Cyclosporin inhibition of apoptosis induced by mitochondrial complex I toxins

The cause of dopaminergic cell death in Parkinson's disease (PD) remains unknown, but may involve oxidative stress and mitochondrial complex I deficiency. Opening of the permeability transition pore and disruption of the mitochondrial transmembrane potential are known to be common events in the apoptotic pathway. Cyclosporin A and its non-immunosuppressant analogue, N-methyl-4-valine cyclosporin inhibit the opening of the mitochondrial megachannel. Complex I inhibitors, including MPP+, are known to induce both apoptosis in cell culture and parkinsonism in man and other primates. The present study using propidium iodide and FITC-TUNEL staining to identify apoptotic cells, demonstrates that rotenone, MPP+ and tetrahydroisoquinoline induce apoptosis in PC12 cells. Apoptosis induced by these agents was decreased by cyclosporin A and N-methyl-4-valine cyclosporin. Thus, apoptosis induced by inhibitors of mitochondrial complex I is probably mediated by permeability pore opening and collapse of the mitochondrial membrane potential. This observation may allow the development of novel neuroprotective strategies in disorders that may involve mitochondrial dysfunction and apoptotic cell death.

Aortoiliac aneurysms: endoluminal repair--clinical evidence for a fully supported stent-graft

PURPOSE

To evaluate aortoiliac aneurysms repaired with endovascular stent-grafts complicated by hemodynamically significant graft stenosis.

MATERIALS AND METHODS

Fifty-four patients (52 men, two women; age range, 41-90 years; mean age, 75 years) with aneurysms of the infrarenal aorta (n = 36) or iliac artery (n = 18) underwent repair by means of placement of an endovascular stent-graft. Technical success was evaluated angiographically during and after placement. At follow-up (range, 12-44 months), all patients underwent sequential duplex ultrasonography, helical computed tomography, and physical examination.

RESULTS

Stent-grafts were placed successfully in all cases. Stenosis at the internal iliac arterial origin was identified at angiography in 17 patients (31%). Supplemental intragraft stents were placed in 11 patients, and stent-graft angioplasty alone was performed in one patient. Intragraft stents were placed percutaneously in five patients when stenosis was discovered during follow-up.

CONCLUSION

Supplemental intragraft stents were required in 31% of aortoiliac endovascular stent-grafts to correct stent-graft stenosis and preserve long-term function. Placement of a fully supported stent-graft is necessary to repair an aortoiliac aneurysm.

Mitochondria in the etiology and pathogenesis of Parkinson's disease

Mitochondria play a critical role in cellular energy metabolism. The identification of a respiratory chain defect in Parkinson's disease (PD) provides not only a direct link with toxin models of parkinsonism but also insight into the mechanisms involved in etiology and pathogenesis. The presence of the complex I deficiency in PD substantia nigra and platelets suggests the involvement of a systemic cause. Genomic transplantation studies have been undertaken that involve the transfer to a novel nuclear background of mitochondrial DNA (mtDNA) from PD patients with a complex I defect, followed by both mixed and clonal expansion of the resulting cybrids. The mixed cybrids with the PD mtDNA expressed the complex I defect present in the original PD donor platelets. Clonal expansion of one such mixed cybrid culture produced a spectrum of clones with complex I and complex IV activities, ranging from severe deficiency to normal range, a pattern typical of a heteroplasmic mtDNA mutation. Histochemical, immunohistochemical, and functional assessments of delta psi(m) all showed a pattern in the PD clones typical of that produced by a mtDNA mutation. Patients with focal dystonia and a platelet complex I defect were used as disease controls for the cybrid studies. The mitochondrial abnormality was eradicated by transfer of dystonia mtDNA to a control nuclear background in both mixed and clonal cybrids, with no evidence of clonal heterogeneity. These results help to validate our findings in the PD patients and suggest that the complex I deficiency in dystonia is not due to an abnormality of mtDNA. We hypothesize that the mtDNA defect alone may be the cause of PD in a proportion of patients and may contribute to pathogenesis in others. Identification of the mtDNA genotype responsible for PD may allow the testing of neuroprotective strategies in appropriate patients.

Portal vein velocities measured by ultrasound: usefulness for evaluating shunt functioning following TIPS placement and TIPS revision

BACKGROUND

To assess the usefulness of following portal vein velocities by Doppler ultrasound in evaluating shunt functioning after transhepatic intrajugular portosystemic shunt (TIPS) placement and revision.

METHODS

We retrospectively analyzed 39 patients who underwent a TIPS procedure in the preceding 4 years. Portal vein (PV) velocities were measured by Doppler ultrasound before and after TIPS insertion and revision and were correlated with portosystemic gradients (PSG) measured at angiography.

RESULTS

Mean PV velocities increased from 18 +/- 6 cm/s before TIPS placement to 50 +/- 21 cm/s (p < 0.001) after TIPS placement, with corresponding decrease of mean PSG from 20 +/- 6 to 8 +/- 3 mmHg (p < 0.001). Mean PV velocities significantly increased from 24 +/- 6 to 43 +/- 14 cm/s after TIPS revision (p < 0.02), with decrease of PSG from 17 +/- 6 to 9 +/- 5 mmHg (p < 0.05). A significant correlation was found between all PV velocities and their corresponding PSG (Spearman r < 0.61, p < 0.001).

CONCLUSION

PV velocities significantly correlate with changes in PSG. Following portal vein velocities by ultrasound is useful for early evaluation of shunt functioning following TIPS.

The influence of nuclear background on the biochemical expression of 3460 Leber's hereditary optic neuropathy

The role of mitochondrial DNA (mtDNA) mutations in the pathogenesis of Leber's hereditary optic neuropathy (LHON) has yet to be characterized. Several clinical features of the disease imply that nuclear genes might also be involved in its expression. We have confirmed the presence of a severe NADH:coenzyme Q1 reductase (complex I) defect in association with the A3460G mtDNA LHON mutation in cultured fibroblasts compared with age-matched controls. This defect was not seen in clonal fibroblasts with 0% mutant mtDNA developed from a heteroplasmic A3460G LHON subject, confirming the association between the A3460G mutation and the complex I defect. Cybrids prepared from the fusion of enucleated fibroblasts homoplasmic for the A3460G mutation with 206 (osteosarcoma) cells lacking mtDNA (p0) also had a severe deficiency of complex I activity. However, in A3460G LHON fusion cybrids containing a different nuclear background, A549 p0 (lung derived), this biochemical defect was not apparent in all the clones studied. These results suggest that the nuclear environment can influence the expression of the biochemical defect in LHON patients with the A3460G mutation.

Mitochondrial DNA in focal dystonia: a cybrid analysis

The cause and pathophysiology of dystonia remain unknown. The recent identification of mitochondrial complex I deficiency in platelets from patients with sporadic focal dystonia suggests that a defect of energy metabolism may be relevant in a proportion of patients. We have addressed the possible contribution of mitochondrial DNA (mtDNA) to the complex I deficiency in dystonia by the use of genome transfer technology. Platelets from patients deficient for complex I were fused with A549 p0 (mtDNA-less) cells to form cybrids comprising the A549 nucleus and dystonia mtDNA. Mixed cybrid cell lines were analyzed for 9 controls and 9 dystonia patients, and clonal cybrid lines were generated for 2 control and 2 dystonia patients. Subsequent biochemical analysis showed that the dystonia complex I defect was complemented in both the mixed and the clonal cybrid lines. These results contrast with similar studies in mitochondrial myopathy and Parkinson's disease patients, in which the mitochondrial defect was maintained in at least a proportion of A549 cybrids, and suggest that the complex I defect in dystonia is not caused by an mtDNA mutation.

Mitochondrial DNA transmission of the mitochondrial defect in Parkinson's disease

Several groups have identified mitochondrial complex I deficiency in Parkinson's disease (PD) substantia nigra and in platelets. A search for any mitochondrial DNA (mtDNA) mutation underlying this defect has not yet produced any consistent result. We have made use of a mtDNA-less (p0) cell line to determine if the complex I deficiency follows the genomic transplantation of platelet mtDNA. From a preselected group of PD patients with low platelet complex I activity, 7 patients were used for detailed study. All 7 patients were used for mixed cybrid analysis and demonstrated a selective 25% deficiency of complex I activity. Individual clonal analysis of A549 p0/PD platelet fusion cybrids from 1 of the patients expressed combined complex I and IV deficiencies with 25% and 20% decreased activities in the PD clones, respectively. Histocytochemical, immunocytochemical, and cellular functional imaging studies of these clones showed the cells within the clones were heterogeneous with respect to cytochrome c oxidase (COX) function, COX I content, and mitochondrial respiratory chain activity. These results are in agreement with a previous study and support the proposition that an mtDNA abnormality may underlie the mitochondrial defect in at least a proportion of PD patients. This p0 technology may serve as a means to identify the subgroup of PD patients in whom an mtDNA defect may contribute to development of the disease.

Single-cell measurements of human neutrophil activation using electrorotation

We have used the technique of cell electrorotation within a microfabricated planar gold electrode array as a means of detecting changes in the physical properties of a single human neutrophil, when activated by the chemotactic factor, phorbol myristate acetate (PMA). The results, which have been analyzed using a double-shell model to represent the cell and its nucleus, provide an indication of the changes in biophysical parameters that occur during cell activation. The methods used in this study have potential applications in the development of single-cell assays for pharmaceutical screening, as a means of determining rapidly the action of drugs.

Mitochondrial function, GSH and iron in neurodegeneration and Lewy body diseases

The cause of neuronal loss in patients with idiopathic Parkinson's disease is unknown. Oxidative stress and complex I deficiency have both been identified in the substantia nigra in Parkinson's disease but their place in the sequence of events resulting in dopaminergic cell death is uncertain. We have analysed respiratory chain activity, iron and reduced glutathione concentrations in Parkinson's disease substantia innominata and in the cingulate cortex of patients with Parkinson's disease, Alzheimer's disease and dementia with Lewy bodies to investigate their association with neuronal death and Lewy body formation. No abnormalities of mitochondrial function, iron or reduced glutathione levels were identified in Parkinson's disease substantia innominata or cingulate cortex. Mitochondrial function also appeared to be unchanged in cingulate cortex from patients with Alzheimer's disease and from patients with dementia with Lewy bodies, however, iron concentrations were mildly increased in both, and reduced glutathione decreased only in Alzheimer's disease. These results confirm the anatomic specificity of the complex I deficiency and decreased levels of reduced glutathione within the Parkinson's disease brain and suggest that these parameters are not associated with cholinergic cell loss in Parkinson's disease nor with Lewy body formation in this or other diseases. We propose that our data support a 'two-hit' hypothesis for the cause of neuronal death in Parkinson's disease.

Direct, real-time sensing of free radical production by activated human glioblastoma cells

Primary brain injury initiates a cascade of events which result in secondary brain damage. Although, at present, the biochemical and molecular mechanisms of nerve cell death are not well understood, sufficient evidence now exists to implicate free radicals in this brain injury response. In the light of the current understanding on the role of free radicals in cell mortality, we report on the use of two specific sensors, which we use to measure the direct, simultaneous and real time electrochemical detection of both superoxide (O2.-) and nitric oxide (NO), produced by activated glioblastoma cells. The development and application of these novel methods has enabled us to show that both the cytokine-mediated induction of the enzymes responsible for the generation of these radical species, and the metabolic requirements of the cell can modulate cell messenger release. Importantly, the data collected provides dynamic information on the time course of free radical production, as well as their interactions and their involvement in the process of cell death. In particular, one of the major advances afforded by this technology is the demonstration that suppression of one of either of the two cellular generated radical species (NO and O2.-) leads directly to a corresponding increase in the species that was not being deliberately inhibited or scavenged. This finding may indicate a mechanism involving inter-enzyme regulation of free radical production in glial cells (a phenomenon which may, in future, also be shown to operate in other relevant cell models).

Liver failure associated with mitochondrial DNA depletion

BACKGROUND/AIMS

Liver failure in infancy can result from several disorders of the mitochondrial respiratory chain. In some patients, levels of mitochondrial DNA are markedly reduced, a phenomenon referred to as mitochondrial DNA depletion. To facilitate diagnosis of this condition, we have reviewed the clinical and pathological features in five patients with mitochondrial DNA depletion.

METHODS

Cases were identified by preparing Southern blots of DNA from muscle and liver, hybridising with appropriate probes and quantifying mitochondrial DNA relative to nuclear DNA.

RESULTS

All our patients with mitochondrial DNA depletion died of liver failure. Other problems included hypotonia, hypoglycaemia, neurological abnormalities (including Leigh syndrome) and cataracts. Liver histology showed geographic areas of fatty change, bile duct proliferation, collapse of liver architecture and fibrosis; some cells showed decreased cytochrome oxidase activity. Muscle from three patients showed mitochondrial proliferation, with loss of cytochrome oxidase activity in some fibres but not in others; in these cases, muscle mitochondrial DNA levels were less than 5% of the median control value. The remaining two patients (from a single pedigree) had normal muscle histology and histochemistry associated with less severe depletion of mitochondrial DNA in muscle.

CONCLUSIONS

Liver failure is common in patients with mitochondrial DNA depletion. Associated clinical features often include neuromuscular disease. Liver and muscle histology can be helpful in making the diagnosis. Mitochondrial DNA levels should be measured whenever liver failure is thought to have resulted from respiratory chain disease.

Single-cell measurements of purine release using a micromachined electroanalytical sensor

To study the cellular events surrounding the formation of purines in cardiac ischemia, we have micromachined a micrometer-scale titer chamber containing an integrated electrochemical sensor, capable of measuring analytes produced by a single heart cell. The analytical procedure involves the determination of metabolites via the amperometric detection of enzymically generated hydrogen peroxide, measured at a platinized microelectrode, poised at a suitably oxidizing potential, equivalent to +420 mV vs Ag/AgCl. Signals were recorded as current-time responses and were integrated to give a total charge (Q) attributable to the reaction under investigation. The amount of analyte produced by the cell was subsequently quantified by the addition of a known amount of calibrant. As a consequence, by using a cascade of three enzymes (adenosine deaminase, nucleotide phosphorylase, and xanthine oxidase), we were able to show that, after rigor contracture had been induced in a single myocyte, adenosine (but not inosine) only reached the extracellular space after the cell membrane had been permeabilized by detergent. These data, which could only be obtained unambiguously by using this single-cell methodology, have provided us with information on the origin of ischemic adenosine which challenges the established assumption that purine release is an early retaliatory response from intact anoxic myocytes.

Complications of fluid overload from resectoscopic surgery

Excess absorption of liquid distending media is one of the most frequent complications of operative hysteroscopy. Although most women recover uneventfully, we are seeing cases of permanent morbidity or death resulting from this complication.

Role of conducting polymeric interfaces in promoting biological electron transfer

In this paper, we explore the role that polymer conductivity and functionality play in determining the nature of molecular recognition at artificial polymer interfaces, as evidenced by electron transfer with the small redox protein, cytochrome c. The relationship is investigated electrochemically using cyclic voltammetry in order to assess the degree of molecular recognition between the biological molecule and carboxyl-functionalized beta-substituted poly(thiophenes) and poly(pyrroles), as well as a co-polymer matrix of these derivatives. In the latter case, the co-polymer film was analysed quantitatively using X-ray photoelectron spectroscopy, and it was found that its composition did not reflect the initial molar ratios of the monomers prior to electrodeposition.

The mitBASE human dataset structure

MitBASE is a comprehensive and integrated mitochondrial genome database funded within the EU BIOTECH PROGRAM. It is a project for the development and implementation of an integrated and comprehensive database of mitochondrial data which will collect all available information from different organisms and from intraspecies variants and mutants. The present paper describes the structure of the Human dataset in mitBASE where human molecular data are distinguished from clinical and pathological data. MitBASE home page address is: http://www.ebi.ac.uk/htbin/Mitbase/mitb ase.pl

Venographic appearance of portosystemic collateral pathways

Many imaging modalities can be used to evaluate various portosystemic collateral pathways seen in patients with portal hypertension. A knowledge of various typical and atypical pathways is essential for a proper understanding of the disease process. Transjugular transhepatic portographic appearance of such pathways are discussed in detail.

Free radical scavengers protect dopaminergic cell lines from apoptosis induced by complex I inhibitors

The cause of dopaminergic neurodegeneration in Parkinson's disease remains unclear, but may involve both oxidative stress and mitochondrial complex I inhibition. We have demonstrated that complex I inhibitors, including rotenone, MPP+, isoquinoline and tetrahydroisoquinoline, induce apoptosis in PC12 and SK-N-MC dopaminergic cell lines which was decreased by pretreatment with N-acetylcysteine, TEMPO, dihydrolipoic acid or pyrrolidine dithiocarbamate. These results indicate that the pathway leading to apoptosis following complex I inhibition involves free radical generation. The free radical generation may result directly from inhibition of the mitochondrial respiratory chain or indirectly during the apoptotic process itself. This has important implications for our understanding of the relationship between complex I deficiency and oxidative stress and neurodegeneration in Parkinson's disease.

Atypical angiographic appearance of a superficial femoral artery mycotic aneurysm

An unusual presentation of mycotic aneurysm is described. In this case, a large thrombosed mycotic aneurysm of the superficial femoral artery was associated with segmental occlusion of the adjacent artery. Small vessels were delineated in the periphery of the aneurysm on angiography.

Molecular mechanisms in mitochondrial DNA depletion syndrome

Depletion of mitochondrial DNA (mtDNA) appears to be an important cause of mitochondrial dysfunction in neonates and infants. We have identified another child in whom depletion of mtDNA was demonstrated in liver and serial skeletal muscle biopsies. A primary myoblast culture from the patient initially showed normal levels of mtDNA, but there was a progressive loss of mtDNA in later cell passages and clonal myoblast cell cultures, similar to that observed in the skeletal muscle tissue of the patient. Thus, these clonal myoblast cultures provide an in vitro model of the in vivo mtDNA dynamics. The levels of mitochondrial mRNAs for subunits I and II of cytochrome c oxidase declined with declining mtDNA levels, but the fall in mitochondrial transcript levels lagged behind that of the mtDNA levels. Levels of cytochrome c oxidase subunit I and II polypeptides, however, declined ahead of declining mtDNA levels. Immunocytochemistry showed that between individual cells of the clonal myoblast cultures, the expression of the mitochondrially encoded subunit I of cytochrome c oxidase was heterogeneous, suggesting variable levels of mtDNA. Transfer of patient mitochondria with residual mtDNA levels to control cells devoid of mtDNA (rho0 cells) led to restoration of mtDNA levels and, hence, suggests a nuclear involvement in the depletion.

Mitochondrial respiratory chain function in multiple system atrophy

Multiple system atrophy (MSA) is a clinico-pathological entity distinct from idiopathic Parkinson's disease (PD) that is responsible for 5-10% of cases of parkinsonism. Degeneration of nigral neurones is a feature of both diseases. A specific deficiency of mitochondrial complex I activity has been found in PD substantia nigra. We have analysed mitochondrial function in substantia nigra and platelets from MSA patients to identify any respiratory chain defect in this disorder and to determine its tissue specificity. As our MSA patients had been on L-DOPA, we also sought to establish whether this treatment could cause the complex I defect as seen in PD. We found no significant difference in respiratory chain activity corrected for mitochondrial mass between control and MSA patients in either of the tissues studied. These results provide a biochemical dimension to the differences between MSA and idiopathic PD. In addition, the fact that L-DOPA failed to induce a complex I defect in MSA substantia nigra suggests that this treatment is unlikely to cause the complex I deficiency in PD, without additional factors that may operate in PD.

Complex I function in familial and sporadic dystonia

A significant proportion of patients with inborn errors of the mitochondrial respiratory chain exhibit movement disorders, particularly dystonia. Point mutations of mitochondrial DNA (mtDNA) are usually expressed systemically, and defects of platelet respiratory chain function have been described in patients with mtDNA mutations and Leber's hereditary optic neuropathy (LHON). Recent reports have documented families with dystonia in association with LHON and mtDNA complex I gene mutations. We have examined mitochondrial function in platelet mitochondria from patients with familial generalized dystonia (linked or not linked to 9q34) and sporadic focal dystonia. We confirm a previous report of a specific complex I defect in patients with sporadic focal dystonia but could not find any abnormality in patients with familial generalized dystonia, linked or not to 9q34. These results support the existence of a mitochondrial deficiency in sporadic focal dystonia and provide a biochemical dimension to the clinical and genetic distinction between focal and generalized familial dystonia.

Mitochondrial dysfunction in neurodegeneration

Numerous toxins are known to interfere with mitochondrial respiratory chain functions. Use has been made of these in the development of pesticides and herbicides, and accidental use in man has led to the development of animal models for human disease. The propensity for mitochondrial toxins to induce neuronal cell death may well reflect not only their metabolic pathways but also the sensitivity of neurons to inhibition of oxidative phosphorylation. Thus, the accidental exposure of humans to 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine and to 3-nitropropionic acid had led to primate models of Parkinson's disease and Huntington's Disease, respectively. These models were made all the more remarkable when identical biochemical deficiencies were identified in relevant areas of human suffering from the respective idiopathic diseases. The place of complex I deficiency in Parkinson's disease remains undetermined, but there is recent evidence to suggest that, in some cases at least, it may play a primary role. The complex II/III deficiency in Huntington's disease is likely to be secondary and induced by other pathogenetic factors. The potential to intervene in the cascade of reactions involving mitochondrial dysfunction and cell death offers prospects for the development of new treatment strategies either for neuroprotection in prophylaxis or rescue.