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1 Second Department of Medicine and 2 Department of Dynamic Pathology, Kyoto Prefectural University of Medicine, Kyoto 602-8566; 3 Department of Clinical Pharmacology, Kyoto Pharmaceutical University, Kyoto 607-8414, Japan; and 4 Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Ontario K1H 8M5, Canada
Recent studies
have suggested that apoptosis and necrosis share common
features in their signaling pathway and that apoptosis requires
intracellular ATP for its mitochondrial/apoptotic
protease-activating factor-1 suicide cascade. The present study was,
therefore, designed to examine the role of intracellular energy levels
in determining the form of cell death in cardiac myocytes. Neonatal rat
cardiac myocytes were first incubated for 1 h in glucose-free
medium containing oligomycin to achieve metabolic inhibition. The cells
were then incubated for another 4 h in similar medium containing
staurosporine and graded concentrations of glucose to manipulate
intracellular ATP levels. Under ATP-depleting conditions, the cell
death caused by staurosporine was primarily necrotic, as determined by
creatine kinase release and nuclear staining with ethidium homodimer-1. However, under ATP-replenishing conditions, staurosporine increased the
percentage of apoptotic cells, as determined by nuclear morphology and DNA fragmentation. Caspase-3 activation by staurosporine was also
ATP dependent. However, loss of mitochondrial transmembrane potential
(
m), Bax translocation, and cytochrome c
release were observed in both apoptotic and necrotic cells.
Moreover, cyclosporin A, an inhibitor of mitochondrial permeability
transition, attenuated staurosporine-induced apoptosis and
necrosis through the inhibition of 
m reduction,
cytochrome c release, and caspase-3 activation. Our data
therefore suggest that staurosporine induces cell demise through a
mitochondrial death signaling pathway and that the presence of
intracellular ATP favors a shift from necrosis to apoptosis through caspase activation.
cytochrome c; mitochondria; necrosis; staurosporine
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