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Bax and Bak function as the outer membrane component of the mitochondrial permeability pore in regulating necrotic cell death in mice
Open accessAbstract
A critical event in ischemia-based cell death is the opening of the mitochondrial permeability transition pore (MPTP). However, the molecular identity of the components of the MPTP remains unknown. Here, we determined that the Bcl-2 family members Bax and Bak, which are central regulators of apoptotic cell death, are also required for mitochondrial pore-dependent necrotic cell death by facilitating outer membrane permeability of the MPTP. Loss of Bax/Bak reduced outer mitochondrial membrane permeability and conductance without altering inner membrane MPTP function, resulting in resistance to mitochondrial calcium overload and necrotic cell death. Reconstitution with mutants of Bax that cannot oligomerize and form apoptotic pores, but still enhance outer membrane permeability, permitted MPTP-dependent mitochondrial swelling and restored necrotic cell death. Our data predict that the MPTP is an inner membrane regulated process, although in the absence of Bax/Bak the outer membrane resists swelling and prevents organelle rupture to prevent cell death.
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“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 [407]
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“Over a decade ago, several reports suggested that Bax and/or Bak directly interacted with presumed components of the MPTP, the adenine nucleotide translocator (ANT) in the inner membrane and the VDAC in the outer membrane (Marzo et al., 1998; Narita et al., 1998; Shimizu et al., 1999).”
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PRC2 loss induces chemoresistance by repressing apoptosis in T cell acute lymphoblastic leukemia
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BackgroundThe Beneficial Roles of SIRT1 in Drug-Induced Liver Injury
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P38α MAPK underlies muscular dystrophy and myofiber death through a Bax-dependent mechanism
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Role of Mitofusins and Mitophagy in Life or Death Decisions
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“Oligomerized BAK and BAX cause mitochondrial outer membrane permeabilization (MOMP) and contribute to mitochondrial permeability transition pore (MPTP) [35].”
BackgroundPromising Strategy of mPTP Modulation in Cancer Therapy: An Emerging Progress and Future Insight
Waseem, M., & Wang, B. (2023) · International Journal of Molecular Sciences · doi:10.3390/ijms24065564 · Cited by 50
“OMM, outer mitochondrial membrane; IMM, inner mitochondrial membrane; VDAC, voltage‐dependent anion channel (mitochondrial porin); HK‐II, hexokinase II; TSPO, translocator protein; ANT, ade‐ nine nucleotide transporter; CypD, cyclophilin D; Bcl‐2, antiapoptotic protein; BAX, proapoptotic protein.”
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Self-citationWang, W., Fernández‐Sanz, C., & Sheu, S. (2017) · Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease · doi:10.1016/j.bbadis.2017.09.004 · Cited by 46
“The outer membrane permeabilization is thought to be the first step of mPTP opening [99].”
BackgroundFunctional Role of microRNAs in Regulating Cardiomyocyte Death
Kansakar, U., Varzideh, F., Mone, P., Jankauskas, S. S., & Santulli, G. (2022) · Cells · doi:10.3390/cells11060983 · Cited by 46
“On the other hand, the intrinsic pathway is mainly mediated by mitochondriaassociated BCL-2 family proteins, namely BAX and BAK [37–42], located in the outer mitochondrial membrane [43].”
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“Members of Bcl-2 family control the integrity of the OMM and are crucial in determining the susceptibility of cells to apoptosis induced by the mitochondria-mediated pathway [20].”
BackgroundMyocardin regulates mitochondrial calcium homeostasis and prevents permeability transition
Mughal, W., Martens, M. D., Field, J. T., Chapman, D. C., Huang, J., Rattan, S. G., Hai, Y., Cheung, K. G., Kereliuk, S. M., West, A. R., et al. (2018) · Cell Death and Differentiation · doi:10.1038/s41418-018-0073-z · Cited by 43
“serve as outer member modulators of permeability transition [16].”
BackgroundRuiz, A., Quintela‐López, T., Sánchez‐Gómez, M. V., Gaminde‐Blasco, A., Alberdi, E. M., & Matute, C. (2020) · Glia · doi:10.1002/glia.23802 · Cited by 43
“Indeed, mitochondrial swelling caused by mitochondrial per- meability transition pore opening is a hallmark of necrotic cell death (Karch et al., 2013), a major cell death mechanism contributing to oli- godendroglial excitotoxicity (Leuchtmann, Ratner, Vijitruth, Qu, & McDonald, 2003).”
BackgroundPekson, R., Liang, F. G., Axelrod, J. L., Lee, J., Qin, D., Wittig, A. J. H., Paulino, V. M., Zheng, M., Peixoto, P. M. V., & Kitsis, R. N. (2023) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.2303713120 · Cited by 42
“…translocator protein (also referred to as peripheral benzodiazepine receptor) (17), BCL2 associated X (BAX) and BCL2 antagonist/ killer 1 (BAK) (18, 19), adenine nucleotide translocase (ANT) (20, 21), the mitochondrial phosphate carrier (22), and cyclophilin D (11, 12) for Ca 2+ - induced mPTP…”
BackgroundSelf-citationAberrant Mitochondrial Fission Is Maladaptive in Desmin Mutation–Induced Cardiac Proteotoxicity
Alam, S., Abdullah, C. S., Aishwarya, R., Miriyala, S., Panchatcharam, M., Peretik, J. M., Orr, A. W., James, J., Robbins, J. M., & Bhuiyan, M. S. (2018) · Journal of the American Heart Association · doi:10.1161/jaha.118.009289 · Cited by 41
“Mitochondrial Ca Retention Capacity and Swelling Assay Mitochondrial Ca retention capacity was measured with Calcium Green 5N (Molecular Probes) as previously described.(22,23) Cardiac mitochondria (100 lg) were suspended in KCl buffer containing 125 mmol/L KCl, 20 mmol/ L HEPES, 2 mmol/L MgCl2, 2 mmol/L potassium pho…”
Self-citationBuskaran, K., Saifullah, B., Hussein, M. Z., Masarudin, M. J., Moklas, M. A. M., & Fakurazi, S. (2021) · Materials · doi:10.3390/ma14040817 · Cited by 41
“abundantly in cell cytosol will assist in the transportation of the protein through the mitochondrial membrane by stimulating the transition pore permeability [55].”
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Cho, G. W., Altamirano, F. J., & Hill, J. A. (2016) · Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease · doi:10.1016/j.bbadis.2016.01.011 · Cited by 40
“13 D- and Bax/Bak, both of which are known regulators of the MPTP, are resistant to necrotic cell death [114].”
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“The loss of mitochondrial membrane potential and a decrease in ATP synthesis can result, eventually inducing necrotic cell death [60].”
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Directly targeting BAX for drug discovery: Therapeutic opportunities and challenges
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“Emerging evidence indicates that BAX drives mitochondrial fusion 180 and MPTP-dependent Ca 2 þ release 181 to sensitize the opening of MPTP, ultimately promoting necrosis.”
BackgroundKerkhofs, M., Rovere, R. L., Welkenhuysen, K., Janssens, A. M., Vandenberghe, P., Madesh, M., Parys, J. B., & Bultynck, G. (2021) · Cell Calcium · doi:10.1016/j.ceca.2020.102333 · Cited by 38
Vimar Is a Novel Regulator of Mitochondrial Fission through Miro
Ding, L., Ye, L., Han, Y., Li, Y., Ji, X., & Liu, L. (2016) · PLoS Genetics · doi:10.1371/journal.pgen.1006359 · Cited by 36
“Necrotic cell death was induced by a calcium ionophore (A23187), which causes calcium overloading and necrosis [52].”
BackgroundDeragon, M. A., McCaig, W. D., Truong, P. V., Metz, K. R., Carron, K. A., Hughes, K. J., Knapp, A. R., Dougherty, M. J., & LaRocca, T. J. (2023) · International Journal of Molecular Sciences · doi:10.3390/ijms24108609 · Cited by 38
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In vitrocytotoxicity assessment of roundup (glyphosate) in L-02 hepatocytes
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“The opening of PTP is viewed as a critical event in the process of cell death.([19]) Calcium is a key element in metabolic and intracellular signaling regulation, and the concentration of Ca2C in the cytosol is tightly controlled under normal conditions.”
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“Mitochondria are critical organelles that are required to provide a biological form of energy, namely, ATPs; however, once becoming dysfunctional, they can trigger apoptotic as well as necrotic cell death [10, 11].”
BackgroundAntoniak, S., Phungphong, S., Cheng, Z., & Jensen, B. C. (2022) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2021.817977 · Cited by 33
“In addition, Bax and Bak are necessary for mPTP-driven necrosis (64, 65).”
BackgroundSedky, N. K., Mahdy, N. K., Abdel-Kader, N. M., Abdelhady, M. M. M., Maged, M., Allam, A. L., Alfaifi, M. Y., Shamma, S. N., Hassan, H. A. F. M., & Fahmy, S. A. (2024) · RSC Advances · doi:10.1039/d3ra08908h · Cited by 31
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“, the voltage dependent anion channel (VDAC), thereby promoting Ca2þ-dependent PTP opening (Morin et al., 2009; Karch et al., 2013; Whelan et al., 2012).”
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“The new knowledge brings uncertainty regarding whether the inner and outer mitochondrial membranes physically couple during MPT; new models indicate that these function independently, with the primary site of regulation being on the inner membrane.”
InfluentialRegulated Necrosis in HeLa Cells Induced by ZnPc Photodynamic Treatment: A New Nuclear Morphology
Soriano, J., Villanueva, Á., STOCKERT, J. C., & Cañete, M. (2014) · International Journal of Molecular Sciences · doi:10.3390/ijms151222772 · Cited by 30
“Mitochondria would be also involved in this mechanism [36], but the integration of these processes is not yet known.”
BackgroundLenti-siRNA Hsp60 promote bax in mitochondria and induces apoptosis during heat stress
Song, E., Tang, S., Xu, J., Yin, B., Bao, E., & Hartung, J. (2016) · Biochemical and Biophysical Research Communications · doi:10.1016/j.bbrc.2016.10.153 · Cited by 30
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Self-citationMitochondrial Volume Regulation and Swelling Mechanisms in Cardiomyocytes
Chapa‐Dubocq, X. R., Rodríguez‐Graciani, K. M., Escobales, N., & Javadov, S. A. (2023) · Antioxidants · doi:10.3390/antiox12081517 · Cited by 30
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“Transmission electron microscopy (TEM) was performed as described previously (44).”
MethodSelf-citationPharmacological Targeting of Executioner Proteins: Controlling Life and Death
Pogmore, J. P., Uehling, D., & Andrews, D. W. (2021) · Journal of Medicinal Chemistry · doi:10.1021/acs.jmedchem.0c02200 · Cited by 28
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“Although it has been disputed whether BAX/BAK regulates the mPTP opening, genetic studies revealed that deletion of BAX/BAK inhibits both the mPTP opening and necrotic cell death, suggesting the ability of BAX/BAK to facilitate mPTP-induced necrotic cell death [42,43].”
BackgroundMitochondrial oxidative stress, calcium and dynamics in cardiac ischaemia‐reperfusion injury
Rozich, E., Ozkurede, U., Pakkiriswami, S., Gemilere, R., Azarin, S. M., & Liu, J. C. (2025) · The Journal of Physiology · doi:10.1113/jp287770 · Cited by 29
“Other regulatory factors controlling mPTP opening include interactions between inner and outer mitochondrial membrane proteins, as well as the pro-apoptotic Bcl-2 family proteins Bax and Bak (Halestrap & Richardson, 2015; Karch et al., 2013; Patel et al., 2021; Whelan et al., 2012).”
[Retracted] Involvement of Mitochondrial Dynamics and Mitophagy in Sevoflurane‐Induced Cell Toxicity
Li, M., Guo, J., Wang, H., & Li, Y. (2021) · Oxidative Medicine and Cellular Longevity · doi:10.1155/2021/6685468 · Cited by 23
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“As a result, loss of Bcl-2 during IRI allows Bax and Bak to create a second pore in the outer mitochondrial membrane that releases cytochrome C into the cytoplasm and activates caspasemediated cellular degradation via caspase-3.(28,29) Recent reports illustrate that stabilizing mitochondrial electron transport chain f…”
BackgroundArumugam, P., Samson, A. A. S., Ki, J., & Song, J. M. (2017) · Cell Biology and Toxicology · doi:10.1007/s10565-016-9378-1 · Cited by 23
“Recently, it has been reported that Bcl-2 family members, Bax and Bak, were critically required for the MPTP-dependent necrotic cell death (Karch andMolkentin 2015) (Karch et al. 2013).”
BackgroundDrees, A. A., Khalil, M. S., & Soliman, M. (2017) · ACTA HISTOCHEMICA ET CYTOCHEMICA · doi:10.1267/ahc.16025 · Cited by 26
Laser-mediated rupture of chlamydial inclusions triggers pathogen egress and host cell necrosis
Kerr, M. C., Gomez, G. A., Ferguson, C., Tanzer, M. C., Murphy, J. M., Yap, A. S., Parton, R. G., Huston, W. M., & Teasdale, R. D. (2017) · Nature Communications · doi:10.1038/ncomms14729 · Cited by 23
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“In addition, the physical interaction of Bax/Bak with the mPTP constituents on the OMM can trigger mPT [8, 9].”
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“RIP1/RIP3 phosphorylation also triggers mixed-lineage kinase domain-like protein (MLKL) activation [90,91], which guides mitochondrial disarrangement, altered cell permeability, and finally, necrosis [92].”
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“Mitochondrial permeability transition pore (MPTP) is a multiple protein complex modulating the opening of the inner mitochondrial membrane and allowing the passage of solutes with molecular weights 1500 Da.45 MPTP opening leads to the loss of ionic homeostasis, depleted ATP and ultimate necrotic cell death.46 The mole…”
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“In addition, Bax is responsible for the formation of these permeability pores leading to cell necrosis [52].”
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“It has been shown that the pathological opening of mPTP is involved in the occurrence of myocardial ischemia/ reperfusion injury and heart failure [19, 20].”
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“The onset of mitochondrial permeability transition pore was involved in necrosis.(15) Apoptosis and necrosis can occur concurrently and share some common pathways, which may be differentially induced by variable doses of pollutants.”
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“These proteins oligomerize or interact with the mitochondrial permeability transition pore to form channels [124].”
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“After being stimulated by apoptotic signal, bad is dephosphorylated, and free bad is promoted by replacing Bax on the Bcl-2/Bax and Bcl-Lx/Bax dimers through the above mechanism to promote apoptosis (Karch et al. 2013).”
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The Mitochondrial Permeability Transition Pore
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Metadata
- Authors
- Karch, J., Kwong, J. Q., Burr, A. R., Sargent, M. A., Elrod, J. W., Peixoto, P. M., Martinez-Caballero, S., Osinska, H., Cheng, E. H.-Y., Robbins, J., Kinnally, K. W., & Molkentin, J. D.
- Affiliations
- Cincinnati Children's Hospital Medical Center (US)
- New York University (US)
- Department of Basic Sciences, New York University College of Dentistry, New York, United States
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, United States
- Memorial Sloan Kettering Cancer Center (US)
- Corresponding author
- Molkentin, Jeffery D
- ORCID
- Venue
- eLife
- Publisher
- eLife Sciences Publications, Ltd
- Published
- 2013-08-27
- Volume
- 2
- Pages
- e00772-e00772
- ISSN
- 2050-084X (ISSN-L)
- PMC
- PMC3755340
- OpenAlex
- W2139284714
- Cited by
- 290
- References
- 53
- Citations by year
- 2026: 8 · 2025: 25 · 2024: 16 · 2023: 31 · 2022: 22 · 2021: 26 · 2020: 25 · 2019: 23 · 2018: 27 · 2017: 22 · 2016: 26 · 2015: 16 · 2014: 21 · 2013: 1
- FWCI
- 9.55
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- eLife (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- CUNY Academic Works (City University of New York) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Howard Hughes Medical Institute
- National Institutes of Health (P01 HL080101)
- American Heart Association pre-doctoral grant
- American Heart Association
- 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 › Cardiology and Cardiovascular Medicine › Cardiac Ischemia and Reperfusion
- Keywords
- Bax, Bak, mitochondrial permeability transition pore, necrosis, mitochondrial outer membrane permeabilization, Bcl-2 family proteins, mitochondrial calcium overload, mitochondrial swelling, ischemia, Bax oligomerization
- MeSH terms
- Mitochondrial Permeability Transition Pore, Animals, Necrosis, Mitochondrial Membrane Transport Proteins, bcl-2 Homologous Antagonist-Killer Protein, bcl-2-Associated X Protein, Mice
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