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Autosis is a Na + ,K + -ATPase–regulated form of cell death triggered by autophagy-inducing peptides, starvation, and hypoxia–ischemia
Open accessAbstract
Significance: We show that the selective overactivation of autophagy can cause cell death with unique morphological features distinct from apoptosis or necrosis. This unique type of autophagic cell death, termed “autosis,” occurs not only in vitro but also in vivo in cerebral hypoxia–ischemia. Moreover, autosis is inhibited both in vitro and in vivo by cardiac glycosides, which are Na + ,K + -ATPase antagonists used in clinical medicine. Our findings contribute to the basic understanding of cell-death mechanisms and suggest strategies for protecting cells against stresses such as hypoxia–ischemia.
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In the citing paper
“Corroborating the physiological relevance of this process, the administration of Na+/K+-ATPase inhibitors such as cardiac glycosides, confers neuroprotection in a rat model of neonatal hypoxia-ischemia [851].”
From Molecular mechanisms of cell death: recommendations of the nomenclature committee on cell death 2018. (2018) · cites this paper as [851]
In the citing paper
“Autosis is a specific variant of autophagy-dependent cell death that relies on the plasma membrane Na+/K+-ATPase [851].”
From Molecular mechanisms of cell death: recommendations of the nomenclature committee on cell death 2018. (2018) · cites this paper as [851]
In the citing paper
“On the one hand, RCD constitutes a primary etiological determinant in diseases associated with the irreversible loss of post-mitotic tissues (e.g., myocardial infarction, neurodegeneration) [687, 752, 851, 869, 1035, 1036].”
From Molecular mechanisms of cell death: recommendations of the nomenclature committee on cell death 2018. (2018) · cites this paper as [851]
In the citing paper
“We found that GC reduced the autophagic gene expression including key genes associated with autophagy induction, such as Atg7 and Beclin 1[45], by 1-5 folds”
From Prevention of glucocorticoid induced bone changes with beta-ecdysone (2015) · cites this paper as [45]
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From defense to dysfunction: Autophagy's dual role in disease pathophysiology
Malik, J. A., Zafar, M. A., Singh, S., Nanda, S., Bashir, H., Das, D. K., Lamba, T., Khan, M. A., Kaur, G., & Agrewala, J. N. (2024) · European Journal of Pharmacology · doi:10.1016/j.ejphar.2024.176856 · Cited by 14
Luo, M., Luan, X., Yang, C., Chen, X., Yuan, S., Cao, Y., Zhang, J., Xie, J., Luo, Q., Chen, L., et al. (2024) · Frontiers in Oncology · doi:10.3389/fonc.2024.1397863 · Cited by 14
Inhibition of regulated cell death by cell-penetrating peptides
Krautwald, S., Dewitz, C., Fändrich, F., & Kunzendorf, U. (2016) · Cellular and Molecular Life Sciences · doi:10.1007/s00018-016-2200-7 · Cited by 14
“death which is inhibitable in vitro and in vivo by cardiac glycosides [50].”
BackgroundEmerging immune and cell death mechanisms in stroke: Saponins as therapeutic candidates
García-Pupo, L., San, E. V., Delgado, R., Berghe, T. V., & Berghe, W. V. (2020) · Brain Behavior & Immunity - Health · doi:10.1016/j.bbih.2020.100152 · Cited by 15
“…leads to organelle dysfunction and finally to several cell death pathways, including apoptosis (Chen et al., 2017; Wu et al., 2018), necrosis (Xu et al., 2016), autophagy (Liu et al., 2013; Song et al., 2017), necroptosis (Yang et al., 2017; Zhan et al., 2019) and ferroptosis (Tuo et al., 2017).”
BackgroundBraasch, K., Kryworuchko, M., & Piret, J. M. (2021) · Biotechnology and Bioengineering · doi:10.1002/bit.27703 · Cited by 15
Zagkou, S., Marais, V., Zeghoudi, N., Guillou, É. L., Eskelinen, E., Panasyuk, G., Verrier, B., & Primard, C. (2022) · Pharmaceutics · doi:10.3390/pharmaceutics14071379 · Cited by 15
“On the other hand, overinduction of autophagy by the T-B has been linked to an Na+/K+-ATPase-dependent cell death, termed autosis [26].”
BackgroundDeisl, C., Fine, M., Moe, O. W., & Hilgemann, D. W. (2019) · Pflügers Archiv - European Journal of Physiology · doi:10.1007/s00424-019-02293-0 · Cited by 14
Zhang, S., Ding, F., Liu, Q., Tian, Y., Wang, W., & Qin, C. (2019) · Brain Research · doi:10.1016/j.brainres.2019.146337 · Cited by 14
MicroRNA-216a is essential for cardiac angiogenesis
Juni, R. P., Kocken, J. M. M., de Abreu, R. C., Ottaviani, L., Davalan, T., Duygu, B., Poels, E. M., Vasilevich, A. S., Hegenbarth, J. C., Appari, M., et al. (2023) · Molecular Therapy · doi:10.1016/j.ymthe.2023.04.007 · Cited by 13
“57 Dysregulation of such processes on ECs could explain the severe phenotypes observed in the miR-216a KO mice, where excessive autophagy directly impairs endothelial function and angiogenic capacity.”
Autophagy machinery as exploited by viruses
Münz, C., Campbell, G. R., Esclatine, A., Faure, M., Labonté, P., Lussignol, M., Orvedahl, A., Altan‐Bonnet, N., Bartenschlager, R. F. W., Beale, R. C. L., et al. (2025) · Autophagy Reports · doi:10.1080/27694127.2025.2464986 · Cited by 14
“Autosis, initially described by the laboratory of Beth Levine, is a unique form of non-apoptotic, non-necrotic cell death specifically relying on ATP1A1 (ATPase Na + /K + transporting subunit alpha 1) and autophagy [56].”
InfluentialAutosis as a selective type of cell death
Bai, L., Wu, Q., Zhang, X., & Zhao, Y. (2023) · Frontiers in Cell and Developmental Biology · doi:10.3389/fcell.2023.1164681 · Cited by 17
“…Zhang et al., 2019; Camuzard et al., 2020; Fernandez et al., 2020; Deng et al., 2022; Yin et al., 2022), neriifolin (in vivo during cerebral H/I) (Liu et al., 2013; Fernandez et al., 2020), ouabain (in vivo during renal and cardiac I/R) (Fernandez et al., 2020; Nah et al., 2020), digitoxigenin…”
BackgroundMethodInfluentialAutophagy and its role in pulmonary hypertension
Chen, Y. (2018) · Aging Clinical and Experimental Research · doi:10.1007/s40520-018-1063-1 · Cited by 13
Zhu, H., Xia, M.-M., Tong, K.-H., & Duan, W. (2022) · Digestive Diseases and Sciences · doi:10.1007/s10620-022-07653-y · Cited by 12
Suppressor of cytokine signaling 2 is induced in Huntington’s disease and involved in autophagy
Cho, K., Kim, S., & Choi, S. H. (2021) · Biochemical and Biophysical Research Communications · doi:10.1016/j.bbrc.2021.04.089 · Cited by 12
Majdoul, S., Cosette, J., Seye, A. K., Bernard, É., Frin, S., Holic, N., Chazal, N., Briant, L., Espert, L., Galy, A. H. M., et al. (2017) · Journal of Biological Chemistry · doi:10.1074/jbc.m117.800813 · Cited by 12
Sato, K., Nishii, T., Sato, A., & Tatsunami, R. (2020) · Heliyon · doi:10.1016/j.heliyon.2020.e03315 · Cited by 12
Recovery Mechanism of Endoplasmic Reticulum Revealed by Fluorescence Lifetime Imaging in Live Cells
Chen, J., Han, G., Liu, Z., Wang, H., Wang, D., Zhao, J., Liu, B., Zhang, R., & Zhang, Z. (2022) · Analytical Chemistry · doi:10.1021/acs.analchem.2c00216 · Cited by 11
Regulatory effect of insulin on the structure, function and metabolism of Na+/K+‑ATPase (Review)
Wen, X.-P., & Wan, Q.-Q. (2021) · Experimental and Therapeutic Medicine · doi:10.3892/etm.2021.10678 · Cited by 11
“Furthermore, it is known that Na+/K+‐ATPase may be degraded by UPP and autophagy‐lysosomal pathway (26,27,33,34).”
BackgroundRoles of Autophagy and Oxidative Stress in Cardiovascular Disease
Yun, H. R., Singh, M. K., Han, S., Ranbhise, J. S., Ha, J., Kim, S. S., & Kang, I. (2025) · Antioxidants · doi:10.3390/antiox14101263 · Cited by 13
“K + -ATPase-dependent cell death under severe stress [266,327,328].”
Mitophagy: At the heart of mitochondrial quality control in cardiac aging and frailty
Picca, A., Calvani, R., Coelho‐Júnior, H. J., & Marzetti, E. (2021) · Experimental Gerontology · doi:10.1016/j.exger.2021.111508 · Cited by 11
Ye, K., Han, X., Tian, M., Liu, L., Gao, X., Xia, Q. H., & Wang, D. (2025) · Journal of Translational Medicine · doi:10.1186/s12967-025-06324-6 · Cited by 11
Metadata
- Authors
- Liu, Y., Shoji-Kawata, S., Sumpter, R. M., Wei, Y., Ginet, V., Zhang, L., Posner, B., Tran, K. A., Green, D. R., Xavier, R. J., Shaw, S. Y., Clarke, P. G. H., Puyal, J., & Levine, B.
- Affiliations
- Center for Autophagy Research,
- Howard Hughes Medical Institute (US)
- University of Lausanne (CH)
- Biochemistry, and
- Center for Systems Biology (US)
- St. Jude Children's Research Hospital (US)
- Broad Institute (US)
- ORCID
- Venue
- Proceedings of the National Academy of Sciences
- Publisher
- National Academy of Sciences
- Published
- 2013-11-25
- Volume
- 110
- Issue
- 51
- Pages
- 20364-20371
- ISSN
- 0027-8424 (ISSN-L)
- 1091-6490
- PMC
- PMC3870705
- OpenAlex
- W2145084709
- Cited by
- 607
- References
- 35
- Citations by year
- 2026: 33 · 2025: 48 · 2024: 38 · 2023: 51 · 2022: 46 · 2021: 58 · 2020: 50 · 2019: 51 · 2018: 43 · 2017: 58 · 2016: 47 · 2015: 43 · 2014: 38
- FWCI
- 31.15
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Proceedings of the National Academy of Sciences (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- SERVAL (Université de Lausanne) (acceptedVersion, other-oa)
- IRIS (submittedVersion)
- Funders
- National Science Foundation (310030)
- Howard Hughes Medical Institute
- McKnight Foundation
- University of Texas Southwestern Medical Center
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (130769, 310030)
- Université de Lausanne
- National Institutes of Health (HHSN268201000044C, 5p01ca095471-10, 1P01CA95471-09)
- U.S. Public Health Service (R01 A140646)
- National Heart, Lung, and Blood Institute (HHSN268201000044C)
- National Cancer Institute (P01 CA95471, P01-CA095471, R01CA169291, CA109618, HHSN268201000044C, (CA142543), R01CA109618, P30CA142543)
- National Institute of Allergy and Infectious Diseases (R01AI040646, U54AI057156)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Autophagy in Disease and Therapy
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Cell death mechanisms and regulation
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Physiology › Calcium signaling and nucleotide metabolism
- Keywords
- autophagic cell death, Na+/K+-ATPase, Beclin-1, starvation, hypoxia-ischemia, hippocampal neurons, cardiac glycosides, Na+/K+-ATPase alpha1 subunit, autophagosomes, cell death regulation
- MeSH terms
- Sodium-Potassium-Exchanging ATPase, Animals, Autophagy, Cardiac Glycosides, Brain Ischemia, HeLa Cells, Humans, Nerve Tissue Proteins, Rats, Cell-Penetrating Peptides
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