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The Journal of Neuroscience, August 15, 2000, 20(16):6294-6301
Nitric Oxide-Stimulated Increase in Extracellular Adenosine
Accumulation in Rat Forebrain Neurons in Culture Is Associated with ATP
Hydrolysis and Inhibition of Adenosine Kinase Activity
Paul A.
Rosenberg,
Ya
Li,
Minou
Le, and
Yumin
Zhang
Department of Neurology and Program in Neuroscience, Children's
Hospital and Harvard Medical School, Boston, Massachusetts 02115
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ABSTRACT |
Adenosine is a putative endogenous sleep-inducing substance, and
nitric oxide has been implicated in arousal and sleep mechanisms. We
found that various nitric oxide donors, including diethylamine NONOate
(DEA/NO), stimulated large increases in extracellular adenosine in
nearly pure cultures of forebrain neurons. The effect of DEA/NO could
be blocked by 2-phenyl-4,4,5,5-tetramethyl-imidazoline-1-oxyl-oxide and
could not be mimicked by degraded solutions of DEA/NO or by DEA itself;
therefore, it was caused by nitric oxide release on hydrolysis
of the parent compound. The accumulation of adenosine was not blocked
by probenecid or GMP, suggesting that neither extracellular cAMP nor
extracellular AMP was the source, and that adenosine was therefore the
most likely species transported across the plasma membrane. To pursue
this further, we tested the effect of DEA/NO on cellular ATP and found
a significant fall in ATP associated with exposure to nitric oxide. In
addition, exposure to DEA/NO nearly completely inhibited adenosine
kinase activity. It has been found previously that adenosine kinase is
inhibited by its substrate, adenosine. We found that exposure to nitric oxide increased intracellular adenosine to 125 ± 18% of control values (p < 0.01), consistent with the
possibility that in our system the inhibition of adenosine kinase is
related to an increase in intracellular adenosine, and that the effect
of nitric oxide on extracellular adenosine is significantly potentiated
by substrate inhibition of adenosine kinase. Furthermore, nitric
oxide-stimulated adenosine accumulation may be important in the
regulation of behavioral state.
Key words:
nitric oxide; adenosine; sleep; adenosine kinase; ATP; laterodorsal tegmental nucleus; pedunculopontine tegmental nucleus
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INTRODUCTION |
Nitric oxide, discovered by
Furchgott and colleagues (Furchgott and Zawadzki, 1980 ; Furchgott,
1998 ) to be an intercellular signaling molecule, appears to be involved
in long-term potentiation (Schuman and Madison, 1994 ) and signal
processing mechanisms (Kara and Friedlander, 1999 ). Other functions for
nitric oxide in the brain are likely. Nitric oxide synthase (NOS) is
richly expressed in a nuclear group that plays an important role in
arousal, the lateral dorsal tegmental (LDT)/pedunculopontine tegmental
nucleus (PPT), suggesting a possible role in sleep physiology. Nitric oxide synthase is also found in cholinergic nuclei of the basal forebrain implicated in sleep mechanisms, including the septum and
nuclei of the diagonal band, and in the hypothalamus (Vincent and
Kimura, 1992 ).
Several studies using inhibitors of nitric oxide synthase have shown
inhibition of sleep with blockade of enzyme activity in the rabbit
(Kapas et al., 1994b ) and the rat (Kapas et al., 1994a ; Dzoljic et al.,
1996 ; Burlet et al., 1999 ). In contrast to these studies that suggest
that nitric oxide facilitates the production of sleep, other studies
have shown that release of nitric oxide in the thalamus is associated
with the waking state and REM sleep (Burlet and Cespuglio, 1997 ;
Williams et al., 1997 ; Cespuglio et al., 1998 ). This is consistent with
patterns of activity of the NOS containing LDT/PPT neurons,
which are most active in waking and in REM sleep. Furthermore, nitric
oxide has been shown to have effects on neurons in the thalamus (Pape
and Mager, 1992 ) and medial pontine reticular formation (Leonard and
Lydic, 1997 ), consistent with a role in the production of waking and
REM sleep.
Adenosine appears to be involved in the regulation of behavioral state
(Rainnie et al., 1994 ; Portas et al., 1997 ). It was found using
microdialysis techniques that adenosine accumulated in the basal
forebrain of cats during waking, increased with sleep deprivation, and
decreased when animals were allowed to sleep. Infusion of an inhibitor
of adenosine uptake caused an increase in sleep when the dialysis probe
was located in the basal forebrain but not in the thalamus
(Porkka-Heiskanen et al., 1997 ). Thus, adenosine appears to be an
endogenous sleep-inducing substance, with regionally specific actions.
We do not know how adenosine levels are regulated in the brain. This
knowledge would enable us to understand how behavioral state is
regulated. We have previously used dissociated cell cultures containing
both neurons and astrocytes derived from rat embryonic forebrain to
study mechanisms of extracellular adenosine accumulation (Rosenberg and
Dichter, 1989 ; Rosenberg and Li, 1994 , 1995 ). In the present study, we
used neuronal cultures derived from rat forebrain to investigate the
effect of nitric oxide on extracellular adenosine accumulation and
found that nitric oxide is a potent and efficacious stimulator of
adenosine release from neurons. These findings suggest the possibility
that nitric oxide release in target areas of the nitrergic neurons of
the LDT/PPT might itself promote the accumulation of extracellular adenosine.
An abstract has been published previously (Li and Rosenberg, 1998 ).
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MATERIALS AND METHODS |
Tissue culture. Neuronal cultures were prepared from
embryonic day 16 Sprague Dawley rat fetuses using methods similar to those previously described but modified to produce cultures that contained <1% astrocytes (Rosenberg, 1991 ; Wang et al., 1998 ). Cultures were initially plated on poly-L-lysine-coated
24-well plastic plates (Costar, Cambridge, MA) using an 80:10:10 (v/v) mixture of DMEM (11960-010; Life Technologies, Grand Island, NY), Ham's F-12 (N-4888; Sigma, St. Louis, MO), heat-inactivated
iron-supplemented calf serum (HyClone A2151), containing 2 mM glutamine, 25 mM HEPES, 24 U/ml penicillin,
and 24 µg/ml streptomycin in a 5% CO2 (balance air) incubator at 36°C. Cell proliferation was inhibited by exposure to 5 µM cytosine arabinoside at 24 hr in vitro
for 72 hr. On the fourth day of culture, the medium was completely
removed and replaced with 90% MEM, 10% NuSerum IV (Collaborative
Research), 2 mM glutamine, 5 mM HEPES, containing 10 µg/ml superoxide
dismutase (Boehringer Mannheim, Indianapolis, IN), 1 µg/ml catalase
(Sigma CV-40), total glucose 11 mM, and total
sodium bicarbonate 9.3 mM, plus 2% B27 supplement (Life Technologies 17504-036). Medium was not subsequently changed. To prevent evaporation of water, culture dishes were kept on
"wet dishes" containing filter paper that was always kept wet.
Protein was 98 ± 19 µg/well (n = 11) determined
with a bovine serum albumin standard using bicinchoninic acid (Pierce,
Rockford, IL).
HPLC. Adenosine assay was performed exactly as
described previously to measure all adenine-containing compounds in the
extracellular medium (Rosenberg and Li, 1994 ). In brief, samples and
standards were derivatized using chloracetaldehyde to produce the
fluorescent etheno compounds; detection was accomplished using a
McPherson fluorimeter with the 265 nm mercury emission band of a 200 W
xenon-mercury lamp. All samples were run with an internal standard,
and ratios of peak heights in the samples to the peak height of the
internal standard were compared with the same for standards. Adenosine was measured in 50 or 100 µl aliquots of extracellular medium applied
to the column, and these data are used for the figures herein.
Experimental design: exposure to nitric oxide donors. In all
such experiments, cultures in 24-well plates were first washed three
times in HBSS containing 0.1% bovine serum albumin, and then they were
placed in Earle's Balanced Salt Solution (EBSS) and preincubated for 2 hr. At zero time, nitric oxide donors were added from a 100× stock in
10 mM NaOH. At the desired time, medium was removed and
placed in a microcentrifuge tube containing EDTA to yield a final
concentration of 10 mM. Samples were derivatized the day of
the experiment and stored at 4°C until assay, which was within 7 d.
Experimental design: assay of adenosine kinase activity. For
assay of adenosine kinase, the procedure of Lynch et al. (1998) was
followed closely, with minor modification. Adenosine kinase activity of
neuronal cultures was determined by measuring the rate of
phosphorylation of 14C-adenosine. For this
purpose, [U-14C]-adenosine [489
mCi/mmol; Amersham (CFB.54), Arlington Heights, IL] was used. Cultures
were treated exactly as they were when testing for the effects of
nitric oxide donors on extracellular adenosine accumulation with
respect to the initial wash and preincubation. Cultures were exposed to
nitric oxide donor for 5 min, and then radioactivity was added (0.04 µM adenosine final concentration). At selected intervals,
medium was removed, and 200 µl of ice-cold 20 mM sodium
acetate solution, pH 4.0, with 2 mM EDTA, was added to each
well. The cells were immediately lysed by freeze-thawing with
ethanol-dry ice, and the cell lysate was spotted onto ion exchange
disks (Whatman DE-81; Fisher Scientific, Pittsburgh, PA). The disks
were then washed with 2 mM ammonium formate, rinsed successively with distilled water, methanol, and acetone, dried in room
air, and exposed to a solution of 0.1 M HCl/0.4
M KCl, and bound radioactivity was measured by liquid scintillation.
Experimental design: assay of intracellular ATP. For assay
of ATP, the Bioluminescent Somatic Cell Assay kit from Sigma (stock FL-ASC) was used. Cultures were treated exactly as they were when testing for the effects of nitric oxide donors on extracellular adenosine accumulation with respect to the initial wash and
preincubation. At selected time points after addition of drug or
vehicle, medium was removed, 100 or 200 µl of releasing agent was
added, cultures were agitated briefly, another equal volume of water
was added, and plate was placed on wet ice until assay. ATP assay mix
was used at a 25-fold dilution, and 100 µl of the extract was assayed.
Experimental design: assay of intracellular adenine containing
compounds by HPLC. For the assay of ATP, AMP, and adenosine, we
used an extraction method similar to that used for the adenosine kinase
procedure described above. Cultures were exposed to diethylamine NONOate (DEA/NO) for 5 min. The extracellular media was removed, and
then an ice-cold solution of 20 mM sodium acetate, pH 4.0, with 2 mM EDTA, was added to the cells. Cells were
immediately lysed by freeze-thawing with ethanol-dry ice. The lysate
was spun for 10 min (14,000 rpm, 4°C). The supernatant was then
collected and derivatized for HPLC analysis.
Statistics. Statistical significance was assessed using
ANOVA with the Tukey-Kramer post hoc multiple comparison
test. Statistical analysis was performed using the Instat program from
GraphPad Software (San Diego, CA). All experiments were repeated a
minimum of three times. In general, experiments were performed with
three to four replicate samples, and error bars represent intra-assay variation expressed as the SD. In Figures, the following convention is
used for indicating statistical significance: *p < 0.05; **p < 0.01; ***p < 0.001.
All NONOate compounds were obtained from Cayman Chemical Co. (Ann
Arbor, MI). Other compounds were obtained from Sigma. Tissue culture
media were obtained from Life Technologies unless noted otherwise.
Purified bovine hemoglobin was obtained as a 100 mg/ml solution from
Biopure Corporation (Cambridge, MA) and was aliquoted and stored at
80°C. HPLC analysis of this hemoglobin solution revealed the
presence of low concentrations of AMP. Therefore, in experiments with
hemoglobin, GMP 500 µM was included to prevent hydrolysis
of AMP from this source to adenosine, once it had been established (see
Results) that GMP had no effect on DEA/NO-evoked adenosine accumulation.
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RESULTS |
Effect of nitric oxide donors
In our initial experiments, we exposed cultures of forebrain
neurons to a series of nucleophile/nitric oxide adducts (Maragos et
al., 1991 ) with half-lives (at 37°C in aqueous solution at physiological pH) of 2.1 min for DEA/NO (Maragos et al., 1991 ), 3 hr
for dipropylenetriamine NONOate (DPT/NO), and 20 hr for
diethylaminetriamine NONOate (DETA/NO) (Mooradian et al., 1995 ). In
these experiments, nitric oxide donors were tested at 1 mM,
and superoxide dismutase and catalase were included in some
experimental categories because of evidence that nitric oxide is toxic
to neurons and that the toxicity is attributable to peroxynitrite
(Lipton et al., 1993 ), formed by the reaction of nitric oxide and
superoxide. The presence of superoxide dismutase and catalase, however,
did not have a significant effect on the accumulation of adenosine
evoked by the nitric oxide donors. Figure
1 shows a representative experiment. DEA/NO, DPT/NO, and DETA/NO all produced a significant increase in
adenosine in the extracellular medium. In three experiments, we found
increases of 627 ± 157, 443 ± 8, and 265 ± 59%,
respectively, with DEA/NO, DPT/NO, and DETA/NO. Thus, the adenosine
accumulation observed was inversely related to the half-life of the
donors, as would be expected, because for a given incubation period, a donor with a half-life much shorter than that period (DEA/NO) will have
released all its nitric oxide, whereas a donor with a half-life much
longer (DETA/NO) will have released only a small fraction of its nitric
oxide.

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Figure 1.
Nitric oxide donors evoke extracellular adenosine
accumulation. Rat forebrain neuron cultures were exposed to DEA/NO
(DEA), DPT/NO (DPTA), or DETA/NO
(DETA) in the presence and absence of superoxide
dismutase (250 U/ml) and catalase (1000 U/ml) at 1 mM for
30 min, after which medium was removed and assayed for adenosine.
DEA/NO, DPT/NO, and DETA/NO produced significant increases in adenosine
compared with control. There was no effect of the presence of
superoxide dismutase and catalase. The experiment shown is
representative of three experiments that were performed.
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Because nitric oxide is known to be toxic to neurons, a major concern
was whether the adenosine that we measured in the extracellular medium
was released from injured cells, rather than by a specific process
activated by nitric oxide. We excluded this possibility on several
grounds. If accumulation of adenosine in the extracellular medium were
caused by plasma membrane damage and nonspecific leak of intracellular
adenosine into the extracellular space, then we would expect to see
other adenine compounds as well. However, the chromatograms of medium
from cultures treated with nitric oxide donors showed only a peak
corresponding to adenosine. Plasma membrane injury would also be
expected to result in the release of lactate dehydrogenase (LDH).
However, we found that there was no significant LDH release from
DEA/NO-treated cultures over the time course of the experiments
(n = 2). Finally, the lack of effect of superoxide
dismutase and catalase suggested that the effect was not caused by
peroxynitrite formation (Koppenol et al., 1992 ) and not dependent on
cell injury, because others have shown that the toxicity of nitric
oxide to neurons depends on the formation of peroxynitrite (Lipton et
al., 1993 ).
The fact that the stimulation of adenosine accumulation was observed
with different donors suggested that the effect was caused by nitric
oxide and was not from the base released on hydrolysis in
solution. For most subsequent experiments, we chose to use DEA/NO. Because it has a short half-life, with this donor exposures are
to a pulse of nitric oxide of short duration (minutes). No effect on
extracellular adenosine was observed when cultures were exposed to DEA,
the base produced on decomposition of DEA/NO, and no effect was
observed when solutions containing DEA/NO were preincubated 20-24 hr
at room temperature, allowing decomposition of the DEA/NO before
exposure to cultures (n = 3; data not shown).
Concentration dependence
The relationship of the concentration of DEA/NO to the
extracellular adenosine attained after a 30 min incubation was examined using selected concentrations up to 1 mM. Figure
2A shows a
representative experiment. In four experiments, the response was not
saturating by 1 mM.

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Figure 2.
Concentration and time dependence of the effect of
DEA/NO on adenosine accumulation. A, Neuronal cultures
were exposed to DEA/NO at selected concentrations up to 1000 µM for 30 min, after which medium was removed and assayed
for adenosine, reported here in pmol/100 µl aliquots for both
A and B. There was a
concentration-dependent increase in adenosine concentration in the
extracellular medium, but the process did not saturate at 1 mM. B, DEA/NO was added to neuronal
cultures, and medium was sampled at selected times and assayed for
adenosine. DEA/NO caused a time-dependent increase in extracellular
adenosine concentration, reaching a maximum by 30 min. The experiments
shown are representative of four experiments that were performed.
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Time course
The time dependence of the effect of DEA/NO was examined (Fig.
2B). In three experiments, large increases in
extracellular adenosine were observed, reaching a maximum by 30 min.
Therefore, in most subsequent experiments, to obtain a near maximal
response, cultures were exposed to DEA/NO for a 30 min interval, and a
concentration of 100 µM was used. Figure
2B shows a representative experiment.
Mediation by nitric oxide
To confirm that the effect of DEA/NO was caused by nitric oxide,
we used 2-phenyl-4,4,5,5,-tetramethyl-imidazoline-1-oxyl-3-oxide (PTIO), a scavenger that reacts directly and stoichiometrically with
nitric oxide (Maeda et al., 1995 ). Figure
3 shows a representative experiment of
three that were performed. PTIO at 100 µM completely blocked the extracellular accumulation of adenosine evoked by 100 µM DEA/NO.

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Figure 3.
PTIO inhibits the formation of extracellular
adenosine evoked by DEA/NO. The nitric oxide scavenger PTIO
(PT; 100 µM) completely blocked the effect
of DEA/NO (D; 100 µM) on extracellular
adenosine accumulation. The experiment shown is representative of three
experiments that were performed.
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Source of extracellular adenosine
There are several routes by which extracellular adenosine may be
increased, including by extracellular degradation of ATP, coreleased by
exocytosis with a number of neurotransmitters and neuromodulators
(Stone et al., 1990 ), by degradation of extracellular cAMP transported
out of all cells that accumulate cAMP in response to activation of
adenylyl cyclase (Barber and Butcher, 1983 ; Rosenberg and Dichter,
1989 ; Rosenberg and Li, 1994 ), and by transport of adenosine itself
across the plasma membrane (Baldwin et al., 1999 ). The last step in the
degradation of ATP and cAMP to adenosine is the hydrolysis of AMP to
adenosine by 5'-ectonucleotidase. This enzyme is inhibited by GMP
(MacDonald and White, 1985 ; Pearson, 1987 ; Rosenberg and Li, 1995 ,
1996 ); therefore, if an increase in extracellular adenosine derives
from extracellular ATP or cAMP, GMP should block it. We found
previously that 5 mM GMP completely blocked cAMP-derived
adenosine accumulation evoked by forskolin or vasoactive intestinal
peptide in mixed cultures of astrocytes and neurons (Rosenberg and Li,
1995 , 1996 ). However, as has been noted before (MacDonald and White,
1985 ), use of such a high concentration of GMP is associated with
numerous peaks in the chromatogram attributable to impurities in the
GMP and the high sensitivity of HPLC. Therefore, we used a lower
concentration, 500 µM, which was found in previous studies to block 61 ± 5% (n = 4) of the
extracellular adenosine accumulation evoked by 100 µM forskolin in neuronal cultures similar to
those used in the present study (P. A. Rosenberg and Y. Li, unpublished observations). It was found, however, that 500 µM GMP had no effect on DEA/NO-stimulated
adenosine accumulation. Figure 4 shows a
representative experiment of four that were performed. Finally, in
previous studies, we found that cAMP-derived adenosine accumulation was
blocked by probenecid and by the cyclic nucleotide phosphodiesterase
inhibitor RO 20-1724 (Rosenberg and Li, 1994 ), but these had no effect
on DEA/NO-evoked adenosine accumulation (n = 2; data
not shown). Therefore, this accumulation of adenosine appeared to be
caused by the transport of adenosine itself across the plasma
membrane.

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Figure 4.
DEA/NO-stimulated adenosine accumulation is
resistant to the 5'-nucleotidase inhibitor guanosine monophosphate.
Cultures were exposed to DEA/NO (D/NO; 100 µM) with or without 500 µM GMP for 30 min.
The presence of GMP had no significant effect on the accumulation of
adenosine or on the basal level of adenosine. The experiment shown is a
representative experiment of four that were performed.
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Seven transporters of adenosine are now known: two that are
equilibrative and five that are concentrative (Thorn and Jarvis, 1996 ;
Yao et al., 1997 ; Baldwin et al., 1999 ). The two equilibrative transporters in the rat are characterized as either sensitive or
resistant to pharmacological inhibition using nitrothiobenzylinosine (NBTI) below 1 µM. Four of the five concentrative
transporters are resistant to pharmacological inhibition, with only a
small degree of blockade observed at 100 µM. We tested
NBTI and dipyridamole for their ability to block the egress of
adenosine from neuronal cultures treated with DEA/NO. No significant
decrease was observed with up to 100 µM of each drug
(n = 3; data not shown).
Nitric oxide-induced adenosine accumulation is
cGMP independent
An important effect of nitric oxide in signal transduction is the
activation of soluble guanylyl cyclase (Murad et al., 1993 ). 1H-[1,2,4]oxadiazolo[4,3,-a]quinoxaline-1-one (ODQ) is a
specific and potent inhibitor of activation of soluble guanylyl cyclase by nitric oxide (Brunner et al., 1995 ). ODQ had no effect on
DEA/NO-induced adenosine accumulation at 10 µM
(n = 3; data not shown), despite the fact that it
completely prevented the increase in cGMP in cultures exposed to DEA/NO
at 1 µM. As an alternative approach to test the
involvement of cGMP in extracellular adenosine accumulation, we tested
the effect of 1 mM 8-bromo-cGMP
(n = 3) and 500-1000 µM
8-CPT-cGMP (n = 2), membrane-permeable, cyclic
nucleotide phosphodiesterase-resistant cGMP analogs. These compounds
produced no effect on extracellular adenosine accumulation (data not shown).
Effect of DEA/NO on intracellular ATP content
Nitric oxide inhibits the Krebs' cycle (Castro et al., 1998 ) and
electron transport at both complex I and complex IV (Clementi et al.,
1998 ) and has been shown to cause compromise of mitochondrial function
in neurons (Brorson et al., 1999 ). These multiple effects on cellular
energy metabolism might be expected to lead to ATP hydrolysis,
intracellular adenosine accumulation, and extracellular adenosine
accumulation mediated by adenosine transporters. To test this we
determined the effect of DEA/NO on intracellular ATP content. Although
in individual experiments the effect of 30 min exposure to 100 µM DEA/NO did not always attain significance, in the
pooled results of nine experiments that were performed, we found a
significant (p < 0.05) fall in ATP content to
78 ± 8% (22% reduction) of control values (Fig.
5A). The effect of nitric
oxide on ATP content that we observed was less than that reported
previously (Brorson et al., 1999 ), but the culture paradigm and
experimental procedure that we used were different. When we tested the
effect of DEA/NO on ATP content in neuronal cultures without a 2 hr
preincubation period, we found that ATP content was reduced to 29 ± 4% of control at 30 µM and to 20 ± 5% of control at 100 µM (30 min exposure;
n = 4), comparable to the magnitude of the effects
reported in the previous study.

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Figure 5.
Effect of DEA/NO and rotenone on intracellular ATP
content. A, Cultures were preincubated for 2 hr as in
all previous experiments in EBSS, after which they were exposed to
DEA/NO (D/NO) at 100 µM or no drug
(C) for 30 min. Cellular ATP was measured by
firefly luciferase chemiluminescence. The data shown are pooled from
nine experiments. DEA/NO produced a significant
(p < 0.05) decrease in cellular ATP content
to ~80% of control value. B, The effects on cellular
ATP of rotenone (R; 100 nM) and DEA/NO
(D; 100 µM) were compared. Cultures were
exposed to DEA/NO or rotenone, or both, for 30 min, after which
cellular ATP was assayed. Rotenone and DEA/NO both produced a
significant (p < 0.001) decrease in
cellular ATP content. DEA/NO and rotenone together did not produce a
larger decrease than rotenone alone. The figure shows data pooled from
three experiments. C, Cultures were exposed to rotenone
at selected concentrations for 30 min, after which medium was collected
and assayed for adenosine. Rotenone potently stimulated extracellular
adenosine accumulation. The experiment shown is representative of three
that were performed.
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If the effect of DEA/NO on extracellular adenosine were mediated by
accumulation of intracellular adenosine secondary to net ATP
hydrolysis, then other causes of ATP depletion would also be expected
to cause accumulation of extracellular adenosine. We therefore tested
the effect of the complex I inhibitor rotenone, chosen because nitric
oxide is an inhibitor of complex I. First, we found that rotenone, at a
concentration of 100 nM, caused significant (p < 0.001) ATP hydrolysis, as did DEA/NO in
these experiments (p < 0.001). Figure 5B shows
data pooled from three experiments. In these experiments, in the
presence of rotenone, ATP extracted from cultures was 66 ± 7.9%
of control. The effect of rotenone occluded the effect of nitric oxide;
there was no additional loss of ATP with DEA/NO plus rotenone compared
with rotenone alone, suggesting that the effect of rotenone might be
attributable to inhibition of the same target as nitric oxide. Finally,
we also tested the ability of rotenone to cause accumulation of
extracellular adenosine. Rotenone very effectively increased
extracellular adenosine, as shown in Figure 5C. In this
particular representative experiment, we determined an
EC50 value of 29 nM for
this effect of rotenone. In three experiments that were performed, the
EC50 was 17.2 ± 11 nM.
Nitric oxide inhibits adenosine kinase
The previous experiments showed that nitric oxide induced release
of adenosine itself from neurons by a cGMP-independent mechanism and
that exposure to nitric oxide was associated with a decrease in
intracellular ATP content. Adenosine kinase is a critical enzyme in the
regulation of intracellular and extracellular adenosine concentration
(Arch and Newsholme, 1978 ; Lloyd and Fredholm, 1995 ). Adenosine kinase
has the interesting property that it is inhibited by its substrate,
adenosine, at concentrations not far above the Km for that substrate (Miller et al.,
1979 ; Palella et al., 1980 ; Rottlan and Miras Portugal, 1985 ; McNally
et al., 1997 ; Mathews et al., 1998 ). Therefore, we asked the question
whether inhibition of adenosine kinase activity might be occurring as a
result of exposure to nitric oxide, hydrolysis of ATP, and increase in
intracellular adenosine levels.
We assayed adenosine kinase activity by an established method (Lynch et
al., 1998 ), exposing cultures to
14C-adenosine, taking lysates at
appropriate times, and counting radioactivity that remained associated
with ion-exchange filters, a property possessed by the phosphorylated
but not parent compound. Neuronal cultures incubated with
14C-adenosine demonstrated an increase in
radioactivity binding to the filters that was blocked by the presence
of 5'-iodotubericidin, a specific inhibitor of adenosine kinase (Lynch
et al., 1998 ). Figure
6A shows a
representative experiment examining the concentration dependence of the
effect of 5'-iodotubericidin on adenosine kinase activity. In three
experiments, 5'-iodotubericidin blocked adenosine kinase activity with
an IC50 of 4.3 ± 4.5 nM. To test the effect of nitric oxide on
adenosine kinase activity, cultures were pretreated with 100 µM DEA/NO for 5 min before addition of
radioactivity. In this case, the adenosine kinase activity was almost
completely inhibited for the first 5 min (zero counts above background
present at the 5 min time point), after which some activity was
detectable in the next 15 min. Figure 6B shows a
representative experiment of three that were performed. Between 20 and
30 min, the radioactivity on the filters increased at a nearly normal
rate, indicating recovery of adenosine kinase activity.

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Figure 6.
Effect of 5'-iodotubericidin (IT), DEA/NO, and
rotenone on adenosine kinase activity. A, Neuronal
cultures were incubated with selected concentrations of
5'-iodotubericidin (iodotub) for 5 min and then exposed
to 14C-adenosine. After 15 min, lysate was prepared and
filtered, and radioactivity bound to filters was assayed. Radioactivity
bound to filters was nearly completely eliminated at 100 nM
IT. The experiment shown is representative of three experiments
that were performed. B, Cultures were pretreated for 5 min with 100 µM DEA/NO and then 14C-adenosine
was added. Samples were taken at 5, 10, 20, and 30 min. Adenosine
kinase activity was markedly suppressed compared with control (vehicle
only) for the first 20 min after exposure to radioactivity, after which
the activity increased steeply. The experiment shown is representative
of three experiments that were performed. C, Cultures
were pretreated with rotenone (100 nM) or no drug for 5 min, after which they were exposed to 14C-adenosine, and
samples were prepared at selected times and assayed by filter binding.
Rotenone at this concentration effectively suppressed the activity of
adenosine kinase. The experiment shown is representative of three that
were performed.
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If a rise in intracellular adenosine attributable to inhibition of ATP
synthesis by nitric oxide was responsible for the inhibition of
adenosine kinase activity, we reasoned that another cause of inhibition
of ATP synthesis would have a similar effect. Therefore we tested the
effect of rotenone on adenosine kinase activity. We found that this was
almost completely inhibited by the presence of 100 nM
rotenone, consistent with a mechanism whereby accumulation of
intracellular adenosine inhibits adenosine kinase activity. Figure
6C is representative of three experiments that were performed.
Neuronal cultures were exposed to selected concentrations of DEA/NO up
to 100 µM for 5, 10, or 15 min intervals to determine the
variation of activity with concentration. Figure
7, A and B, shows
results from a single representative experiment of three that were
performed. Figure 7A shows the concentration dependence of
the adenosine kinase activity represented by a family of curves, each
obtained at a different time interval after addition of radioactivity (5, 10, and 15 min). In Figure 7B, the same data are plotted
to show the time dependence of uptake at different concentrations. In
three experiments we determined an IC50 value for
DEA/NO on adenosine kinase activity of 10.7 ± 5.9 µM, using the data obtained at 10 min, and a
value of 20.1 ± 6.6 µM using the data
obtained at 15 min. These values are not significantly different.

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Figure 7.
Concentration and time dependence of the effect of
DEA/NO on adenosine kinase activity. Cultures were exposed to selected
concentrations of DEA/NO before addition of radioactivity. Samples were
taken at 5, 10, and 15 min after addition of radioactivity. The same
data are plotted in A, with concentration as the
independent variable, and in B with time as the
independent variable. A, Clear concentration dependence
is evident at the 10 and 15 min intervals. B, The
accumulation of radioactivity appears to be linear over 15 min in the
absence of DEA/NO. The experiment shown is representative of three
experiments that were performed.
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To test whether the effect of DEA/NO on adenosine kinase activity was
caused by nitric oxide, experiments were performed in which hemoglobin
or carboxy-PTIO (a water-soluble derivative of PTIO) were used to
scavenge nitric oxide. Figure 8 is a
representative experiment of three that were performed. There was no
difference between the cultures exposed to DEA/NO plus hemoglobin and
cultures exposed to hemoglobin alone, or between cultures exposed to
DEA/NO plus carboxy-PTIO and cultures exposed to carboxy-PTIO alone. Therefore, the effect of DEA/NO on adenosine kinase activity is mediated by nitric oxide, as we have shown for the effect of DEA/NO on
extracellular adenosine accumulation.

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Figure 8.
Effect of scavengers of nitric oxide on the effect
of DEA/NO on adenosine kinase activity. Cultures were exposed to DEA/NO
(D/NO), hemoglobin (Hb), or carboxy PTIO
(PT), or DEA/NO plus an inhibitor, followed by
addition of radioactivity after 5 min. Exposure was performed for
another 10 min, after which lysate was prepared and filtered, and
radioactivity bound to filters was assayed. Hemoglobin completely
blocked the effect of DEA/NO: there was no significant difference
between the effect of Hb alone and DEA/NO plus Hb. There was also no
significant difference between carboxy PTIO by itself and carboxy PTIO
plus DEA/NO. The statistics indicated represent the significance of the
difference between the experimental condition under the
asterisks and the D/NO condition. The experiment shown
is representative of three experiments that were performed.
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Finally, we tested the hypothesis that nitric oxide caused the
inhibition of adenosine kinase by increasing intracellular adenosine
concentrations. Cultures exposed to DEA/NO for 5 min were extracted,
and the extracts were assayed by HPLC. Figure 9 shows data pooled from three
experiments. ATP concentration decreased in DEA/NO-treated cultures
compared with control cultures (70 ± 15; p < 0.0001). AMP concentration increased in treated cultures (150 ± 24%; p < 0.0001), as did adenosine concentration (125 ± 18%; p < 0.01).

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Figure 9.
Effect of DEA/NO on intracellular ATP, AMP, and
adenosine content. Neuronal cultures were exposed to DEA/NO
(D/NO, 100 µM) for 5 min. Cell extracts
were prepared by adding 20 mM sodium acetate and 2 mM EDTA to the cultures, freezing on dry ice, and thawing.
Data were normalized by dividing individual values by the control mean
for each experiment. Graphs represent data pooled from three separate
experiments. A, Change in intracellular ATP
concentration; p < 0.001. B, Change
in intracellular AMP concentration; p < 0.001. C, Change in intracellular adenosine concentration;
p < 0.05.
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 |
DISCUSSION |
We here present the following evidence that nitric oxide causes an
increase in extracellular adenosine in neuronal cultures: (1) different
donors all produced a similar effect; (2) nitric oxide scavengers
blocked the increase in adenosine; and (3) the product of hydrolysis of
DEA/NO, diethylamine, had no effect.
Other publications have presented direct or indirect evidence that
nitric oxide stimulates adenosine release from cells and tissue derived
from the CNS (Boulton et al., 1994 ; Broome et al., 1994 ; Fischer et
al., 1995 ; Fallahi et al., 1996 ). However, Craig and White (1993) found
no effect on adenosine of the nitric oxide donor sodium nitroprusside
in superfused rat cortical slices. They also found no evidence to
suggest that NMDA-stimulated adenosine accumulation was mediated by
activation of nitric oxide synthase and release of nitric oxide.
Finally, in a recent study of the regulation of adenosine in rat
striatum using high-energy focused microwave irradiation to preserve
postmortem tissue levels, it was found that intrastriatal arginine
decreased and the inhibitor of nitric oxide synthase, NAME, increased
basal adenosine levels, results opposite to those expected on the basis
of the present findings. Consistent with the findings of Craig and
White (1993) mentioned above, neither arginine nor NAME had any effect
on the NMDA-stimulated increase in adenosine (Delaney et al., 1998 ). In
unpublished studies from our own laboratory, we found that NMDA
stimulated extracellular adenosine accumulation in neuronal cultures
and that inhibitors of nitric oxide synthase did not block this effect.
In these cultures a very small number of neurons stain positively for
nitric oxide synthase (~1%), and therefore the lack of effect may be
attributable to the low levels of nitric oxide production by the few
NOS-containing neurons that are present (Samdani et al., 1997 )
The present report strongly suggests that adenosine accumulation in
neuronal cultures evoked by nitric oxide does not derive from
extracellular AMP via the action of 5'-ectonucleotidase, because its
accumulation could not be blocked to any degree by GMP, an inhibitor of
5'-ectonucleotidase (Pearson, 1987 ). Although the adenosine appears to
derive from adenosine transported across the plasma membrane rather
than from the transport and extracellular degradation of a nucleotide,
it was not possible to block the accumulation using inhibitors of
adenosine transport. Therefore, release could be occurring via an
inhibitor-insensitive equilibrative transporter or one or more
of the inhibitor-insensitive concentrative transporters, either because
intracellular adenosine concentration had built up in excess of what
the transport system could maintain or because the sodium gradient had
diminished, for example because of a compromise in energy metabolism by
nitric oxide (Thorn and Jarvis, 1996 ). In fact, iodoacetate-evoked
release of adenosine by a concentrative transporter has been observed
(Foga et al., 1996 ).
Although the best-known action of nitric oxide is its ability to
activate guanylyl cyclase, a novel finding of this report is that the
action of nitric oxide on extracellular adenosine accumulation appears
to be independent of cGMP metabolism. Thus, we found that cGMP analogs
did not mimic the effect of nitric oxide and an inhibitor of guanylyl
cyclase activation did not block the effects of nitric oxide. Other
actions of nitric oxide are known and include interaction with heme and
non-heme iron in various proteins, as well as
S-nitrosylation reactions (Stamler et al., 1997 ). In
addition, nitric oxide rapidly interacts with superoxide to form
peroxynitrite (Koppenol et al., 1992 ). However, because peroxynitrite
formation is blocked by superoxide dismutase, and we found no effect of
inclusion of superoxide dismutase (Fig. 1), it seems likely that the
effect of nitric oxide donors on adenosine accumulation that we
observed is caused by nitric oxide itself and not peroxynitrite. Our
experiments do not exclude the possibility that peroxynitrite itself
may stimulate adenosine formation, but because of its neurotoxicity and
the confounding effects of leakage from damaged membranes, we have not
pursued this possibility in the present work.
From previous work (Clementi et al., 1998 ; Brorson et al., 1999 ), it
was expected that nitric oxide would cause ATP concentration derived
from oxidative phosphorylation to rapidly fall, leading to an
accumulation of AMP and adenosine. To pursue this, we measured ATP
extractable from neuronal cultures after exposure to DEA/NO and found a
significant decrease in ATP content compared with control. This
reduction in ATP was not observed in the presence of hemoglobin (data
not shown). As a test of the notion that this metabolic blockade might
be sufficient for the extracellular adenosine accumulation that was
observed, we tested the effect of rotenone, a complex I inhibitor, and
found that it potently stimulated adenosine release in addition to
decreasing intracellular ATP content.
Adenosine kinase is a critical enzyme in intracellular adenosine
metabolism. Interestingly, adenosine kinase is inhibited by adenosine
at a concentration not far from the Km for its catalytic activity (Miller et al., 1979 ; Palella et al., 1980 ; Rotllan and Miras
Portugal, 1985 ; Hawkins and Bagnara, 1987 ; McNally et al., 1997 ;
Mathews et al., 1998 ). Exposure to nitric oxide or any other experimental manipulation that causes intracellular adenosine accumulation would potentially inhibit adenosine kinase, resulting in
further adenosine accumulation. Indeed, another novel observation reported here is that exposure of neurons to nitric oxide was associated with inhibition of adenosine kinase. Thus, we found that 100 µM DEA/NO caused a nearly complete suppression
of adenosine kinase activity in neuronal cultures. Similar to what was
observed with DEA/NO, rotenone also inhibited adenosine kinase
activity. Therefore, it appears that the effects of DEA/NO and rotenone on intracellular ATP hydrolysis and consequent elevation in
intracellular adenosine levels might account for the blockade in
adenosine kinase that was observed; however, a direct action of either
nitric oxide or rotenone on adenosine kinase cannot be excluded.
Although the change in the intracellular adenosine that was measured
was small, given the presence in the plasma membrane of equilibrative
transporters, it is perhaps remarkable that we were able to measure any
increase. The change in adenosine that we measured was averaged over
whole cells and over all the cells that were present. Some cells may be
more affected than others, and within a given cell,
compartmentalization of intracellular adenosine increases might be
important for example, in the vicinity of mitochondria affected by
nitric oxide.
Other possibilities need to be considered as well, however, including
the involvement of a second messenger system, such as protein kinase C
(Sinclair et al., 2000 ), and a direct effect of lowering of the
concentration of ATP, which provides the phosphate group and the energy
for the phosphorylation of adenosine by adenosine kinase. However,
normal levels of ATP are well above saturation at the ATP binding site
(McNally et al., 1997 ), and a change of ~20% in cellular ATP, as we
have observed, is not likely to be responsible for any reduction of activity.
Adenosine kinase inhibition has also been demonstrated in other
settings associated with ATP hydrolysis: hypoxia in the guinea pig
heart (Decking et al., 1997 ) and oxygen-glucose deprivation in rat
cortical neuronal cultures (Lynch et al., 1998 ). The consequence of
inhibition of adenosine kinase activity, triggered by a small increase
in intracellular adenosine concentration, is that cells are switched
into a mode of extracellular adenosine accumulation. Thus adenosine
kinase is likely to be of central importance in the protective role of
adenosine in the setting of energy compromise. In addition, the
switching property of adenosine kinase may be of physiological
importance as well, for example in the production of sleep.
Because of the high expression of NOS in neurons of the LDT/PPT, it
seems likely that nitric oxide is important in the function of this
nucleus. Inhibition of NOS in general has been shown to result in a
diminution in sleep, whereas electrophysiological studies are
consistent with a facilitatory effect of nitric oxide on arousal and
REM generation mechanisms in target areas of the LDT/PPT. We think that
this paradox might be resolvable by considering the effects of nitric
oxide as both phasic and tonic. Acute release of nitric oxide by the
activity of NOS-containing neurons has potentiating effects on the
release of neurotransmitters such as acetylcholine (Leonard and Lydic,
1997 ) and glutamate (Montague et al., 1994 ; Kara and Friedlander, 1999 )
and increases IH to change the firing
pattern of thalamic neurons, all of which effects act to promote the
arousal or REM generation function of the LDT/PPT. Sustained, tonic
activity of nitrergic neurons may produce accumulation of extracellular
adenosine resulting in an increasing drive to sleep. Our hypothesis is
that the activity of LDT/PPT neurons during waking is associated with
the continuous release of nitric oxide in sleep-relevant target areas,
leading to the accumulation of adenosine in these areas and an
increasing tendency to sleep. It has been generally thought that the
release of adenosine that occurs with waking may be attributable to a
nonspecific depletion of energy stores during waking (Benington and
Heller, 1995 ). Our view is that this may be attributable rather to
a specific metabolic action of the nitric oxide that is released
coincidentally with the activity of neurons that play a central role in
arousal. We postulate that release of adenosine by the action of nitric
oxide on cellular energy production may be important in homeostatic sleep mechanisms.
 |
FOOTNOTES |
Received March 21, 2000; revised May 15, 2000; accepted June 6, 2000.
This work was supported by a grant from National Institutes of Health
(HL59595) and a Mental Retardation Research Center grant to Children's
Hospital. We thank Drs. Clifford Saper, Thomas Scammell, David White,
Woody Weiss, and, in particular, Robert Greene of the Harvard
Center on Sleep Neurobiology and Sleep Apnea for helpful discussions
and encouragement.
Correspondence should be addressed to Dr. Paul A. Rosenberg, Department
of Neurology, Children's Hospital, 300 Longwood Avenue, Boston, MA
02115. E-mail: rosenberg{at}a1.tch.harvard.edu.
 |
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