Bax regulates primary necrosis through mitochondrial dynamics
Open accessAbstract
The defining event in apoptosis is mitochondrial outer membrane permeabilization (MOMP), allowing apoptogen release. In contrast, the triggering event in primary necrosis is early opening of the inner membrane mitochondrial permeability transition pore (mPTP), precipitating mitochondrial dysfunction and cessation of ATP synthesis. Bcl-2 proteins Bax and Bak are the principal activators of MOMP and apoptosis. Unexpectedly, we find that deletion of Bax and Bak dramatically reduces necrotic injury during myocardial infarction in vivo. Triple knockout mice lacking Bax/Bak and cyclophilin D, a key regulator of necrosis, fail to show further reduction in infarct size over those deficient in Bax/Bak. Absence of Bax/Bak renders cells resistant to mPTP opening and necrosis, effects confirmed in isolated mitochondria. Reconstitution of these cells or mitochondria with wild-type Bax, or an oligomerization-deficient mutant that cannot support MOMP and apoptosis, restores mPTP opening and necrosis, implicating distinct mechanisms for Bax-regulated necrosis and apoptosis. Both forms of Bax restore mitochondrial fusion in Bax/Bak-null cells, which otherwise exhibit fragmented mitochondria. Cells lacking mitofusin 2 (Mfn2), which exhibit similar fusion defects, are protected to the same extent as Bax/Bak-null cells. Conversely, restoration of fused mitochondria through inhibition of fission potentiates mPTP opening in the absence of Bax/Bak or Mfn2, indicating that the fused state itself is critical. These data demonstrate that Bax-driven fusion lowers the threshold for mPTP opening and necrosis. Thus, Bax and Bak play wider roles in cell death than previously appreciated and may be optimal therapeutic targets for diseases that involve both forms of cell death.
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Pro- and anti-apoptotic BCL2 family members such as BAX, BAK, BID, BCL2, and BCL-XL regulate MPT-driven necrosis.
“These include: (1) pro- and anti-apoptotic BCL2 family members such as BAX, BAK, and BID [407–410], as well as BCL2 and BCL-XL [411–414]”
From Molecular mechanisms of cell death: recommendations of the nomenclature committee on cell death 2018. (2018) · cites this paper as [408]
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- Authors
- Whelan, R. S., Konstantinidis, K., Wei, A.-C., Chen, Y., Reyna, D. E., Jha, S., Yang, Y., Calvert, J. W., Lindsten, T., Thompson, C. B., Crow, M. T., Gavathiotis, E., Dorn, G. W., O'Rourke, B., & Kitsis, R. N.
- Affiliations
- Yeshiva University (US)
- Johns Hopkins University (US)
- Washington University in St. Louis (US)
- Emory University (US)
- Memorial Sloan Kettering Cancer Center (US)
- Albert Einstein College of Medicine (US)
- ORCID
- Venue
- Proceedings of the National Academy of Sciences
- Publisher
- National Academy of Sciences
- Published
- 2012-04-09
- Volume
- 109
- Issue
- 17
- Pages
- 6566-6571
- ISSN
- 0027-8424 (ISSN-L)
- 1091-6490
- PMC
- PMC3340068
- OpenAlex
- W2047322721
- Cited by
- 290
- References
- 37
- Citations by year
- 2026: 6 · 2025: 19 · 2024: 13 · 2023: 17 · 2022: 10 · 2021: 14 · 2020: 20 · 2019: 27 · 2018: 13 · 2017: 20 · 2016: 18 · 2015: 30 · 2014: 34 · 2013: 33 · 2012: 16
- FWCI
- 14.52
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Proceedings of the National Academy of Sciences (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Aging (T32AG023475)
- National Heart, Lung, and Blood Institute (R01HL098481, 5R01HL60665-13, R00HL095929, R37HL054598, R01HL060665, R01HL059888)
- National Cancer Institute (P30CA013330)
- National Institute of Diabetes and Digestive and Kidney Diseases (P60DK020541)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Cell death mechanisms and regulation
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Mitochondrial Function and Pathology
- Health Sciences › Medicine › Pathology and Forensic Medicine › Cardiac Ischemia and Reperfusion
- Keywords
- Bax, Bak, mitochondrial permeability transition pore, mitochondrial dynamics, mitochondrial fusion, mitofusin 2, mitochondrial fission, mitochondrial dysfunction, cyclophilin D, myocardial infarction, apoptosis, Bcl-2 family proteins, cell death
- MeSH terms
- Adenosine Triphosphate, Animals, Mitochondria, Myocardial Infarction, Necrosis, Mice, Knockout, bcl-2-Associated X Protein, Mice
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