(Stroke. 1996;27:122-126.)
© 1996 American Heart Association, Inc.
Articles |
From the Division of Neurosurgery, Department of Surgery (K.W.-Y., H.L.M., L.D.B., R.W.B.), and Department of Pharmacology and Physiological Science (K.W.-Y., R.K.D.), St Louis (Mo) University Health Science Center.
| Abstract |
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Methods Dissociated rat hippocampal neurons were traumatized by disrupting the culture by scratching the plate. The toxicity expressed by the injured culture was studied by transferring the medium to an uninjured culture and assessing the death rate by trypan blue exclusion.
Results This neurotoxin is stable in the medium at room temperature for several hours and withstands boiling. The molecular weight is between 100 and 500. The release and the effect of this toxin seem to be independent of glutamate receptor activation. The toxicity is unaffected by removal of extracellular calcium. However, dantrolene dose-dependently blocked the toxicity in the recipient culture, suggesting that the release of intracellular stores of calcium is involved in the toxic effect. This release of calcium is likely to be followed by an activation of nitric oxide synthase because competitive nitric oxide synthase inhibitors attenuated this toxicity. Consistent with this result, cholecystokinin octapeptide significantly reduced cell death when combined with this toxic medium.
Conclusions Traumatic injury of dissociated cells can propagate neurotoxicity in uninjured cells by a soluble toxin released into the extracellular space. This toxin causes a rise in cytosolic calcium that activates nitric oxide synthase that can be blocked by cholecystokinin.
Key Words: neuronal death neurotoxins nitric oxide trauma rats
| Introduction |
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Many neuropathological processes that lead to neuronal degeneration seem to converge at several steps that lead to eventual cellular demise. Many of these processes may not be universally recognized as prerequisites for neuronal degeneration. However, the mere existence of common pathways suggests that many pathophysiological processes share the same mechanism of cell death. At the same time, treatment directed against some of these processes could lead to effective therapies for multiple nervous system disorders.
Several of these common processes are well recognized. Excitotoxicity mediated by certain amino acid neurotransmitters has been recognized as a mediator of cell death.1 2 An important consequence of excitotoxicity is a rise in intracellular calcium concentration,2 another critical step, followed by an activation of NOS.3 4 Generation of nitric oxide has been demonstrated to be toxic to neurons by generation of free radicals.5
The aforementioned key events in cell death (ie, excitotoxicity, intracellular calcium, NOS, nitric oxide, and free radicals) are likely to be the points where multiple processes converge. At the same time, it is also likely that multiple processes diverge at each of these steps. Therefore, it is important to consider the fact that multiple and divergent processes could lead to (for example) excitotoxicity and/or free radical generation.
We recently reported that in vitro traumatic cell death in dissociated hippocampal cells6 is mediated, at least in part, by a substance that is released in the EC solution and that this toxicity can be transferred to an uninjured cell culture.7 This "neurotoxin" is released transiently after the traumatic insult because its effects are greatest when the medium is transferred within 5 minutes and decreases in a time-dependent fashion. This toxicity, induced by trauma and transferred to an uninjured culture, was independent of the NMDA receptor mechanism of neurotoxicity. Our findings suggested an alternative mechanism of neurotoxicity induced by traumatized hippocampal cell culture.
In this report we extend our previous findings to show that trauma-induced neurotoxicity is mediated by a heat-resistant toxin that can be blocked at various steps of the known cellular injury mechanisms.
| Materials and Methods |
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All cultures were washed with EC solution containing (mmol/L) NaCl 140, KCl 3, Na-HEPES 10, CaCl2 1, MgCl2 2, and pH adjusted to 7.35. The EC fluids containing the desired compounds were freshly mixed on the day of the experiment. CCK and NS-CCK were dissolved in ethanol at 1 mmol/L before dilution with EC solution. The final concentration of CCK and NS-CCK used was 100 nmol/L (104 dilution factor). All chemicals were obtained from Sigma Chemical Co except CNQX, MK801, L-NAME, L-NMMA, and D-NMMA. CCK and NS-CCK were obtained from Research Biochemicals International.
The method of inducing cell injury was adapted from the published procedure of Tecoma et al.6 A 20-gauge needle was drawn across the Petri dish to produce a tear in the neuronal and glial layer in the 35-mm dish. A total of four tears were made in each culture dish. The EC fluid in the culture (total volume, 2 mL) was collected 5 minutes after the trauma and applied to the uninjured culture wells (volume per well, 1 mL). The cultures were placed back into the incubator overnight before the cell death assessment.
In some experiments, the fluid collected from the traumatized culture at 5 minutes was placed in a dialysis bag (100 or 500 D, Spectra/Por, Spectrum, Fischer). The fluid was equilibrated in plain EC fluid for 4 hours before the application to the naive culture.
The neuronal cell cultures were stained with 0.4% trypan blue in EC solution. Five minutes after they were stained with the dye solution, the cells were washed with EC solution. Dead neurons took up the dye and stained purple, while viable neurons were not stained. Both viable and nonviable cells were then counted with the use of a phase-contrast microscope within a grid.
In most instances there were at least two wells of control, with each batch of experiment in one or two 12-well plates. The control wells received the EC solution collected from an untraumatized dish. This resulted in the same number of fluid exchanges. In some experiments, two additional wells for control toxicity (5 minutes after injury) were also incorporated with each batch of experiments. In these wells, the traumatized fluid collected at 5 minutes was applied without any treatment. Those batches that had a high rate of control death (>0.40) and/or a low rate of control trauma-induced neurotoxicity (<0.55) were discarded.
As another control, plain EC solution was exchanged for the same number
of times in six dishes that had an average death rate of 0.31±0.01
(Fig 1A
, "wash"). The average control death rate in
all
experiments was 0.31±0.01 (n=21, P>.5 compared with
wash),
and the traumatized fluid caused cell death of 0.63±0.01 (n=36).
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The results are expressed as a ratio of dead cells to the total number of cells counted. The numerical data are expressed as mean±SE. The significance was tested by two-tailed t test, F test, and the Tukey test when appropriate. Results found to have a value of P<.05 were considered significant.
| Results |
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To develop an estimate of the size of the toxic mediator, dialysis
experiments were performed (Fig 1A
). In these experiments the
traumatized fluid was allowed to equilibrate with EC fluid in either
100- or 500-D dialysis bags for 4 hours at 37°C. After transfer of
the dialyzed fluid into naive cultures of neurons, the cell cultures
were allowed to incubate overnight. Those cells treated with
traumatized fluid from 100-D dialysis bags retained the toxicity
(0.60±.02, n=6), while those treated with fluid from 500-D
dialysis
bags had a death rate of only 0.17±0.08 (n=4). This result
estimates
the molecular weight of the toxic mediator to be between 100 and
500.
In our previous report,7 we demonstrated that the
glutamate concentration in the traumatized culture never exceeded 20
nmol/L and that MK801, an NMDA receptor antagonist added to
EC fluid in the donor (ie, traumatized) culture before injury, had no
effect on the neurotoxicity seen in the recipient culture. It is still
possible that glutamate receptor activation or glutamate release in the
recipient culture could be involved in the mechanism of this
neurotoxicity. To test this possibility, CNQX (30 µmol/L) and MK801
(10 µmol/L) alone and in combination were added to the traumatized
fluid after removal from the traumatized donor culture (Fig
1B
). None
of these glutamate receptor antagonists had any effect on
the rate of cell death (P>.2, F test comparing all injury
groups including control injury).
A rise in the intracellular calcium concentration is one of the
critical steps in neurotoxic mechanisms.2 10 To
determine
whether this toxicity is dependent on entry of calcium into the cell
from the extracellular space, all extracellular calcium was removed and
replaced with magnesium (Fig 2A
). The control death rate
in low-calcium EC fluid was 0.34±0.02 (n=4). The removal of
calcium had no effect on the neurotoxicity (0.62±0.03, n=10,
P>.2, compared with toxicity in standard EC fluid).
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Another possible mechanism of rise in intracellular calcium is by
release from the intracellular store. This release of calcium can be
blocked by dantrolene.11 12 Consistent with this
notion, dantrolene dose-dependently protected the neurons from the
trauma-induced neurotoxin (Fig 2B
). In these experiments,
dantrolene was added to the toxic fluid after collection from the
traumatized culture and before the medium exchange in the naive
culture.
The stability of this toxin in heat suggests that nitric oxide is not
the toxin that is transferred with the medium to the recipient culture.
However, it is possible that the effect of this toxin could be mediated
by the generation of nitric oxide after the transfer, particularly
since the rise in intracellular calcium could activate
NOS.3 To test this hypothesis, a competitive NOS
inhibitor, L-NAME (10 and 100 µmol/L), was added to the
fluid collected after trauma (Fig 3A
). The protective
effect of L-NAME was dose dependent (0.47±0.02, n=4;
0.40±0.03, n=4,
respectively). Another competitive NOS inhibitor, L-NMMA
(100 µmol/L), also had a protective effect (0.39±0.02, n=6),
but its
less-active enantiomer, D-NMMA, had no protective effect
(0.68±.03, n=6, P<.005, paired t test
compared
with L-NMMA).
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CCK, a gastric octapeptide, has been demonstrated to protect dissociated cortical neurons from glutamate-induced excitotoxicity.13 14 Studies by Tamura et al14 demonstrated that CCK-mediated protection does not involve antagonism of glutamate receptor activation. Instead, CCK directly inhibits the activation of NOS after NMDA receptor activation, with a resultant rise in cytosolic calcium. If the neurotoxicity induced by trauma in the recipient culture is mediated by a rise in cytosolic calcium and activation of NOS, CCK may also attenuate this toxicity. In these experiments CCK was added to the traumatized fluid after the collection from the donor culture. At 100 nmol/L, CCK significantly protected the neurons from trauma-induced neurotoxicity (0.29±0.05, n=7, P<.001). The protective effect of CCK was reproduced by NS-CCK (0.34±0.02, n=5, P<.001), a specific agonist for the central CCKB receptor.15
| Discussion |
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The mechanism of this trauma-induced toxicity is dependent on the activation of NOS, which can be activated by calcium/calmodulin complex.3 4 Consistent with this observation, this toxicity is also dependent on the rise in cytosolic calcium, which seems to be released from the intracellular store instead of from entry from the extracellular space.
Excitotoxicity is an important component of trauma-induced neuronal destruction.6 However, other possible neurotoxic mechanisms have also been implicated.16 For example, a similar observation of trauma-induced release of an unknown toxin has been reported.17 The toxin released in this case was also heat resistant and was released by reactive mononuclear phagocytes. An important variance of the neurotoxicity described in the present report is that glutamate antagonists had no protective effect against this unknown toxin.
CCK has been shown to be widely distributed throughout the brain15 by radioimmunoassay. High levels of CCK precursor-specific mRNA have been detected in the rat hippocampus.18 However, the functional role of this neurotransmitter and its receptors remains to be clearly elucidated.
There are two types of CCK receptors. CCKA is known as the peripheral type of receptor and is found primarily in autonomic ganglia and the gastrointestinal system, although these receptors occur in discrete brain regions as well. CCKB receptors, through the use of radioligand binding19 and selective nonpeptide CCK receptor antagonists,20 have been shown to be abundantly distributed throughout the mammalian brain and have been implicated in most of the effects of CCK in the brain.
The purpose of using CCK as a protective agent in the present study was to indicate that trauma-induced neurotoxicity is mediated by an activation of NOS without activation of glutamate receptors. CCK has been shown to protect cortical neuron cultures from excitotoxicity by activation of the CCKB receptor21 and by attenuation of the nitric oxide mechanism. Consistent with this observation, the neuroprotective effect of CCK against trauma-induced neurotoxicity is reproduced by NS-CCK, which is a specific agonist for the CCKB receptor. Our results indicate that the site of CCK action is a step after the rise in cytosolic calcium.
An important consideration in the mechanism of cellular injury is the
role of endogenous protective mechanisms.22 23
Some of these endogenous protective factors seem to be
peptides already present within the neuronal milieu. Destruction of
such protective factors could account for the increase in toxicity with
the heat-treated traumatic fluid (Fig 1A
). The fact that the
medium
dialyzed in 500-D membrane had even less toxicity than the control also
could be consistent with the presence of endogenous
protective factors.23
Even in this limited model of in vitro physical cell injury, the outcome of cell survival seems to be a consequence of multiple toxic and protective effects. The observations described above indicate that cell death could be mediated by a mechanism independent of glutamate excitotoxicity. On the other hand, this toxic effect seems to converge with excitotoxicity at the point where the rise in cytosolic calcium activates the final steps that lead to cell destruction.
| Selected Abbreviations and Acronyms |
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| Acknowledgments |
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| Footnotes |
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Received April 17, 1995; revision received August 25, 1995; accepted September 27, 1995.
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