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The Journal of Neuroscience, August 15, 2002, 22(16):7006-7015
An In Vitro Model of Parkinson's Disease: Linking
Mitochondrial Impairment to Altered -Synuclein Metabolism and
Oxidative Damage
Todd B.
Sherer1,
Ranjita
Betarbet1,
Amy K.
Stout1,
Serena
Lund1,
Melisa
Baptista2,
Alexander V.
Panov1,
Mark R.
Cookson2, and
J. Timothy
Greenamyre1
1 Center for Neurodegenerative Disease and Department
of Neurology, Emory University, Atlanta, Georgia 30322, and
2 National Institute on Aging, National Institutes of
Health, Bethesda, Maryland 20892
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ABSTRACT |
Chronic systemic complex I inhibition caused by rotenone exposure
induces features of Parkinson's disease (PD) in rats, including selective nigrostriatal dopaminergic degeneration and formation of
ubiquitin- and -synuclein-positive inclusions (Betarbet et al.,
2000 ). To determine underlying mechanisms of rotenone-induced cell
death, we developed a chronic in vitro model based on
treating human neuroblastoma cells with 5 nM rotenone for
1-4 weeks. For up to 4 weeks, cells grown in the presence of rotenone
had normal morphology and growth kinetics, but at this time point,
~5% of cells began to undergo apoptosis. Short-term rotenone
treatment (1 week) elevated soluble -synuclein protein levels
without changing message levels, suggesting that -synuclein
degradation was retarded. Chronic rotenone exposure (4 weeks) increased
levels of SDS-insoluble -synuclein and ubiquitin. After a latency of
>2 weeks, rotenone-treated cells showed evidence of oxidative stress,
including loss of glutathione and increased oxidative DNA and protein
damage. Chronic rotenone treatment (4 weeks) caused a slight elevation
in basal apoptosis and markedly sensitized cells to further oxidative
challenge. In response to H2O2, there
was cytochrome c release from mitochondria, caspase-3
activation, and apoptosis, all of which occurred earlier and to a much
greater extent in rotenone-treated cells; caspase inhibition provided
substantial protection. These studies indicate that chronic low-grade
complex I inhibition caused by rotenone exposure induces accumulation
and aggregation of -synuclein and ubiquitin, progressive oxidative
damage, and caspase-dependent death, mechanisms that may be central to
PD pathogenesis.
Key words:
-synuclein; cytochrome c; glutathione; caspase-3; carbonyls; ubiquitin
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INTRODUCTION |
Parkinson's disease (PD) is marked
by selective nigrostriatal dopaminergic degeneration and formation of
ubiquitin- and -synuclein-positive cytoplasmic inclusions known as
Lewy bodies (Spillantini et al., 1997 ; Wooten, 1997 ). Although the
cause of sporadic PD is unknown, genetic and environmental factors may
both be important. Epidemiological studies highlight involvement of
pesticide exposure in PD pathogenesis (Gorell et al., 1998 ; Menegon et
al., 1998 ), and there are systemic reductions in activity of complex I
of the mitochondrial electron transfer chain in PD patients (Mizuno et
al., 1989 ; Parker et al., 1989 ; Schapira et al., 1989 ).
We developed a novel in vivo model of PD, integrating the
involvement of pesticide exposure and systemic mitochondrial defects in
PD etiology (Betarbet et al., 2000 ). Rats were systemically exposed to
the pesticide rotenone for 1-5 weeks. Rotenone, a naturally occurring
compound, is used as an insecticide and to kill nuisance fish in lakes.
Rotenone is also a well characterized, specific inhibitor of complex I. Chronic systemic rotenone exposure reproduced many features of PD,
including nigrostriatal dopaminergic lesions and development of
-synuclein-positive cytoplasmic inclusions in nigral neurons
(Betarbet et al., 2000 ).
Oxidative stress may contribute to the neurodegeneration observed in PD
(Jenner, 1998 ). Brains of PD patients have decreased levels of reduced
glutathione (GSH), and there is oxidative damage to DNA, lipids, and
protein (Dexter et al., 1989 ; Sian et al., 1994 ; Alam et al., 1997 ;
Pearce et al., 1997 ; Floor and Wetzel, 1998 ). Reactive oxygen species
(ROS) responsible for this oxidative damage may be produced during
dopamine metabolism or during oxidative phosphorylation (Hasegawa et
al., 1990 ; Lotharius and O'Malley, 2000 ). Within complex I, upstream
from the rotenone binding site, is a site of electron leak that can
enhance ROS formation (Hensley et al., 1998 ). Reduced complex I
activity, as produced by rotenone and
N-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) and
observed in PD, increases ROS production (Turrens and Boveris, 1980 ;
Hasegawa et al., 1990 ; Cassarino et al., 1997 ; Votyakova and Reynolds, 2001 ). Oxidative stress may also contribute to -synuclein pathology in PD. Oxidatively modified -synuclein is more prone to aggregation than native protein (Souza et al., 2000 ). Furthermore, elevated -synuclein expression can itself cause oxidative stress (Hsu et al.,
2000 ).
Brains from PD patients show evidence of apoptosis, including
fragmented nuclei and caspase activation (Tatton et al., 1998 ; Hartmann
et al., 2000 ; Tatton, 2000 ). However, the role of apoptosis in PD
remains controversial, and other studies of end-stage PD patients
demonstrate little evidence of apoptosis (Burke and Kholodilov, 1998 ;
Wüllner et al., 1999 ).
Here we report development of an in vitro model to examine
mechanisms through which chronic complex I inhibition causes or potentiates neural cell death. Previous studies have examined the acute
impact (1-3 d) of rotenone exposure, at relatively high doses, which
may not be relevant to the progressive nature of PD (Leist et al.,
1999 ; Taylor et al., 2000 ; King et al., 2001 ; Lee et al., 2002b ). We
exposed human neuroblastoma cells to a low concentration of rotenone
for up to 4 weeks and found accumulation of -synuclein, progressive
oxidative damage, and increased basal and
H2O2-induced
caspase-dependent cell death.
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MATERIALS AND METHODS |
Cell culture. SK-N-MC neuroblastoma cells were
cultured in minimum essential medium (MEM) with Earle's salts
containing 5 mM glucose (Mediatech, Herndon, VA), 15%
fetal bovine serum (Invitrogen, Carlsbad, CA), 50 U/ml penicillin and
streptomycin, 5 mM sodium pyruvate, and nonessential amino
acid solutions for MEM (Mediatech). Media were supplemented with 5 nM rotenone (Sigma, St. Louis, MO) or solvent (ethanol) for
up to 4 weeks. The concentration of rotenone was chosen on the basis of
a pilot study and previous observations (Sherer et al., 2001b ). For
routine culture, cells were grown in 100 mm plates, fed three times per
week with control medium or medium supplemented with 5 nM
rotenone, and passaged approximately once a week on reaching
confluence. Rotenone (5 nM) did not alter cellular
morphology or growth kinetics over the 4 week exposure period.
Mitochondrial respiration. For studies of oxygen
consumption, cells were grown in 12 150 cm2 cell culture flasks. Mitochondria were
isolated using a previously published protocol (Trounce et al., 1996 )
without BSA, because BSA binds rotenone nonspecifically. Oxygen
consumption was measured polargraphically as described previously
(Panov and Scaduto, 1996 ) using an Instech minichamber (Instech
Laboratories, Plymouth Meeting, PA) equipped with a magnetic stirrer
and oxygen electrode (Yellow Spring Instrument Co., Yellow Springs, OH)
connected to a chart recorder. The following medium was used: 125 mM KCl, 10 mM 4-morpholinepropanesulfonic acid, 2 mM
KH2PO4, 2 mM
MgCl2, 10 mM NaCl, 0.7 mM
CaCl2, 1 mM EGTA, 0.5 µM carbonyl cyanide
p-trifluoromethoxyphenylhydrazone, 20 mM glutamate, and 2 mM malate.
Determination of -synuclein and ubiquitin levels. Levels
and distributions of -synuclein and ubiquitin were determined by immunocytochemistry and protein dot blots. For immunocytochemistry, control and rotenone-treated cells were grown on 18 mm coverslips coated with 0.1% gelatin (Sigma) and fixed for 15 min with 4% paraformaldehyde. Cells were incubated in primary antibody for 24 hr,
followed by 1 hr incubation with biotinylated secondary antibody. The
avidin-biotin complex method was used to detect antigen signal (ABC
Elite kit; Vector Laboratories, Burlingame, CA), and
3,3'diaminobenzidine tetrachloride was used to visualize the final
product. The primary antibodies used were polyclonal rabbit antibody
against -synuclein (1:100; a gift from Mark Cookson, Bethesda,
MD) and polyclonal rabbit antibody against ubiquitin (1:1000;
Dako, Carpinteria, CA). Secondary antibody used was biotinylated goat
anti-rabbit IgG (1:200; Jackson ImmunoResearch, West Grove, PA). We
examined images using bright-field microscopy. Images were captured
using Zeiss (Thornwood, NY) Axiovision 3.0 software. For final output,
images were processed simultaneously and identically using Adobe
Photoshop 5.5 software (Adobe Systems, San Jose, CA).
For dot blots, control and rotenone-treated cells were grown on 100 mm
plates. Cells were washed two times with PBS, pH 7.4, and incubated in
900 µl of cell lysis buffer (Promega, Madison, WI) containing 0.5 mg/ml benzamidine, 2 µg/ml aprotinin, 2 µg/ml leupeptin, 0.75 mM phenylmethylsulfonyl fluoride, 700 U/ml DNase I, and 1%
-mercaptoethanol (all from Sigma) for 15 min at room temperature.
Cells were scraped, and the cell lysate was centrifuged at 12,000 × g for 2 min. The supernatant was collected as the soluble
protein fragment. The insoluble pellet was resuspended in 12% SDS.
Protein assays were done using a Bio-Rad protein assay and Bio-Rad Dc
protein assay (Bio-Rad, Hercules, CA) according to the manufacturer's
protocol. Protein (15-20 µg) was combined with an equal volume of
2× loading buffer with -mercaptoethanol and heated to 65°C for 10 min. Protein was added to an Immunobilon P transfer membrane
(Millipore, Bedford, MA) and cross-linked using a UV Stratalinker
(Stratagene, La Jolla, CA). The membrane was washed twice for 5 min in
PBS and then twice for 10 min in PBS. The membrane was blocked with
1:10 milk diluent/water for 1 hr and incubated overnight at 4°C in
primary antibody. The membrane was washed twice for 5 min in PBS and
Tween 20 and then twice for 10 min in PBS and Tween 20 and
incubated in secondary antibodies conjugated to horseradish peroxidase
(1:7500; ICN Pharmaceuticals, Costa Mesa, CA), for 1.5 hr at room
temperature. After two 5 min and two 10-min washes in PBS, the blot was
detected using Supersignal West Dura extended duration substrate
(Pierce, Rockford, IL). The blot was developed and analyzed using
Eastman Kodak (Rochester, NY) Digital Science 1D image analysis
software version 3.0.2. Primary antibodies were mouse
anti- -synuclein (1:400; Zymed, South San Francisco, CA) and rabbit
anti-ubiquitin (1:500; Dako).
Reverse transcription, primer design, and quantitative reverse
transcription-PCR. First-strand cDNA was synthesized by priming 2 µg of total RNA with oligo-dT and using a Superscript II enzyme according to the manufacturer's instructions (Invitrogen, Rockville, MD). Primers were designed using the Primer Express program (Applied Biosystems, Foster City, CA). Both primer pairs cross exon boundaries. The following primers were used: -actin forward,
tcaccatggatgatgatatcgcc; -actin reverse, ccacacgcagctcattgtagaagg;
-synuclein forward, aggactttcaaaggccaagg; and -synuclein reverse, tcctccaacatttgtcacttgc.
Real-time quantitative PCR was performed using the Applied Biosystems
7900HT system. The amount of double-stranded PCR product synthesized in
each cycle was measured using SyBr green I dye, with fluorescence being
measured at the end of the annealing step of each cycle to monitor
amplification. Reactions were performed in a 20 µl volume with 5 pmol
each of forward and reverse primers. Expression levels for each gene
for each template were calculated for four simultaneous reactions at
each of three different dilutions (undiluted and 1:2 and 1:4 of the
original cDNA sample). Average threshold cycle (Ct) values from the
replicate PCRs were normalized to the average Ct values for the
-actin control from the same cDNA preparations. The ratio of
expression of each gene was calculated as
2(mean Ct), where  Ct is the
difference Ct(test gene) Ct( -actin). Ratios of rotenone
versus mean control were calculated.
Glutathione levels. Control and rotenone-treated cells were
grown on 100 mm culture plates. Cells were scraped and collected by
centrifugation. The cell pellet was homogenized in 1 ml of PBS
containing 1 mM EDTA. The supernatant was collected after centrifugation at 10,000 × g for 15 min at 4°C. The
supernatant was deproteinated by adding an equal volume of 10%
metaphosphoric acid (Sigma), incubating at room temperature for 5 min,
and centrifuging for 5 min at 5,000 × g. Total
glutathione was determined using a glutathione assay kit (Cayman
Chemical Co., Ann Arbor, MI), which is based on the glutathione
reductase enzymatic recycling method. Glutathione was normalized to
cellular protein and expressed as a percentage of glutathione levels in
control cells at each weekly time point.
Detection of protein carbonyls. For determination of protein
carbonyls, control and rotenone-treated cells were grown on 100 mm
plates. Soluble and insoluble protein fractions were collected as
described above for dot blots. Protein carbonyls were assayed with the
Oxyblot protein oxidation detection kit (Intergen, Purchase, NY).
Briefly, 10 µg of protein was mixed with an equal volume of 12% SDS
and 2 volumes of 1× 2,4-dinitrophenylhydrazine (DNPH) solution.
Control reactions used 1× derivatization control solution instead of
the DNPH solution. The reaction proceeded for 15 min at room
temperature and was stopped by the addition of 1.5 volumes of
neutralization solution. Protein (3 µg) was added to an Immunobilon P
transfer membrane (Millipore) and cross-linked using a UV Stratalinker (Stratagene). The membrane was washed twice for 5 min in PBS and then
twice for 10 min in PBS. The membrane was blocked with 1:10 milk
diluent/water for 1 hr and incubated overnight at 4°C in 1:150 rabbit
anti-2,4-dinitrophenylhydrazone antibody (Intergen). The
membrane was washed twice for 5 min in PBS and Tween 20 and then twice
for 10 min in PBS and Tween 20 and incubated in goat-anti-rabbit IgG
(1:300; Intergen) for 1.5 hr at room temperature. After two 5-min and
two 10-min washes in PBS, the blot was detected using the Supersignal
West Dura extended duration substrate (Pierce). The blot was developed
and analyzed using Kodak Digital Science 1D image analysis software
version 3.0.2.
Oxidative DNA damage. Oxidative DNA damage was determined
using anti-8-hydroxydeoxyguanosine (8-oxo-dG) antibodies, according to
the manufacturer's protocol (1:300; Trevigen, Gaithersburg, MD).
Control and rotenone-treated cells were grown on eight-well Labtek
chamber permanox slides coated with 0.1% gelatin (Fischer Scientific,
Pittsburgh, PA) and treated with 300 µM
H2O2 for 6 hr. Cells were
fixed with 4% paraformaldehyde for 15 min. Alexa-488 anti-mouse IgG
(1:200; Molecular Probes, Eugene, OR) was used as the secondary
antibody. Fluorescence images were captured on a Leitz microscope
(Leica, Nussloch, Germany) linked to a microcomputer imaging
device (MCID) image analysis system (Imaging Research, St.
Catharines, Ontario, Canada) with selective filters to visualize FITC
and UV. For final output, images were processed identically and
simultaneously using Adobe Photoshop 5.5 software.
Cell death assays. Rates and levels of cell death were
determined at 1-week intervals during exposure to rotenone or vehicle. Cell death assays used the cell-impermeable dye Sytox green (Molecular Probes), which intercalates into the DNA of dead cells and fluoresces; it was detected with excitation at 485 nm and emission at 538 nm with a
fluorescence microplate system (Molecular Devices, Sunnyvale, CA).
Control and rotenone-treated cells were grown at similar cell densities
in 96-well plates, loaded with 1 µM Sytox green for 10 min, and then treated with
H2O2 at final
concentrations of 10, 100, and 300 µM. Control wells
received equivalent volumes of fresh medium. In some experiments, cells
were preincubated with the caspase inhibitor z-Asp-Glu-Val-fluoromethyl
ketone (Z-DEVD-FMK) (150 µM; Calbiochem, San
Diego, CA) for 2 hr before addition of H2O2. Fluorescence readings
were taken once per hour and normalized to initial plating density
after fixation with 4% paraformaldehyde for 45 min at 4°C.
Detection of apoptosis. Control and rotenone-treated cells
were grown on eight-well Labtek chamber permanox slides (Fischer Scientific) coated with 0.1% gelatin. Cells were exposed to 300 µM H2O2 for
24 hr and fixed with 4% paraformaldehyde for 15 min. Apoptotic nuclei
were detected using an Apoptag Plus fluorescein in situ
apoptosis detection kit (Intergen) according to the manufacturer's protocol. Nuclei were stained with bisbenzimide (1:1000; Sigma). Fluorescence images were captured on a Leitz microscope (Leica) linked
to an MCID image analysis system (Imaging Research) with selective
filters to visualize FITC and UV. For final output, images were
processed using Adobe Photoshop 5.5 software. The percentage of cells
showing apoptotic nuclei was determined.
Cytochrome c distribution and caspase-3
activation. Determination of cytochrome c distribution
and caspase-3 activation used immunofluorescence. For double labeling
of cytochrome c and activated caspase-3, control and
rotenone-treated cells were grown on 18 mm coverslips coated with 0.1%
gelatin (Sigma). Cells were exposed to 300 µM
H2O2 for 2-4 hr and fixed
with 4% paraformaldehyde for 15 min. Cells were washed three times for
5 min with Tris-buffered saline (TBS), blocked with 10% normal goat
serum for 30 min, and then incubated overnight in the appropriate
primary antibody. After three 5 min washes in TBS, cells were incubated
in 1:200 secondary antibody (Alexa anti-mouse IgG or Cy3 anti-rabbit
IgG; Molecular Probes) for 1 hr. Cells were washed three times for 5 min in TBS, and then nuclei were stained with bisbenzimide (1:1000; Sigma) for 5 min and washed in TBS three times for 5 min. Cells were
coverslipped with Aquamount (Lerner Laboratories, Pittsburgh, PA).
Cytochrome c was detected using a mouse monoclonal antibody (1:500; PharMingen, San Diego, CA). Active caspase-3 was detected using
a polyclonal rabbit antibody (1:500; Cell Signaling, Beverly, MA). For
controls, primary antibodies were omitted. Cells were imaged using a
Zeiss laser scanning microscope 510 with nonlinear optics. For
final output, images were processed using Adobe Photoshop 5.5 software.
Live imaging of caspase activation. Control and
rotenone-treated SK-N-MC cells were plated on 25 mm coverslips. After a
6 hr exposure to 300 µM
H2O2, cells were
simultaneously labeled with 4.5 µM bisbenzimide (Sigma)
and 25 µM rhodamine 110 bis-L-aspartic acid
amide (Molecular Probes) for 15 min. The presence of activated caspases
is indicated by cytoplasmic green fluorescence, because activated
caspases cleave side chains from the nonfluorescent rhodamine 110 bis-L-aspartic acid amine to generate green fluorescent rhodamine 110. Cells were imaged using a Zeiss laser scanning microscope 510 with nonlinear optics. For final output, images were
processed using Adobe Photoshop 5.5 software.
Statistical analysis. Statistical analysis used multivariate
ANOVA or Student's t test for independent samples.
Significance was set at p 0.05. Values shown
represent mean ± SEM.
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RESULTS |
In vitro model of chronic rotenone exposure
In vivo, chronic rotenone exposure caused -synuclein
aggregation and selective nigrostriatal dopaminergic degeneration
(Betarbet et al., 2000 ). Here, SK-N-MC neuroblastoma cells were grown
for up to 4 weeks in medium supplemented with 5 nM rotenone, a sublethal dose of rotenone. Oxygen
consumption studies showed that 5 nM rotenone
caused no reduction in mitochondrial respiration, whereas 15-30
nM rotenone caused 20-30% reductions in
mitochondrial respiration. Thus, as in the in vivo model
(Betarbet et al., 2000 ), we found no evidence for a rotenone-induced
bioenergetic defect per se. Up to 4 weeks of exposure to 5 nM rotenone did not affect cell density or cell
morphology, as determined by phase contrast microscopy and bisbenzimide
staining (data not shown); however, as described below, a small
proportion of cells (~5%) began to undergo apoptosis by this time point.
Rotenone exposure increased -synuclein and ubiquitin levels
To determine whether this in vitro model mimicked the
effects of in vivo rotenone infusion, we determined
-synuclein protein levels in control and rotenone-treated cells.
After 1 week of rotenone exposure, soluble -synuclein levels were
elevated (41 ± 16% increase; p < 0.05) (Fig.
1A). After 4 weeks of
rotenone exposure, soluble -synuclein levels remained elevated
(40 ± 15% increase; p < 0.05), but there was
also an increase in insoluble -synuclein as well (29 ± 9%
increase; p < 0.05) (Fig. 1A).
Levels of -synuclein mRNA, determined by quantitative reverse
transcription-PCR, were not altered significantly despite the increase
in -synuclein protein levels. Immunocytochemistry revealed
accumulation of -synuclein immunoreactivity in the cytoplasm after 4 weeks of rotenone exposure (Fig. 1B,C).

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Figure 1.
Chronic rotenone exposure increased -synuclein
protein levels. A, One week of rotenone treatment
increased soluble -synuclein levels, whereas 4 weeks of rotenone
treatment elevated -synuclein levels in both soluble and insoluble
protein fractions. Results are expressed as percent increase from
control and represent mean ± SEM of three or four independent
experiments. *p < 0.05 compared with control
cells. Compared with control cells (B), chronic
rotenone exposure (C) caused cytoplasmic
-synuclein accumulation, as determined by immunocytochemistry. Scale
bar, 10 µm. Similar results were observed in four independent
experiments.
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The Lewy bodies seen in PD brains contain ubiquitin in an insoluble
form, and chronic in vivo rotenone exposure reproduced these
ubiquitin-positive inclusions (Betarbet et al., 2000 ). Therefore, we
assessed ubiquitin in control and rotenone-treated cells. Short-term rotenone exposure (1 week) did not alter levels of ubiquitin
immunoreactivity. However, after 4 weeks of rotenone exposure,
ubiquitin levels were elevated in the insoluble protein fraction
(87 ± 14% increase; p < 0.05).
Immunocytochemistry revealed an elevation in cytoplasmic ubiquitin
staining in cells grown chronically (4 weeks) in rotenone (Fig.
2).

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Figure 2.
Chronic rotenone exposure increased levels of
ubiquitin immunoreactivity. A, B, Chronic rotenone
exposure resulted in elevated cytoplasmic ubiquitin levels, as
determined by immunocytochemistry. A, Control cells.
B, Cells treated with rotenone for 4 weeks. Scale bar,
10 µm. Similar results were observed in four independent
experiments.
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These results demonstrate that chronic in vitro rotenone
treatment caused -synuclein and ubiquitin accumulation. Elevated -synuclein levels may cause oxidative stress (Hsu et al., 2000 ) as
well as increased sensitivity to oxidative challenges (Kanda et al.,
2000 ; Ko et al., 2000 ). Furthermore, rotenone itself induces oxidative
damage (Votyakova and Reynolds, 2001 ; Zhang et al., 2001 ). Thus, we
examined levels of basal and
H2O2-induced oxidative damage and cell death after prolonged rotenone exposure.
Chronic rotenone exposure reduced glutathione levels
Pilot studies showed that rotenone treatment caused parallel
reductions in oxidized and reduced GSH; after 4 weeks, glutathione disulfide was decreased by 40%, and GSH was decreased by 44%. Therefore, subsequent studies measured total cellular GSH. Short-term rotenone exposure (1-2 weeks) did not alter GSH levels, although there
was a nonsignificant trend toward increased levels during the second
week of exposure. In contrast, chronic rotenone treatment (3-4 weeks)
caused a 50% reduction in cellular GSH levels
(p < 0.05) (Fig.
3A).

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Figure 3.
Chronic rotenone treatment caused delayed
oxidative damage. A, Chronic rotenone exposure (5 nM) decreased cellular GSH. Control values at 1 week were
4.97 ± 1.2 nmol/mg of protein. Results are expressed as
percentages of levels in control cells at each time point and represent
mean ± SEM of four independent experiments at each time point.
B, Delayed oxidative protein damage in rotenone-treated
cells. Protein carbonyl levels are expressed as percentages of levels
in control cells at each time point. Results show mean ± SEM of
four independent experiments at each time point. *p < 0.05 compared with control.
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Chronic rotenone exposure caused oxidative protein damage
Rotenone-induced loss of GSH raised the possibility of oxidative
damage. Reactive carbonyls, another index of oxidative damage, are
found on DNA and protein (Alam et al., 1997 ) and can be detected using
the DNPH reaction. We analyzed protein carbonyl levels using dot blots
of both soluble and insoluble protein isolated from control and
rotenone-treated cells. Protein was isolated in the presence of DNase I
to remove DNA from the lysate. Exposure of cells to rotenone for 1-2
weeks did not alter protein carbonyl levels, but exposure for 3-4
weeks caused a large increase in carbonyls in the insoluble fraction
(223 ± 29% of control; p < 0.05) (Fig.
3B). Elevated carbonyls were not found in the soluble protein fraction.
Chronic rotenone exposure causes oxidative DNA damage
To assess oxidative DNA damage in control and rotenone-treated
cells, we used antibodies to 8-oxo-dG. Short-term rotenone exposure
(1-2 weeks) did not induce oxidative DNA damage, but there was a
marked increase in 8-oxo-dG immunoreactivity in cells exposed to
rotenone for 4 weeks (Fig.
4B). Interestingly,
after a 6 hr exposure to 300 µM
H2O2, an oxidative
challenge, cells grown in rotenone for 4 weeks showed increased
oxidative DNA damage compared with control cells (Fig. 4). Nuclear
staining with bisbenzimide showed that many rotenone-treated cells with
oxidative DNA damage also had nuclear condensation or fragmentation
characteristic of apoptosis (Figs. 4B,D). Thus,
chronic rotenone exposure increased basal levels of oxidative DNA
damage.

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Figure 4.
Chronic rotenone treatment caused
oxidative DNA damage. Control cells (A, C) and cells
treated with rotenone for 4 weeks (B, D) were stained
with antibodies against 8-oxo-dG, a marker of oxidative DNA damage
(top panels). The same cells were also labeled with
bisbenzimide for nuclear morphology (bottom panels).
Rotenone-treated cells showed increased 8-oxo-dG immunoreactivity
before H2O2 exposure (B).
H2O2 increased 8-oxo-dG staining to a greater
extent in rotenone-treated cells (D) than in
control cells (C). Many cells with
oxidative DNA damage showed fragmented nuclear morphology
characteristic of apoptosis (B, D). Similar results were
observed in four replicates.
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Chronic rotenone exposure potentiated
H2O2-induced cell death and oxidative protein
damage
Because chronic rotenone treatment caused progressive oxidative
damage, and rotenone-treated (4 weeks) cells were much more vulnerable
to oxidative DNA damage resulting from
H2O2 exposure, we examined
whether chronic rotenone treatment elevated the rates of basal and
oxidant-induced death. At weekly intervals, cell death was assayed
using Sytox green fluorescence. Sytox green intercalates into the DNA
of cells in which the plasma membrane has been perturbed, and as such,
it measures both necrotic and apoptotic cells. We chose
H2O2 as an oxidative
stressor because dopaminergic cells are normally exposed to
H2O2 during dopamine synthesis and catabolism. Pilot studies showed that 10 and 100 µM H2O2 did
not induce consistent death in control SK-N-MC cells, whereas 300 µM H2O2
caused progressive cell death over 24 hr. For this reason, all
subsequent comparisons between control and rotenone-treated cells
focused on responses to 300 µM
H2O2 during the 24 hr after
exposure. We did not detect any differences in rates of basal cell
death resulting from chronic rotenone treatment (up to 4 weeks) by this
measure (Fig. 5A,B). Although
short-term exposure to rotenone (1-2 weeks) did not alter cell death
in response to H2O2,
chronic rotenone exposure (3-4 weeks) markedly and progressively potentiated and accelerated oxidant-induced cell death
(p < 0.05) (Fig. 5A,B). The rate of
cell death, calculated as the slope of the linear portion of cell death
curves, was 92% higher in cells treated chronically with rotenone
(p < 0.05).

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Figure 5.
Chronic rotenone treatment sensitized cells to
H2O2-induced death and oxidative protein
damage. Cells were grown in medium supplemented with 5 nM
rotenone for 1-4 weeks before exposure to 300 µM
H2O2. Cell death was then monitored over 24 hr.
Cells treated with rotenone for 1 week (A) showed
responses to H2O2 similar to those of control
cells. However, after exposure to rotenone for 4 weeks
(B), cells were markedly sensitized to
H2O2. Results show mean ± SEM of three
independent experiments at each time point. *p < 0.05. A.U., Arbitrary units.
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Chronic rotenone exposure also potentiated oxidative protein damage
after exposure to H2O2.
Although a 6 hr exposure to
H2O2 did not increase
protein carbonyl levels in control cells, soluble protein carbonyl
levels were significantly elevated in cells that had been grown in the
presence of rotenone for 4 weeks (246 ± 30% of baseline;
p < 0.05). These results demonstrate that chronic rotenone treatment markedly sensitized cells to subsequent oxidative stress.
Chronic rotenone exposure increased apoptotic death
Because Sytox green fluorescence (Fig. 5) did not differentiate
necrotic or apoptotic cell death, we used terminal deoxynucleotidyl transferase-mediated biotinylated UTP nick end-labeling (TUNEL) staining to detect the DNA strand breaks characteristic of apoptosis. At baseline, cells treated with rotenone for 4 weeks had a small but
significant increase in apoptosis compared with control cells (p < 0.05) (Fig.
6A,C,E). This slight
increase in apoptotic death was not detected with the Sytox green assay
(Fig. 5B, bottom curves). After exposure to
H2O2, there was
substantially more apoptosis in rotenone-treated cells than in control
cells (p < 0.05) (Fig. 6B,D,E), and the rate of apoptotic death was
substantially faster in cells treated chronically with rotenone
(1.44 ± 0.02% vs 0.38 ± 0.07% apoptosis/hr;
p < 0.05).

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Figure 6.
Chronic rotenone treatment increased apoptotic
cell death before and after H2O2 exposure.
Cells were analyzed for DNA fragmentation using TUNEL staining before
and 24 hr after H2O2 exposure. Control cells
showed little evidence of apoptosis (A), whereas
cells treated with rotenone for 4 weeks showed a small but significant
increase in apoptosis before H2O2 exposure
(C, E). Cultures treated with rotenone for 4 weeks
showed more TUNEL-positive cells after H2O2
exposure (D) compared with control cultures
(B). Arrows indicate some
TUNEL-positive cells. E, Quantification of apoptotic
cells. Cultures treated with rotenone for 4 weeks showed elevated
apoptosis before and 24 hr after H2O2 exposure.
Results are expressed as mean ± SEM of four experiments.
*p < 0.05 compared with control.
|
|
Cytochrome c redistribution and activation
of caspase-3
Under some conditions, mitochondrial impairment may cause
cytochrome c release, caspase-3 activation, and apoptosis.
We conducted a time course study to examine the role of cytochrome
c redistribution and caspase-3 activation in the
differential cell death observed in rotenone-treated cells. At specific
time points before and after
H2O2 treatment, cells were
triple-labeled with bisbenzimide and antibodies against cytochrome
c and activated caspase-3. In control cells, cytochrome
c had a punctate distribution reflecting its mitochondrial
localization, and there was no caspase-3 activation (Fig.
7A). After 2 hr exposure to
H2O2, there was
redistribution of cytochrome c such that staining was less
punctate and less intense, consistent with cytosolic redistribution
(Fig. 7B). After 4 hr, scattered cells began to show
evidence of caspase-3 activation, but nuclear morphology remained
normal (Fig. 7C). In cells treated with rotenone for 4 weeks, there was generally a normal cytochrome c
distribution, but there were occasional cells with apparent cytochrome
c redistribution or caspase-3 activation associated with
nuclear fragmentation (Fig. 7D). After a 2 hr exposure to H2O2, rotenone-treated
cells showed extensive activation of caspase-3, and many cells had
fragmented nuclei (Fig. 7E). At 4 hr, there was further
caspase-3 activation, and many cells were in advanced stages of
apoptosis, based on nuclear morphology (Fig. 7F). At baseline and 2 and 4 hr after
H2O2 treatment, more
rotenone-treated cells showed caspase-3 activation than control cells
(p < 0.05) (Fig. 7G).

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Figure 7.
Time course of cytochrome
c redistribution and caspase-3 activation in control and
rotenone-treated cells after H2O2 exposure.
Control cells (A-C) and cells treated with
rotenone for 4 weeks (D-F) were triple-stained
for nuclear morphology (bisbenzimide; blue), cytochrome
c (green), and activated caspase-3
(red) before (A, D) and 2 hr (B,
E) and 4 hr (C, F) after
H2O2 exposure. Under basal conditions, both
control and rotenone-treated cells showed punctate cytochrome
c staining, consistent with its mitochondrial
localization (A, D). After H2O2
exposure (B, C, E, F), there was release of
cytochrome c from mitochondria to cytosol, resulting in
loss of punctate staining and a more diffuse, less intense staining
pattern. A, B, insets, Cytochrome
c redistribution at higher power. D, In
occasional rotenone-treated cells under basal conditions, there was
redistribution of cytochrome c such that staining was
less punctate and less intense, consistent with cytosolic distribution.
Increased caspase-3 activation was evident 2 and 4 hr after
H2O2 exposure but occurred to a greater extent
in rotenone-treated cells (E, F) than in control
cells (B, C). Many of the rotenone-treated cells
expressing activated caspase-3 contained fragmented nuclei
characteristic of apoptosis, indicating that rotenone treatment was
associated with more advanced stages of apoptosis. Similar results were
observed in four independent experiments. G,
Quantification of cells with caspase-3 activation after
H2O2 treatment. More rotenone-treated cells
expressed activated caspase-3 before and 2-4 hr after
H2O2 exposure. *p < 0.05 compared with controls. H, Caspase activation in live
cells after H2O2 exposure. Cells treated with
rotenone for 4 weeks were exposed to 300 µM
H2O2 for 6 hr and then imaged simultaneously
for cell morphology using phase-contrast microscopy
(gray), nuclear morphology using bisbenzimide
(blue), and caspase activation using rhodamine 110 bis-L-aspartic acid amide (green).
H2O2 caused some cells to retract their
processes, round up, and undergo nuclear fragmentation
(arrows). Some cells showed caspase activation before
nuclear fragmentation (arrowhead). Similar results were
observed in four independent experiments.
|
|
To confirm caspase activation after
H2O2 exposure, we monitored
caspase substrate cleavage in living cells. Cells were treated for 6 hr
with H2O2 and loaded with
rhodamine-110 bis-L-aspartic acid amide, a cell permeant,
nonfluorescent substrate that fluoresces on cleavage by caspase-3 or
-7. Cells were simultaneously loaded with bisbenzimide to analyze
nuclear morphology. After
H2O2 treatment, rotenone-treated cells retracted their processes and activated caspase
proteases, as indicated by rhodamine 110 green fluorescence (Fig.
7H, arrows). At this time point, many cells that
showed caspase activation also demonstrated evidence of the nuclear
fragmentation characteristic of apoptosis (Fig. 7H,
arrows), but some cells expressed activated caspases before
nuclear fragmentation (Fig. 7H, arrowheads).
Thus, live cell imaging confirmed caspase activation after
H2O2 exposure in
rotenone-treated cells.
To further assess the involvement of caspase activation in
H2O2-induced cell death, we
exposed cells to H2O2 in
the presence or absence of 150 µM Z-DEVD-FMK, which
inhibits caspase-3 as well as caspase-6, -7, -8, and -10. Treatment
with Z-DEVD-FMK delayed and reduced
H2O2-induced cell death
(Fig. 8).

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Figure 8.
Caspase inhibition delayed and reduced
H2O2-induced death. Cells treated with rotenone
for 4 weeks were incubated with vehicle or caspase inhibitor
(Z-DEVD-FMK) for 2 hr before and throughout the exposure to
H2O2. Cell death was analyzed as described.
Results are expressed as mean ± SEM. Similar results were
obtained in three independent experiments. *p < 0.05 compared with cells treated with rotenone and
H2O2 alone.
|
|
 |
DISCUSSION |
The goal of the current study was to develop a novel in
vitro system to model the pathogenesis of PD. Although PD is a
progressive, chronic neurological disease, most in vitro
studies, including ours, have examined pathogenic mechanisms over
24-48 hr (Seaton et al., 1998 ; Fukuhara et al., 2001 ; Zhang et al.,
2001 ; Stephans et al., 2002 ). Moreover, PD is marked by a modest
systemic complex I dysfunction, an ~25% loss of activity (Langston
et al., 1983 ; Mizuno et al., 1989 ; Parker et al., 1989 ; Schapira et
al., 1989 ); however, many studies that examine mechanisms of
1-methyl-4-phenylpyridinium (MPP+) and
rotenone toxicity use concentrations of rotenone or
MPP+ that are more than sufficient to
inhibit complex I completely (Leist et al., 1999 ; King et al., 2001 ;
Zhang et al., 2001 ). In contrast, the concentration of rotenone we used
(5 nM) (1) is low relative to its
IC50 (20-30 nM), (2) did
not inhibit respiration in mitochondria isolated from these cells, and
(3) produced a level of complex I inhibition similar to what is seen in
PD (Sherer et al., 2001b ). Damage developed over a protracted time
course, and features of PD pathogenesis, such as -synuclein
accumulation and aggregation and oxidative damage, were reproduced,
even in the absence of -synuclein mutations or overexpression. This
chronic model system may provide an accurate means of studying toxic
mechanisms and compensatory cellular responses that occur over time in PD.
It is important to note that our model used human neuroblastoma cells
rather than dopaminergic neurons. Unfortunately, it is extremely
difficult to keep sufficient numbers of primary dopaminergic neurons
alive long enough to perform the types of experiments described here.
Despite this limitation, there are advantages of our system. First,
cells can be cultured in the presence of rotenone for at least 1 month.
Second, the cells express endogenous human -synuclein, and chronic
rotenone treatment increased its levels and caused it to become
insoluble. Finally, we can simulate the oxidative stress inherent to
dopaminergic neurons by adding exogenous
H2O2. Tyrosine hydroxylase
and monoamine oxidase, two enzymes involved in dopamine metabolism,
produce H2O2 as a normal byproduct. Additionally, auto-oxidation of dopamine results in H2O2 formation and,
subsequently, ·OH, an extremely reactive ROS (Lotharius and
O'Malley, 2000 ). Thus,
H2O2 is a relevant
oxidative stressor in the context of dopaminergic degeneration that
occurs in PD.
This in vitro system allowed us to begin to define the
sequence of cellular responses to chronic complex I inhibition.
Although 1 week of rotenone exposure increased soluble -synuclein
levels, chronic rotenone treatment resulted in cytoplasmic accumulation of insoluble -synuclein and ubiquitin. Similarly, chronic in vivo rotenone induced formation of cytoplasmic inclusions
containing -synuclein and ubiquitin (Betarbet et al., 2000 ). Other
studies have also suggested a role for complex I dysfunction in
regulating -synuclein levels. MPTP administration increased
-synuclein immunoreactivity in brain (Kowall et al., 2000 ; Vila et
al., 2000 ), but it is unclear whether the accumulated -synuclein in
these studies was soluble or insoluble. Although rotenone exposure has been reported to cause -synuclein aggregation, these studies used
high concentrations of rotenone (100 nM to 100 µM) and short periods (hours to days) and were
conducted in either artificial cell-free systems or cells that
overexpressed -synuclein, thereby making aggregation much more
likely (Uversky et al., 2001 ; Lee et al., 2002a ,b ). Also, at rotenone
concentrations of >1 µM, rotenone may have
nonspecific effects (Barrientos and Moraes, 1999 ).
In our study, because there was no change in -synuclein mRNA levels,
the increased -synuclein protein levels most likely reflect retarded
degradation. -Synuclein may be a substrate for the
ubiquitin-proteasome system (UPS), and it has been suggested that
impairment of UPS function may be central to PD pathogenesis (Bennett
et al., 1999 ; McNaught et al., 2001 ; Rideout et al., 2001 ). Whether
chronic rotenone impairs the UPS is currently under investigation.
Nevertheless, our in vitro model demonstrates that chronic
low-grade complex I inhibition can increase levels of endogenous human
-synuclein and eventually cause it to become insoluble.
Although Lee et al. (2002b) found that 100 nM rotenone
could induce formation of inclusions containing -synuclein, they
used an overexpression system. Because -synuclein aggregation is
concentration-dependent, overexpression of the protein makes
aggregation much more likely. It is also worth noting that, in contrast
to our results, these authors did not find that rotenone treatment
increased the level of -synuclein protein, perhaps because of the
acute nature of their experiments.
How chronic rotenone causes -synuclein to become insoluble is
unclear but might be related to oxidative damage. Interestingly, the
elevation in soluble -synuclein levels preceded other changes associated with chronic rotenone treatment. Elevated -synuclein expression alone can both cause oxidative damage and sensitize cells to
exogenous oxidative challenges, and rotenone itself can produce
oxidative stress (Hsu et al., 2000 ; Kanda et al., 2000 ; Ko et al.,
2000 ; Seyfried et al., 2000 ; Zhang et al., 2001 ). Additionally, oxidative damage and cytochrome c can cause -synuclein to
aggregate (Hashimoto et al., 1999 ; Giasson et al., 2000 ). Therefore, we examined in rotenone-treated cells the progression of oxidative damage,
cytochrome c redistribution, and cell death at baseline and
after exogenous oxidative stress.
Chronic rotenone treatment caused delayed oxidative damage, which
correlated temporally with -synuclein aggregation. Thus, after 3 weeks of rotenone exposure, cells had a loss of GSH and oxidative DNA
and protein damage. Oxidative damage, perhaps resulting from decreased
complex I dysfunction, may be important in PD pathogenesis. Brains from
PD patients demonstrate loss of GSH and oxidative DNA and protein
damage (Alam et al., 1997 ; Floor and Wetzel, 1998 ; Jenner, 1998 ). In
the in vivo rotenone model, chronic rotenone infusion
induced selective oxidative damage in striatum (Sherer et al., 2001a ).
Other studies have also demonstrated rotenone-induced ROS synthesis and
oxidative damage. However, these studies typically used excessive
concentrations of rotenone (5-100 µM) or
examined acute effects (15 min to 1 hr) of complex I inhibition in
cells or isolated mitochondria (Hensley et al., 1998 ; Bailey et al., 1999 ; Boldyrev et al., 1999 ; Zhang et al., 2001 ). Another acute study
found that a low concentration of rotenone (20 nM) did not cause persistent superoxide
production over a 24 hr period (Nakamura et al., 2000 ). In contrast to
these studies, Barrientos and Moraes (1999) found that 5 nM rotenone, a concentration that inhibited complex I by ~50% and respiration by only 20%, induced a marked increase in ROS production and lipid peroxidation. However, these phenomena could only be observed after 2-3 d of rotenone exposure. This suggests that mild complex I inhibition may cause a slow but
steady production of ROS that is below the limit of sensitivity of
conventional acute assays. Unlike these acute model systems, our
chronic rotenone model allowed analysis of cumulative oxidative damage
over time, and the temporal correlation between oxidative protein
damage and -synuclein aggregation suggests a possible causal
relationship (Giasson and Lee, 2000 ).
After 4 weeks, rotenone-treated cells began to show cytochrome
c redistribution, caspase activation, and apoptosis, as
assessed by TUNEL staining and nuclear morphology. This small but
significant elevation in basal apoptotic death (5.6 vs 1.4%) was
undetectable by our plate-reader assay and only became apparent with
TUNEL staining. Interestingly, we have found numerous nigral
dopaminergic neurons expressing activated caspase-3 after in
vivo rotenone infusion; however, we have not found convincing
evidence of apoptosis in vivo (Sherer et al., 2001a ).
Previous studies determined that acute exposure (4-48 hr) to extremely
high doses of rotenone (1-100 µM) resulted in
caspase activation and both apoptotic and necrotic cell death
(Seaton et al., 1998 ; Leist et al., 1999 ; King et al., 2001 ; Zhang et
al., 2001 ). Our results demonstrate that chronic, low-level complex I
inhibition leads to delayed activation of the apoptotic pathway, a
mechanism that may be relevant to late-onset PD.
Dopaminergic neurons are thought to exist in a state of constant
oxidative stress, in large part because of generation of H2O2. In our system,
H2O2 induced cytochrome
c redistribution, activation of caspases, and DNA
fragmentation, as described by others (Jiang et al., 2001 ; Zhuang et
al., 2001 ). Compared with control cultures, however, rotenone-treated
cultures showed
H2O2-induced caspase
activation and apoptosis earlier and in a larger percentage of cells.
Although a similar process occurs after
H2O2 exposure in control
and rotenone-treated cells, more rotenone-treated cells entered and
progressed more quickly through a caspase-dependent apoptotic pathway.
Moreover, the rate of cell death was two to three times as fast in
cells treated chronically with rotenone (Fig. 5B). An
analogous situation may occur in PD, in which there is a normal,
age-related loss of dopaminergic neurons (Ma et al., 1999 ), possibly
related to ongoing oxidative stress, and an additional insult, possibly
a mild complex I defect. The modest cell death induced by a chronic
complex I defect superimposed on the age-related decline in
dopaminergic cells means the threshold for development of parkinsonian
symptoms will be reached much earlier in PD.
The mechanisms responsible for the sensitization of rotenone-treated
cells to H2O2 are not
clear. Studies from Chinopoulos and Adam-Vizi (2001) indicate that
mitochondria with mild complex I defects depolarize acutely in response
to H2O2. We do not know whether this phenomenon is important in our system; however,
sensitization required ~3 weeks of rotenone exposure despite the
immediate effects of rotenone on complex I. Because
H2O2-induced death
reportedly requires mitochondrial-derived ROS (Dumont et al., 1999 ),
progressive oxidative damage resulting from chronic rotenone treatment
may render cells more vulnerable to this oxidative challenge. In
addition, the rotenone-induced loss of GSH probably contributes to
increased vulnerability.
The in vivo rotenone model of PD substantiated the
involvement of chronic systemic complex I defects in PD pathogenesis
(Betarbet et al., 2000 ). The in vitro model of chronic
rotenone exposure provides a novel system, which links a number of
events implicated in PD pathogenesis, including altered -synuclein
metabolism, decreased GSH, progressive oxidative damage, and apoptosis.
This model system may provide an improved understanding of mechanisms of cell death in PD and an opportunity to screen potential therapeutic strategies.
 |
FOOTNOTES |
Received April 15, 2002; revised May 24, 2002; accepted May 31, 2002.
This work was supported by National Institutes of Health Grants
NS38399 (J.T.G.) and F32NS11132 (T.B.S.).
Correspondence should be addressed to Dr. J. Timothy Greenamyre, Center
for Neurodegenerative Diseases, Emory University, Whitehead Biomedical
Research Building, Room 505M, 615 Michael Street, Atlanta, GA 30322. E-mail: jgreena{at}emory.edu.
 |
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