations of NO are not fully explained by the direct effects on mitochondrial activity alone but
must involve the inhibition of glycolysis as well. These inhibitory effects on energy production may contribute to the delayed toxicity of
NO in vitro and in ischemic stroke.
Key words:
nitric oxide; ischemia; peroxynitrite; poly-(ADP ribose)
polymerase; mitochondria; glycolysis
 |
INTRODUCTION |
The marked toxicity of nitric oxide
(NO) to neurons is not fully explained. NO is known to have a number of
cellular effects of possible pathophysiological significance (Gross and
Wolin, 1995
; Iadecola, 1997
). Although it is not intrinsically
unstable, NO avidly combines with the superoxide anion
(O2
) to form peroxynitrite
(ONOO
), which is a highly reactive free radical,
and has been shown to mediate much of the neurotoxicity of NO (Lipton
et al., 1993
; Bolaños et al., 1995
). The cellular targets of NO
or ONOO
responsible for subsequent neuronal death
are not fully defined. One action linked to toxicity is the prolonged
activation of poly-(ADP ribose) polymerase (PARP) (Zhang et al., 1994
),
leading to energy depletion. Inhibiting PARP prevents much of the
delayed neurotoxicity of NO. However, multiple toxic effects of NO or
ONOO
may interact to initiate neuronal death. For
example, a disruption of Ca2+ homeostasis, which
persists for hours after toxic exposure to NO (Brorson et al., 1997
),
also can be shown to contribute to its delayed neuronal toxicity
(Brorson and Zhang, 1997
). The final demise after NO exposure can be
either apoptotic or necrotic cell death, depending on the intensity of
the injury (Bonfoco et al., 1995
).
NO impairs mitochondrial respiration in isolated mitochondria (Stadler
et al., 1991
; Radi et al., 1994
; Lizasoain et al., 1996
). The relevance
of this action to toxicity in central neurons has not been demonstrated
clearly. After 24 hr of ONOO
exposure
(Bolaños et al., 1995
) or 24 hr after brief glutamate exposure
(Almeida et al., 1998
), decreased activities of mitochondrial electron
transport chain complexes have been described in neurons, but it is not
clear whether these caused or rather resulted from ONOO
or glutamate-induced toxicity. A recent
report has described acute compromise of mitochondrial complex
activities after 5 min of asphyxia in perinatal rats (Bolaños et
al., 1998
). This effect was blocked by a nitric oxide synthase (NOS)
inhibitor, suggesting a role for NO production. Nevertheless, the
possibility remains that other effects of anoxia, such as reactive
oxygen species production or transmembrane ion fluxes, may have
combined with NO generation to affect mitochondria. Only by the
application of NO from exogenous sources can its mitochondrial effects
be isolated from multiple other effects of anoxia or glutamate exposure.
Neurons are particularly dependent on mitochondrial energy production.
If neuronal mitochondria are inhibited by NO, energy depletion could
result, possibly leading to either necrosis or apoptosis (Pang and
Geddes, 1997
). Ca2+ homeostasis also depends on ATP,
and the observed disruption by NO of neuronal Ca2+
homeostasis appears to be attributable to energy depletion, because it
could be prevented by provision of an ATP supply via a patch pipette
(Brorson et al., 1997
). The effect of NO on cellular energy might be
ascribed to the inhibition of the respiratory enzymes of mitochondria,
to the inhibition of glycolysis, or to the induction of increased
energy consumption. Whatever the cause, energy depletion might explain
the early pathophysiological actions of NO. In the present studies we
have examined directly the effects of toxic exposures to NO on
mitochondria, energy supply, and survival in cultured neurons.
 |
MATERIALS AND METHODS |
Neuronal cultures. Dissociated cultures of
hippocampal neurons were prepared from day 18 embryonic Sprague Dawley
or Holtzman rats (with the sperm-positive day numbered as day 1), as
previously described in detail (Brorson et al., 1997
). The procedures
that were followed were in accordance with a protocol approved by the University of Chicago Institutional Animal Care and Use Committee. Trypsin-dissociated neurons were plated on 15-mm-round glass coverslips and suspended over a feeding glial layer in a serum-free defined medium
(N2.1, with 15 mM HEPES added). Hippocampal neurons for [Ca2+]i fluorimetric studies were of
age 11-25 d in vitro (DIV), for ATP assays of age 11-19
DIV, and for toxicity studies of age 11-17 DIV.
Generation of solutions of NO. Most experiments used NO
donors (see below) freshly dissolved from stock solutions in saline buffer immediately before application. Some experiments were performed with gaseous NO. NO gas (5% NO in N2), applied in
different proportions with an excess of 20% O2/80%
N2, was bubbled in stirred saline buffer at 22°C.
During NO application the pH in the buffer was monitored. At higher
rates of NO gas application the pH of the solution was found to
decrease, presumably as a result of nitrous acid formation (Butler et
al., 1995
). To maintain neutral pH, we continuously replaced the
buffer as it flowed from the chamber with alkaline buffer, pH 7.8. In
contrast, by using NO donors, the pH changes during 20 min exposures
were generally small (<0.1 pH units over 20 min periods). The only
exception was 1 mM SNAP, which caused a drop in pH of
0.16 ± 0.03 at 5 min (mean ± SD) and no further pH drop thereafter.
Measurement of NO. To make approximate measurements of the
NO concentrations generated by the NO donors or by gaseous NO, we used
a NO-selective electrode (IsoNO, World Precision Instruments, Sarasota,
FL). Calibration was performed according to instructions by using
injections of defined amounts of NaNO2 in stirred
deoxygenated solutions of KI and acetic acid, generating stoichiometric
amounts of NO. Highly linear responses resulted and were used to
convert the electrode current to [NO]. Measurements were made in 50 ml plastic tubes placed in a constant temperature water bath at
22-23°C. Immediately after the NO donor was mixed in buffer and at 5 min intervals thereafter, the tip of the NO electrode was placed in the
NO solution and gently stirred for 1 min to achieve a stable reading
and then was removed to control the buffer between readings. Separate
[NO] measures also were made with the tip of the NO electrode in the
well of the Plexiglas perfusion chamber used in physiological experiments during 5 min superfusions with NO donor-containing (or
dissolved NO gas-containing) solutions.
Fluorescence imaging with rhodamine-123. Fluorimetric
digital imaging of rhodamine-123 fluorescence was used to detect the effects on mitochondrial membrane potential. Hippocampal neurons were
loaded by incubation for 10 min in 10 µg/ml rhodamine-123, followed
by a 5 min wash, both at room temperature (22°C) in the standard
saline buffer containing (in mM): NaCl 145, KCl 3, CaCl2 2, MgCl2 1, HEPES 10, and glucose 10, pH-adjusted to 7.4 with NaOH. The coverslips were mounted on a
Plexiglas superfusion chamber, placed in a Nikon Diaphot fluorescence
microscope, and continuously superfused with 0.5 µM
tetrodotoxin-containing buffer to which various compounds were added.
For digital imaging, excitation used a 495 nm light with a 505 nm
dichroic mirror and a 515 nm long-pass barrier filter, plus a 40×
fluorescence objective. Image acquisition and analysis were performed
by commercial image-processing hardware and software (MetaFluor,
Universal Imaging, West Chester, PA). A field of healthy-appearing
neurons from the central region of a coverslip was selected, and the
neurons were identified by typical morphology. Areas of interest were
outlined over the soma of each neuron, including nuclear areas, and
over a blank area of the coverslip for background. The average
fluorescence was recorded digitally for each indicated area at 2 Hz for
the duration of each experiment. Neurons were rejected if the baseline
fluorescence was highly unstable or if significant digital saturation
occurred during the experiment. Background traces were subtracted from the records for each neuron. Quantitative analysis was performed by
comparing average background-corrected fluorescence at certain time
points as a fraction of the difference between the baseline value and
the peak carbonyl cyanide m-chlorophenylhydrazone-evoked (CCCP) fluorescence in the same cell. The relative fluorescence values
were averaged over all imaged cells, usually 5-12 neurons for each
experiment. Every condition was evaluated in four or more experiments.
ATP-luciferase assays. Cellular ATP and ADP assays in
cultured neurons were performed with a firefly luciferase
chemiluminescence assay essentially as described by Budd and Nicholls
(1996)
. Coverslips were washed and exposed in the standard saline
buffer at 37°C to various donors or at 22°C to NO dissolved from
bubbled 5% NO gas (see above). Then the coverslips were washed, and
the cells either immediately were taken up in 100 µl of lysis buffer
(0.5 M KH2PO4, 1% Triton
X-100, 2 mM EDTA, and 1 mM DTT, pH 7.8) or were
returned to incubation in glia-conditioned serum-free medium for lysis
at later time points. The extracted samples were centrifuged and stored
at
20°C until an assay could be performed on all samples in
parallel. Reagents were obtained from Analytical Luminescence Laboratory (Ann Arbor, MI). The low background reagent (Firelight LB)
was used in 20 µl amounts with 100 µl of reaction buffer. Luminescence was measured by the Monolight 1500 luminometer (Analytical Luminescence Laboratory), made available via the generosity of Dr.
Harinda Singh of the Howard Hughes Medical Institute of the University
of Chicago (Chicago, IL). After a determination of the luciferase
signal corresponding to the ATP concentration, pyruvate kinase (2 U)
and phosphoenol pyruvate (0.5 mM) were added and a second
measurement of luminescence was taken, the additional signal reflecting
the conversion of ADP to ATP (driven to near-completion by an excess of
phosphoenol pyruvate). The signal difference gave an estimate of ADP
concentration for the calculation of ATP/ADP ratios.
Total protein was measured with the Bio-Rad DC Protein Assay kit
(Bio-Rad Laboratories, Hercules, CA), according to the instructions supplied for the microplate assay protocol, and, through the generosity of Dr. Anthony Reder (Department of Neurology, University of Chicago), a Molecular Devices Thermomax microplate reader (Palo Alto, CA) at a
wavelength of 650 nm. Because the buffer used for luciferase assays was
incompatible with any of the available colorimetric protein assays, we
were unable to normalize ATP values to concurrent measures of the total
cellular protein. Instead, the total ATP signal per coverslip of
cultured neurons exposed to various treatments was normalized to the
total ATP signal from parallel control coverslips. Figures show the
mean ± SD of normalized ATP or of the ATP/ADP ratio for each
condition. An estimation of ATP per unit of protein also was performed
by measures from coverslips treated in parallel, with quantities
calculated by using linear regression of calibration data generated
with known amounts of ATP and of ovalbumin. The ATP per total protein
from cultured neurons was found to be 8.7 ± 1.6 pmol/mg
(mean ± SD) in controls versus 0.7 ± 0.1 pmol/mg after
exposure to 30 µM SNOC.
Survival assays. Cell death and survival were assayed by
using the fluorescent markers fluorescein diacetate and propidium iodide as previously described (Brorson and Zhang, 1997
). Drug exposure
was at 37°C in the standard physiological buffer described above.
After 20 min exposures the coverslips were washed and returned to
incubation in glia-conditioned serum-free medium. After 24 hr the
living neurons and dead cells were counted in a blinded manner in each
experiment, and the percentage of survival was calculated.
Data analysis. Statistical evaluations of rhodamine
fluorescence changes and of survival were by ANOVA on ranks and of
normalized ATP values by repeated measures ANOVA on ranks, followed by
Dunn's test of pairwise comparisons to control values (SigmaStat,
Jandel Scientific, San Rafael, CA).
Materials. A 100 mM stock of
S-nitrosocysteine (SNOC) was produced immediately before
each use from a mixture of 100 mM L-cysteine and 100 mM NaNO2 by acidification with 5%
(v/v) with 10N HCl. SNOC was added to saline buffer at room
temperature, and the pH was brought back to 7.4 with 1N NaOH. It was
applied within minutes of its synthesis, and no additional fresh SNOC
was added subsequently during the 20 min exposures. After synthesis,
stocks of SNOC were left at room temperature for several days to
degrade fully to "old SNOC" for use as a control.
S-nitroso-N-acetylpenicillamine (SNAP), stored in
1 M aliquots in DMSO at
20°C until use, and 3-morpholino-sydnonimine (SIN-1), stored at
20°C as 1 M
aliquots in water, were obtained from Molecular Probes (Pitchford, OR), as were fura-2 AM and rhodamine-123. Spermine-NO and diethylamine sodium-nitric oxide complex (DEA-NO) were purchased from Research Biochemicals (Natick, MA). Spermine-NO was dissolved as a 15 mM stock in water on the day of use, and DEA-NO was
dissolved in methanol at 0.1 M, stored on dry ice in
ethanol, and used within hours. Frozen stocks of the latter agents did
not retain activity. Bovine hemoglobin (Sigma, St. Louis, MO) was
reduced with excess sodium hydrosulfite and purified on a Sephadex G-25
column to produce 3 mM stocks of oxyhemoglobin, which was
refrigerated and used within 3 d. The compound
2-phenyl-4,4,5,5-tetramethylimidazoline-1-oxyl-3-oxide (PTIO) was
purchased from Alexis Biochemicals (San Diego, CA) and stored at 4°C
as a 100 mM stock in ethanol. Calpain inhibitor-1 (Calbiochem, San Diego, CA) and MDL-28170 (the kind gift of Dr. Shujaath Mehdi, Marion Merrell Dow, Cincinnati, OH) were both stored as
10 mM stocks in ethanol at 4°C. All other reagents and chemicals were purchased from Sigma. CCCP and carbonyl cyanide p-trifluoromethoxy-phenylhydrazone (FCCP) were stored at
4°C as 5 mM stocks in DMSO, and rotenone was stored at 10 mM in DMSO. Ethanol-dissolved stocks of oligomycin at 6 mg/ml and
-cyano-4-hydroxycinnamic acid (4-CIN) at 1 M
were stored at
20°C. SOD was stored at 4°C as a 100,000 U/ml
stock in water; iodoacetate was stored at
20°C at 1 M
in water. 3-Nitropropionic acid was mixed as a fresh 1 M
stock in water on the same day that it was used, and pyruvate was added
directly to buffer at the final 10 mM concentration.
 |
RESULTS |
NO donors
In previous work we have shown that NO donors, including SNOC,
SNAP, and SIN-1, induce acute toxicity in neurons (Brorson and Zhang,
1997
). To elucidate the mechanisms leading to neuronal death after
exposure to NO, we have used these agents and others as NO sources,
exploring their effects on mitochondrial physiology and energy homeostasis.
The varied physiological effects of different NO donors must be
interpreted in the light of the NO concentration ([NO]) that they
each produced. Using an NO-sensitive electrode, we measured the NO
concentrations produced by the various NO donors in unstirred buffer
over 20 min periods (Table 1). In static
buffer, high initial readings from SNOC dilutions decayed over the
first few minutes to substantially lower values. At 5 min the
accumulations of NO ranged from 0.5 µM (for 3 µM SNOC) to nearly 10 µM (for 1 mM SNOC). The relationship between [NO] and SNOC
concentration was nonlinear, reflecting more complex chemical kinetics
than a simple irreversible first order decay. In contrast, SNAP (1 mM) produced much lower [NO], rising slowly to only
~0.5 µM, whereas SIN-1 (1 mM) produced no
detectable [NO]. The other NO donors used, spermine-NO (300 µM) and DEA-NO (100 µM), produced
micromolar concentrations of NO. Neither saline alone nor 1 mM L-cysteine plus NaNO2 generated
signals (data not shown). Because the actual NO concentrations applied
to the cells might be dependent on the handling of the agents and on
the configuration used, they also were assayed in the perfusion chamber
that was used in our experiments. The values of [NO] delivered to the
perfusion chamber from solutions of the various NO donors closely
matched those measured in the static buffer at the 5 min time point,
although the initial high peak values generated by SNOC were blunted in
the perfusion chamber (data not shown). The NO concentrations generated
from gaseous NO were measured also, as cited below.
NO depolarizes mitochondria in living hippocampal neurons
To study mitochondrial function in intact hippocampal neurons, we
used the fluorophore rhodamine-123 as an indicator of mitochondrial depolarization (Duchen, 1992
). Rhodamine-123 is sequestered into mitochondria by the highly negative potential of the inner
mitochondrial membrane, designated 
m, which is
maintained by the proton translocation of the electron transport
system. If this activity is inhibited pharmacologically or if the
proton gradient is eliminated by one of the protonophores CCCP or FCCP,
the membrane depolarizes and rhodamine-123 is released into the
cytoplasm. We observed increases in overall cytoplasmic fluorescence
with mitochondrial depolarization (Figs.
1, 2). Basal rhodamine-123 fluorescence
was quite stable in neurons, fading only slowly, whereas the
fluorescence in intermingled glial cells faded rapidly within the first
few minutes of observation. CCCP (1 µM) produced a rapid
rise in average somatic fluorescence, reaching a plateau value within
90 sec. With the washout of CCCP, fluorescence recovered to the same
baseline in each cell over a 1-5 min interval. Repeated exposures to
CCCP (at 0.1, 1, and 10 µM) or by FCCP (1 or 10 µM) produced approximately the same maximal rhodamine-123
fluorescence increases (data not shown). We used this peak increase in
fluorescence produced by 1 µM CCCP to normalize
subsequent changes produced by other agents.

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Figure 1.
Mitochondrial imaging with rhodamine-123.
A, Photomicrographs of rhodamine-123 fluorescence in
cultured hippocampal neurons (26 DIV). Successive frames show (1) a
phase contrast image, (2) baseline fluorescence with a particulate
cytoplasmic distribution consistent with localization of fluorophore to
mitochondria, (3) increased diffuse cytoplasmic fluorescence after 1 min of stimulation with CCCP (1 µM), and (4) recovery of
the particulate fluorescence pattern with the washout of CCCP. Scale
bar, 30 µm. B, Digital fluorimetric imaging of
rhodamine-123 fluorescence at baseline, after 1 min of exposure to 1 mM SNOC, and after 3 min of washout, demonstrating a
reversible increase in cytoplasmic fluorescence induced by SNOC
(indicated by warmer colors on the pseudocolor
scale).
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High concentrations of NO (~9 µM) generated by 1 mM SNOC consistently produced an increase in rhodamine-123
fluorescence in most neurons (Figs. 1,
2). The increase was a variable fraction of the signal change produced by CCCP. The effect generally occurred quickly with the application of SNOC, sometimes increasing further over
a 5 or 10 min exposure, and often with incomplete recovery after
washout. Changes in rhodamine-123 fluorescence at 1 and 5 min,
quantified as a fraction of the maximal change produced by CCCP, showed
that the average fluorescence in cells perfused with buffer alone
slightly decreased over 5 min (Fig. 2E). In contrast,
SNOC (1 mM) produced significant average increases in fluorescence, whereas inactivated SNOC ("old SNOC") or
L-cysteine plus NaNO2 (from which SNOC is
synthesized) had no significant effects. Neither the NMDA antagonist
MK-801 (1 µM) nor the enzyme superoxide dismutase-1 (SOD)
changed the significant effects of NO released from SNOC. Electron
transport inhibitors, including the complex I inhibitor rotenone (5 µM) (Budd and Nicholls, 1996
) and the irreversible
complex II inhibitor 3-nitropropionic acid (1 mM) (Beal,
1995
), also produced qualitative increases in the rhodamine signal. The
submicromolar NO concentrations produced by SNAP (1 mM) or
SIN-1 (1 mM) (see Table 1) did not produce significant
fluorescence changes.

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Figure 2.
Rhodamine-123 detection of mitochondrial
depolarization. Cytoplasmic rhodamine-123 fluorescence (arbitrary
units) versus time for seven representative hippocampal neurons for
each experiment. A, In control experiments 90 sec
exposures to CCCP (1 µM) resulted in rapid increases in
fluorescence, followed by stable or slightly decreased signals over 10 min exposures. B, SNOC (1 mM) produced rapid
fluorescence increases. C, The effects of SNOC were not
blocked by the coapplication of superoxide dismutase
(SOD; 100 U/ml). D, The complex I
inhibitor rotenone (5 µM) produced slower increases in
fluorescence in some imaged neurons, with little reversibility.
E, Quantitative summary of rhodamine-123 fluorescence
studies, comparing changes in relative cytoplasmic fluorescence after 1 or 5 min averaged over all neurons in each experiment. These values
then were averaged over all experiments for each agent. The
concentrations used were 1 mM for SNOC, "old SNOC,"
SIN-1, SNAP, and L-cysteine
(L-Cys) plus NaNO2, 100 U/ml for SOD, 1 µM for MK-801, 5 µM for
rotenone, and 1 mM for 3-nitropropionic acid
(3-NP) (mean ± SEM; *p < 0.05; n = 6-10 experiments for each
condition).
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We performed similar experiments by applying a range of NO
concentrations, using several NO donors as well as gaseous NO dissolved in buffer (Fig. 3). Agents producing
several micromolar NO concentrations, including 30 µM
SNOC and 100 µM DEA-NO, produced large increases in
rhodamine-123 fluorescence. NO concentrations in the 1-2
µM range (produced by 3 µM SNOC or 300 µM spermine-NO) appeared to produce smaller, variable
qualitative fluorescence changes (Fig. 3A) that did not
reach statistical significance. NO dissolved from gas at 1.55 µM also evoked significant increases in rhodamine-123 fluorescence, whereas buffer bubbled with 20%
O2/80% N2 alone showed no changes from
control traces. When the mean change in rhodamine-123 fluorescence was
plotted as a function of the mean NO concentrations in the perfusion
chamber for each treatment, a striking NO concentration-dependent
relationship emerged (Fig. 3D). Concentrations of NO rising
into the micromolar range produced increasing acute rhodamine-123
signals, indicating changes of 
m. At ~4
µM the rhodamine-123 signal changes appeared to reach a
plateau.

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Figure 3.
Mitochondrial effects of other NO donors.
A, Representative cytoplasmic rhodamine-123 fluorescence
recordings from hippocampal neurons exposed to 3 µM SNOC,
30 µM SNOC, and 100 µM DEA-NO. CCCP (1 µM) was applied before and after each agent.
B, The effects of dissolved NO from gas on rhodamine-123
fluorescence. Saline buffer was bubbled continuously with an
NO/O2/N2 mixture and perfused over the
neurons. Buffer bubbled with O2/N2 alone
(top) had no effect. The buffer containing
dissolved NO produced a modest rise in the rhodamine123
fluorescence (bottom). C, Summary
of average changes in relative rhodamine-123 fluorescence
(mean ± SEM; *p < 0.05 compared with
controls) for 3 and 30 µM SNOC, 300 µM
spermine-NO, 100 µM DEA-NO, and for NO from gas at two
rates, which generated dissolved [NO] values at 5 min of 0.44 ± 0.07 and 1.55 ± 0.44 µM (mean ± SEM).
D, The average changes in rhodamine-123 fluorescence are
plotted versus the average concentrations of NO at 5 min produced by
each agent, measured in the perfused chamber (mean ± SEM). The
mitochondrial depolarization, indicated by fluorescence changes,
correlated with the NO concentration (r = 0.86;
p < 0.01).
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As a final confirmation that NO actually mediated the effects of SNOC
on rhodamine-123 fluorescence, the NO scavenging agents oxyhemoglobin
and PTIO (Akaike et al., 1993
) were used (Fig.
4). As before, no significant change in
fluorescence occurred in control neurons exposed to buffer alone,
whereas 10 min exposures to SNOC (1 mM) alone produced
increasing elevations in rhodamine fluorescence. Both oxyhemoglobin and
PTIO prevented significant increases in fluorescence for 5 min of
simultaneous exposure, whereas fluorescence increases followed
scavenger washout with continued exposure to SNOC. The evidence
confirmed a specific action of NO in producing the fluorescence
changes.

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Figure 4.
NO scavengers block the effects of SNOC on
mitochondrial potential. Shown are the effects of the NO scavenging
agents oxyhemoglobin (Hgb; 30 µm) or PTIO (50 µm) on
NO-induced changes in rhodamine-123 fluorescence hippocampal neurons.
A, After a 90 sec exposure to CCCP (1 µM),
fluorescence (arbitrary units) remained stable during 5 min of NO
exposure (1 mM SNOC) in the presence of oxyhemoglobin but
began to rise after the removal of oxyhemoglobin. B,
SNOC (1 mM) alone for 10 min produced rapid, sustained, and
reversible fluorescence increases. C, Quantitative
summary of effects of scavengers on changes in rhodamine-123
fluorescence relative to a maximal fluorescence change produced by
CCCP. SNOC alone produced a rapid, sustained rise in relative
fluorescence. No significant increase was produced by SNOC in the
presence of either oxyhemoglobin or PTIO. PTIO alone, in the
pretreatment phase, appeared to produce a small decrease in
rhodamine-123 fluorescence, likely because of its absorbance by the
blue-colored PTIO (mean ± SEM; *p < 0.05 compared with baseline).
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It is noteworthy that the decreases in 
m
induced by NO concentrations of several micromolars were similar to or
greater than those produced by agents known to inhibit enzymes of
mitochondrial respiration (rotenone or 3-nitropropionic acid), although
less than those produced by direct depolarization of the mitochondrial membrane (by CCCP). The partial depolarization of mitochondria caused
by high concentrations of NO is consistent with the expected effects of
an inhibition of electron transport.
NO rapidly depletes ATP in hippocampal neurons
Mitochondrial dysfunction might result in energy depletion.
Luciferase-based assays of total ATP and of the ATP/ADP ratio served to
assess neuronal energy stores after 20 min exposures to various
conditions (Fig. 5A). Average
NO concentrations of 5-9 µM, produced by 300 µM or 1 mM SNOC, resulted in severe
depletions of total ATP as compared with controls. Again, the depletion
of ATP appeared to be mediated specifically by NO, because it was not
reproduced by controls of old SNOC or L-cysteine plus
NaNO2. Changes in the ratio of ATP/ADP generally paralleled
the effects on total ATP, with substantially greater variance, likely
related to uncertainties in the ADP measurements (see Materials and
Methods). Subsequent analyses of neuronal energy stores primarily
examined total ATP. Qualitative changes in the ATP/ADP ratio continued to parallel the effects on total ATP.

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Figure 5.
Depletion of neuronal ATP by NO. Normalized total
ATP values and ATP/ADP ratios (means ± SD), were determined by
luciferase assays, as described, from cultured hippocampal neurons.
A, After 20 min exposures, NO produced by 300 µM or 1 mM SNOC produced a near-complete
depletion of cellular total ATP stores and of the ATP/ADP ratio,
whereas treatments with "old SNOC" or
L-Cys+NaNO2, also at 1 mM,
had no substantial effect on energy stores although the slight changes
in total ATP, but not in the ATP/ADP ratio, reached statistical
significance (n = 5; *p < 0.05 compared with controls). B, Concentration-response data
for SNOC on cellular energy indicated highly sensitive effects on ATP
and ATP/ADP (n = 4). C, The time
course of ATP depletion by SNOC over a 20 min exposure period and over
the subsequent 24 hr after a return to the culture medium.
D, Effect of receptor and enzyme antagonists on the
recovery of cellular ATP stores at 6 hr after NO exposure. The NMDA
antagonist MK-801 (1 µM), the PARP antagonist benzamide
(500 µM), the calpain antagonists calpain inhibitor-1
(CI-1; 3 µM) or MDL-28170 (10 µM), and superoxide dismutase (SOD; 100 U/ml) each allowed partial recovery of cellular ATP levels at 6 hr
after NO exposure (n = 4; *p < 0.05 compared with controls and p < 0.05 compared with SNOC alone).
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ATP depletion by SNOC exhibited a concentration-response relationship
with a half-maximal effect at ~3 µM, corresponding to an [NO] of ~0.5 µM (Fig. 5B). The time
course was characterized by a steady decline of total ATP over the 20 min exposure, with no significant recovery of cellular energy stores in
the subsequent 24 hr (Fig. 5C). Agents that partially
protect neurons from delayed death after NO exposure (Brorson and
Zhang, 1997
), including MK-801, benzamide, calpain inhibitors, and SOD,
did not substantially prevent the acute depletion of ATP during the 20 min SNOC exposures, but each significantly enhanced total energy
recovery over the next 6 hr (Fig. 5D), as expected given
previous findings of their neuronal protection. Benzamide, which
inhibits PARP, slightly decreased the degree of energy depletion during
the 20 min exposures and also allowed for the largest energy recovery
in the post-treatment period.
NO produced by other agents also depleted energy stores (Fig.
6). NO at concentrations ranging from
~0.5 µM (from 3 µM SNOC or 1 mM SNAP) to 1.5 µM (from 30 µM
SNOC) or 1.9 µM (from 300 µM spermine-NO)
each partially reduced total ATP and the ATP/ADP ratio after 20 min.
SIN-1 (1 mM), which did not produce a measurable amount of
NO, nevertheless also partially depleted energy stores. NO dissolved in
solution from a gaseous mixture with
O2/N2 also was applied, using a
continuous exchange of buffer to maintain neutral pH over the 20 min
exposures. At an average [NO] of 0.55 ± 0.20 µM
(mean ± SD), a modest depletion of ATP to ~60% of parallel controls occurred, whereas an [NO] of 2.98 ± 1.46 µM depleted most of the neuronal energy stores (Fig.
6B). With the exception of the anomalous energy
depletion by SIN-1, the ATP depletion under various conditions
correlated with the associated measured [NO], with concentrations of
NO >1-2 µM resulting in severe depletion of neuronal
energy stores (Fig. 6C).

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Figure 6.
ATP effects of lower concentrations of NO.
A, Exposures to lower concentrations of SNOC were
repeated in parallel with other NO donors, producing lower NO
concentrations. SNAP (1 mM), spermine-NO (300 µM), SNOC (3 or 30 µM), and SIN-1 (1 mM) each produced significant decrements of ATP and ATP/ADP
(mean ± SD; *p < 0.05). B,
Neurons also were exposed for 20 min to an
O2/N2 mixture alone and to NO from 5%
NO gas dissolved in stirred buffer at two concentrations, 0.55 ± 0.09 and 2.98 ± 0.65 µM (mean ± SEM;
averaged over 20 min). O2/N2 alone
produced no measurable [NO] (0.00 ± 0.01 µM), and
this treatment resulted in only a slight decrement in ATP as compared
with untreated control coverslips. In contrast, NO from gas produced
large concentration-dependent ATP depletions (mean ± SD;
n = 4; p < 0.05 compared with
O2/N2 treatment alone).
C, The relative ATP after 20 min exposures to various NO
donors or to gaseous NO was compared with the average measured [NO]
produced by each agent. A strong concentration dependence was observed,
with exposure to ~2 µM NO or more producing a 50%
depletion of ATP. The effect of SIN-1 (asterisk) was
anomalous in that it produced significant ATP depletion without
producing measurable [NO].
|
|
Our expectation was that NO was causing energy depletion in the neurons
by the inhibition of mitochondrial function. To test this hypothesis,
we compared the effects of NO (from 1 mM SNOC) on ATP with
the effects of mitochondrial inhibitors. In contrast to the near-total
depletion of ATP by 20 min exposure to NO, rotenone (5 µM), 3-nitropropionic acid (1 mM), or the
mitochondrial ATP synthase inhibitor oligomycin (6 µg/ml) each only
produced a partial depletion of ATP (Fig.
7). We confirmed that this concentration of oligomycin was saturating by comparing 6 with 18 µg/ml, which produced no significant additional ATP depletion over 20 min exposures (data not shown). The protonophore CCCP (1 µM) or CCCP in
combination with oligomycin also produced only partial depletion of ATP
over 20 min, much less than that of SNOC. Unexpectedly, it thus
appeared that the toxic NO concentrations, which had been found to
depolarize mitochondria only partially, were having substantially
greater energy-depleting effects than the complete inhibition of
mitochondrial ATP production.

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Figure 7.
Effects of mitochondrial inhibitors on ATP.
Effects of NO from SNOC on neuronal ATP at 20 min and 6 hr were
compared with those of oligomycin (6 µg/ml), CCCP (1 µM), rotenone (5 µM), 3-nitropropionic acid
(3-NP; 1 mM), and the combinations of SNOC
plus oligomycin (SNOC+Oligo) or CCCP plus oligomycin
(CCCP+Oligo). All treatments were applied for 20 min,
and the cells were harvested for ATP assay at 20 min and 6 hr
(mean ± SD; n = 6; *p < 0.05 compared with controls and p < 0.05 compared with SNOC alone). NO produced more severe energy
depletion than did mitochondrial inhibitors.
|
|
ATP depletion: Increased consumption or decreased production?
One possible explanation for the disparity between the energy
depletion produced by NO and that by mitochondrial inhibitors might be
that the severe effects of NO are the result of a large increase in ATP
consumption as well as of the inhibition of mitochondrial ATP
production. Indeed, PARP activation by NO is thought to cause toxicity
in part because of increased ATP consumption (Zhang et al., 1994
). The
blockade of PARP by benzamide caused only a minor relief of ATP
depletion by NO (see Fig. 5), but other avenues of ATP hydrolysis also
might be activated by NO. It might be postulated that even the
mitochondrial depolarizations observed during NO exposures are
attributable to overactivity of the ATP synthase driven by increased
ATP demand, producing a drain on the proton gradient and membrane
depolarization. If the mitochondrial depolarizations were attributable
solely to overdrive of the ATP synthase, oligomycin would reverse
completely the rhodamine-123 signal changes produced by NO. However, on
coapplication of oligomycin (6 µg/ml) with SNOC (1 mM),
no reversal of the NO-induced rhodamine-123 signal changes was observed
(n = 5; data not shown). The mitochondrial depolarization by NO appeared to be a primary effect on mitochondrial electron transport. With inhibition sufficient to depolarize the mitochondria, cessation of mitochondrial ATP synthesis is the expected result.
Contributions of glycolysis to energy stores
Glycolytic energy production alone generally has been thought to
be insufficient to meet the energy demands of neurons (Siesjö, 1978
). To test whether the partial preservation of energy stores in the
face of complete mitochondrial inhibition depended on glycolytic energy
production, we compared the effects of inhibiting mitochondrial respiration or glycolysis alone with those of inhibiting both glycolysis and mitochondria (Fig.
8A). Iodoacetate, which
inhibits the key glycolytic enzyme glyceraldehyde-3-phosphate
dehydrogenase (Sabri and Ochs, 1971
), produced severe depletion of ATP
at 1 mM, a concentration producing near-maximal effects in
separate experiments (data not shown). Because these experiments were
performed in simple buffers containing glucose but no other hydrocarbon substrates such as lactate or pyruvate, the inhibition of glycolysis might produce energy depletion in part by blocking the substrate supply
to the tricarboxylic acid cycle, indirectly halting mitochondrial oxidative phosphorylation as well. Accordingly, the depletion of ATP by
iodoacetate was relieved partially by extracellular pyruvate, whereas
additionally including the monocarboxylic acid transport inhibitor
4-CIN (Williams et al., 1996
) prevented the relief of energy depletion,
corroborating the specificity of the action of iodoacetate on
glycolysis. Thus the inhibition of glycolysis alone did not deplete ATP
severely if a substrate supply for mitochondrial respiration was
maintained. In a similar manner, 2-deoxyglucose, which prevents
glycolysis when completely substituted for extracellular glucose, also
produced a partial energy depletion that was reversible by pyruvate,
restored by 4-CIN, and increased by oligomycin (data not shown).
Complete inhibition of mitochondria by the combination of saturating
concentrations of FCCP (1 µM, shown to be a maximally effective concentration for depleting ATP in separate experiments) and
oligomycin (6 µg/ml) also only partially depleted ATP. Furthermore, adding oligomycin to FCCP lessened the resulting energy depletion as
compared with the protonophore alone, suggesting that part of the ATP
depletion resulting from mitochondrial depolarization was occurring by
reversal of the mitochondrial ATP synthase, leading to the consumption
of ATP, as has been described in cerebellar granule neurons (Budd and
Nicholls, 1996
). The simultaneous inhibition of both glycolysis and
mitochondria by treatment with iodoacetate plus FCCP or iodoacetate
plus oligomycin produced near-complete depletion of ATP after 20 min
exposures, similar to the effect of high [NO]. Thus, neither the
inhibition of glycolysis alone nor the inhibition of mitochondrial
respiration alone, but only a simultaneous inhibition of both
glycolysis and oxidative energy production was sufficient to reproduce
the severe energy-depleting effects of NO exposure.

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Figure 8.
Comparison of effects of the inhibition of
glycolysis and of mitochondria on ATP levels. Shown are normalized ATP
values after 20 min treatments with the indicated agents (mean ± SD). A, The glycolytic inhibitor iodoacetate (1 mM) caused a substantial depletion of ATP, which was
prevented mainly by the inclusion of 10 mM pyruvate
(pyr) in the buffer. The monocarboxylic acid
uptake inhibitor 4-CIN (10 mM) reversed the effect of
pyruvate. FCCP (1 µM) partially depleted ATP; this was
partially prevented by oligomycin (6 µg/ml). Combinations of
iodoacetate (iodo) and oligomycin (oligo)
and FCCP caused a severe depletion of ATP after 20 min
(n = 6; *p < 0.05 compared
with controls and p < 0.05 compared
with iodoacetate alone). B, ATP depletion by 3 µM SNOC was not significantly prevented by the addition
of 10 mM pyruvate; 3 µM SNOC added to
iodoacetate and pyruvate (iodo+pyr) or to oligomycin
(oligo) depleted the cells of most ATP
(*p < 0.05 compared with control; not significant
when compared with SNOC alone). C, SNOC at a range of
concentrations was applied in buffer also containing either iodoacetate
and pyruvate or FCCP and oligomycin, demonstrating the
concentration-response relationships of ATP depletion in the face of
the inhibition of glycolysis or of oxidative phosphorylation.
|
|
Although high concentrations of NO appeared to be inhibiting both
glycolytic and oxidative energy production, the concentrations required
to inhibit the two arms of energy metabolism might be quite different.
To assess whether a lower [NO] (~0.5 µM) might inhibit one of the processes selectively, we applied 3 µM
SNOC (Fig. 8B). Adding 10 mM pyruvate to
3 µM SNOC did not reverse its partial ATP depletion
substantially, showing that the inhibitory effect of NO was not acting
at glycolysis alone. Adding inhibitors of glycolysis or of
mitochondrial ATP synthesis appeared to deplete ATP further, suggesting
that neither arm of energy production was fully inhibited by modest
[NO]. With the full inhibition of glycolysis by iodoacetate plus
pyruvate (Fig. 8C), increasing SNOC concentrations induced
additional energy depletion, with a broad concentration dependence.
Similarly, with the full inhibition of mitochondria by FCCP and
oligomycin, SNOC also produced a concentration-dependent further
depletion of ATP with a somewhat higher concentration threshold. These
pharmacological manipulations partially isolated the effects
of NO on mitochondria from those on glycolysis and suggested that in
neurons NO can inhibit both mitochondrial energy production and,
somewhat less sensitively, glycolytic energy production.
Delayed toxicity of NO is not mimicked by inhibitors
of mitochondria
Given the evidence for a rapid energy depletion by NO in
neurons, we asked whether the energy depletion itself could be
sufficient to explain the neuronal death induced by NO. We applied the
various NO donors that were found to produce ATP depletion in 20 min
exposures, including SNOC, SIN-1, SNAP, and spermine-NO. Each agent
significantly reduced the survival of hippocampal neurons 24 hr after
exposure (Fig. 9A). When the
survival was compared with measures of the average [NO] over 20 min
for each NO donor, a clear concentration-dependent toxicity was
demonstrated, with 2 µM NO reducing survival by
approximately one-third (Fig. 9B). SIN-1 produced toxicity
despite its undetectable elevations of [NO]. The proportional
decreases in survival for each NO donor were notably less than the
relative decreases in ATP after 20 min (compare Figs. 9B and
6C). Nevertheless, the cell death induced by the various
donors correlated closely with the degree of energy depletion that they
produced.

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Figure 9.
Neuronal survival after energy-depleting
treatments. A, Neuronal survival was assayed 1 d
after 20 min exposures to control buffer, SIN-1 (1 mM),
SNAP (1 mM), spermine-NO (300 µM), or SNOC (3 or 30 µM). Each agent produced a modest decrease in
survival (n = 4; *p < 0.05).
B, The survival at 24 hr after exposure to each NO donor
was correlated with the measured [NO] produced by each agent. SIN-1
(asterisk) was anomalous, producing toxicity without
producing a measurable [NO] (see Table 1). C, Survival
assayed 1 d after 20 min exposures to high [NO], ~9
µM, from 1 mM SNOC as compared with metabolic
inhibitors (mean ± SD; n = 4;
*p < 0.05 compared with controls and
p < 0.05 compared with SNOC alone).
The concentrations used were as above.
|
|
If the neurotoxicity of NO depends on the energy depletion it produces,
then other agents that deplete energy (presumably without other actions
specific to NO or peroxynitrite) also should produce similar neuronal
death. Therefore, we also tested the delayed neuronal survival after 20 min treatments with saturating concentrations of inhibitors of energy
production in comparison to that after treatment with a high level of
NO (~9 µM, from 1 mM SNOC). This
concentration substantially decreased neuronal survival after 24 hr. In
contrast, iodoacetate, iodoacetate/pyruvate, and oligomycin each
produced substantially less toxicity, paralleling the lesser effects of
these agents on energy depletion. Of note, the combination of
iodoacetate and oligomycin, which causes complete energy depletion
similar to that of 1 mM SNOC, produced as much toxicity at
24 hr, suggesting that the effects of NO on energy metabolism may be
sufficient to explain the neurotoxicity it produces.
 |
DISCUSSION |
Many of the varied physiological roles of NO are mediated by
cyclic GMP formation. In addition to the activation of soluble guanylate cyclase, NO is known to act on many other cellular sites by
binding to heme and Fe-S centers (Butler et al., 1995
),
S-nitrosation of thiol proteins, and nitrotyrosine formation
(Gross and Wolin, 1995
). In addition, NO may produce oxidative damage,
probably in large part via more reactive products such as peroxynitrite (ONOO
), irreversibly inactivating certain enzymes
and producing DNA single-strand breaks (Nguyen et al., 1992
). Of
particular importance to the toxicity of NO is the activation of the
energy-consuming and NAD-depleting enzyme PARP, activated by DNA strand
breaks (Zhang et al., 1994
). Although the neuronal toxicity of NO is clear, it is not known at which targets the primary attack of NO takes
place, triggering eventual cell death. By studying the actions of
exogenous NO on isolated neurons in culture, without the confounding
effects of the elevations of intracellular Ca2+
required to activate neuronal NOS, we have attempted to look at the
earliest effects of NO directly in neurons, asking which mechanisms are
most relevant to toxicity.
In the present study we have demonstrated that the application to
cultured hippocampal neurons of toxic concentrations of NO results in
mitochondrial depolarization and progressive ATP depletion. Remarkably,
the ATP depletion after 20 min exposures to high NO concentrations is
profound and substantially greater than that produced by inhibitors of
mitochondrial energy production, suggesting that the energy-depleting
action of NO is not confined to the inhibition of mitochondrial
metabolism but also may involve the inhibition of glycolytic energy production.
To understand the pathophysiological relevance of these findings, it is
essential to compare them with the range of the [NO] found in
biological tissues. The maximal NO levels used in these experiments
were high, ranging up to 10 µM (see Table 1). These high
concentrations produced large depolarizations of mitochondria and
near-complete depletions of energy stores after 20 min. However, lower
[NO] from NO donors or from dissolved gaseous NO also produced mitochondrial depolarizations, and partial depletions of ATP were found
with [NO] of <0.5 µM. How do these compare with
physiological or pathophysiological NO concentrations? Resting levels
of [NO] in tissue are thought to be in the low nanomolar range (Gross and Wolin, 1995
). However, direct [NO] measurements in rabbit aortic
wall by porphyrinic sensors recorded peak values of 1.3 µM at the endothelial surface and of 0.85 µM in the adjacent smooth muscle layer after stimulation
with bradykinin (Malinski et al., 1993b
). In a rat middle cerebral
artery occlusion model of stroke, using microdialysis techniques, peak
tissue [NO] was found to be 1.3-4 µM within 3-24 min
of the onset of ischemia (Malinski et al., 1993a
). Even higher [NO]
values averaging 11 µM were estimated in complete
forebrain ischemia (Tominaga et al., 1994
). These concentrations of NO,
reported in vascular wall and in ischemic brain, correspond to values
that produce partial mitochondrial depolarizations and severe
derangements of energy metabolism in the present experiments. Thus, the
effects reported here of NO on the metabolism of neurons are likely to
be quite relevant to diseases involving large increases in tissue
[NO], such as stroke, and possibly even to local effects of
physiological NO release.
The effect of temperature must be considered in the interpretation of
the present experiments. Physiological experiments studying mitochondrial membrane potential were performed at room temperature, whereas the exposures for the reported ATP and survival assays generally were performed at 37°C. However, in separate experiments there were no significant differences in the ATP depletion by SNOC
exposure at room temperature when compared with those at 37°C (data
not shown). Furthermore, the exposures to NO dissolved from gas were
done at 22°C, and they produced ATP depletions in line with those
from chemical NO donors at 37°C. Thus the differences in temperature
do not alter the large effect of NO on energy metabolism substantially.
In these experiments SIN-1 produced no measurable NO accumulation.
Nevertheless, it produced partial energy depletion at 20 min and
neuronal death at 24 hr, consistent with its well established neuronal
toxicity (Lipton et al., 1993
; Bolaños et al., 1995
; Brorson and
Zhang, 1997
). Parallel production of
O2
from SIN-1 is likely to allow
the very rapid conversion of NO to ONOO
,
preventing any measurement of [NO]. ONOO
also is
reported to inhibit enzymes of oxidative phosphorylation in isolated
mitochondria or submitochondrial particles (Cassina and Radi, 1996
;
Lizasoain et al., 1996
), yet SIN-1 failed to cause measurable
mitochondrial depolarization. It may be that extracellular ONOO
, although highly injurious to neurons because
of actions on the cellular surface, does not affect mitochondria
directly because the access of this highly reactive anion to
intracellular organelles is limited. In contrast, NO is known to
permeate cell membranes readily so that it can reach the mitochondria.
The present experiments with exogenous NO do not define whether the
actual intracellular toxic agent is NO or ONOO
.
This issue is difficult to settle in intact neurons, because manipulations to alter O2
levels,
such as by administration of SOD, are limited to the extracellular
space. However, one of the primary sites for
O2
production is likely to be at
the mitochondrial membrane itself as a byproduct of oxidative
phosphorylation (Bindokas et al., 1996
), so that NO may form
ONOO
intracellularly. Locally produced
ONOO
would be predicted to exert a potent
inhibitory effect on mitochondria. Indeed, the effects of
ONOO
have been said to be less reversible than
those of NO, so that the measured change in 
m in the
short-term experiments may be attributable mainly to rapid reversible
cytochrome c oxidase inhibition by NO (Lizasoain et al.,
1996
), whereas irreversible damage by ONOO
may
occur more slowly but may accumulate over extended exposures.
Is ATP depletion caused by decreased production or
increased consumption?
The present studies demonstrate the occurrence of rapid
mitochondrial depolarization by NO in hippocampal neurons. Energy depletion soon follows, and the facile conclusion is that decreased production of ATP is entirely responsible. However, NO also may increase ATP hydrolysis by the cell, particularly by activation of PARP
(Zhang et al., 1994
). To what extent is the early ATP depletion
produced by NO a result of increased consumption? During the immediate
20 min exposure period the energy depletion produced by NO was reduced
only slightly by the PARP inhibitor benzamide (see Fig. 5D)
so that PARP activation alone accounted for little of the ATP
depletion. Further, the mitochondrial depolarization produced by NO was
not blocked by oligomycin, showing that one of the primary events
leading to mitochondrial rundown was not a large increase in energy
consumption beyond mitochondrial capacity. Instead, it appears that
inhibition by NO is the predominant effect on mitochondria early in
exposure. However, at lower concentrations of NO, increased consumption
might combine with partially decreased energy production to produce
energy failure. Furthermore, in the period after treatment, PARP
activation appears to play a major role in the prolonged energy
depletion that occurs, in that the late energy depletion can be blocked
mainly by benzamide.
Potential sites at which NO may inhibit ATP production
These experiments directly demonstrate the effect of NO
exposure on mitochondrial membrane potential. Although the
depolarization produced by NO appears to be incomplete as compared with
that produced by CCCP, the degree of impairment of oxidative
phosphorylation may be underestimated by this method. Inhibition of
electron transport may depolarize the mitochondrial membrane only to
the point at which turnover of the ATP synthase slows to a halt,
stopping the drain of the proton gradient. During the first several
minutes cellular ATP stores may remain high enough that they contribute to maintaining the 
m at this level by driving the ATP
synthase in reverse. Thus the mitochondria themselves might be
consuming cytosolic ATP stores as a secondary effect (Budd and
Nicholls, 1996
). Inhibition of ATP production by NO might be complete
although the mitochondrial membrane depolarization is only partial.
Previous work has demonstrated the suppression of mitochondrial
respiration by NO. In hepatocytes NO was reported to inhibit complexes
I and II and, most sensitively, mitochondrial aconitase, an enzyme of
the tricarboxylic acid cycle (Stadler et al., 1991
). Studies of
isolated mitochondrial preparations have suggested that NO reversibly
inhibits cytochrome c oxidase (complex IV) of the electron
transport chain (Cassina and Radi, 1996
; Lizasoain et al., 1996
),
ascribing the irreversible inhibition of complexes I and II to
peroxynitrite. In addition, peroxynitrite impairs the action of the
mitochondrial ATP synthase (Radi et al., 1994
; Cassina and Radi, 1996
).
Thus NO or ONOO
might be acting at the entry
points of electron transport, at multiple points along the chain, and
at the ATP synthase. Nevertheless, the inhibition of mitochondria alone
appears to be insufficient to explain the severe depletion of energy
production by higher levels of NO, suggesting that the inhibition of
glycolysis must be occurring also.
How might NO affect glycolysis to produce the profound energy depletion
reported here? The most likely target is the glyceraldehyde-3-phosphate dehydrogenase complex, which is inhibited by NO (Molina y Vedia et al.,
1992
). The present experiments imply that the threshold for the
inhibition of mitochondrial energy production is lower than that for
the inhibition of glycolysis; however, at higher levels of NO exposure,
severe depletion of neuronal energy stores occurs as the result of the
simultaneous inhibition of glycolysis. A similar conclusion was reached
in a study of brain synaptosomes exposed to NO in which lower
concentrations inhibited oxidative metabolism, but higher
concentrations inhibited anaerobic metabolism as well (Erecinska et
al., 1995
).
The traditional emphasis of the dependence of neurons on aerobic
metabolism stems from experiments clearly demonstrating the vulnerability of the brain to hypoxia (Siesjö and Wieloch, 1985
). However, this vulnerability results in part from the effects of lactic
acidosis, which develops in tissue under hypoxic conditions (Kraig et
al., 1987
; Tombaugh and Sapolsky, 1990
). In vitro, where pH
can be controlled independently, neurons have been found to survive
hours of exposure to hypoxia alone, in contrast to their exquisite
sensitivity to combined glucose and oxygen deprivation (Goldberg et
al., 1987
; Goldberg and Choi, 1993
). Few studies have looked directly
at energy stores in isolated neurons, but recent work in cerebellar
granule cells has confirmed that glycolysis alone can maintain energy
charge for 10 min (Budd and Nicholls, 1996
). Thus perhaps it should
come as no surprise that, to disrupt neuronal energy production
severely, NO must affect both glycolysis and mitochondria.
Relevance to neurological disease processes
If energy depletion by NO is relevant to its toxicity, why did
lower [NO], here found sufficient to produce substantial energy depletion, produce relatively small decreases in neuronal survival at
24 hr? It may be that only the more severe insults produce rapid
neuronal death via necrosis (Bonfoco et al., 1995
). Partial energy
depletion may trigger apoptosis, and it is possible that low-level
exposures to NO, although not producing substantial cell death at the
24 hr time point, might initiate apoptotic pathways leading to a more
delayed neuronal death. Ongoing experiments aim to test this
hypothesis. High NO levels producing rapid neuronal death via severe
mitochondrial dysfunction are likely to be more relevant to acute
damage to the brain in processes like ischemia (Bolaños et al.,
1998
), whereas lower [NO] might cause slower and more subtle damage
in the brain by effects on neuronal mitochondrial function. Some
evidence for the involvement of NO has been offered in diseases in
which neuronal damage takes place over many years, including
Alzheimer's disease (Good et al., 1996
) and amyotrophic lateral
sclerosis (Beal et al., 1997
). "Slow excitotoxicity" has been
postulated to occur in chronic neurological conditions whereby the
combination of underlying defects in energy metabolism in neurons,
combined with the stress of ongoing glutamate receptor activation,
gradually produces neuronal damage or death (Albin and Greenamyre,
1992
; Beal, 1995
). The sensitive effects of NO on neuronal energy
metabolism might contribute to such neurodegenerative processes.
 |
FOOTNOTES |
Received Sept. 15, 1998; accepted Oct. 12, 1998.
This work was supported by Grant NS01630 from National Institutes of
Health to J.R.B. and by the support of the Brain Research Foundation to
H.Z. and J.R.B. We thank Arush Angirasa for technical assistance in
performing the neuronal cultures, toxicity assays, and ATP-luciferase
assays and William Thistlethwaite for assistance in measuring NO concentrations.
Correspondence should be addressed to Dr. James R. Brorson, Department
of Neurology, MC2030, The University of Chicago, 5841 South Maryland
Avenue, Chicago, IL 60637.
Dr. Zhang's present address: Department of Neurosurgery, The
University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216.
 |
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