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The Journal of Neuroscience, March 15, 2001, 21(6):1931-1938
Delayed Neurodegeneration in Neonatal Rat Thalamus after
Hypoxia-Ischemia Is Apoptosis
Frances J.
Northington1,
Donna M.
Ferriero3,
Debra
L.
Flock1, and
Lee J.
Martin2
Eudowood Neonatal Pulmonary Division, Departments of
1 Pediatrics and 2 Pathology, The Johns Hopkins
University School of Medicine, Baltimore, Maryland 21287, and
3 Departments of Neurology and Pediatrics, University of
California-San Francisco, San Francisco, California 94143
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ABSTRACT |
Brain injury in newborns can cause deficits in motor and sensory
function. In most models of neonatal brain injury, thalamic damage
often occurs. Using the Rice-Vannucci model of neonatal hypoxic-ischemic brain injury, we have shown that neuronal
degeneration in somatosensory thalamus is delayed in onset (~24 hr)
compared with cortical and striatal injury and exhibits prominent
structural features of apoptosis. In the present study, we examined
whether cell death in the thalamus has molecular features of apoptosis. Fas death receptor protein expression increased rapidly after neonatal
hypoxia-ischemia, in concert with cleavage of procaspase 8 to its
active form. Concurrently, the levels of Bax in mitochondrial-enriched cell fractions increase, and cytochrome c accumulates in the soluble fraction. Mitochondria accumulate in a perinuclear distribution by 6 hr
after hypoxia-ischemia. Cytochrome oxidase subunit 1 protein levels
also increase at 6 hr after hypoxia-ischemia. Increased levels of Fas
death receptor, Bax, and cytochrome c, activation of caspase 8, and
abnormalities in mitochondria in the thalamus significantly precede the
activation of caspase 3 and the appearance of neuronal apoptosis at 24 hr. We conclude that the delayed neurodegeneration in neonatal rat
ventral basal thalamus after hypoxic-ischemic injury is apoptosis
mediated by death receptor activation.
Key words:
mitochondria; neonatal brain injury; Bax; Fas death
receptor; caspase; cytochrome oxidase
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INTRODUCTION |
A large amount of investigation has
focused on cytokine- and hypoxia-ischemia-mediated injury to the
developing cortex and periventricular white matter as the cause of the
neurodevelopmental handicaps suffered by infants who have experienced
perinatal brain injury. Energy failure, free radical, cytokine, and
excitatory amino acid release, and caspase-dependant cell death are
known to contribute to injury in the neocortex, striatum, and
periventricular white matter (McDonald et al., 1988 ; Barks and
Silverstein, 1992 ; Hagan et al., 1996 ; Liu et al., 1996 ; Martin et al.,
1997a , b ; Back et al., 1998 ; Cheng et al., 1998 ). However, the
degeneration of thalamus and other nonforebrain structures after
hypoxia-ischemia is studied less frequently. Injury to somatosensory
thalamus has been described in human newborns after hypoxia-ischemia
(Barkovich, 1995 ; Roland et al., 1998 ) and may contribute to
sensorimotor deficits in infants with perinatal brain injury and
cerebral palsy. Sensorimotor deficits have been detected in neonatal
rats subjected to the Rice-Vannucci model (Rice et al., 1981 ) of
hypoxic-ischemic injury (Bona et al., 1997 ). A few detailed
neuropathological studies of animal models have revealed injury to the
developing thalamus after neonatal hypoxia-ischemia (Towfighi et al.,
1991 ). In addition, we have demonstrated recently that injury to the
thalamus occurs in a delayed manner and exhibits prominent structural
features of apoptosis when compared with the early necrotic cell death seen in the forebrain after hypoxia-ischemia (Northington et al., 2001 ).
The mechanisms of apoptotic neurodegeneration in the thalamus and other
brain regions remote from the forebrain after neonatal hypoxia-ischemia are completely unknown. However, death
receptor-activated pathways, altered mitochondrial function, and
changes in expression of mitochondrial-related bcl-2 family
proteins are likely important effectors of programmed cell death in the
present model of neonatal brain injury (Nelson and Silverstein, 1994 ;
Silverstein, 1998 ; Felderhoff-Mueser et al., 2000 ). Fas death receptor
protein expression is increased in hippocampus bilaterally during the
24 hr immediately after neonatal hypoxia-ischemia (Felderhoff-Mueser
et al., 2000 ), and administration of cytokine antagonists afford
neuroprotection in the present model (Liu et al., 1996 ). In adult
models of apoptosis, mitochondrial accumulation occurs during the
critical chromatolytic phase before apoptosis simultaneously with
increased expression of the proapoptosis proteins Bax and Bak
(Martin, 1999 ; Martin et al., 1999 ).
In this study, we investigate whether a cascade of events (including
death receptor activation, alteration in the ratio of proapoptosis- and
antiapoptosis-regulating proteins in mitochondria, altered
mitochondrial activity and location, cytochrome c accumulation, and
cleavage of caspases into active subunits) leads to apoptotic neurodegeneration in the thalamus after neonatal hypoxia-ischemia.
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MATERIALS AND METHODS |
Hypoxia-ischemia in 7-d-old rats. The Rice-Vannucci
(Rice et al., 1981 ) neonatal adaptation of the Levine procedure
(Levine, 1960 ) was used to cause hypoxic-ischemic brain injury in
7-d-old (p7) rats. In brief, rat pups were anesthetized with 2.5%
halothane and 15% nitrous oxide in O2. The right
common carotid artery was permanently ligated (in sham controls the
ligature was passed around the artery and removed). After the wound was
sutured, the pups recovered from anesthesia and were returned to the
dam. Two hours later, pups were placed in an airtight container in a
37°C water bath through which humidified 8% O2
and balance nitrogen flowed for 150 min. After hypoxia, pups were
returned to the dam until death.
The animals were killed, and the brains were retrieved at 0, 1.5, 3, 6, and 24 hr after the end of hypoxia for histological analysis
(n = 6 for each time point) or at 3, 6, and 24 hr after the end of hypoxia for Western blotting. Because of the small size of
the immature rat thalamus, three hemithalami per pooled sample were
required to generate adequate tissue homogenate for immunoblot
analysis. Thus tissue from12 to 15 animals per time point were used to
generate four to five pooled samples at each time point for
immunoblotting. The multiple early time points were chosen because our
data, as well as that of others, showed a faster progression of injury
after hypoxia-ischemia in neonates as compared with adults (Towfighi
et al., 1995 ; Martin et al., 1997a ; Northington et al., 2001 ).
Control groups consisted of sham-operated littermates
(n = 4-6 for histological analysis; n = 4 pooled thalami for Western blotting). Because the entire thalamus
could be used to create tissue homogenates in sham controls, only eight
animals were required to generate adequate tissue samples for
immunoblotting. Sham controls were killed on postnatal day 7 to provide
age-matched tissue for comparison of expression of apoptosis-related
proteins and levels of cytochrome oxidase activity.
All animal studies received previous approval from the Animal Care and
Use Committee of Johns Hopkins University School of Medicine and were
performed in accordance with the National Institutes of Health
Guide for the Care and Use of Laboratory Animals (United States Department of Health and Human Services 85-23, 1985).
Tissue preparation. Animals were killed with an overdose of
pentobarbital (65 mg/kg, i.p.) and exsanguinated with cold 0.1 M PBS, pH 7.4, via intracardiac perfusion. Brains were
perfusion fixed with 4% paraformaldehyde in PBS for 30 min at 4 ml/min. The brains were removed, post-fixed in 4% paraformaldehyde
overnight, cryoprotected in 30% sucrose, and frozen in isopentane
( 30°C). Sixty micrometer coronal sections were cut on a sliding
microtome for cresyl violet and immunohistochemical staining.
Immunoblotting. Samples of thalamus were rapidly
microdissected under a surgical microscope, immediately after death,
and frozen on dry ice. Pooled samples (150-200 mg) were homogenized in
cold 20 mM Tris-HCl, pH 7.4, containing 10% (w/v) sucrose, 20 µg/ml aprotinin (Trayslol), 20 µg/ml leupeptin, 20 µg/ml
antipain, 20 µg/ml pepstatin A, 20 µg/ml chymostatin, 0.1 mM phenylmethylsulfonyl fluoride, 10 mM
benzamidine, 1 mM EDTA, and 5 mM EGTA. Crude
homogenates were centrifuged at 1000 × g for 10 min.
The supernatant (S1 fraction) was then centrifuged at 114,000 × g for 20 min, and the resulting supernatant (S2 soluble
fraction) was collected. The pellet (P2, mitochondrial-enriched,
membrane fraction) was washed in homogenization buffer (without
sucrose) three times by resuspension and centrifugation at 114,000 × g for 20 min. The P2 fraction was then resuspended fully
in homogenization buffer supplemented with 20% (w/v) glycerol. This
subcellular fractionation protocol has been verified to be enriched in
mitochondria but also contains other organelle constituents (i.e.,
endoplasmic reticulum and Golgi apparatus) (Martin et al., 2000 ).
Protein concentrations were measured by a Bio-Rad (Hercules, CA)
protein assay with bovine serum albumin as a standard.
Samples of membrane or soluble proteins were subjected to SDS-PAGE and
electroeluted onto nitrocellulose membranes. The reliability of sample
loading and protein transfer was evaluated by staining nitrocellulose
membranes with Ponceau S before immunoblotting and by quantification of
Coomassie-stained gels and Ponceau-stained blots with OD. Blots
were blocked with 2.5% nonfat dry milk with 0.1%Tween 20 in 50 mM Tris-buffered saline, pH 7.4, and incubated overnight at
4°C with antibody. After primary incubation, blots were washed,
incubated with peroxidase-conjugated secondary antibodies (0.2 µg/ml), and developed with enhanced chemiluminescence. To quantify
cell death protein immunoreactivity, films were scanned using Adobe
Photoshop, and OD was performed with IP Lab Gel H software. The
OD of the corresponding lanes in Coomassie-stained gels or
Ponceau-stained blots was used to correct the OD of the cell death
protein immunoreactivity for differences in protein loading. Protein
levels are thus expressed as relative OD measurements compared with
control lanes in the same blot.
Antibodies. Anti-Fas death receptor antibody (Santa Cruz
Biotechnology, Santa Cruz, CA) is a rabbit polyclonal antibody
generated against an epitope mapping to the C terminal of human Fas and is noncross-reactive with other tumor necrosis factor receptor (TNFR)
type-1 receptors. It recognizes a single band at 45 kDa and higher
molecular weight bands after SDS-PAGE. Jurkat cells known to express
high levels of the Fas death receptor were used as a positive control.
Anti-caspase 8 antibody (Santa Cruz Biotechnology) is a rabbit
polyclonal antibody raised against a recombinant protein corresponding
to amino acids 217-350 of human caspase 8. Anti-Bax (Upstate
Biotechnology, Lake Placid, NY) and anti-Bcl-2 antibodies (Santa Cruz
Biotechnology) are affinity-purified rabbit polyclonal antibodies
generated against a peptide corresponding to amino acids 1-21 of human
Bax and a peptide mapping at the N terminal of human Bcl-2,
respectively. Anti-Bax antibody recognizes a single 23 kDa band, a
faint band at 18.5 kDa representing the cleaved form of Bax, and
several less intense high-molecular weight bands in P2 protein
fractions. Anti-Bcl-2 antibody recognizes a band at 26 kDa and several
less intense high-molecular weight bands in P2 protein fractions. A
second rabbit polyclonal anti-Bax antibody (Santa Cruz Biotechnology)
generated against a peptide homologous to amino acids 11-30 of human
Bax gave results identical to those of the Upstate Biotechnology
antibody. Because these proteins were fractionated in denaturing gels,
it is unlikely that the high-molecular weight bands represent various
Bax and Bcl-2 homodimers and heterodimers. Anti-cytochrome c antibody
(Santa Cruz Biotechnology) is a rabbit polyclonal antibody directed
against amino acids 1-104 of full-length horse cytochrome c. It
recognizes a band at 12-15 kDa. Anti-cytochrome oxidase subunit 1 (anti-COX1) antibody (Molecular Probes, Eugene, OR) is a mouse
monoclonal antibody generated against subunit 1 of human cytochrome
oxidase. The antibody recognizes only a single band of ~35 kDa in
nonboiled P2 protein samples subjected to SDS-PAGE. Anti-caspase 3 antibody (Santa Cruz Biotechnology) is a rabbit polyclonal antibody
generated against amino acids 1-277 of full-length human caspase-3,
and it recognizes the 32 kDa proenzyme with an intense band of
immunoreactivity and the 12, 17, and 20 kDa active fragments with less
intense single bands. Cleaved caspase 3 antibody (Cell Signaling
Technology, Beverly, MA) is a rabbit polyclonal antibody generated
against a synthetic peptide corresponding to residues surrounding the
cleavage site of human caspase 3.
Cytochrome oxidase histochemistry. To identify the levels of
oxidative metabolism and intracellular distribution of oxidatively active mitochondria, we used the cytochrome oxidase
histochemical method of Wong-Riley (1979 , 1989 ) as described previously
for our laboratory (Martin et al., 1997a ). Briefly, brain
sections from control and hypoxic-ischemic rat pups were exposed to
the assay simultaneously. The enzymatic reaction medium was prepared immediately before each experiment and consisted of 100 mM
phosphate buffer, pH 7.4, 0.1% horse heart cytochrome c (Sigma, St.
Louis, MO), 117 mM sucrose, and 1.4 mM
diaminobenzidine tetrahydrochloride. In this histochemical reaction,
in situ cytochrome oxidase catalyzes the transfer of
electrons (donated by diaminobenzidine) from cytochrome c, provided as
substrate, to O2 to form
H2O. The donation of electrons from
diaminobenzidine is a chromogenic reaction that yields the formation of
an insoluble precipitate in the vicinity of cytochrome oxidase
activity, thus revealing both the location of the mitochondria and the
relative metabolic activity of cytochrome oxidase (Wong-Riley, 1979 ).
Sections were incubated for 2.5 hr at 37°C in a Dubnoff metabolic
shaker incubator. After the reaction, sections were rinsed in phosphate
buffer, mounted on glass slides, and coverslipped.
Statistical analysis. To quantify changes in the expression
of Fas death receptor protein, mitochondrial apoptosis-regulating proteins, COX1 protein, and caspase 8 and 3 active fragments, protein
expression was corrected for loading differences and then expressed as
a percent of control. In some blots, two different controls were used,
and the average optical density of the two bands was used for percent
control calculations. Mean and SD for protein expression in tissue
obtained at similar time points were calculated, and ANOVA was used to
compare differences in protein expression over time. Post
hoc testing for differences in expression at 3, 6, and 24 hr was
performed with Fisher's analysis. A p value of <0.05 was
used to determine significance.
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RESULTS |
In the ipsilateral thalamus at 24 hr after neonatal
hypoxia-ischemia, many degenerating neurons display light microscopic features of apoptosis (Fig.
1B, arrows)
(Northington et al., 2001 ). This contrasts with the normal morphology
of thalamic neurons from sham controls (Fig. 1A).

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Figure 1.
Thalamic neurons die by apoptosis after neonatal
hypoxia-ischemia. A, B, Compared with sham controls
(A), neurons at 24 hr after hypoxia-ischemia
(B) contain many apoptotic profiles as seen in
cresyl violet-stained sections of the ventral basal thalamus
(arrows).
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Fas receptor expression is induced in thalamus rapidly after
neonatal hypoxia-ischemia
By immunoblotting, Fas death receptor protein expression is
increased in the diencephalon after neonatal hypoxia-ischemia (Fig.
2). In membrane protein fractions of
newborn rat thalamus, Fas was detected at 45 kDa, corresponding to the
known molecular weight of Fas death receptor protein in Jurkat cells.
Jurkat cells were chosen as a positive control because they are known
to express high levels of Fas death receptor (Felderhoff-Mueser et al.,
2000 ). A comparison of samples from sham-operated controls and p7 rat pups at 3, 6, and 24 hr after hypoxia-ischemia revealed a significant (p < 0.05) increase in Fas levels after
hypoxia-ischemia (Fig. 2) in the rat thalamus. This increase occurred
as early as 3 hr after hypoxia-ischemia. The increase in Fas death
receptor was not caused by a generalized increase in similar cytokine
receptor expression because expression of the closely related TNF
receptor 1 did not change in response to neonatal hypoxia-ischemia
(Fig. 2).

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Figure 2.
Fas death receptor protein levels increase in the
thalamus after neonatal hypoxia-ischemia. A,
Top, Immunoblot showing increased Fas death receptor
protein in membrane fractions from thalamic homogenates obtained 3, 6, and 24 hr after neonatal hypoxia-ischemia compared with noninjured
control samples. Jurkat cell lysates were used as a positive control,
because they express high levels of Fas as detected at 45 kDa. The
corresponding 45 kDa band in controls and injured thalamic samples was
used for quantification. Bottom, The corresponding
Coomassie-stained gel. B, Top, Immunoblot showing no
change in TNFR1 death receptor protein in membrane fractions from
thalamic homogenates obtained 3, 6, and 24 hr after neonatal
hypoxia-ischemia compared with noninjured control samples.
Bottom, The corresponding Ponceau-stained blot. For
A and B each lane
represents a pooled sample of thalamus from three animals at the
indicated time point (i.e., sham control and 3, 6, or 24 hr after
hypoxia-ischemia). C, Graph representing changes in Fas
death receptor protein levels in the thalamus over time after neonatal
hypoxia-ischemia. Results are shown as the mean ± SD of four to
five pooled samples per time point (*p < 0.05 compared with control). Jk, Jurkat cell lysates;
SC, sham control.
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Caspase 8 is cleaved to its active subunits after
neonatal hypoxia-ischemia
Procaspase 8 undergoes cleavage and activation in cell culture
model systems of apoptosis (Dragovich et al., 1998 ; Nagata, 1999a ,b ). Procaspase 8 (54-55 kDa) is cleaved to its 30 and 18 kDa subunits in soluble protein from ipsilateral thalamus after neonatal hypoxia-ischemia (Fig. 3). The
levels of procaspase 8 in soluble fractions decrease as the expression
of cleaved subunits increases after hypoxia-ischemia (Fig. 3). Jurkat
cells, which are highly sensitive to Fas-mediated apoptosis, express
both procaspase 8 and the active subunits (Fig. 3).

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Figure 3.
Procaspase 8 is cleaved to active fragments in the
thalamus after neonatal hypoxia-ischemia. A, Immunoblot
showing that procaspase 8 (54-55 kDa) levels decrease concurrently
with an increase in the levels of the 30 and 18 kDa active fragments of
caspase 8 in cytosolic fractions from the thalamus at 3, 6, and 24 hr
after neonatal hypoxia-ischemia. There is a progressive increase in
expression of the active subunits during the first 24 hr after
hypoxia-ischemia compared with controls (SC).
Anti-caspase 8 antibody also reacts strongly with a 55, 30, and 18 kDa
protein in Jk cells consistent with the proenzyme and
active fragment forms of caspase 8. Bottom, The
corresponding Ponceau-stained blot. Each lane represents
a pooled sample of thalamus from three animals at the indicated time
point (i.e., sham control and 3, 6, or 24 hr after hypoxia-ischemia).
B, Graph representing changes in abundance of the 18 kDa
active subunit of caspase 8 in the thalamus over time after neonatal
hypoxia-ischemia. After correcting for protein-loading differences and
comparing with control, results are shown as the mean ± SD of
four to five pooled samples per time point (*p < 0.05 compared with control).
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A potential target of Fas- and caspase 8-mediated apoptosis is the
Bcl-2 family protein Bid that has been shown to cause cytochrome c
release and subsequent apoptosis (Li et al., 1998 ). We found no
evidence of Bid cleavage in either soluble or mitochondrial-enriched fractions (data not shown).
Ratio of mitochondrial apoptosis-regulating proteins is altered
rapidly after hypoxia-ischemia in the thalamus before the appearance
of prominent apoptosis
After neonatal hypoxia-ischemia, levels of the proapoptosis
protein Bax rapidly increase in mitochondrial-enriched fractions of
thalamus (Fig. 4A).
Additionally, at 24 hr there is faint immunoreactivity of an 18 kDa Bax
band (Fig. 4A) consistent with a cleaved fragment of
Bax reported also to have potent proapoptosis activity (Wood and
Newcomb, 2000 ). This increase in Bax protein, within the
mitochondrial fraction, occurs without a concomitant change in the
level of the antiapoptosis Bcl-2 protein in the mitochondrial fraction within the same time period (Fig. 4B). The increase
in expression of Bax and stable expression of Bcl-2 proteins result in
a marked shift in protein abundance in favor of proapoptosis Bax (Fig. 4C). A significant change in the relative abundance of Bax
and Bcl-2 is evident as early as 3 hr after neonatal
hypoxia-ischemia.

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Figure 4.
Neonatal hypoxia-ischemia causes an elevation in
proapoptosis Bax protein levels in the mitochondrial fraction but does
not alter levels of antiapoptosis Bcl-2. A, Top,
Immunoblot shows increased Bax protein levels in mitochondrial membrane
fractions from the thalamus from homogenates obtained 3, 6, and 24 hr
after neonatal hypoxia-ischemia compared with noninjured control
samples (SC). Anti-Bax antibody recognizes the expected
21 kDa band corresponding to Bax protein. Bottom, The
corresponding Ponceau-stained blot is shown. Each lane
represents a pooled sample of thalamus from three animals at the
indicated time point (i.e., sham control and 3, 6, or 24 hr after
hypoxia-ischemia). B, In comparison Bcl-2 protein
expression is not changed in mitochondrial membrane fractions from
thalamus homogenates obtained 3, 6, and 24 hr after neonatal
hypoxia-ischemia compared with noninjured control samples
(SC). Anti-Bcl-2 antibody recognizes the expected 26 kDa
band corresponding to Bcl-2 protein. Bottom, The
corresponding Coomassie-stained gel is shown. C, Graph
represents alteration in relative amounts of Bax and Bcl-2 protein in
the mitochondrial membrane fraction in the thalamus over time after
neonatal hypoxia-ischemia. By 3 hr, there is a significant shift in
the Bax/Bcl-2 ratio favoring proapoptosis Bax. After correcting for
protein-loading differences and comparing with control, results are
shown as the mean ± SD of four to five pooled samples per time
point (*p < 0.05 compared with control).
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Cytochrome c rapidly accumulates in the soluble fraction of
thalamus after neonatal hypoxia-ischemia
Cytochrome c levels increase in the soluble fraction as early as 3 hr after neonatal hypoxia-ischemia (Fig.
5A). This increase is
coincident with the appearance of cleaved caspase-8 and before the
increase in expression of the 12 kDa subunit of caspase 3. The initial
increase in the amount of cytochrome c in the soluble fraction at 3 hr
is sustained at 6 and 24 hr after neonatal hypoxia-ischemia (Fig.
5B).

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Figure 5.
Cytochrome c accumulates in the soluble fraction
in the thalamus after neonatal hypoxia-ischemia. A,
Top, Immunoblot showing increased cytochrome c protein in
soluble fractions from thalamic homogenates obtained 3, 6, and 24 hr after neonatal hypoxia-ischemia compared with noninjured control
samples (SC). Bottom, The corresponding
Ponceau-stained blot. Each lane represents a pooled
sample of thalamus from three animals at the indicated time point
(i.e., sham control and 3, 6, or 24 hr after hypoxia-ischemia).
B, Graph showing the accumulation of cytochrome c in the
thalamus over time after neonatal hypoxia-ischemia. After correcting
for protein-loading differences and comparing with control, results are
shown as the mean ± SD of four to five pooled samples per time
point (*p < 0.05 compared with control).
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Caspase-3 is cleaved into its active subunits at 24 hr after
neonatal hypoxia-ischemia in the thalamus
Caspases 3 and 8 are primary targets of death receptor-mediated
apoptosis cascades (Nagata, 1999b ; Yamada et al., 1999 ). When cleaved from its 32 kDa proenzyme form, the active 12, 17, and 20 kDa
fragments have a central role in activating DNA fragmentation and other
irreversible steps in apoptosis (Du et al., 1997 ). Caspase 3 is cleaved
to its active forms in the thalamus after neonatal hypoxia-ischemia
(Fig. 6A).
Interestingly this activation is found only at 24 hr after
hypoxia-ischemia (Fig. 6B). This result was confirmed using both the Santa Cruz Biotechnology anti-caspase 3 antibody that recognizes procaspase 3 and the active fragments and an
antibody against the 17 kDa cleaved caspase 3 fragment.

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Figure 6.
Cleavage of procaspase 3 to active fragments
occurs at 24 hr after neonatal hypoxia-ischemia. A,
Top, Immunoblot shows levels of 32 kDa procaspase 3 and its
lower molecular weight cleavage products in thalamus cytosolic
fractions from homogenates obtained 3, 6, and 24 hr after neonatal
hypoxia-ischemia compared with noninjured control samples
(SC). Bottom, The corresponding
Coomassie-stained blot is shown. Each lane represents a
pooled sample of thalamus from three animals at the indicated time
point (i.e., sham control and 3, 6, or 24 hr after hypoxia-ischemia).
B, Graph represents change in expression of the12 kDa
cleavage product in the thalamus over time after neonatal
hypoxia-ischemia. Not until 24 hr is there a significant increase in
the expression of the 12 kDa fragment. After correcting for
protein-loading differences and comparing with control, results are
shown as the mean ± SD of four to five pooled samples per time
point (*p < 0.05 compared with control).
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Mitochondria accumulate at perinuclear locations in thalamic
neurons after neonatal hypoxia-ischemia
Using a histochemical detection method for cytochrome oxidase
activity to identify mitochondria, we found that neurons in the ventral
basal thalamus, after neonatal hypoxia-ischemia, accumulate mitochondria (Fig. 7). These changes
occur before the appearance of a significant number of apoptotic
profiles at 24 hr (Northington et al., 2001 ). In normal neurons,
cytochrome oxidase activity is evenly distributed throughout the cell
soma in ventral basal thalamic neurons (Fig. 7A). In
contrast, by 3-6 hr after neonatal hypoxia-ischemia, mitochondria
within neurons in the ipsilateral ventral basal thalamus exhibit
intense cytochrome oxidase activity and form prominent perinuclear
aggregates of mitochondria (Fig. 7B). These changes are most
prominent in neurons in the chromatolytic stage of early neuronal
apoptosis (Fig. 7C, cytochrome oxidase histochemistry and
cresyl violet counterstaining) according to a recently proposed staging
scheme for apoptosis of neurons (Al-Abdulla and Martin, 1998 ;
Al-Abdulla et al., 1998 ; Martin et al., 1999 ). In these cells, dense
cytochrome oxidase-positive aggregates cluster adjacent to peripherally
displaced nuclei. By 24 hr, cells in late phases of apoptosis
with tightly condensed chromatin aggregates have lost or are losing
immunoreactivity for cytochrome oxidase (Fig. 7D, cytochrome
oxidase histochemistry and cresyl violet counterstaining)

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Figure 7.
Mitochondria accumulate in a perinuclear location
in ventral basal thalamic neurons after neonatal hypoxia-ischemia.
Histochemistry for cytochrome oxidase activity in the thalamus after
neonatal hypoxia-ischemia shows intense cytochrome oxidase activity in
mitochondria and alteration in appearance and intracellular location of
mitochondria after neonatal hypoxia-ischemia. At 6 hr, mitochondria
are densely immunoreactive for cytochrome oxidase, assuming a punctate
appearance and clustering near nuclei that are in the chromatolytic
phase of apoptosis (B, C, cytochrome oxidase
histochemistry and cytochrome oxidase histochemistry counterstained
with cresyl violet, respectfully). By 24 hr (D),
cytochrome oxidase immunoreactivity is dissipating in thalamic neurons
undergoing late stages of apoptotic degeneration. Three cells with
densely condensed chromatin are shown with variable but decreasing
levels of cytochrome oxidase activity. Scale bars: A-C,
12 µm; D, 6 µm.
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The accumulation of mitochondria in the thalamus after neonatal
hypoxia-ischemia was confirmed indirectly by immunoblotting. By
immunoblotting, levels of COX1 increased after neonatal
hypoxia-ischemia (Fig. 8). Expression of
this inner mitochondrial membrane protein increases in the thalamus
(Fig. 8A). In the thalamus, a significant increase in
expression of COX1 is evident at 6 hr after hypoxia-ischemia (Fig.
8B) coincident with the peak of cytochrome oxidase
activity in neurons in early phases of apoptotic neurodegeneration
(Fig. 7C).

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Figure 8.
COX1 protein increases in thalamic mitochondrial
protein fractions coincident with mitochondrial accumulation after
neonatal hypoxia-ischemia. A, Top, Immunoblot shows an
increase in COX1 protein in mitochondria-enriched membrane fractions
from the thalamus from homogenates obtained 3, 6, and 24 hr after
neonatal hypoxia-ischemia compared with noninjured control samples
(SC). Bottom, The corresponding
Ponceau-stained blot is shown. Each lane represents a
pooled sample of thalamus from three animals at the indicated time
point (i.e., sham control and 3, 6, or 24 hr after hypoxia-ischemia).
B, Graph represents changes in COX1 protein levels in
the thalamus over time after neonatal hypoxia-ischemia. The maximal
increase at 6 hr corresponds nicely with the peak in mitochondrial
accumulation seen at 6 hr in Figure 7C. After correcting
for protein-loading differences and comparing with control, results are
shown as the mean ± SD of four to five pooled samples per time
point (*p < 0.05 compared with control).
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DISCUSSION |
We found previously that neuronal degeneration in the neonatal
thalamus after hypoxia-ischemia is apoptosis (Northington et al.,
2001 ). In this study, we explored the mechanisms and conclude that
delayed neuronal degeneration in neonatal rat thalamus after hypoxia-ischemia has biochemical and molecular features of apoptosis. The findings that support this conclusion are (1) increased Fas death
receptor levels, (2) an alteration in the levels of Bax and Bcl-2
favoring apoptosis-promoting Bax, (3) intracellular redistribution of
active mitochondria, (4) accumulation of soluble cytochrome c, and (5)
cleavage of caspases 8 and 3 to active forms. This cascade of
biochemical and molecular events is consistent with Fas-mediated,
mitochondrial-amplified, apoptosis as a major mechanism of delayed
neurodegeneration after neonatal hypoxia-ischemia.
Thalamic damage after hypoxia-ischemia in newborns has long been
recognized and is particularly important in infants with extrapyramidal
cerebral palsy (Malamud, 1950 ; Volpe, 1995 ; Roland et al., 1998 ). Human
neuroimaging and neuropathological studies have revealed that the
thalamus is among the selectively vulnerable brain regions in the human
newborn (Yokochi et al., 1991 ; Barkovich, 1995 ; Roland et al., 1998 ).
Despite recognition of injury to the thalamus in children with cerebral
palsy, the contribution of delayed injury and injury to nonforebrain
regions to the development of cerebral palsy has been less well
studied. The ventral basal thalamus contains afferent and efferent
connections to the ipsilateral cortex and functions prominently in
sensorimotor integration (Erzurumlu and Jhaveri, 1990 ). Injury to these
circuits interrupts cortical sensory function and the integration of
sensory information into volitional movement (White, 1989 ). Damage to
motor relay nuclei in the thalamus may lead to movement disorders such
as ataxia or dystonia (White, 1989 ) and when this injury occurs in the
immature brain may contribute to the motor and sensory handicaps
suffered by children with cerebral palsy.
In the model of neonatal brain injury used in these studies, the
ipsilateral forebrain is the most vulnerable region and clearly represents the ischemic core of the lesion (Rice et al., 1981 ). However, the thalamus is also damaged in this and most other models of
neonatal brain injury (present data) (Myers, 1975 ; Towfighi et al.,
1991 , 1995 ; Martin et al., 1997a ; Northington et al., 2001 ). We
postulated that this thalamic injury is apoptosis. We identified
increased Fas death receptor protein levels in the ventral basal
thalamus after neonatal hypoxia-ischemia. This observation suggests an
additional link between cytokine- and hypoxia-ischemia-mediated neonatal brain injury. Previous studies have demonstrated activation of
interleukin (IL) (Szaflarski et al., 1995 ) neuroprotection with
cytokine antagonists and in the absence of IL-1 -converting enzyme
(Liu et al., 1996 , 1999 ). The mechanism of hypoxia-ischemia-induced, cytokine-mediated cell death in the developing brain has not been clearly defined. The present study demonstrates that hypoxia-ischemia induces a cytokine death receptor that functions in apoptosis (Nagata,
1999b ). Although we have not shown directly that Fas is induced
in thalamic neurons, the rapid induction (by 3 hr) and the sustained
elevation over the relevant time preceding thalamic neuronal apoptosis
make Fas death receptor induction unlikely to be the result of inflammation.
An elevation in Fas death receptor is a link to multiple pathways of
cell death. Fas is a member of the TNFR family. Oligomerization of Fas death receptor and recruitment of FADD/MORT1 and
procaspase 8 create the death-inducing signal complex (DISC). DISC is a
potent apoptosis stimulus in multiple cell culture models. When
procaspase 8 is bound by the DISC, autocleavage to its active fragments
occurs. Cleaved caspase 8 then acts directly and indirectly to cleave caspase 3, depending on cell type and injury stimulus (Dragovich et
al., 1998 ; Nagata, 1999a ,b ). Cleavage of caspase 3 is generally considered one of the irreversible steps immediately responsible for
the execution of apoptosis in which the cell develops the morphological
features recognizable as late-stage apoptosis (Petit et al., 1996 ). Our
data demonstrate early Fas death receptor elevation and early and
progressive cleavage of caspase 8 to its active form, followed by
delayed caspase 3 cleavage just at the time of appearance of
significant apoptosis in the thalamus after neonatal hypoxia-ischemia.
This change is selective for Fas because TNFR1 was not changed. We have
not yet shown activation of caspase 8 and caspase 3 specifically in
thalamic neurons because of the lack of specific reagents. Fas death
receptor protein and downstream caspase 3 cleavage likely bracket an
important signaling cascade for apoptotic neurodegeneration in the thalamus.
Direct caspase 8 cleavage of caspase 3 is the original model of
Fas-mediated apoptosis signaling (Dragovich et al., 1998 ); however
mitochondria and mitochondrial apoptosis-regulating proteins of the
bcl-2 family are now known to amplify cell death signals greatly (Susin et al., 1997 ). Bid, a cytosolic protein with homology to
the BH3 domain of the Bcl-2 family, is cleaved in several models of
Fas-mediated apoptosis and causes cytochrome c release from the
mitochondria (Susin et al., 1997 ; Nagata, 1999a ). We did not find evidence of Bid cleavage in the present model. However, we did
find cytochrome c accumulation in the soluble fraction. Most of the
bcl-2 family of proteins that regulate the rate of
programmed cell death are normally present within mitochondrial
membranes. Several in vivo and in vitro systems
have shown the ratio of the proapoptosis protein Bax and the
antiapoptosis proteins Bcl-2 and Bcl-x(l) to be critical in determining
cell survival (Krajewski et al., 1995 ; Vekrellis et al., 1997 ; Isenmann
et al., 1998 ; Antonawich et al., 1999 ; Martin, 1999 ; Shimizu et al.,
1999 ; Almeida et al., 2000 ).
We find a marked alteration in the balance of proapoptosis and
antiapoptosis bcl-2 proteins in the P2 fraction of thalamus after hypoxia-ischemia. This accumulation of Bax in the
mitochondrial-enriched fraction occurs before caspase 3 cleavage
and the appearance of large numbers of apoptotic profiles (present
data) (Northington et al., 2001 ). A fourfold increase in the amount of
proapoptosis protein Bax in the mitochondrial-enriched fraction was
detected by 3 hr after injury, whereas the amount of Bcl-2 in the
mitochondria is not changed during the first 24 hr after
hypoxia-ischemia. These changes in the relative ratio of Bax to Bcl-2
favors the formation of Bax homodimers, the configuration in which Bax
exerts its proapoptosis activity (Gross et al., 1998 ). Bax normally
exists as a cytosolic protein and is translocated to the mitochondria after ligation of Fas receptor. This translocation is inhibited by
Bcl-2 (Murphy et al., 2000 ). The present data suggest active mitochondrial translocation of Bax greatly in excess of the
steady-state amount of Bcl-2. This is consistent with a strong death
signal and may participate in mitochondrial amplification of
Fas-mediated apoptosis. Cleavage of Bax to an 18 kDa isoform also
enhances its cell death potency (Wood and Newcomb, 2000 ).
Although neither antibody used in the present study was designed to
detect the 18 kDa isoform, there is weak expression of an 18 kDa Bax
band in the diencephalon at 24 hr after neonatal hypoxia-ischemia. The
late appearance of this isoform in mitochondrial-enriched fractions is
consistent with published reports of calpain-mediated Bax cleavage
after translocation of Bax to the mitochondria (Wood and Newcomb,
1999 ).
Release of cytochrome c and changes in mitochondrial morphology and
membrane potential and function precede caspase 3 activation in
in vitro model systems (Zamzami et al., 1996 ; Vander Heiden et al., 1997 ). Cytochrome c has been identified as APAF2, and cytochrome c release is the immediate upstream event preceding caspase
3 cleavage and the execution phase of apoptosis (Susin et al., 1999 ).
Our data show that cytochrome c accumulates in the soluble fraction of
thalamus, in concert with caspase 8 cleavage and an altered Bax/Bcl-2
ratio and before the appearance of large amounts of caspase 3 cleavage.
In axotomy models of neuronal apoptosis, mitochondrial trafficking is
altered with perinuclear accumulation of mitochondria in neurons as
they undergo apoptosis (Al-Abdulla and Martin, 1998 ; Martin et al.,
1999 ), a finding very similar to that of the present study. These
previous in vitro and in vivo observations
support our conclusions described here. Within 3-6 hr after neonatal
hypoxia-ischemia, neurons in the ventral basal thalamus exhibit marked
accumulation of mitochondria (as revealed by intense cytochrome oxidase
activity) and simultaneously display altered morphology. The
mitochondria assume a prominent punctate appearance and concentrate in
a perinuclear location. As thalamic neurons enter late stages of
apoptosis, the cytoplasm becomes progressively devoid of COX activity.
These data are consistent with immunoblotting for cytochrome oxidase
subunit 1 protein, which shows maximal levels at 6 hr after neonatal
hypoxia-ischemia in the thalamus. Taken together these data provide
evidence of the participation of mitochondria in thalamic
neurodegeneration after neonatal hypoxia-ischemia.
In summary, these experiments provide the first evidence of the
presence of crucial components of Fas-mediated,
mitochondrial-amplified, apoptosis in the thalamus after neonatal brain
injury. These findings are important for the further understanding of
the mechanisms of neuronal apoptosis in the immature brain. Eventually,
these studies may be important for development of appropriately timed and targeted therapies for the protection of the neonatal brain and
rescue of neurons after hypoxic-ischemic insults.
 |
FOOTNOTES |
Received June 27, 2000; revised Dec. 19, 2000; accepted Dec. 21, 2000.
These studies were supported by Johns Hopkins Internal Research Grant
funds (F.J.N.), a United Cerebral Palsy Grant (F.J.N.), United
States Army Department of Defense Grant DAMD17-99-1-9553, and National
Institutes of Health Grants AG 16282 (L.J.M.) and NS 35902 (D.M.F.). We
gratefully acknowledge the expert technical assistance of Ann Sheldon,
Ann Price, and George Kuck III.
Correspondence should be addressed to Dr. Frances J. Northington,
Eudowood Neonatal Pulmonary Division, Department of Pediatrics, CMSC 210, Johns Hopkins Hospital, 600 North Wolfe Street,
Baltimore, MD 21287. E-mail: fnorthin{at}welchlink.welch.jhu.edu.
 |
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C. Manabat, B.H. Han, M. Wendland, N. Derugin, C.K. Fox, J. Choi, D.M. Holtzman, D.M. Ferriero, and Z.S. Vexler
Reperfusion Differentially Induces Caspase-3 Activation in Ischemic Core and Penumbra After Stroke in Immature Brain
Stroke,
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[Abstract]
[Full Text]
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B. H. Han, D. Xu, J. Choi, Y. Han, S. Xanthoudakis, S. Roy, J. Tam, J. Vaillancourt, J. Colucci, R. Siman, et al.
Selective, Reversible Caspase-3 Inhibitor Is Neuroprotective and Reveals Distinct Pathways of Cell Death after Neonatal Hypoxic-ischemic Brain Injury
J. Biol. Chem.,
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30128 - 30136.
[Abstract]
[Full Text]
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J. Qiu, M. J. Whalen, P. Lowenstein, G. Fiskum, B. Fahy, R. Darwish, B. Aarabi, J. Yuan, and M. A. Moskowitz
Upregulation of the Fas Receptor Death-Inducing Signaling Complex after Traumatic Brain Injury in Mice and Humans
J. Neurosci.,
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3504 - 3511.
[Abstract]
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