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Effects of metformin and other biguanides on oxidative phosphorylation in mitochondria
Open accessAbstract
The biguanide metformin is widely prescribed for Type II diabetes and has anti-neoplastic activity in laboratory models. Despite evidence that inhibition of mitochondrial respiratory complex I by metformin is the primary cause of its cell-lineage-specific actions and therapeutic effects, the molecular interaction(s) between metformin and complex I remain uncharacterized. In the present paper, we describe the effects of five pharmacologically relevant biguanides on oxidative phosphorylation in mammalian mitochondria. We report that biguanides inhibit complex I by inhibiting ubiquinone reduction (but not competitively) and, independently, stimulate reactive oxygen species production by the complex I flavin. Biguanides also inhibit mitochondrial ATP synthase, and two of them inhibit only ATP hydrolysis, not synthesis. Thus we identify biguanides as a new class of complex I and ATP synthase inhibitor. By comparing biguanide effects on isolated complex I and cultured cells, we distinguish three anti-diabetic and potentially anti-neoplastic biguanides (metformin, buformin and phenformin) from two anti-malarial biguanides (cycloguanil and proguanil): the former are accumulated into mammalian mitochondria and affect oxidative phosphorylation, whereas the latter are excluded so act only on the parasite. Our mechanistic and pharmacokinetic insights are relevant to understanding and developing the role of biguanides in new and existing therapeutic applications, including cancer, diabetes and malaria.
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![Figure 2 Biguanide effects on the flavin site of complex I (A) Effects of metformin on flavin site reactions that require nucleotide binding to the reduced flavin [NADH:HAR (blue) and NADH:paraquat (green) oxidoreduction] [27], and nucleotide-free reduced flavin [NADH:FeCN (purple) and NADH:O2 (red) oxidoreduction] [26]. NADH:O2 oxidoreduction (H2O2 production) was detected directly (by NADH oxidation, circles) or as H2O2 by the Amplex Red assay (squares) [15], with/without (open/closed symbols respectively) 1 μM rotenone. Data for H2O2 production by subcomplex Iλ are shown as open diamonds (◇). Data points are means±S.E.M., n=3–5. (B) Stimulation of flavin-site reactions, measured at the inhibitory IC50 concentrations (black, H2O2 production measured using Amplex Red; grey, NADH:FeCN oxidoreduction). Gu, 25 mM guanidinium; Me, 25 mM metformin; Bu, 5 mM buformin; Ph, 0.5 mM phenformin; Cy, 0.7 mM cycloguanil; Pr, 0.05 mM proguanil. Data are presented as means±S.E.M., n=3–5. (C) NADH-dependence of NADH:FeCN catalysis by isolated bovine complex I. ●, 100 mM metformin; ○, control. Data points are means±S.E.M., n=3–5 and data were fit as described previously [26] with KMNADH=220 μM, kcatNADH=1500 s−1, kcatFeCN=3.7×107 M−1·s−1 and KNADHRed (the dissociation constant for NADH binding to the reduced flavin)=KNADHSemi=11 μM (control) or 181 μM (metformin). (D) Dependence of H2O2 production on the NAD+ potential, set by the Nernst equation with 30 μM NADH and variable NAD+ [15]. Control [with (●) and without (○) 200 mM NaCl], 20 mM phenformin (green) and 200 mM metformin (purple). Data points are means±S.E.M., n=3–5. The stimulation of H2O2 production by metformin (red) is also represented as the non-normalized percentage activity relative to the control (see A for the effect of metformin in NADH only). (E) Simplified scheme illustrating how metformin affects the different flavin site reactions differently. The boxes represent different states of the complex I flavin site, with the flavin oxidized or reduced, and with or without NADH or NAD+ bound.](/paper-figures/b1040fc70c984873b1f2a822729b0b9f/effects-of-metformin-and-other-biguanides-on-oxidative-phosphorylation-in-figure-2.jpg)
![Figure 3 Biguanide interactions with respiratory complexes II, III and IV (A) Rates of complex II + III + IV activity in bovine SMPs measured by a coupled enzyme assay [28] in the presence of biguanide concentrations equivalent to IC50 for NADH:decylubiquinone catalysis. Results are means±S.E.M. as a percentage of the biguanide-free control, n=3–4. (B) Rates of respiratory complex activity in the presence of 0.7 mM cycloguanil as a percentage of their respective cycloguanil-free controls. ****P<0.0001.](/paper-figures/3594ae939ca941f18611dc8951166636/effects-of-metformin-and-other-biguanides-on-oxidative-phosphorylation-in-figure-3.jpg)
![Figure 4 Biguanide inhibition of F1F0-ATP synthase in bovine SMPs (A) Inhibition of ATP hydrolysis by SMPs (colours as in B). Data points are means±S.E.M., n=3–5, and IC50 values are indicated in mM. (B) Relationship between the IC50 values for ATP hydrolysis and the log D values. IC50 values are in mM with 95% confidence intervals; log D values are means±S.E.M., n=3. Linear fit with R2=0.948. (C) Relative inhibition of ATP production in SMPs in the presence of piericidin A (○) or metformin (●). ATP synthesis was driven using 200 μM NADH; NADH oxidation was measured spectroscopically, and the concentration of ATP determined after 3.5 min (during this time a linear rate is observed). NADH oxidation rates were adjusted using 0–50 nM piericidin A or 0–250 mM metformin, with the ionic strength kept constant at 250 mM using NaCl. (D–F) Dose-dependent effects of biguanides on succinate-driven ATP production. Data points are means±S.E.M., n=3, as a percentage of ATP production in the absence of biguanide. ATP concentrations were determined after 3.5 min (○) then corrected for the rate of succinate oxidation, detected spectroscopically using a coupled assay system [28] (●). The IC50 values for hydrolysis are marked with vertical lines.](/paper-figures/a2da011e7240455b8c7c2350b86dd89b/effects-of-metformin-and-other-biguanides-on-oxidative-phosphorylation-in-figure-4.jpg)


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In the citing paper
“inhibition of mitochondrial complex 1 in the electron transport chain and reduction of endogenous production of reactive oxygen species (ROS) (Batandier et al., 2006; Bridges et al., 2014; Zheng et al., 2012)”
From Metformin as a tool to target aging (2016) · cites this paper as Bridges et al., 2014
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In the citing paper
“inhibition of mitochondrial complex 1 in the electron transport chain and reduction of endogenous production of reactive oxygen species (ROS) (Batandier et al., 2006; Bridges et al., 2014; Zheng et al., 2012)”
From Metformin as a tool to target aging (2016) · cites this paper as Bridges et al., 2014
In the citing paper
“However, metformin, one of the commonly prescribed drugs for treating type II diabetes, is safe despite acting as a mitochondrial complex I inhibitor that impairs respiration (Bridges et al., 2014; El-Mir et al., 2000; Owen et al., 2000; Wheaton et al., 2014).”
From Targeting Metabolism for Cancer Therapy (2017) · cites this paper as Bridges et al., 2014
In the citing paper
“It is also worthy of note that the IC50 for metformin to inhibit mitochondrial complex 1 is 19–66 mM (140, 141).”
From A Critical Review of the Evidence That Metformin Is a Putative Anti-Aging Drug That Enhances Healthspan and Extends Lifespan (2021) · cites this paper as [141]
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Cites
1 retracted
Activation of the AMP-activated Protein Kinase by the Anti-diabetic Drug Metformin in Vivo
Zou, M., Kirkpatrick, S. S., Davis, B. J., Nelson, J. S., Wiles, W. G., Schlattner, U., Neumann, D., Brownlee, M., Freeman, M. B., & Goldman, M. H. (2004) · Journal of Biological Chemistry · doi:10.1074/jbc.m404421200 · Cited by 480
RetractedUnderstanding the Warburg Effect: The Metabolic Requirements of Cell Proliferation
Vander Heiden, M. G., Cantley, L. C., & Thompson, C. B. (2009) · Science · doi:10.1126/science.1160809 · Cited by 16,197
How mitochondria produce reactive oxygen species
Murphy, M. P. (2009) · Biochemical Journal · doi:10.1042/bj20081386 · Cited by 8,207
Watterson, K. R., Bestow, D., Gallagher, J. R., Hamilton, D. L., Ashford, F. B., Meakin, P. J., & Ashford, M. L. J. (2012) · Neurosignals · doi:10.1159/000334144 · Cited by 3,395
OWEN, M. R., DORAN, E., & HALESTRAP, A. P. (2000) · Biochemical Journal · doi:10.1042/bj3480607 · Cited by 2,157
The Kinase LKB1 Mediates Glucose Homeostasis in Liver and Therapeutic Effects of Metformin
Shaw, R. J., Lamia, K. A., Vasquez, D., Koo, S.-H., Bardeesy, N., DePinho, R. A., Montminy, M., & Cantley, L. C. (2005) · Science · doi:10.1126/science.1120781 · Cited by 1,950
Kinaan, M., Ding, H., & Triggle, C. R. (2015) · Medical Principles and Practice · doi:10.1159/000381643 · Cited by 1,515
El-Mir, M.-Y., Nogueira, V., Fontaine, E., Avéret, N., Rigoulet, M., & Leverve, X. (2000) · Journal of Biological Chemistry · doi:10.1074/jbc.275.1.223 · Cited by 1,399
Metformin—mode of action and clinical implications for diabetes and cancer
Pernicova, I., & Korbonits, M. (2014) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2013.256 · Cited by 1,393
Partial Resolution of the Enzymes Catalyzing Oxidative Phosphorylation
Kagawa, Y., & Racker, E. (1971) · Journal of Biological Chemistry · doi:10.1016/s0021-9258(18)61930-1 · Cited by 1,361
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Rena, G., Hardie, D. G., & Pearson, E. R. (2017) · Diabetologia · doi:10.1007/s00125-017-4342-z · Cited by 2,287
High-Resolution CRISPR Screens Reveal Fitness Genes and Genotype-Specific Cancer Liabilities.
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Zielonka, J., Joseph, J., Sikora, A., Hardy, M., Ouari, O., Vasquez-Vivar, J., Cheng, G., Lopez, M., & Kalyanaraman, B. (2017) · Chemical Reviews · doi:10.1021/acs.chemrev.7b00042 · Cited by 1,683
Metformin: from mechanisms of action to therapies
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Metadata
- Authors
- Bridges, H. R., Jones, A. J. Y., Pollak, M. N., & Hirst, J.
- Affiliations
- MRC Mitochondrial Biology Unit (GB)
- Department of Oncology, McGill University and Lady Davis Research Institute of the Jewish General Hospital, Montreal, Quebec, Canada, H3T 1E2
- Corresponding author
- Hirst, Judy
- Venue
- Biochemical Journal
- Publisher
- Portland Press Ltd.
- Published
- 2014-08-22
- Volume
- 462
- Issue
- 3
- Pages
- 475-487
- ISSN
- 0264-6021 (ISSN-L)
- 1470-8728
- PMC
- PMC4148174
- OpenAlex
- W2012442095
- Cited by
- 661
- References
- 79
- Citations by year
- 2026: 30 · 2025: 53 · 2024: 45 · 2023: 41 · 2022: 61 · 2021: 95 · 2020: 72 · 2019: 66 · 2018: 64 · 2017: 60 · 2016: 43 · 2015: 22 · 2014: 9
- FWCI
- 18.33
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Biochemical Journal (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Canadian Institutes of Health Research
- Medical Research Council (U105663141)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Metabolism, Diabetes, and Cancer
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Mitochondrial Function and Pathology
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › ATP Synthase and ATPases Research
- Keywords
- metformin, biguanides, oxidative phosphorylation, mitochondrial complex I, ubiquinone reduction, reactive oxygen species, ATP synthase inhibition, buformin, phenformin, cycloguanil, proguanil, mitochondrial accumulation, type 2 diabetes, anticancer activity, malaria
- MeSH terms
- Animals, Antimalarials, Antineoplastic Agents, Biguanides, Cattle, Proguanil, Diabetes Mellitus, Type 2, Humans, Metformin, Mitochondria, Heart, Mitochondria, Liver, Oxidative Phosphorylation, Plasmodium, Triazines, Reperfusion Injury, Mitochondrial Proton-Translocating ATPases, Electron Transport Complex I, Rats, Hep G2 Cells
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