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The Journal of Neuroscience, February 15, 2003, 23(4):1228
Synergistic Dopaminergic Neurotoxicity of the Pesticide Rotenone
and Inflammogen Lipopolysaccharide: Relevance to the Etiology of
Parkinson's Disease
Hui-Ming
Gao1, 2,
Jau-Shyong
Hong1,
Wanqin
Zhang2, and
Bin
Liu1
1 Neuropharmacology Section, Laboratory of Pharmacology
and Chemistry, National Institute of Environmental Health
Sciences/National Institutes of Health, Research Triangle Park, North
Carolina 27709, and 2 Department of Physiology, Dalian
Medical University, Dalian, 116027, China
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ABSTRACT |
Parkinson's disease (PD) is characterized by a progressive
degeneration of the nigrostriatal dopaminergic pathway resulting in
movement disorders. Although its etiology remains unknown, PD may be
the final outcome of interactions among multiple factors, including
exposure to environmental toxins and the occurrence of inflammation in
the brain. In this study, using primary mesencephalic cultures, we
observed that nontoxic or minimally toxic concentrations of the
pesticide rotenone (0.5 nM) and the inflammogen
lipopolysaccharide (LPS) (0.5 ng/ml) synergistically induced
dopaminergic neurodegeneration. The synergistic neurotoxicity of
rotenone and LPS was observed when the two agents were applied either
simultaneously or in tandem. Mechanistically, microglial NADPH
oxidase-mediated generation of reactive oxygen species appeared to be a
key contributor to the synergistic dopaminergic neurotoxicity. This
conclusion was based on the following observations. First, inhibition
of NADPH oxidase or scavenging of free radicals afforded significant
neuroprotection. Second, rotenone and LPS synergistically stimulated
the NADPH oxidase-mediated release of the superoxide free radical.
Third and most importantly, rotenone and LPS failed to induce the
synergistic neurotoxicity as well as the production of superoxide in
cultures from NADPH oxidase-deficient animals. This is the first
demonstration that low concentrations of a pesticide and an inflammogen
work in synergy to induce a selective degeneration of dopaminergic neurons. Findings from this study may be highly relevant to the elucidation of the multifactorial etiology of PD and the discovery of
effective therapeutic agents for the treatment of the disease.
Key words:
pesticide; inflammation; microglia; NADPH oxidase; Parkinson's disease; synergistic neurotoxicity
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Introduction |
The cause of sporadic Parkinson's
disease (PD), which accounts for >90% of the incidence of PD, remains
unknown. Increasing evidence indicates that PD may represent the final
outcome of a complex set of interactions, over decades of time, among
factors that include genetic predisposition, innate characteristics of the nigrostriatal dopaminergic system of the brain, and exposure to
environmental toxins (Olanow and Tatton, 1999 ; Kidd, 2000 ).
Among the various environmental factors suspected to play a role in the
pathogenesis of PD, exposure to agrochemicals has been most intensely
investigated (Gorell et al., 1998 ; Ritz and Yu, 2000 ; Herishanu et al.,
2001 ; Priyadarshi et al., 2001 ). A number of groups have reported that
administration of herbicides such as rotenone and paraquat induces
parkinsonism in rodents (Betarbet et al., 2000 ; Thiruchelvam et al.,
2000 ). Mechanistically, the degeneration of nigral dopaminergic neurons
induced by rotenone may not be solely the result of an impairment of
neuronal mitochondrial complex I activity but may also involve the
participation of the resident immune cells of the brain, microglia (Gao
et al., 2002a ).
Microglial activation is a hallmark of the pathogenesis of a number of
neurodegenerative diseases, including PD and Alzheimer's disease
(McGeer et al., 1988 ; Hauss-Wegrzyniak et al., 1998 ; Gonzalez-Scarano and Baltuch, 1999 ; Liu and Hong, 2003 ). Historically, postmortem analysis of the nigra of PD patients has frequently detected markers for microglial activation, accumulation of proinflammatory cytokines, and footprints for oxidative stress (McGeer et al., 1988 ). Under physiological conditions, microglia perform the role of immune surveillance (Kreutzberg, 1996 ). In response to immunological challenges such as invading pathogens and neuronal injuries, microglia readily become activated. Activated microglia produce a wide array of
proinflammatory and cytotoxic factors, including cytokines, free
radicals, and eicosanoids, which work in concert to induce neurodegeneration (Liu et al., 2002 ). Within the spectrum of neurotoxic factors produced by activated microglia, reactive oxygen species (ROS)
appear to be a key effector of dopaminergic neurodegeneration attributable to the known vulnerability of dopaminergic neurons to oxidative stress as a consequence of reduced antioxidant capacity, high content of iron and dopamine, and possible defect in mitochondrial function (Jenner and Olanow, 1998 ). Superoxide free radical, released by activated microglia through the multi-subunit and membrane-bound NADPH oxidase, together with other microglia-originated factors, such
as nitric oxide (NO), tumor necrosis factor- (TNF ), and interleukin-1- (IL-1 ), contribute significantly to dopaminergic neurodegeneration (Liu et al., 2000 ; Gao et al., 2002b ). In fact, cerebral inflammation sustained by microglial activation triggered by
the inflammogen lipopolysaccharide (LPS) reproduces the delayed and
progressive degenerative feature of nigral dopaminergic neurons in PD
(Gao et al., 2002b ).
In this study, we investigated the effect of exposure to a pesticide
(i.e., rotenone) and an inflammogen (i.e., LPS) on the degeneration of
dopaminergic neurons using primary mesencephalic neuron-glia cultures
as a chronic in vitro model of PD. We report here that
rotenone and LPS, at concentrations that were nontoxic or minimally
toxic when applied alone, worked in synergy to induce the degeneration
of dopaminergic neurons. Results obtained from studies using cultures
from NADPH oxidase-null and wild-type mice demonstrated that the
release of oxygen free radicals from rotenone and LPS-stimulated
microglia appeared to be a key contributor to the dopaminergic neurotoxicity.
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Materials and Methods |
Animals. NADPH oxidase-deficient
(gp91phox / ) and wild-type C57BL/6J
(gp91phox+/+) mice were obtained from
The Jackson Laboratory (Bar Harbor, ME). Breeding of the
mice was performed to achieve timed pregnancy with the accuracy of
±0.5 d. Timed-pregnant Fisher F344 rats were obtained from
Charles River Laboratories (Raleigh, NC). Housing and
breeding of the animals were performed in strict accordance with the
National Institutes of Health guidelines.
Primary mesencephalic neuron-glia cultures. Neuron-glia
cultures were prepared from the ventral mesencephalic tissues of
embryonic day 13-14 rats or day 12-13 mice, as described previously
(Liu et al., 2000 ; Gao et al., 2002a ). Briefly, dissociated cells were seeded at 1 × 105/well and 5 × 105/well to
poly-D-lysine-coated 96-well and 24-well plates,
respectively. Cells were maintained at 37°C in a humidified
atmosphere of 5% CO2 and 95% air, in minimal
essential medium (MEM) containing 10% fetal bovine serum (FBS), 10%
horse serum (HS), 1 gm/l glucose, 2 mM
L-glutamine, 1 mM sodium
pyruvate, 100 µM nonessential amino acids, 50 U/ml penicillin, and 50 µg/ml streptomycin. Seven-day-old cultures
were used for treatment. At the time of treatment, immunocytochemical analysis indicated that the rat neuron-glia cultures were made up of
11% microglia, 48% astrocytes, 41% neurons, and 1% tyrosine hydroxylase-immunoreactive (TH-IR) neurons. The composition of the neuron-glia cultures of NADPH oxidase-deficient mice was very similar to that of the wild-type mice in that there were 12%
microglia, 48% astrocytes, 40% neurons, and 1% TH-IR neurons.
Primary rat mesencephalic neuron-enriched cultures.
Neuron-enriched cultures were prepared from the ventral mesencephalic tissues of embryonic day 13-14 rats as described previously (Gao et
al., 2002a ). Briefly, dissociated cells were seeded at 1 × 105/well and 5 × 105/well to
poly-D-lysine-coated 96-well and 24-well plates,
respectively. Glial proliferation was suppressed by the inclusion of
cytosine -D-arabinocide (5-10
µM). Used for treatment were 7-d-old cultures, which were composed of 91% neurons, 9% astrocytes, and <0.1% microglia.
Primary microglia-enriched cultures. Microglia were prepared
from the whole brains of 1-d-old rats or NADPH oxidase-deficient or
wild-type mice, as described previously (B. Liu et al., 2001 ). Immunocytochemical analysis indicated that the cultures were 95-98% pure for microglia. Cells were seeded at 1 × 105/well in 96-well plates and used for
treatment the following day.
Assessment of neurotoxicity. For treatment, cultures were
switched to treatment medium consisting of MEM, 2% FBS, 2% HS, 2 mM L-glutamine, 1 mM sodium pyruvate, 50 U/ml penicillin, and 50 µg/ml streptomycin. Cultures were treated with vehicle, LPS (E
scherichia coli 0111:B4; Calbiochem, San Diego, CA),
and/or rotenone (Calbiochem) as described previously (Gao
et al., 2002a ,b ). Degeneration of dopaminergic neurons in the cultures
was analyzed by using several parameters. Uptake of
[3H]dopamine (DA) was determined by
incubation of cultures for 15 min at 37°C with 1 µM [3H]DA (30 Ci/mmol; NEN, Boston, MA) as described previously (Gao et
al., 2002a ). Nonspecific uptake was determined in the presence of 10 µM mazindol. The number and the average
dendrite length of TH-IR neurons were determined as described
previously (Gao et al., 2002a ). The specificity of neurotoxicity was
analyzed by comparing the uptake capacity of cultures for
[3H]DA and
[3H]GABA and by double-label
immunostaining with the anti-TH antibody and an antibody against the
neuron-specific nuclear protein (NeuN) as described previously (Gao et
al., 2002a ).
Measurement of superoxide release. The release of superoxide
was determined by measuring the superoxide dismutase (SOD)-inhibitable reduction of cytochrome c as described previously (Liu et
al., 2000 ; Gao et al., 2002a ). To measure the immediate
release of superoxide from microglia-enriched, neuron-glia, or
neuron-enriched cultures after stimulation, cultures grown in 96-well
plates were switched to phenol red-free HBSS (100 µl/well). To
each well was added 50 µl of HBSS containing vehicle, rotenone,
and/or LPS, followed by 50 µl of ferricytochrome c (100 µM) in HBSS, with and without 600 U/ml SOD. The
cultures were then incubated at 37°C for 30 min, and the absorbance
at 550 nm was read with a SpectraMax Plus microplate spectrophotometer
(Molecular Devices, Sunnyvale, CA). To determine the
effect of NADPH oxidase inhibitors [diphenylene iodonium (DPI) or
apocynin] on superoxide release, microglia were pretreated for 30 min
at 37°C with vehicle, DPI, or apocynin in HBSS (100 µl/well) before
stimulation with rotenone and/or LPS. To measure the levels of
superoxide in mouse neuron-glia cultures at extended time points after
treatment, cultures grown in 96-well plates were treated with vehicle,
rotenone, and/or LPS in treatment medium containing phenol red-free MEM
(150 µl/well). Four days later, to each well was added 50 µl of
ferricytochrome c (100 µM) in phenol
red-free MEM, with and without 600 U/ml SOD. Thirty minutes after the
addition of cytochrome c, the absorbance at 550 nm was read.
Assay of intracellular ROS.
5-(and-6)-Chloromethyl-2',7'-dichlorodihydrofluorescein
diacetate (CM-H2-DCFDA) (Molecular
Probes, Eugene, OR), a chloromethyl derivative of
H2-DCFDA, passively diffuses into cells in which
it is hydrolyzed by intracellular esterases to liberate
2'-7'-dichlorofluoresein which, during reaction with oxidizing
species, yields a highly fluorescent compound 2',7'-dichlorofluorescein (DCF) that is trapped inside the cell (S.X. Liu et al., 2001 ). For each measurement, a fresh stock solution of
CM-H2-DCFDA (5 mM) was
prepared in dimethylsulfoxide. CM-H2-DCFDA,
diluted to a final concentration of 1 µM in
phenol red-free HBSS containing 2% FBS and 2% HS, was added to
cultures and incubated for 30 min at 37°C. After washing two times
with warm HBSS, vehicle or stimulators in HBSS were added to cultures.
After incubation for 30 min at 37°C, fluorescence intensity was
measured at 485 nm for excitation and 530 nm for emission using a
SpectraMax Gemini XS fluorescence microplate reader (Molecular Devices).
Nitrite and TNF assays. The production of NO was
determined by measuring the accumulated levels of nitrite in the
supernatant with the Griess reagent that had a detection limit of 0.5 µM. The amount of TNF released into the
medium was measured with a rat TNF enzyme-linked immunosorbent assay
kit (detection limit, 5 pg/ml; R & D Systems, Minneapolis, MN).
Statistical analysis. Statistical significance was
determined using an ANOVA, followed by the Bonferroni's
t test using the StatView program (Abacus
Concepts, Berkeley, CA). A value of p < 0.05 was considered statistically significant.
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Results |
Rotenone and LPS synergistically induce a selective degeneration of
dopaminergic neurons
To determine the combined neurotoxicity of rotenone and LPS, a
nontoxic or minimally toxic concentration of rotenone (0.5 nM) or LPS (0.5 ng/ml) was selected based on our previous
reports (Gao et al., 2002a ,b ). Primary rat mesencephalic neuron-glia
cultures were treated with vehicle, 0.5 nM rotenone, 0.5 ng/ml LPS, or a combination of 0.5 nM rotenone and 0.5 ng/ml LPS. Eight days later, the degeneration of dopaminergic neurons
was assessed by determining [3H]DA
uptake, counting TH-IR neurons, and measuring TH-IR dendrites. As shown
in Figure 1A, treatment
for 8 d with 0.5 nM rotenone alone did not
cause a significant reduction in DA uptake (5%) or loss of TH-IR
neurons (2%) compared with vehicle-treated control cultures,
consistent with our previous report (Gao et al., 2000a ). Treatment with
0.5 ng/ml LPS alone resulted in a significant reduction in DA uptake
(25%; p < 0.05 compared with control cultures) and an
insignificant loss of TH-IR neurons (9%), similar to that reported previously (Gao et al., 2002b ). In contrast, the reduction in DA uptake
in cultures treated with the combination of 0.5 nM rotenone and 0.5 ng/ml LPS reached 60%, which
was twice the sum of the reduction induced by 0.5 nM rotenone alone (5%) and by 0.5 ng/ml LPS
alone (25%). Similarly, the loss of TH-IR neurons induced by 0.5 nM rotenone and 0.5 ng/ml LPS was 48%, which was
four times the sum of that induced by 0.5 nM
rotenone alone (2%) and by 0.5 ng/ml LPS alone (9%). In addition, the
average length of TH-IR dendrites in cultures treated for 8 d with
0.5 nM rotenone and 0.5 ng/ml LPS was shortened
by 60 ± 5% (n = 3) compared with control cultures. Cultures treated with 0.5 nM rotenone
or 0.5 ng/ml LPS alone exhibited a 2 ± 2 or 19 ± 4%
(n = 3) decrease in the average length of TH-IR
dendrites.

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Figure 1.
Rotenone and LPS induce synergistic degeneration
of dopaminergic neurons. Primary rat neuron-glia cultures were treated
with vehicle, indicated concentrations of rotenone or LPS alone, or
combinations of indicated concentrations of rotenone and LPS. Eight
days later, neurotoxicity was determined by [3H]DA
uptake assay and quantification of TH-IR neurons after immunostaining
of dopaminergic neurons with an anti-TH antibody. The results are the
mean ± SEM of three experiments performed in triplicate.
Rot, Rotenone. **p < 0.005 compared
with the cultures treated with either rotenone or LPS alone.
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Because the dopaminergic neurotoxicity of either rotenone or LPS alone
exhibited a positive correlation with the concentrations applied (Gao
2002a ,b ), an alternative measure of the synergistic neurotoxicity was
to determine whether the sum of neurotoxicity induced by each
individual agent at a fixed concentration would equal that induced by
the combination of both agents at one-half the concentration of
individual agent. Therefore, rat neuron-glia cultures were treated
with vehicle, 5 nM rotenone, 1 ng/ml LPS, or a combination
of 2.5 nM rotenone and 0.5 ng/ml LPS, and neurotoxicity was
assessed 8 d later. As shown in Figure 1B,
neurotoxicity induced by a combination of 2.5 nM
rotenone and 0.5 ng/ml LPS was twice the sum of neurotoxicity induced
by 5 nM rotenone alone and that by 1 ng/ml LPS
alone. Together, these results indicated that rotenone and LPS acted
synergistically to induce the degeneration of dopaminergic neurons.
The specificity of rotenone and LPS-induced synergistic neurotoxicity
was determined by measurement of DA and GABA uptake, quantification of
TH-IR and NeuN-IR neurons, and morphological analysis after
double-label immunostaining for TH and NeuN. As shown in Figure
2A, treatment for
8 d with a combination of 0.5 nM rotenone
and 0.5 ng/ml LPS did not significantly affect GABA uptake when
compared with the marked decrease in DA uptake. Similarly, no
significant loss of NeuN-IR neurons was observed compared with the
dramatic loss of TH-IR neurons (Fig. 2B).
Double-label immunostaining confirmed that the destruction of TH-IR
neurons was most prominent, whereas the number and integrity of NeuN-IR
neurons were not significantly affected (Fig.
3). Compared with the healthy TH-IR
neurons in the control cultures, those in the rotenone- and LPS-treated
cultures were less numerous, and the remaining TH-IR neurons had
markedly shorter and less elaborate dendrites (Fig. 3). These data
demonstrated that the synergistic neurotoxicity of rotenone and LPS was
preferential to dopaminergic neurons.

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Figure 2.
Rotenone and LPS-induced neurotoxicity is
preferential to dopaminergic neurons. Rat neuron-glia cultures were
treated with vehicle, 0.5 nM rotenone, and/or 0.5 nM rotenone. Eight days later, cultures were subjected to
[3H]DA or [3H]GABA uptake
assay (A) or immunostaining with an anti-TH or
anti-NeuN antibody followed by quantification of the immunostained
neurons (B). The results are the mean ± SEM
of three experiments performed in triplicate. R + L,
Rotenone plus LPS. **p < 0.005 compared with the
control cultures.
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Figure 3.
Double-label immunocytochemical analysis for TH-
and NeuN-IR neurons. Rat neuron-glia cultures treated for 8 d
with vehicle (Control) or 0.5 nM
rotenone and 0.5 ng/ml LPS were double immunostained with anti-TH and
anti-NeuN antibodies. The images are from one experiment that is
representative of three separate experiments. Scale bar, 50 µm.
Arrowheads, TH-IR neurons.
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Effect of tandem exposure to rotenone and LPS on
dopaminergic neurotoxicity
In addition to simultaneously exposing the mesencephalic
neuron-glia cultures to both rotenone and LPS, we also examined the effect of sequential addition of rotenone and LPS on dopaminergic neurons using the following two treatment paradigms. In the first scheme, cultures were first treated with 0.5 nM rotenone,
and, 4 d later, LPS was added to a final concentration of 0.5 ng/ml. Conversely, cultures were first treated with LPS (0.5 ng/ml), and rotenone (0.5 nM) was added 4 d later. Eight days
after the initial treatment, neurotoxicity was determined by measuring
DA uptake and counting TH-IR neurons. For comparison, cultures were treated with either rotenone (0.5 nM) or LPS (0.5 ng/ml)
for the entire period (8 d) or only for the last 4 d.
Neurotoxicity induced by exposure to rotenone for 8 d and LPS for
the last 4 d was more than twice the sum of that induced by
exposure to rotenone alone for 8 d and that induced by exposure to
LPS alone for the last 4 d. Conversely, neurotoxicity induced by
exposure to LPS for 8 d and rotenone for the last 4 d was
nearly twice the sum of that induced by rotenone alone for the last
4 d and that by LPS for 8 d (Fig.
4A).

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Figure 4.
Effect of tandem addition of rotenone and LPS on
dopaminergic neurodegeneration. A, Tandem addition
without change of medium in between. Rat neuron-glia cultures were
treated for the indicated periods with rotenone (0.5 nM)
and/or LPS (0.5 ng/ml) in the following manner: rotenone or LPS for the
entire 8 d (0-8) or only the last 4 d
(4-8), rotenone for 8 d (0-8) plus
LPS for the last 4 d (4-8), or LPS for 8 d
(0-8) plus rotenone for the last 4 d
(4-8). Afterward, neurotoxicity was determined by DA
uptake and quantification of TH-IR neurons. **p < 0.005 compared with the cultures treated with rotenone alone;
+p < 0.05 and
++p < 0.005 compared with the cultures
treated with LPS alone. B, Tandem addition with change
of medium. Rat neuron-glia cultures were treated for the indicated
periods of time with vehicle, 0.5 nM rotenone, and/or 0.5 ng/ml LPS in sequential orders and with medium changes in between as
follows: rotenone or LPS alone for the first 3 d only
(0-3) or the last 3 d only
(5-7), rotenone for the first 3 d
(0-3) followed by resting for 1 d and then LPS for
3 d (5-7), LPS for the first 3 d
(0-3) followed by resting for 1 d and then
rotenone for 3 d (5-7). Afterward,
neurotoxicity was determined by DA uptake and quantification of TH-IR
neurons. The results are the mean ± SEM of two experiments
performed in triplicate. *p < 0.05 compared with
the cultures treated with rotenone alone;
+p < 0.05 compared with the cultures
treated with LPS alone. Rot, Rotenone.
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In the second treatment scheme, cultures were first treated with
rotenone (0.5 nM). Three days later, the spent medium was changed to fresh medium. On day 5, cultures were treated with LPS (0.5 ng/ml). On day 7, neurotoxicity was assessed. Conversely, cultures were
first treated for 3 d with LPS (0.5 ng/ml), allowed to rest for
1 d in fresh medium, and then treated with rotenone (0.5 nM) for 3 d. As shown in Figure 4B,
neurotoxicity induced by exposure first to LPS then to rotenone was
twice the sum of that induced by exposure for the same length of time
to either agent alone. Conversely, the neurotoxicity induced by
exposure first to rotenone and then to LPS was slightly greater than
the sum of that induced by either agent alone (Fig.
4B). These results indicated that exposure of
cultures to rotenone and LPS in tandem resulted in additive to
synergistic neurotoxicity.
Superoxide released from microglia is a key contributor to the
synergistic neurotoxicity of rotenone and LPS
Multiple approaches were taken to investigate the potential
underlying mechanism of action responsible for the rotenone and LPS-induced synergistic neurotoxicity. Because LPS-induced
neurotoxicity appears to be exclusively mediated by glia, especially
microglia, and rotenone-elicited neurodegeneration, at least in
vitro, is markedly enhanced by microglia (Bronstein et al., 1995 ;
Araki et al., 2001 ; Gao et al., 2002a ; Liu et al., 2002 ), the role of microglia was first examined. For this purpose, neuron-glia and neuron-enriched cultures, both prepared from rat ventral mesencephalon, were compared for their susceptibility to neurotoxicity induced by
rotenone and LPS. As shown in Figure 5,
synergistic dopaminergic neurotoxicity was observed only in
neuron-glia cultures treated for 8 d with 0.5 nM rotenone and 0.5 ng/ml LPS but not in
neuron-enriched cultures treated in the same manner. Therefore, the
presence of glial cells was a prerequisite for rotenone- and
LPS-induced synergistic neurotoxicity.

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Figure 5.
Induction of synergistic neurotoxicity by rotenone
and LPS depends on the presence of glial cells. Rat neuron-glia or
neuron-enriched cultures were treated with vehicle, 0.5 nM
rotenone, and/or 0.5 ng/ml LPS. Eight days later, neurotoxicity was
determined by [3H]DA uptake assay. The results are
the mean ± SEM of three experiments performed in triplicate.
**p < 0.005 compared with the cultures treated
with either rotenone or LPS alone. N/G, Neuron-glia
cultures; N/N, neuron-enriched cultures.
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Microglia are known to induce neurodegeneration by the release of a
variety of neurotoxic factors, including cytokines such as TNF and
free radicals such as NO and ROS (Liu and Hong, 2003 ). Hence, the
effect of rotenone and LPS on the production of key neurotoxic factors
by microglia in the neuron-glia cultures was determined. First,
analysis of the accumulation of nitrite, an indicator of NO production,
indicated that the levels of nitrite detected in cultures after
treatment for 8 d with 0.5 nM rotenone and 0.5 ng/ml
LPS were 0.9 ± 0.4 µM (n = 3),
similar to that observed in the cultures treated for 8 d with 0.5 ng/ml LPS alone (0.8 ± 0.6 µM;
n = 3) (Gao et al., 2002b ). The levels of nitrite in vehicle-treated cultures were 0.3 ± 0.4 µM (n = 3). In contrast, the
levels of nitrite in cultures treated with 0.5 nM
rotenone were below the detection limit of the assay (0.5 µM), an observation consistent with our
previous report (Gao et al., 2002a ). Therefore, the minute quantities
of nitrite produced in cultures treated with rotenone and LPS were
probably attributable to the stimulation of glial cells by LPS but not
rotenone. Second, the levels of TNF in cultures treated with 0.5 nM rotenone and 0.5 ng/ml LPS were below the
detection limit of the assay (5 pg/ml). Similarly, the amount of TNF
in cultures treated with either agent alone was nondetectable,
consistent with our previous reports (Gao et al., 2002a ,b ). Third, in
sharp contrast to the lack of synergy in stimulating the production of
NO and TNF , rotenone (0.5 nM) and LPS (0.5 ng/ml) synergistically stimulated the release of superoxide free
radical measured as SOD-inhibitable reduction of cytochrome
c (Fig. 6A).
Although no significant release of superoxide was detected in cultures
stimulated with 0.5 nM rotenone, a twofold
increase was observed in cultures stimulated with 0.5 ng/ml LPS alone,
and a fourfold increase was detected in cultures stimulated with both
0.5 nM rotenone and 0.5 ng/ml LPS (Fig.
6A). The fact that rotenone and LPS failed to
increase the production of superoxide in neuron-enriched cultures may
underlie their inability to induce neurotoxic effect. In addition to
the measurement of superoxide release, the levels of intracellular ROS
were determined after stimulation with rotenone and LPS. In
neuron-enriched cultures, no significant increase in the levels of
intracellular ROS was detected. In neuron-glia cultures, however, LPS
and rotenone synergistically induced an increase in the levels of
intracellular ROS (Fig. 6A).

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Figure 6.
Role of ROS in the induction of synergistic
neurotoxicity by rotenone and LPS. A, Measurement of
release of superoxide and levels of intracellular ROS. To measure
superoxide release, rat neuron-glia or neuron-enriched cultures were
stimulated with vehicle, 0.5 nM rotenone, and/or 0.5 ng/ml
LPS. The release of superoxide was measured by the SOD-inhibitable
reduction of cytochrome c. The levels of intracellular
ROS were detected with CM-H2-DCFDA. The relative
fluorescence intensities in the control cultures were 300-450 and
450-600 arbitrary units per well for N/N and
N/G, respectively. The results are expressed as the
percentage of control and are the mean ± SEM of two to three
experiments performed in triplicate. *p < 0.05 and
**p < 0.005 compared with the control cultures,
respectively; ++p < 0.05 compared with
the cultures treated with either rotenone or LPS alone.
B, Measurement of the release of superoxide from
microglia. Microglia-enriched cultures were pretreated for 30 min with
5 µM DPI or 0.25 mM apocynin before
stimulation with vehicle, 0.5 nM rotenone, and/or 0.5 ng/ml
LPS. Superoxide released from microglia was determined by measuring the
SOD-inhibitable reduction of cytochrome c. The results
are the mean ± SEM of three experiments performed in triplicate.
*p < 0.05 compared with the vehicle control;
+p < 0.05 compared with the rotenone
and LPS-treated cultures. C, Effect of apocynin,
L-NAME, or SOD-catalase on the rotenone and LPS-induced
synergistic neurotoxicity. Rat neuron-glia cultures were pretreated
for 30 min with vehicle, 0.25 mM apocynin, or 1 mM L-NAME before treatment with 0.5 nM rotenone and 0.5 ng/ml LPS. SOD-catalase (100 and 150 U/ml, respectively) were added at the same time with rotenone and LPS.
Seven days later, neurotoxicity was determined by
[3H]DA uptake assay. The results are the mean ± SEM of three experiments performed in triplicate.
**p < 0.005 compared with the vehicle control;
+p < 0.05 compared with the rotenone
and LPS-treated cultures. N/N, Neuron-enriched cultures;
N/G, neuron-glia cultures; C, control;
R, rotenone; L, LPS; D,
DPI; A, apocynin; S/C, SOD-catalase;
L-N, L-NAME.
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Previously, we showed that superoxide released from LPS- or
rotenone-activated microglia appeared to be a major effector of the
dopaminergic neurodegeneration (Gao et al., 2002a ,b ). To determine the
source of extracellular superoxide in rotenone and LPS-stimulated cultures, microglia-enriched cultures were tested for response to both
rotenone and LPS. As shown in Figure 6B, significant
release of superoxide was detected in microglia stimulated with 0.5 nM rotenone and 0.5 ng/ml LPS, whereas no
apparent superoxide release was observed in microglia stimulated with
the same concentrations of either agent alone. Furthermore, the
rotenone and LPS-stimulated superoxide release was almost completely
prevented by preincubation with DPI and apocynin, inhibitors of NADPH
oxidase (Fig. 6B).
The relevance of the release of superoxide to the rotenone and
LPS-induced synergistic neurotoxicity was also determined. Preincubation of neuron-glia cultures with apocynin (0.5 mM) or coincubation with SOD-catalase (100 and 150 U/ml,
respectively) significantly reduced the neurotoxicity induced by
rotenone and LPS (Fig. 6C). Preincubation with 1 mM
NG-nitro-L-arginine methyl ester
(L-NAME), an inhibitor of nitric oxide synthase,
did not afford a statistically significant degree of neuroprotection
(Fig. 6C). These results demonstrated that stimulation of
the production of superoxide in microglia, at least in part, underlie
the mechanism of action responsible for the synergistic neurotoxicity
of rotenone and LPS.
Microglial NADPH oxidase is the primary source of
superoxide production
The observation that both microglial production of superoxide and
synergistic neurotoxicity induced by rotenone and LPS were sensitive to
modulation by inhibitors of NADPH oxidase prompted us to speculate that
NADPH oxidase played a critical role in mediating the synergistic
neurotoxicity. To test this hypothesis, we established primary
mesencephalic neuron-glia cultures from NADPH oxidase-deficient (PHOX / ) and wild-type
(PHOX+/+) mice. Similar to rat
neuron-glia cultures (Fig. 1), synergistic dopaminergic neurotoxicity
was observed in neuron-glia cultures from wild-type mice
(PHOX+/+) after treatment for 8 d
with 0.5 nM rotenone and 0.5 ng/ml LPS (Fig.
7A). However, neuron-glia
cultures from PHOX / mice were nearly
completely resistant to neurotoxicity induced by 0.5 nM rotenone and 0.5 ng/ml LPS (Fig.
7A). The resistance of
PHOX / cultures to rotenone and LPS
neurotoxicity suggested that production of superoxide was a key event
in the induction of neurotoxicity. Indeed, in neuron-glia cultures
treated for 4 d with 0.5 nM rotenone and 0.5 ng/ml LPS, significant production of superoxide was observed only in
PHOX+/+ but not in
PHOX / cultures (Fig. 7B).
Furthermore, the primary source of superoxide production was microglia,
as exemplified by the markedly increased production of superoxide in
rotenone and LPS-stimulated microglia from
PHOX+/+ mice but not those from
PHOX / mice (Fig. 7C). These
results lend strong support to the notion that ROS production mediated
by the microglial NADPH oxidase plays a critical role in the
synergistic neurotoxicity induced by rotenone and LPS.

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|
Figure 7.
Effect of NADPH oxidase deficiency on the
induction of neurotoxicity and production of superoxide induced by
rotenone and LPS. A, Neurotoxicity. Neuron-glia
cultures from wild-type (PHOX+/+) or NADPH
oxidase-deficient (PHOX / ) mice were treated with
vehicle, 0.5 nM rotenone, and/or 0.5 ng/ml LPS. Eight days
later, neurotoxicity was determined by [3H]DA
uptake assay. The results are the mean ± SEM of three experiments
performed in triplicate. **p < 0.005 compared with
the rotenone or LPS-treated cultures. B, Determination
of superoxide production in neuron-glia cultures 4 d after
treatment. PHOX+/+ or PHOX /
neuron-glia cultures were treated with vehicle, 0.5 nM
rotenone, and/or 0.5 ng/ml LPS. Four days later, levels of superoxide
were measured as SOD-inhibitable cytochrome c reduction.
**p < 0.005 compared with the vehicle control;
++p < 0.005 compared with the cultures
treated with either rotenone or LPS alone. C, Production
of superoxide in microglia. PHOX+/+ or
PHOX / microglia-enriched cultures were
stimulated with vehicle, 0.5 nM rotenone, and/or 0.5 ng/ml
LPS. Release of superoxide were measured as SOD-inhibitable cytochrome
c reduction. **p < 0.005 compared
with the vehicle control; ++p < 0.005 compared with the cultures treated with either rotenone or LPS alone.
C, Control; R, rotenone;
L, LPS.
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|
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Discussion |
Idiopathic PD is an age-related neurodegenerative disease that
usually occurs late in life and progresses over many years. The
pathogenesis of PD involves a progressive and selective
destruction of the nigrostriatal dopaminergic pathway, which is
critical for the regulation of body movements. Although the exact cause
of PD remains unknown, the late onset and slow progressing nature of
the disease suggests the possibility that interactions among a variety
of intrinsic and environmental factors may set in motion a cascade of
events leading to the eventual destruction of the nigrostriatal
dopaminergic pathway.
One of those suspected factors is exposure to agrochemicals, such as
pesticides. Results from a number of epidemiological and
case-controlled studies appear to indicate a positive correlation between early exposure to pesticides and development of PD (Gorell et
al., 1998 ; Ritz and Yu, 2000 ; Herishanu et al., 2001 ). Experimentally, several groups have reported recently that administration of pesticides and/or related agrochemicals results in the degeneration of the nigrostriatal dopaminergic pathway. For example, chronic administration of rotenone has been reported to reproduce parkinsonian features in
rats (Betarbet et al., 2000 ). Alteration of striatal dopaminergic chemistry and induction of behavioral abnormalities have also been
reported in rats after exposure to a combination of the herbicide paraquat and the fungicide maneb (Thiruchelvam et al., 2000 ). The exact
mechanism of action responsible for the preferential degeneration of
the nigrostriatal dopaminergic pathway by these agrochemicals, however,
is not completely clear.
Another intriguing factor that has been increasingly associated with
the pathogenesis of PD is inflammation in the brain. Clues to the
involvement of inflammation in the pathogenesis of PD have derived from
postmortem analyses of PD brains in which microglial activation,
elevated levels of proinflammatory mediators such as TNF , IL-1 ,
and NO, and evidence of ROS production have been detected in the
substantia nigra (McGeer et al., 1988 ; Cassarino et al., 1997 ; Hunot et
al., 1999 ; Nagatsu et al., 2000 ). However, it is not clear whether
these inflammatory "footprints" observed in the late stages of the
pathogenesis of PD may merely be a reflection of reactive gliosis after
the occurrence of the initial neuronal injuries. On the other hand,
increasing evidence has suggested that early-life occurrence of
inflammation in the brain, either as a result of exposure to infectious
agents or brain injury, plays an important role in later-life
development of PD (Ravenholt and Foege, 1982 ; Factor et al., 1988 ;
Mattock et al., 1988 ; Williams et al., 1991 ; Casals et al., 1998 ;
Plassman et al., 2000 ). The likelihood that inflammation plays a key
role in the earlier stages of PD is significantly enhanced by the
observation that the midbrain region is particularly rich in microglia
(Lawson et al., 1990 ; Kim et al., 2000 ), which are readily activated by
immunological challenges and neuronal injuries (Kreutzberg, 1996 ). In
fact, we demonstrated recently that chronic intranigral infusion of LPS
results in a delayed and progressive degeneration of nigral dopaminergic neurons (Gao et al., 2002b ). In addition, Ling et al.
(2002) has also demonstrated that in utero exposure of
developing fetuses to LPS results in a loss of nigral dopaminergic
neurons in neonates.
Despite the intense effort to identify individual agents and/or factors
as potential etiological culprits, development of PD may be a result of
the interaction of multiple factors, including genetic predisposition,
the intrinsic nature of the dopaminergic system, and exposure to
environmental toxins (Olanow and Tatton, 1999 ; Kidd, 2000 ). In the
category of insults from environmental factors, early-life exposures
(either simultaneously or in tandem) to multiple agents that are vastly
different in identity may contribute significantly to the initiation
and/or progression of the disease. In this study, using a chronic (8 d
after drug treatment) in vitro model of PD, we provided
evidence that the herbicide rotenone and the inflammogen LPS worked in
synergy to induce dopaminergic neurotoxicity. Exposure to rotenone (0.5 nM) or LPS (0.5 ng/ml) alone produced little or
minimal neurotoxicity (Fig. 1). However, exposure to a combination of
the two agents, each at the same concentration as that used
individually, resulted in a synergistic dopaminergic neurotoxicity
(Fig. 1). Furthermore, enhanced neurotoxicity did not derive only from
simultaneous exposure to both agents; tandem exposure also resulted in
additive to synergistic dopaminergic neurotoxicity (Fig. 4). These
results indicate that exposure to agrochemicals and episodes of
inflammation in the brain, occurring either simultaneously or in
tandem, may promote, if not trigger, the neurodegenerative processes.
Confirmation of these in vitro observations in animal
studies and in multifactorial epidemiological studies should shed
significant light on the understanding of the etiology of PD.
Analysis of the underlying mechanism of action responsible for the
synergistic neurotoxicity of rotenone and LPS indicates that, at the
cellular level, the participation of glial cells is indispensable for
the induction of the synergistic neurotoxicity (Fig. 5). Because glial
cells induce neurodegeneration by the production and release of
neurotoxic factors, including cytokines, reactive nitrative species,
and ROS, the effect of rotenone and LPS on the release of TNF , NO,
and superoxide was first examined. No detectable release of TNF was
observed in neuron-glia cultures treated with rotenone (0.5 nM) and LPS (0.5 ng/ml) or either agent alone, consistent
with previous reports (Gao et al., 2002a ,b ). Therefore, release of
TNF did not seem to be involved in the synergistic neurotoxicity of
rotenone and LPS observed in this study. Production of NO, on the other
hand, appeared to be more relevant than TNF to the observed
synergistic neurotoxicity. Although rotenone (0.5 nM) did
not appear to elevate NO production (this study; Gao et al. 2002b ),
modest NO production was detected in neuron-glia cultures treated with
0.5 ng/ml LPS (Gao et al., 2002a ) or the same concentration of LPS plus
0.5 nM rotenone (this study). The low micromolar quantities
of nitrite (an indicator of NO production) by itself might not be
directly toxic to neurons. However, NO could react with other soluble
factors such as superoxide free radical to form highly toxic
intermediates such as peroxynitrite (Beckman et al., 1993 ; Xie et al.,
2002 ). Hence, although rotenone at 0.5 nM did not promote
the production of NO beyond that induced by 0.5 ng/ml LPS, the
involvement of NO in the synergistic neurotoxicity could not be ruled
out because of the possibility of formation of peroxynitrite with
superoxide that was abundantly produced.
A remarkable finding of this study is that rotenone and LPS act
synergistically to induce microglia to release superoxide free radical.
Although at higher concentrations, each agent alone is capable of
stimulating microglia to release superoxide (Liu et al., 2000 ; Gao et
al., 2002a ,b ), at lower concentrations, rotenone or LPS is either
ineffective or only modestly effective in inducing superoxide
generation (Gao et al., 2002a ,b ). However, when microglia were
stimulated with a combination of singularly ineffective or minimally
effective concentrations of rotenone and LPS, robust production of
superoxide was observed (Figs. 6B, 7C).
Mechanistically, the rotenone and LPS-stimulated release of superoxide
was mediated through the activity of the membrane-associated and
multi-subunit NADPH oxidase, which is the primary enzymatic machinery
for the production of superoxide in immune cells of peripheral system and the brain (Babior, 1999 ). In support of this conclusion were observations that the rotenone and LPS-stimulated superoxide production in microglia was nearly completely prevented by
pharmacological inhibition or genetic inactivation of NADPH oxidase
(Figs. 6B, 7B,C)
and that rotenone and LPS failed to induce neurotoxicity in
neuron-glia from NADPH oxidase-deficient mice (Fig. 7A).
Hence, NADPH oxidase may be an important therapeutic target for the
treatment of PD.
In addition to microglia, it has been reported recently that neurons
may also express a functional NADPH oxidase (Noh and Koh, 2000 ;
Tammariello et al., 2000 ). However, in this study, neuronal NADPH
oxidase did not appear to be directly involved in the production of
superoxide or the induction of neurodegeneration because rotenone (0.5 nM) and LPS (0.5 ng/ml) neither induced superoxide release
(Fig. 6A) nor caused significant neurotoxicity in
neuron-enriched cultures (Fig. 5).
Worth noting is the role of intracellular ROS in the induction of
synergistic neurotoxicity. At high nanomolar to low micromolar concentrations, rotenone is postulated to work as an inhibitor of
mitochondrial complex I and may promote the production of ROS in
neurons (Greenamyre et al., 1999 ). In this study, using
CM-H2-DCFDA as a probe, we did not observe
significant elevations of intracellular ROS in neuron-enriched cultures
stimulated with 0.5 nM rotenone, 0.5 ng/ml LPS, or the
combination of both (Fig. 6A). Interestingly, in
neuron-glia cultures, although rotenone (0.5 nM)
did not induce any changes in fluorescent intensity, LPS (0.5 ng/ml) or
LPS (0.5 ng/ml) and rotenone (0.5 nM) did cause a
significant increase in fluorescent signal (Fig. 6A).
The increased fluorescent signal observed in the neuron-glia cultures
may reflect increased ROS generation inside glia, increased levels of
intracellular hydrogen peroxide as a consequence of conversion from
extracellular superoxide, and/or the intracellular ROS generation in
neurons in the presence of superoxide-generating microglia, which were
otherwise dormant in the absence of glial cells. Nevertheless,
intracellular ROS probably played a role in the synergistic
neurotoxicity induced by rotenone and LPS.
Significant rises in extracellular levels of reactive nitrative and
oxidative species are highly relevant to the induction of dopaminergic
neurodegeneration because dopaminergic neurons are known to be
particularly vulnerable to oxidative damage attributable to a number of
intrinsic characteristics. Among the various types of neurons,
dopaminergic neurons have a reduced antioxidant capacity that is
exemplified by a lower content of glutathione, an increased accumulation of iron that may participate in the formation of ROS such
as hydroxyl radical through Fenton reaction, and a high content of
oxidation-prone dopamine and lipids (Jenner and Olanow, 1998 ;
Greenamyre et al., 1999 ). Oxygen free radicals can trigger chain
reactions of lipid peroxidation as well as functional and structural
modifications of proteins, enzymes, and nucleic acid macromolecules. In
addition, ROS such as superoxide can react with reactive nitrative
species such as NO to form more reactive intermediates such as
peroxynitrite. Furthermore, it has been proposed that extracellular ROS
may promote the mitochondria-mediated generation of intracellular ROS
(Hasegawa et al., 1990 ). In the brain, at least for
rodents, the midbrain region, which encompasses the substantia nigra,
is particularly rich in microglia (Lawson et al., 1990 ; Kim et al.,
2000 ). Therefore, the combination of the intrinsic characteristics of
dopaminergic neurons and their physical location in a microglia-rich
microenvironment renders them especially vulnerable to attacks by free
radicals generated both extracellularly and intracellularly.
In summary, this study, for the first time, demonstrated the
synergistic dopaminergic neurotoxicity of a pesticide (rotenone) and an
inflammogen (LPS). NADPH oxidase-mediated production of superoxide free
radical from rotenone and LPS-activated microglia appears to be an
important mediator of the synergistic neurotoxicity. Continued
exploration of the impact of multiple environmental factors on the
degeneration of the nigrostriatal dopaminergic pathway should
significantly advance our understanding of the etiology and
pathogenesis of Parkinson's disease and our search for effective
therapeutic strategies to slow the progression of the disease.
 |
FOOTNOTES |
Received Oct. 15, 2002; revised Nov. 21, 2002; accepted Nov. 25, 2002.
Correspondence should be addressed to Dr. Bin Liu, F1-01, National
Institute of Environmental Health Sciences/National Institutes of
Health, P.O. Box 12233, Research Triangle Park, NC 27709. E-mail: liu3{at}niehs.nih.gov.
 |
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