Cardioprotection by metabolic shut-down and gradual wake-up
Open accessAbstract
Mitochondria play a critical role in cardiac function, and are also increasingly recognized as end effectors for various cardioprotective signaling pathways. Mitochondria use oxygen as a substrate, so by default their respiration is inhibited during hypoxia/ischemia. However, at reperfusion a surge of oxygen and metabolic substrates into the cell is thought to lead to rapid reestablishment of respiration, a burst of reactive oxygen species (ROS) generation and mitochondrial Ca(2+) overload. Subsequently these events precipitate opening of the mitochondrial permeability transition (PT) pore, which leads to myocardial cell death and dysfunction. Given that mitochondrial respiration is already inhibited during hypoxia/ischemia, it is somewhat surprising that many respiratory inhibitors can improve recovery from ischemia-reperfusion (IR) injury. In addition ischemic preconditioning (IPC), in which short non-lethal cycles of IR can protect against subsequent prolonged IR injury, is known to lead to endogenous inhibition of several respiratory complexes and glycolysis. This has led to a hypothesis that the wash-out of inhibitors or reversal of endogenous inhibition at reperfusion may afford protection by facilitating a more gradual wake-up of mitochondrial function, thereby avoiding a burst of ROS and Ca(2+) overload. This paper will review the evidence in support of this hypothesis, with a focus on inhibition of each of the mitochondrial respiratory complexes.
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Diazoxide transiently induces increased ROS production, consistent with mitochondria-derived ROS being involved in cardioprotective signaling during ischemic and pharmacological preconditioning.
“Diazoxide transiently induces increased ROS production [43,[131][132][133], which is in agreement with the view that mitochondria-derived reactive oxygen species are involved in cardioprotective signaling during ischemic and pharmacological preconditioning (overview in [8,39,40]).”
From Differential effects of complex II on mitochondrial ROS production and their relation to cardioprotective pre- and postconditioning (2013) · cites this paper as [40]
Mitochondria are a physiologically significant source of ROS with important implications in physiology, not only in cardiovascular disease but in many other conditions like aging.
“Mitochondria are a physiologically significant source of ROS with important implications in physiology, not only in cardiovascular disease but in many other conditions like aging (57, 84, 136, 165, 170, 290, 864, 997).”
From Sources of Vascular Nitric Oxide and Reactive Oxygen Species and Their Regulation (2019) · cites this paper as [136]
NO inhibits cytochrome c oxidase, decreases mitochondrial ROS formation, and limits apoptotic cytochrome c release.
“NO is a well-characterized regulator of mitochondrial function that inhibits cytochrome c oxidase, decreases mitochondrial ROS formation, and limits apoptotic cytochrome c release [32–36].”
From Inorganic nitrite therapy: historical perspective and future directions (2011) · cites this paper as [35]
NO metabolism in the mitochondria plays a key role in regulating cellular respiration, mitochondrial transmembrane potential and transmembrane pH gradient.
“NO metabolism in the mitochondria plays a key role in regulating cellular respiration, mitochondrial transmembrane potential and transmembrane pH gradient [35].”
From Inorganic nitrite therapy: historical perspective and future directions (2011) · cites this paper as [35]
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Ischaemic accumulation of succinate controls reperfusion injury through mitochondrial ROS
Chouchani, E. T., Pell, V. R., Gaude, E., Aksentijević, D., Sundier, S. Y., Robb, E. L., Logan, A., Nadtochiy, S. M., Ord, E. N. J., Smith, A. C., et al. (2014) · Nature · doi:10.1038/nature13909 · Cited by 2,907 · see citing works
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“Inhibitors of complex I have been demonstrated to attenuate I/R injury by limiting electron flow through the ETC at reperfusion, thereby limiting ROS generation [32].”
BackgroundLysine deacetylation in ischaemic preconditioning: the role of SIRT1
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Ingram, T. E., Fraser, A. G., Bleasdale, R. A., Ellins, E. A., Margulescu, A. D., Halcox, J. P., & James, P. E. (2013) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2013.03.050 · Cited by 69 · see citing works
Dröse, S., Bleier, L., & Brandt, U. (2011) · Molecular Pharmacology · doi:10.1124/mol.110.070342 · Cited by 64 · see citing works
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- Authors
- Burwell, L. S., Nadtochiy, S. M., & Brookes, P. S.
- Affiliations
- University of Rochester Medicine (US)
- Venue
- Journal of Molecular and Cellular Cardiology
- Publisher
- Elsevier BV
- Published
- 2009-06
- Volume
- 46
- Issue
- 6
- Pages
- 804-810
- ISSN
- 0022-2828 (ISSN-L)
- PMC
- PMC2683198
- OpenAlex
- W2092708055
- Cited by
- 146
- References
- 98
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 2 · 2023: 7 · 2022: 4 · 2021: 5 · 2020: 10 · 2019: 5 · 2018: 10 · 2017: 12 · 2016: 8 · 2015: 8 · 2014: 13 · 2013: 17 · 2012: 13
- FWCI
- 1.65
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- Locations
- Journal of Molecular and Cellular Cardiology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Heart, Lung, and Blood Institute (R01HL071158)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Cardiac Ischemia and Reperfusion
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Mitochondrial Function and Pathology
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Cell death mechanisms and regulation
- Keywords
- cardioprotection, ischemia-reperfusion injury, mitochondrial respiration, ischemic preconditioning, mitochondrial permeability transition pore, reactive oxygen species, mitochondrial calcium overload, hypoxia-ischemia, respiratory inhibitors, myocardial cell death, glycolysis inhibition
- MeSH terms
- Electron Transport Complex IV, Glycolysis, Mitochondria, Models, Biological, Nitric Oxide, Electron Transport Complex III, Myocardial Reperfusion Injury, Ischemic Preconditioning, Myocardial, Electron Transport Complex II, Electron Transport Complex I
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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