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The Journal of Neuroscience, December 8, 2004, 24(49):11057-11069; doi:10.1523/JNEUROSCI.2829-04.2004
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Neurobiology of Disease
Sodium Influx Pathways during and after Anoxia in Rat Hippocampal Neurons
Claire Sheldon,1
Abdoullah Diarra,2
Y. May Cheng,1 and
John Church1,2
Departments of 1Physiology and 2Anatomy and Cell Biology, University of British Columbia, Vancouver, British Columbia, Canada V6T 1Z3
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Abstract
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Mechanisms that contribute to Na+ influx during and immediately after 5 min anoxia were investigated in cultured rat hippocampal neurons loaded with the Na+-sensitive fluorophore sodium-binding benzofuran isophthalate. During anoxia, an influx of Na+ in the face of reduced Na+,K+-ATPase activity caused a rise in [Na+]i. After the return to normoxia, Na+,K+-ATPase activity mediated the recovery of [Na+]i despite continued Na+ entry. Sodium influx during and after anoxia occurred through multiple pathways and increased the longer neurons were maintained in culture. Under the experimental conditions used, Na+ entry during anoxia did not reflect the activation of ionotropic glutamate receptors, TTX- or lidocaine-sensitive Na+ channels, plasmalemmal Na+/Ca2+ exchange, Na+/H+ exchange, or -dependent mechanisms; rather, contributions were received from a Gd3+-sensitive pathway activated by reactive oxygen species and Na+/K+/2Cl- cotransport in neurons maintained for 6-10 and 11-14 d in vitro (DIV), respectively. Sodium entry immediately after anoxia was not attributable to the activation of ionotropic glutamate receptors, voltage-activated Na+ channels, or Na+/K+/2Cl- cotransport; rather, it occurred via Na+/Ca2+ exchange, Na+/H+ exchange, and a Gd3+-sensitive pathway similar to that observed during anoxia; 11-14 DIV neurons received an additional contribution from an -dependent mechanism(s). The results provide insight into the intrinsic mechanisms that contribute to disturbed internal Na+ homeostasis during and immediately after anoxia in rat hippocampal neurons and, in this way, may play a role in the pathogenesis of anoxic or ischemic cell injury.
Key words: anoxia; ischemia; intracellular sodium; Na+/K+/2Cl- cotransport; Na+/Ca2+ exchange; Na+/H+ exchange; Gd3+
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Introduction
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In neurons of the mammalian CNS, anoxia and ischemia lead to early changes in internal ion homeostasis that are important determinants of subsequent injury and death. Although the contribution of changes in intracellular Ca2+ (Ca2+i) has received particular attention, notably within the framework of the excitotoxic model of injury, early increases in intracellular Na+ (Na+i) also occur and contribute to the pathophysiology of neuronal death (Lipton, 1999 ; Martinez-Sánchez et al., 2004 ). Sodium influx increases the demand for cellular ATP to maintain the Na+ gradient (Chinopoulos et al., 2000 ) and may contribute to neuronal injury by promoting, for example, the following: membrane depolarization (Haddad and Jiang, 1993 ; Calabresi et al., 1999 ), neuronal swelling (Goldberg and Choi, 1993 ; Chidekel et al., 1997 ), reverse-mode glutamate reuptake (Roettger and Lipton, 1996 ), cytosolic Ca2+ accumulation via reverse-mode Na+/Ca2+ exchange and/or impaired mitochondrial Ca2+ uptake (Zhang and Lipton, 1999 ; Breder et al., 2000 ; Czy et al., 2002 ), Na+i-dependent increases in NMDA receptor-mediated responses (Yu and Salter, 1998 ; Manzerra et al., 2001 ), and the activation of second-messenger pathways (Cooper et al., 1998 ; Hayasaki-Kajiwara et al., 1999 ).
Although the detrimental effects of Na+ entry are recognized, in contrast to non-neuronal cell types (e.g., cardiac myocytes) (Carmeliet, 1999 ), the mechanisms that mediate Na+ influx in response to anoxia or ischemia in mammalian central neurons remain relatively poorly defined. Although Na+ entry attributable to the activation of ionotropic glutamate receptors has received some attention, with conflicting results (cf. Pisani et al., 1998 ; Chen et al., 1999 ; Müller and Somjen, 2000 ; LoPachin et al., 2001 ), glutamate-mediated excitotoxicity cannot fully account for the direct actions of anoxia or ischemia on neurons, and the potential contribution from mechanisms integral to neurons (i.e., independent from glutamate receptor activation and changes in the external microenvironment) to Na+ influx during anoxia or ischemia has not been systematically addressed. Furthermore, despite indications that continued Na+ influx after reperfusion may be as damaging as Na+ entry during anoxia or ischemia (Lipton, 1999 ), the pathways that mediate Na+ influx after anoxia or ischemia have not been well characterized, and it remains unknown whether these pathways might differ from those active during an insult, as reported for Ca2+ (Silver and Ereci ska, 1990 , 1992 ).
We have therefore undertaken an assessment of the intrinsic mechanisms that contribute to Na+ influx during and immediately after 5 min anoxia in cultured postnatal rat hippocampal neurons. We find not only that Na+ influx during and after anoxia is positively related to the length of time that neurons are maintained in culture but also that different pathways are involved during, compared with immediately after, anoxia.
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Materials and Methods
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Cell preparation. Primary cultures of hippocampal neurons from 2- to 4-d-old postnatal Wistar rats (Animal Care Centre, University of British Columbia) were prepared as described previously (Diarra et al., 2001 ). Briefly, rat pups were anesthetized and decapitated, and the hippocampi were removed. The hippocampi were enzymatically and mechanically dissociated, and the resulting cell suspension was plated at a density of 5-8 x 105 neurons/cm2 onto glass coverslips coated with poly-D-lysine and laminin. The initial growth medium was DMEM/F-12 (Invitrogen Canada, Burlington, Ontario, Canada) supplemented with 10% fetal bovine serum. After 24 hr, this medium was fully changed to serum-free Neurobasal medium A. Cultures were fed every 4-5 d by half-changing the existing medium with fresh Neurobasal medium A. Glial proliferation was inhibited 48 hr after initial plating by adding 5-10 µM cytosine arabinoside.
Solutions and test compounds. The majority of experiments were performed under nominally -free, HEPES-buffered conditions. Standard -free perfusion medium contained (mM) 136.5 NaCl, 3 KCl, 2 CaCl2, 1.5 NaH2PO4, 1.5 MgSO4, 10 D-glucose, and 10 HEPES and was titrated with 10 M NaOH to pH 7.35 at 37°C. In standard -buffered medium, HEPES was isosmotically replaced by NaCl and solutions contained 19.5 mM NaHCO3, by equimolar substitution for NaCl, together with the constituents listed above (pH 7.35 at 37°C after equilibration with 5% CO2/95% air); during perfusion with -buffered media, the atmosphere in the recording chamber contained 5% CO2/95% air. When external Na+ was reduced to 2-4 mM, N-methyl-D-glucamine (NMDG+) was used as a substitute, and solutions were titrated to pH 7.35 (37°C) with 10 M HCl. For Ca2+-free media, CaCl2 was omitted, [Mg2+] was increased to 3.5 mM, and 200 µM EGTA was added. In solutions containing Zn2+, Gd3+, or Ni2+, NaH2PO4 was omitted and MgSO4 was replaced with MgCl2. All experiments were performed at 37°C, and neurons were continuously superfused at a rate of 2 ml/min; unless noted otherwise, extracellular pH (pHo) was 7.35.
As described previously (Diarra et al., 2001 ), media used to calibrate sodium-binding benzofuran isophthalate (SBFI)-derived fluorescence ratio measurements contained 0.6 mM MgCl2, 0.5 mM CaCl2, 10 mM HEPES, 130 mM [Na+] plus [K+], 100 mM gluconate, 30 mM Cl-, and 4 µM gramidicin D, titrated with 10 M KOH to pH 7.35. In experiments in which seminaphthorhodafluor (SNARF) pH indicators were used, SNARF-derived fluorescence ratio measurements were calibrated with media containing the same components as the standard HEPES-buffered medium, except for the substitution of K gluconate (130.5 mM) and Na gluconate (9 mM) for NaCl and KCl and the addition of 10 µM nigericin (Sheldon et al., 2004 ).
Test compounds were obtained from Sigma-Aldrich Canada (Oakville, Ontario, Canada), with the exception of the Rp isomer of adenosine-3',5'-cyclic monophosphorothioate (Rp-cAMPS) (Biolog Life Science Institute, La Jolla, CA); arachidonyltrifluoromethyl ketone (AACOCF3) (Calbiochem, San Diego, CA); and (5S, 10 R)-(+)-5-methyl-10,11-dihydro-5H-dibenzo[a,d]cyclohepten-5,10-imine maleate (MK-801), 6-cyano-7-nitroquinoxaline-2,3-dione (CNQX), and 2-[2-[4-(4-nitrobenzyloxy)phenyl]ethyl]isothiourea mesylate (KBR7943) (all from Tocris Cookson, Ellisville, MO).
Induction of anoxia. Anoxia was induced by the addition of 1-2 mM sodium dithionite, an O2 scavenger, to the superfusing medium. Solutions containing Na2S2O4 were prepared immediately before use and bubbled with either 100% Ar (HEPES-buffered media) or 5% CO2/95% Ar ( -buffered media); during perfusion with these media, the atmosphere in the recording chamber was switched to 100% Ar or 5% CO2/95% Ar, respectively. We have previously reported that media containing 1-2 mM Na2S2O4 have PO2 values <1 mmHg and that the changes in pHi evoked by anoxia in rat hippocampal neurons are not secondary to any additional properties of the O2 scavenger (Diarra et al., 1999 ; Sheldon and Church, 2002 ). In the present study, we assessed the possibility that Na2S2O4 may induce changes in [Na+]i via mechanisms unrelated to its O2 scavenging property in two ways. First, solutions containing 1-2 mM Na2S2O4 were bubbled vigorously with air for 20-30 min, which elevated the PO2 in these solutions from <1 to 152 ± 6 mmHg (n = 5), as measured with an oxygen electrode (ISO2; World Precision Instruments, Sarasota, FL). The increase in [Na+]i observed during a 5 min exposure to media containing 1-2 mM Na2S2O4 equilibrated with air was 3 ± 1 mM (n = 7), significantly (p < 0.05) less than the 23 ± 3 mM (n = 23) increase observed in age-matched sister neurons exposed to media also containing 1-2 mM Na2S2O4 but equilibrated with 100% Ar (see Fig. 1 A). Second, standard HEPES-buffered medium was bubbled vigorously with ultra-pure Ar for >18 hr, reducing PO2 in the medium to <1 mmHg (Sheldon and Church, 2002 ). The increases in [Na+]i observed during a 5 min exposure to this medium were similar to those measured in age-matched neurons when PO2 was reduced to <1 mmHg by the addition of sodium dithionite (see Fig. 1 B). Thus, the [Na+]i changes evoked by exposure to media containing 1-2 mM Na2S2O4 primarily reflect reductions in PO2.
Microspectrofluorimetry. The AM ester forms of the Na+-sensitive fluorophore SBFI and the pH-sensitive fluorophores carboxy SNARF-1 and SNARF-5F were obtained from Molecular Probes (Eugene, OR). Neurons were incubated with 10 µM SBFI-AM (in the presence of 0.1% Pluronic F-127 and 5 mg/ml bovine serum albumin) for 120-180 min at 32°C. In experiments in which [Na+]i and pHi were measured concurrently (see below), SBFI-loaded neurons were incubated with 10 µM carboxy SNARF-1-AM or SNARF-5F-AM in the presence of 0.1% Pluronic F-127 for 30 min at 32°C. After dye loading, coverslips with cells attached were placed in standard HEPES-buffered medium for 20 min and then mounted in a temperature-controlled recording chamber. Neurons were superfused for 15 min with the initial experimental solution at 37°C before the start of an experiment.
In the majority of experiments, cells were loaded only with SBFI, and measurements of [Na+]i were performed using the dual-excitation ratio method using an imaging system (Atto Bioscience, Rockville, MD) in conjunction with an Axiovert 135 epifluorescence microscope (Carl Zeiss Canada, Don Mills, Ontario, Canada). As described by Diarra et al. (2001 ), fluorescence emissions (at >510 nm) were measured by a single intensified charge-coupled device camera from regions of interest placed on individual neuronal somata. Raw emission intensity data at each excitation wavelength (334 and 380 nm) were corrected for background fluorescence before the calculation of a ratio. Ratio pairs were acquired at 2-15 sec intervals and analyzed off-line. A one-point calibration technique was used to convert background-corrected SBFI ratio values (BI334/BI380) into [Na+]i values as described previously (Diarra et al., 2001 ). In brief, at the end of an experiment, neurons loaded with SBFI were exposed to a pH 7.35 medium containing 10 mM Na+ and 4 µM gramicidin D, and the resulting background-corrected ratio value at 10 mM [Na+]i was used as a normalization factor for experimentally derived BI334/BI380 ratio values. Parameters used for the calculation of [Na+]i values were derived from full in situ calibration experiments in which neurons were exposed sequentially to media containing eight different [Na+] values (Diarra et al., 2001 ).
In a number of experiments, carboxy SNARF-1 and SNARF-5F were used to measure pHi concurrently with changes in [Na+]i. In neurons coloaded with SBFI and a SNARF-based fluorophore, ratio pairs were collected continuously by alternating between the dual-excitation and dual-emission modes [for technical details and validation of the technique, see Sheldon et al. (2004 )]. In brief, SBFI-derived fluorescence emission intensities were measured with a single camera at 550 nm during excitation at 334 nm and then at 380 nm; the excitation wavelength was then changed to 488 nm, and SNARF-derived fluorescence emissions were split by a dichroic mirror centered at 605 nm and measured by two separate cameras at 550 and 640 nm. Camera registration was confirmed before every experiment. To convert background-corrected, SNARF-derived ratio values (BI550/BI640) into pHi, neurons loaded with a SNARF derivative were exposed at the end of an experiment to a pH 7.00 high-[K+] medium containing 10 µM nigericin, and the resulting background-corrected ratio value at pHi 7.00 was used as a normalization factor for experimentally derived BI550/BI640 ratio values. The constants required to convert experimentally derived BI550/BI640 ratio values into pHi values were determined in full calibration experiments as described previously (Sheldon et al., 2004 ).
To limit potential cross-contamination by ionophores, perfusion lines were replaced, and the imaging chamber was decontaminated after each experiment.
Data analysis. The magnitude of the increase in [Na+]i during 5 min anoxia ( [Na+]i(during)) was measured as the difference between the resting [Na+]i value before anoxia and the peak [Na+]i value reached during anoxia (see Fig. 1 A). To characterize the Na+ influx pathways active immediately after anoxia, neurons were exposed to 5 min anoxia and, after the return to normoxia, Na+,K+-ATPase activity was inhibited for 7 min by exposure to K+-free medium or the application of 500 µM ouabain, as described by van Emous et al. (1998 ). The magnitude of the increase in [Na+]i after anoxia under these conditions ( [Na+]i(after)) was measured as the difference between the [Na+]i value observed at the end of 5 min anoxia and the [Na+]i value observed at the end of the 7 min exposure to 0 [K+]o or 500 µM ouabain (see Fig. 5A). In experiments in which changes in pHi and [Na+]i during and after anoxia were measured concurrently, the magnitude of the fall in pHi during anoxia was measured as the difference between the pHi value at the end of 5 min anoxia and the preanoxic pHi value (see Fig. 8 A), and the magnitude of the increase in pHi after anoxia (Na+,K+-ATPase inhibited) was measured as the difference between the pHi value at the end of 5 min anoxia and the pHi value at the end of 7 min exposure to 0 [K+]o (see Fig. 8 B).

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Figure 8. Anoxia-evoked changes in pHi and [Na+]i in rat hippocampal neurons coloaded with SBFI and SNARF-5F. A, Anoxia induced an increase in [Na+]i ( ) and a fall in pHi ( ), both of which recovered toward resting values after the return to normoxia. B, Inhibition of Na+,K+-ATPase activity (perfusion with K+-free medium) for 7 min after anoxia failed to influence the postanoxic rise in pHi ( ) but revealed an additional increase in [Na+]i ( ). C, During 5 min anoxia imposed in the presence of external Na+, [Na+]i ( ) increased and pHi ( ) fell. Immediately after anoxia, neurons were superfused with K+- and Na+-free medium (pHo constant at 7.35). Reducing Na+o (NMDG+ substitution) for the period indicated by the short bar above the records prevented the increases in pHi and [Na+]i seen after anoxia in the presence of normal Na+o (compare with B). After the return to normal Na+o (in the continued absence of external K+; arrow), both pHi and [Na+]i increased. D, Measured in 20 neurons maintained for 7-10 DIV and coloaded with SBFI and SNARF-5F, rates at which [Na+]i ( ) and pHi ( ) increased immediately after anoxia (Na+,K+-ATPase inhibited) exhibited an inverse dependence on absolute pHi values. Similar results were observed in 11-14 DIV neuronal cultures (E; n = 10). In D and E, rates at which pHi and [Na+]i increased after anoxia under K+o-free conditions were determined by fitting the pHi and [Na+]i records to single exponential functions; the first derivatives of these functions were used to determine rates of pHi and [Na+]i increase at 0.05 pH unit and 5 mM intervals, respectively. The pHi values at which rates of [Na+]i increase were measured were determined from obtained curve-fitted parameters.
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In light of the findings that the magnitudes of the changes in [Na+]i both during and after anoxia were related to the length of time that neurons had been maintained in culture (see Results), experiments were performed routinely on cultures maintained for 6-10 d in vitro (DIV) and, where noted, were repeated using 11-14 DIV neuronal cultures. In both groups, measurements of anoxia-evoked changes in [Na+]i observed under a given test condition were normalized to measurements made under control conditions in age-matched sister neurons (yielding normalized [Na+]i(during) and [Na+]i(after) values) (Tables 1, 2). Student's two-tailed unpaired t tests were used to compare statistically the absolute (i.e., not normalized) [Na+]i(during) and [Na+]i(after) measurements made under a given test condition to the respective measurements made in age-matched sister neurons under control conditions; significance was assumed at the 5% level.
Data are reported as means ± SEM, with the accompanying n value referring to the number of neuronal populations (i.e., coverslips) from which data were obtained. In studies in which neurons were coloaded with SBFI and either carboxy SNARF-1 or SNARF-5F, experiments were performed on at least three (usually more than five) coverslips obtained from at least three (usually more than four) different batches of neuronal cultures, and the accompanying n value refers to the number of neurons from which data were analyzed.
Intracellular ATP measurements. Cellular ATP content was determined from luciferin-luciferase luminescence, using the ATP determination kit (Molecular Probes). Anoxia was induced in neuronal cultures under conditions identical to those used for the great majority of the microspectrofluorimetric studies (i.e., conditions of constant superfusion at 37°C, pHo 7.35). Before and at fixed time points during and after anoxia, neurons were lysed by the addition of 40 µl of 10 mM Tris buffer, pH 7.5, 0.1 M NaCl, 1 mM EDTA, and 0.01% Triton X-100 in the presence of a protease inhibitor mixture (Roche Diagnostics, Laval, Quebec, Canada). Aliquots (10 µl) were then removed, and sample luminescence was detected with a Berthold LB9507 Lumat luminometer (Fisher Scientific, Ottawa, Ontario, Canada). ATP measurements were made in triplicate on a minimum of four samples at each time point and are reported as percentage declines compared with measurements made before anoxia in paired samples.
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Results
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Changes in [Na+]i during 5 min anoxia
Characterization of baseline response
Before anoxia, resting [Na+]i was 11 ± 1 mM (n = 444), a value similar to those reported previously in mammalian central neurons both in culture (Rose and Ransom, 1997 ; Chen et al., 1999 ; Diarra et al., 2001 ) and in slice preparations (Pisani et al., 1998 ; Calabresi et al., 1999 ). Five-minute anoxia evoked an increase in [Na+]i that began 90 sec after the start of anoxia and recovered to resting levels within 6-10 min of the return to normoxia (Fig. 1A). As illustrated in Figure 1B, there was a positive correlation between the magnitude of the increase in [Na+]i observed during anoxia and the length of time neurons had been maintained in culture. The increases in [Na+]i seen during anoxia are broadly consistent with those observed previously in a variety of mammalian central neurons in response to anoxia or oxygen-glucose deprivation in vitro (Friedman and Haddad, 1994 ; Pisani et al., 1998 ; Calabresi et al., 1999 ; Diarra et al., 2001 ) and in CA1 neurons in response to 8 min global ischemia in vivo (Ereci ska and Silver, 2001 ). When anoxia was imposed under reduced [Na+]o, NMDG+-substituted conditions, the increase in [Na+]i was prevented (n = 8) (Fig. 1C), indicating a requirement for Na+ entry. In neurons maintained for either 6-10 or 11-14 DIV, ionotropic glutamate receptor activation did not contribute to the increase in [Na+]i induced by anoxia under the constant superfusion conditions of the present experiments (supplemental Fig. 1, available at www.jneurosci.org as supplemental material).
Consistent with previous findings that the maintenance of resting [Na+]i in rat hippocampal neurons reflects a balance between Na+,K+-ATPase activity and Na+ influx driven by a steep inward electrochemical gradient for Na+ (Rose and Ransom, 1997 ), 5 min applications of K+-free medium or 500 µM ouabain under normoxic conditions evoked increases in [Na+]i of 26 ± 5 and 27 ± 4 mM, respectively (n = 6 neuronal cultures at 6-10 DIV in each case) (Fig. 2A). The accumulation of Na+i in neurons during anoxia also reflects a balance between reduced Na+,K+-ATPase activity and ongoing/increased Na+ influx. In the present experiments, increases in [Na+]i during anoxia occurred at times at which ATP levels were reduced; after 3 min anoxia, internal ATP had fallen by 66 ± 7%, with an additional decrease to 24 ± 8% of preanoxic values at the end of 5 min anoxia (Fig. 2B). When neuronal cultures were incubated with 10 mM creatine for 2 hr to increase intracellular phosphocreatine levels (Balestrino et al., 2002 ), the fall in ATP observed after 3 min anoxia under control conditions was attenuated (Fig. 2B) (Sheldon and Church, 2004 ) and the increase in [Na+]i observed at this time was reduced by 55% compared with that seen in age-matched sister neurons not pretreated with creatine (Fig. 2C). Creatine pretreatment failed to significantly limit either the fall in internal ATP (Fig. 2 B) or the increase in [Na+]i (Fig. 2C) seen after 5 min anoxia. For each of these experimental series, qualitatively similar effects were observed in neurons maintained for 11-14 DIV.

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Figure 2. Contribution of reduced Na+,K+-ATPase activity to the increase in [Na+]i during anoxia. A, Superimposed records of the changes in [Na+]i observed under normoxic conditions in response to 5 min exposures to either K+-free medium ( ) or normal medium (3 mM K+) containing 500 µM ouabain ( ), as indicated by the bar above the traces. B, Internal ATP levels were determined after 3 and 5 min anoxia induced by exposure to sodium dithionite-containing medium in 6-10 DIV neurons under control conditions ( ) or after pretreatment with 10 mM creatine for 2 hr ( ). In each experimental group, ATP levels were normalized to preanoxic measurements made in age-matched sister neuronal cultures. The fall in internal ATP levels evoked by 3 min, but not 5 min, anoxia under control conditions was significantly attenuated by creatine pretreatment (*p < 0.05). The numbers in parentheses indicate the number of neuronal populations examined under each experimental condition. C, In neurons pretreated with 10 mM creatine for 2 hr ( ), the increase in [Na+]i measured 3 min after the start of anoxia was significantly less than that observed under control conditions ( ; *p < 0.05; n = 6 neuronal cultures at 6-10 DIV in each case). The increases in [Na+]i measured after 5 min anoxia under control conditions and in creatine-treated, age-matched sister neurons were not significantly different (p = 0.57).
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Together, these results indicate that the increase in [Na+]i during anoxia under the present experimental conditions reflects reduced Na+,K+-ATPase activity in the face of an ongoing/increased entry of Na+ ions that is not dependent on ionotropic glutamate receptor activation. Therefore, in subsequent experiments, we were able to assess the role of pathways intrinsic to hippocampal neurons in Na+ influx during anoxia.
Voltage-activated Na+ channels
In whole-cell recordings obtained using the perforated patch (amphotericin B) configuration, the resting membrane potential of cultured postnatal rat hippocampal neurons before anoxia was -63 ± 2 mV, and 5 min anoxia evoked a depolarization of 24 ± 4 mV (n = 6), similar to depolarizations observed by others in a variety of isolated mammalian central neurons in response to 5 min anoxia (Haddad and Jiang, 1993 ) or 30 min metabolic inhibition (Aarts et al., 2003 ). However, although 1 µM tetrodotoxin (TTX) reduced the increases in [Na+]i evoked by 60 sec applications of 50 mM K+o under normoxic conditions from 14 ± 3 to 2 ± 1 mM (n = 6; p < 0.05) (Rose and Ransom, 1997 ), it failed to affect the magnitudes of anoxia-induced increases in [Na+]i in neurons maintained for either 6-10 or 11-14 DIV (Table 1, Fig. 3A). Lidocaine (250 µM) also failed to significantly affect the rise in [Na+]i during anoxia (Table 1, Fig. 3A), suggesting that TTX-resistant Na+ channels do not contribute to Na+ influx at this time.

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Figure 3. Contribution of voltage-activated Na+ channels, Na+/Ca2+ exchange, and Na+/K+/2Cl- cotransport to the increase in [Na+]i during anoxia. Shown are superimposed records of the changes in [Na+]i observed in response to 5 min anoxia imposed in age-matched sister neurons under control conditions ( ) and in the presence of an experimental treatment (open symbols); pharmacological inhibitors were present throughout the duration of the traces shown. A, Neither 1 µM TTX nor 250 µM lidocaine affected the increase in [Na+]i during anoxia. B, Neither 1 µM KB-R7943 nor 50 µM bepridil exerted a significant effect on the increase in [Na+]i during anoxia. C, A concentration of 100 µM bumetanide significantly reduced the rise in [Na+]i during anoxia in 14 DIV neurons. See also Table 1.
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Plasmalemmal Na+/Ca2+ exchange and Na+/K+/2Cl- cotransport
Although the increase in [Ca2+]i observed in cultured postnatal rat hippocampal neurons during 5 min anoxia (Diarra et al., 1999 ) could activate forward-mode Na+/Ca2+ exchange and thereby contribute to Na+ influx, a rise in [Na+]i could promote reverse-mode operation of the exchanger and thus Na+ efflux. Forward- and reverse-mode operation of the plasmalemmal Na+/Ca2+ exchanger can be inhibited with bepridil (50 µM) and KB-R7943 (1 µM), respectively, whereas higher concentrations of KB-R7943 (10 µM) inhibit both forward and reverse Na+/Ca2+ exchange in rat hippocampal neurons (Breder et al., 2000 ). In the present study, neither bepridil (50 µM) nor KB-R7943 (1 or 10 µM) significantly influenced the magnitude of the increase in [Na+]i during anoxia (Table 1, Fig. 3B). 7-Chloro-5-(2-chlorophenyl)-1,5-dihydro-4,1-benzothiazepin-2(3H)-one (CGP-37157) (25 µM), which has been reported to inhibit both mitochondrial and plasmalemmal Na+/Ca2+ exchange (Blaustein and Lederer, 1999 ; Czy and Kiedrowski, 2003 ), or the removal of external Ca2+ similarly failed to modulate the increase in [Na+]i during anoxia (Table 1).
To assess the potential contribution of Na+/K+/2Cl- cotransport, neurons were pretreated for 10 min with 100 µM bumetanide, which has previously been found to inhibit Na+/K+/2Cl- cotransport in cultured rat cortical neurons (Sun and Murali, 1999 ). Given that Na+/K+/2Cl- cotransporter expression increases with time in rat brain (Plotkin et al., 1997 ) and in cultured neurons (Sun and Murali, 1999 ), the effects of bumetanide were examined in 6-10 and 11-14 DIV neurons. Bumetanide did not affect resting [Na+]i in either 6-10 (n = 5) or 11-14 (n = 9) DIV neurons (Rose and Ransom, 1997 ) and failed to significantly influence the increase in [Na+]i during anoxia in 6-10 DIV neurons (Table 1). In contrast, in 11-14 DIV neurons, bumetanide caused an 40% reduction in the rise in [Na+]i during anoxia (Table 1, Fig. 3C). Although 100 µM bumetanide may inhibit exchange and K+/2Cl- cotransport (Russell, 2000 ), there are no indications that these mechanisms contribute to changes in Na+i homeostasis during brief periods of anoxia or ischemia (Diarra et al., 1999 ; Sheldon and Church, 2002 ; Payne et al., 2003 ).
pHi-regulating mechanisms
Proton-equivalent efflux by the major acid extrusion mechanisms present in rat hippocampal neuron somata, Na+/H+ exchange, and Na+-dependent exchange (Raley-Susman et al., 1991 ; Schwiening and Boron, 1994 ; Baxter and Church, 1996 ) is accompanied by Na+ influx (Canzoniero et al., 1996 ; Rose and Ransom, 1997 ; Sheldon et al., 2004 ).
In the absence of a selective pharmacological inhibitor of Na+/H+ exchange in rat hippocampal neurons (Raley-Susman et al., 1991 ; Schwiening and Boron, 1994 ; Baxter and Church, 1996 ), the transport mechanism was inhibited with harmaline, a nonselective agent that has previously been found to inhibit not only functional Na+/H+ exchange activity in rat hippocampal neurons (Raley-Susman et al., 1991 ) but also the activities of the Na+/H+ exchanger (NHE) isoforms likely to mediate this activity under conditions of normal osmolarity (i.e., NHE1 and NHE5) (Orlowski, 1993 ; Attaphitaya et al., 1999 ; Szabó et al., 2000 ; Douglas et al., 2001 ). Initially, we confirmed that pretreatment with 200 µM harmaline inhibited Na+/H+ exchange activity under our experimental conditions by measuring rates of pHi recovery from NH4+-induced internal acid loads imposed under normoxic nominally -free, HEPES-buffered conditions (see Fig. 7A, inset). However, consistent with previous suggestions (made on the basis of pHi measurements) that Na+/H+ exchange activity in rat hippocampal neurons becomes inhibited soon after the onset of anoxia (Diarra et al., 1999 ; Sheldon and Church, 2004 ), harmaline pretreatment failed to limit the rise in [Na+]i during 5 min anoxia in either 6-10 or 11-14 DIV neurons (Table 1).

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Figure 7. Effects of maneuvers that modulate Na+/H+ exchange activity on increases in [Na+]i after anoxia (Na+,K+-ATPase inhibited). A, At the end of 5 min anoxia, neurons were exposed to K+-free medium for 7 min. Compared with the increase in [Na+]i seen under control conditions ( ), the increase in [Na+]i after anoxia was reduced by 60 min pretreatment with 200 µM harmaline ( ). Inset, Rates of pHi recovery from internal acid loads imposed under nominally -free, HEPES-buffered normoxic control conditions ( ; n = 10) or after 60 min pretreatment with 200 µM harmaline ( ; n = 6). Harmaline pretreatment reduced rates of pHi recovery, consistent with inhibition of Na+/H+ exchange activity. B, Compared with the [Na+]i changes evoked by 5 min anoxia under control conditions ( ), the increase in [Na+]i after anoxia in age-matched sister neurons was augmented by exposure to 100 µM Zn2+ ( ). Exposure to Zn2+ began immediately after the end of 5 min anoxia and continued for the duration of the record shown. C, Summary of the effects of maneuvers that modulate Na+/H+ exchange activity on the increase in [Na+]i after anoxia in 6-10 and 11-14 DIV neurons. The asterisk indicates statistical significance (p < 0.05) compared with measurements made in age-matched sister neurons under control conditions.
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The potential contribution of -dependent mechanisms to anoxia-induced increases in [Na+]i was examined by measuring changes in [Na+]i during anoxia under -containing conditions. As reported previously (Rose and Ransom, 1997 ), the transition from a -free, HEPES-buffered medium to a -buffered medium (pHo constant at 7.35) caused a small ( 3 mM) increase in [Na+]i, consistent with the activation of Na+-dependent exchange. However, the increases in [Na+]i during 5 min anoxia imposed in the presence of were not significantly different from those observed in age-matched sister neurons at 6-10 or 11-14 DIV under -free conditions (Table 1). In addition, the application of 200 µM DIDS under -buffered conditions failed to limit the rise in [Na+]i during anoxia (Table 1), further suggesting that -dependent, pHi-regulating transport mechanisms do not contribute significantly to the increase in [Na+]i during anoxia in rat hippocampal neurons.
Nonselective cation channels
During anoxia or ischemia, increases in [Ca2+]i or free radical production can activate nonselective cation channels (NSCCs) that in turn may contribute to the pathogenesis of injury (Chen et al., 1999 ; Barros et al., 2001 ; Aarts et al., 2003 ). To examine the contribution of Na+ influx through NSCCs to the rise in [Na+]i during anoxia, we applied Gd3+ (Caldwell et al., 1998 ).
Five to 20 min exposures to 30 or 100 µM Gd3+ did not affect resting [Na+]i but reduced the magnitude of the increase in [Na+]i during anoxia in 6-10 DIV neurons by 40% (Fig. 4A,B). The finding presented above that the increase in [Na+]i during anoxia was not attenuated in the absence of external Ca2+ suggests that the effect of Gd3+ is unlikely to be mediated via an inhibition of NSCCs activated by increases in [Ca2+]i (we were unable to assess the effect of flufenamate, an inhibitor of Ca2+i-activated NSCCs, on the increase in [Na+]i during anoxia because it evoked variable increases in resting [Na+]i). In addition, neither the broad spectrum voltage-activated Ca2+ channel blocker Ni2+ nor the L-type Ca2+ channel blockers verapamil and nifedipine significantly influenced the increase in [Na+]i during anoxia (Fig. 4B). CNQX (20 µM), applied alone (supplemental Fig. 1, available at www.jneurosci.org as supplemental material) or in the presence of the broad spectrum high-voltage-activated Ca2+ channel blocker loperamide (50 µM) (Church et al., 1994 ) (Fig. 4B), also failed to influence the increase in [Na+]i during anoxia. Together, these findings indicate that the effect of Gd3+ to limit Na+ influx during anoxia is likely independent of its ability to block voltage-activated Ca2+ channels (Boland et al., 1991 ) or AMPA/kainate receptors (Lei and MacDonald, 2001 ) (see also Caldwell et al., 1998 ).
To examine the potential role of NSCCs activated by reactive oxygen species (ROS) in the effect of Gd3+ to reduce Na+ influx during anoxia, neurons were treated with the antioxidant 6-hydroxy-2,5,7,8-tetramethylchroman-2-carboxylate (trolox) for 2-3 hr before anoxia. After pretreatment with 1 mM trolox (Chow et al., 1994 ; Brookes et al., 1998 ; Vergun et al., 2001 ; Aarts et al., 2003 ), the magnitude of the increase in [Na+]i during anoxia in 6-10 DIV neurons was reduced by 40% (Fig. 4C). Pretreatment with 200 µM trolox elicited similar effects in both 6-10 DIV neurons (Fig. 4D) and 11-14 DIV neurons (the normalized [Na+]i(during) value after pretreatment with 200 µM trolox in 11-14 DIV neurons was 0.51 ± 0.18; n = 4; p < 0.05). In neurons pretreated with trolox, Gd3+ failed to exert an additional inhibitory effect (Fig. 4C,D), supporting the possibility that NSCCs activated by ROS may contribute to Na+ influx during anoxia. However, neither 20 min pretreatment with 500 µM NG-nitro-L-arginine methyl ester hydrochloride (L-NAME) or 15-30 µM AACOCF3 significantly affected the increase in [Na+]i (Fig. 4D), suggesting a lack of involvement of nitric oxide synthase (NOS) and cytosolic phospholipase A2 (cPLA2), respectively, in the generation of the ROS involved. We were unable to examine the potential effects of manganese (III) tetrakis (4-benzoic acid) porphyrin (an scavenger) or mepacrine (a non-specific PLA2 inhibitor), which were highly fluorescent during excitation at both 334 and 380 nm.
Changes in [Na+]i immediately after 5 min anoxia
Characterization of baseline response
The rise in [Na+]i observed during 5 min anoxia recovered rapidly to resting levels after the return to normoxia (Fig. 1A), presumably reflecting the resumption of Na+,K+-ATPase activity (Ekholm et al., 1993 ). In the present experiments, internal ATP levels 5 min after the return to normoxia increased by 33% (n = 4) from those measured at the end of 5 min anoxia. In addition, inhibition of Na+,K+-ATPase activity (K+o-free conditions for 7 min, starting at reoxygenation) prevented the recovery of [Na+]i seen under control conditions and revealed a secondary increase in [Na+]i that, as for the increase in [Na+]i during anoxia, was positively related to the length of time neurons had been maintained in culture (Fig. 5A,B). Similar results were observed when 500 µM ouabain was used to inhibit Na+,K+-ATPase after anoxia (Fig. 5B). When Na+,K+-ATPase activity was reestablished by perfusion with standard medium containing 3 mM K+, [Na+]i recovered to preanoxic resting values (Fig. 5A). The secondary increase in [Na+]i observed during Na+,K+-ATPase inhibition after anoxia was blocked when NMDG+ was substituted for external Na+ (n = 4) (Fig. 5A). Together, these results indicate that, in the period immediately after 5 min anoxia, Na+,K+-ATPase activity acts to lower [Na+]i to resting levels despite continued Na+ entry. The positive relationship between the rise in [Na+]i (Na+,K+-ATPase blocked) after anoxia and the length of time that neurons had been maintained in culture could reflect, for example, developmental upregulation of the pathways that contribute to Na+ influx after anoxia (see below) or the intracellular signaling cascades that regulate their activities (Durkin et al., 1997 ). In subsequent experiments, to characterize the pathways that contribute to Na+ influx after 5 min anoxia, Na+,K+-ATPase was blocked for 7 min immediately after the return to normoxia (van Emous et al., 1998 ).
Ionotropic glutamate receptor-operated and voltage-activated Na+ channels
Analogous to findings made during anoxia, 2 µM MK-801 and 20 µM CNQX failed to significantly affect the increase in [Na+]i observed after anoxia under conditions of Na+,K+-ATPase inhibition (supplemental Fig. 1, available at www.jneurosci.org as supplemental material). Similarly, 1 µM TTX failed to reduce the increase in [Na+]i after anoxia in 6-10 and 11-14 DIV neurons (Table 2). TTX (100 µM) and lidocaine (250 µM) were also without significant effects in 6-10 and 11-14 DIV neurons, respectively (Table 2), suggesting that TTX-resistant Na+ channels do not contribute to Na+ influx in the immediate postanoxic period.
Na+/K+/2Cl- cotransport and plasmalemmal Na+/Ca2+ exchange
In contrast to findings made in 11-14 DIV neurons during anoxia (Table 1), 100 µM bumetanide failed to significantly reduce the increase in [Na+]i after anoxia in either 6-10 or 11-14 DIV neuronal cultures (Table 2). The tendency for bumetanide to augment the rise in [Na+]i after anoxia in 11-14, but not 6-10, DIV hippocampal neurons (Table 2) may reflect the finding in cardiac myocytes that Na+/K+/2Cl- cotransport contributes to Na+ efflux at reperfusion (Anderson et al., 1996 ).
Na+/Ca2+ exchange, operating in forward mode, may mediate Ca2+ efflux after anoxia or ischemia (Breder et al., 2000 ) and thereby contribute to Na+ influx at this time. Conversely, the present experimental conditions (in which [Na+]i after anoxia was maintained at a relatively high level) could favor reverse-mode operation of the exchange mechanism and thus Na+ efflux (Czy et al., 2002 ). Applied immediately after anoxia under conditions in which Na+,K+-ATPase was inhibited, 50 µM bepridil significantly reduced the increase in [Na+]i (Table 2, Fig. 6), suggesting that forward-mode Na+/Ca2+ exchange contributes to Na+ influx immediately after anoxia. In contrast, KB-R7943 (1 µM) or the removal of external Ca2+ at reoxygenation enhanced the increase in [Na+]i (Table 2, Fig. 6), suggesting that some Na+/Ca2+ exchangers may be operating in reverse mode to promote Na+ efflux at this time. Finally, when applied at 10 µM to inhibit both forward- and reverse-mode Na+/Ca2+ exchange, KB-R7943 reduced the increase in [Na+]i after anoxia compared with the increase observed in age-matched sister neurons under control conditions (Table 2, Fig. 6). Together, these results are consistent with those of White and Reynolds (1995 ), who reported considerable variability in the contribution of forward-mode Na+/Ca2+ exchange to the recovery of [Ca2+]i after glutamate stimulation in rat forebrain neurons, and those of Yu and Choi (1997 ), who suggested the possibility that both forward and reverse Na+/Ca2+ exchange can take place concurrently in the same cell. These issues are considered further in Discussion.
Na+/H+ exchange
Although Na+/H+ exchange in rat hippocampal neurons is inhibited during anoxia, pHi measurements indicate that the transporter is activated immediately after reoxygenation (Diarra et al., 1999 ; Sheldon and Church, 2002 ) and thus may contribute to Na+ influx at this time. Consistent with this possibility, harmaline pretreatment significantly reduced the increase in [Na+]i after anoxia in 6-10 and 11-14 DIV neurons (Fig. 7A,C). Although harmaline also affects voltage-gated Na+ channels (Deecher et al., 1992 ) and Na+,K+-ATPase (Kim et al., 1988 ), conventional inhibitors of voltage-gated Na+ channels failed to influence the rise in [Na+]i after anoxia (see above), and harmaline reduced Na+ entry after anoxia under conditions in which Na+,K+-ATPase activity was already blocked. Intracellular pH measurements also indicate that Na+/H+ exchange activity in rat hippocampal neurons after anoxia is attenuated at pHo 6.60 or by inhibition of the cAMP-protein kinase A (PKA) pathway and is augmented at pHo 7.80 (Diarra et al., 1999 ; Sheldon and Church, 2002 ). In the present study, pHo 6.60 conditions or the PKA inhibitor Rp-cAMPS reduced the rise in [Na+]i after anoxia, whereas, at pHo 7.80, the increase in [Na+]i was enhanced (Fig. 7C). We also reported previously that a Zn2+-sensitive H+ efflux pathway contributes to acid extrusion after anoxia in rat hippocampal neurons and that inhibition of this pathway increases the observable contribution of Na+/H+ exchange to acid extrusion at this time (Diarra et al., 1999 ; Sheldon and Church, 2002 ) (see also Demaurex et al., 1995 ). In the present experiments, 100 µM Zn2+ failed to influence the increase in [Na+]i during anoxia [i.e., at a time when Na+/H+ exchange is inhibited; normalized [Na+]i(during) values in the presence of 100 µM Zn2+ were 1.03 ± 0.18 (n = 12; p = 0.38) and 1.17 ± 0.15 (n = 15; p = 0.62) in 6-10 and 11-14 DIV neurons, respectively]. In contrast, applied immediately after anoxia under K+o-free conditions, Zn2+ significantly enhanced the increase in [Na+]i (Fig. 7B,C), lending additional support to the possibility that Na+/H+ exchange contributes to Na+ influx immediately after anoxia. Although Zn2+ can modulate the activities of a variety of ion channels and transport mechanisms (Harrison and Gibbons, 1994 ), under the conditions used here, anoxia-evoked changes in [Na+]i were unaffected by NMDA or AMPA receptor antagonists or blockers of voltage-activated Ca2+ channels, and the effect of Zn2+ on the increase in [Na+]i after anoxia was observed when Na+,K+-ATPase activity was already inhibited (cf. Manzerra et al., 2001 ).
Although the above findings are consistent with an important contribution from Na+/H+ exchange to Na+ influx in the period immediately after anoxia, they are limited by the lack of selectivity of harmaline and the other maneuvers used to modulate Na+/H+ exchange activity at this time. Therefore, to further explore the role of Na+/H+ exchange in Na+ influx after anoxia, we examined directly the relationship between the changes in [Na+]i and pHi evoked by anoxia by measuring [Na+]i and pHi concurrently in individual neurons (Sheldon et al., 2004 ). In neurons coloaded with SBFI and either carboxy SNARF-1 or SNARF-5F, 5 min anoxia evoked a 16 ± 2 mM increase in [Na+]i and a 0.37 ± 0.04 pH unit fall in pHi (n = 13 neurons at 7-10 DIV), both of which recovered to near resting values on the return to normoxia (Fig. 8A). Perfusion with K+-free medium for 7 min immediately after anoxia did not affect the recovery of pHi (Fig. 8, compare A, B); however, consistent with changes seen in neurons single-loaded with SBFI (Fig. 5A), inhibition of Na+,K+-ATPase revealed an additional rise in [Na+]i after anoxia of 26 ± 2 mM (Fig. 8B) (n = 49 neurons at 7-10 DIV). For both of these experimental series, qualitatively similar changes were observed in neurons maintained for 11-14 DIV (data not shown). If Na+/H+ exchange contributes to increases in [Na+]i and pHi in the immediate postanoxic period (Na+,K+-ATPase blocked), both events should be dependent on external Na+, and the rates at which pHi and [Na+]i increase should exhibit an inverse dependency on pHi. Indeed, as illustrated in Figure 8C, the increases in pHi and [Na+]i after 5 min anoxia were abolished under reduced [Na+]o, NMDG+-substituted conditions; when [Na+]o was returned to normal (in the continued absence of K+o), both pHi and [Na+]i rapidly increased (n = 6). In addition, when rates at which [Na+]i and pHi increased after anoxia were plotted as functions of absolute pHi in 7-10 (Fig. 8D) and 11-14 (Fig. 8E) DIV neurons, both parameters were faster at lower pHi values.
Finally, we used neurons coloaded with SBFI and a SNARF derivative to examine concurrently the effects on [Na+]i and pHi of maneuvers previously found (Diarra et al., 1999 ; Sheldon and Church, 2002 ) to limit the activation of Na+/H+ exchange after 5 min anoxia. Consistent with findings that Na+/H+ exchange is inhibited during anoxia, pretreatment with harmaline failed to influence the magnitudes of the increase in [Na+]i or decrease in pHi during anoxia (Fig. 9A); in contrast, harmaline significantly reduced the increases in [Na+]i and pHi after anoxia (Fig. 9B). In further support of a contribution from Na+/H+ exchange to Na+ influx (and H+ efflux) in the immediate postanoxic period, lowering pHo to 6.60 or the application of 50 µM Rp-cAMPS also reduced the increases in [Na+]i and pHi after anoxia (Fig. 9B). Although PKA regulates Na+/Ca2+ exchange activity in rat hippocampal neurons under normoxic conditions (Blaustein and Lederer, 1999 ), the effect of Rp-cAMPS to reduce the increase in [Na+]i after anoxia was accompanied by a concomitant reduction in the postanoxic increase in pHi and, as shown in Figure 9B, was not mimicked when anoxia was imposed under Ca2+o-free conditions. In the latter experiments (compare the 0 Ca2+o experiments reported in Table 2), Ca2+o was absent before, during, and after anoxia to prevent the rise in [Ca2+]i during anoxia (Diarra et al., 1999 ; Sheldon and Church, 2002 ) and inhibit both forward and reverse Na+/Ca2+ exchange in the immediate post-anoxic period. In addition, we have shown previously that this maneuver does not influence anoxia-evoked changes in pHi in rat hippocampal neurons (Diarra et al., 1999 ; Sheldon and Church, 2002 ).

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Figure 9. The influence of maneuvers that inhibit Na+/H+ exchange activity on anoxia-evoked changes in [Na+]i and pHi measured concurrently in neurons coloaded with SBFI and either carboxy SNARF-1 or SNARF-5F. Measurements of the changes in [Na+]i and pHi observed during (A) and after (B) anoxia under the test conditions indicated on the figure were normalized to corresponding measurements made in experiments performed on age-matched sister neurons (7-10 DIV) under control conditions. Statistical comparisons were performed by comparing absolute measurements of anoxia-evoked changes in [Na+]i and pHi made under a given test condition with corresponding measurements made in age-matched sister neurons under control conditions. The asterisk indicates statistical significance (p < 0.05) compared with measurements made in age-matched sister neurons under control conditions. The numbers in parentheses indicate the number of neurons from which data were obtained under each test condition.
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