title: The common inhalational anesthetic isoflurane induces apoptosis via activation of inositol 1,4,5-trisphosphate receptors.
abstract: BACKGROUND
  Isoflurane induces cell apoptosis by an unknown mechanism. The authors hypothesized that isoflurane activates inositol 1,4,5-trisphosphate (IP3) receptors on the endoplasmic reticulum (ER) membrane, causing excessive calcium release, triggering apoptosis.
  
  
  METHODS
  The authors determined isoflurane-induced cytotoxicity by measuring caspase-3 activity, lactate dehydrogenase release, MTS (3-(4,5-dimethylthiazol-2-yl)-5-(3carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium, inner salt) reduction, and imaging analysis of cell damage markers (annexin V and propidium iodide staining) in different cell types. The authors used the chicken B lymphocyte with a total knock-out of IP3 receptors, PC12 cells with elevated IP3 receptor activity (transfected with L286V presenilin 1), striatal cells with a knock-in of Q111 Huntingtin, and each cell line's corresponding wild-type controls. The authors also measured the isoflurane-evoked changes of calcium concentration in cytosol and/or mitochondria in these cells.
  
  
  RESULTS
  Isoflurane induced apoptosis concentration- and time-dependently, and sequentially elevated cytosolic and then mitochondrial calcium in the chicken B-lymphocyte wild-type but not the IP3 receptor total knock-out cells. Thapsigargin, a calcium adenosine triphosphatase inhibitor on ER membranes, induced apoptosis and elevations of calcium in cytosol and mitochondria in both chicken B-lymphocyte wild-type and IP3 receptor total knock-out cells. Isoflurane induced significantly more neurotoxicity and greater calcium release from the ER in L286V PC12 and Q111 Huntingtin striatal cells than in their corresponding wild-type controls, both of which were significantly inhibited by the IP3 receptor antagonist xestospongin C.
  
  
  CONCLUSIONS
  These findings suggest that isoflurane activates the ER membrane IP3 receptor, producing excessive calcium release and triggering apoptosis. Neurons with enhanced IP3 receptor activity, as in certain cases of familial Alzheimer or Huntington disease, may be especially vulnerable to isoflurane cytotoxicity.
authors.affiliation: Department of Anesthesiology and Critical Care, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA. weih@uphs.upenn.edu
authors.forename: Huafeng
authors.initials: H
authors.lastname: Wei
authors.forename: Ge
authors.initials: G
authors.lastname: Liang
authors.forename: Hui
authors.initials: H
authors.lastname: Yang
authors.forename: Qiujun
authors.initials: Q
authors.lastname: Wang
authors.forename: Brian
authors.initials: B
authors.lastname: Hawkins
authors.forename: Muniswamy
authors.initials: M
authors.lastname: Madesh
authors.forename: Shouping
authors.initials: S
authors.lastname: Wang
authors.forename: Roderic G
authors.initials: RG
authors.lastname: Eckenhoff
mesh_terms: D018685:Anesthetics, Inhalation / Q000494:pharmacology*; D000818:Animals; D030801:Animals, Genetically Modified; D017304:Annexin A5 / Q000378:metabolism; D017209:Apoptosis / Q000187:drug effects*; D001402:B-Lymphocytes / Q000187:drug effects / Q000502:physiology*; D053148:Caspase 3 / Q000378:metabolism; D002460:Cell Line; D002645:Chickens; D003342:Corpus Striatum / Q000187:drug effects / Q000502:physiology; D017353:Gene Deletion; D053496:Inositol 1,4,5-Trisphosphate Receptors / Q000187:drug effects / Q000235:genetics / Q000502:physiology*; D007530:Isoflurane / Q000494:pharmacology*; D051379:Mice; D016716:PC12 Cells; D010673:Pheochromocytoma; D053764:Presenilin-1 / Q000235:genetics / Q000502:physiology; D051381:Rats
chemical_list: D018685:Anesthetics, Inhalation; D017304:Annexin A5; D053496:Inositol 1,4,5-Trisphosphate Receptors; D053764:Presenilin-1; D007530:Isoflurane; D053148:Caspase 3