
[Cancer Research 61, 1038-1044, February 1, 2001]
© 2001 American Association for Cancer Research
Experimental Therapeutics |
Anticancer Drugs Induce Increased Mitochondrial Cytochrome c Expression That Precedes Cell Death1
José A. Sánchez-Alcázar,
Alexey Khodjakov and
Erasmus Schneider2
Wadsworth Center, New York State Department of Health [J. A. S-A., A. K., E. S.], and Department of Biomedical Sciences, School of Public Health, University at Albany [A. K., E. S.], Albany, New York 12201
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ABSTRACT
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Recent studies have demonstrated that cytochrome c plays
an important role in cell death. In the present study, we report that
teniposide and various other chemotherapeutic agents induced a
dose-dependent increase in the expression of the mitochondrial
respiratory chain proteins cytochrome c, subunits I and
IV of cytochrome c oxidase, and the free radical
scavenging enzyme manganous superoxide dismutase. The
teniposide-induced increase of cytochrome c was
inhibited by cycloheximide, indicating new protein synthesis. Elevated
cytochrome c levels were associated with enhanced
cytochrome c oxidase-dependent oxygen uptake using
TMPD/ascorbate as the electron donor, suggesting that the newly
synthesized proteins were functional. Cytochrome c was
released into the cytoplasm only after maximal levels had been reached
in the mitochondria, but there was no concomitant decrease in
mitochondrial membrane potential or caspase activation. Our results
suggest that the increase in mitochondrial protein expression may play
a role in the early cellular defense against anticancer drugs.
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INTRODUCTION
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Recent studies have shown that alterations of mitochondrial
functions such as
PT3
play a major role in the apoptotic process induced by chemotherapeutic
agents (1
, 2)
. Mitochondria undergoing PT release
apoptogenic proteins such as cytochrome c or the
apoptosis-inducing factor from the mitochondrial intermembrane space
into the cytosol, where they can activate caspases and endonucleases
(3
, 4)
. The release of mitochondrial cytochrome
c in particular is a critical step in the apoptotic as well
as the necrotic process (5, 6, 7)
. However, the mechanism(s)
by which cytochrome c is released from mitochondria remains
unclear. It has been proposed that PT would allow the passive release
of cytochrome c and other caspase-activating factor(s) from
the mitochondrial intermembrane space into the cytosol (8
, 9)
. However, it has also been reported that in various cell
types the release of cytochrome c occurs before or even in
the absence of a change in mitochondrial permeability, suggesting that
this release can occur by mechanisms other than the opening of the PT
pore (10, 11, 12, 13)
. For example, overexpression of the
pro-apoptotic protein Bax has been shown to trigger cytochrome
c efflux from mitochondria and cell death (14
, 15)
, possibly via the formation of membrane channels, whereas
the redistribution of cytochrome c during apoptosis can be
prevented by overexpression of the anti-apoptotic protein Bcl-2
(10
, 11)
. Thus, the exact sequence of events leading to
the onset of cell death remains unclear and may differ in different
systems.
The goal of the present study was to characterize the biochemical and
molecular events occurring in the various stages leading to cell death,
using human breast epithelial cells as a model. To this end we took
advantage of the fact that, during apoptosis, cells grown as monolayers
detach from the surface of the culture flask and float in the medium.
The standard procedure of collecting the medium, trypsinizing the
attached cells and then combining both populations (floating cells and
adherent cells) is often used for quantitative analysis of apoptosis.
However, this approach may bias biochemical studies carried out on the
bulk cell population and may result in misinterpretation of the real
events occurring in the living population before death. Therefore, in
the present study we separately collected and studied attached and
floating cells to characterize the biochemical/molecular events,
whereas we combined both populations to quantify apoptosis. Using this
approach, we showed that teniposide and other chemotherapeutic agents
increased the levels of proteins of the mitochondrial respiratory
chain, such as cytochrome c, and subunits I and IV of COX.
This up-regulation of mitochondrial proteins preceded cytochrome
c release, drop of 
m and caspase
activation.
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MATERIALS AND METHODS
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Reagents.
All reagents and drugs were obtained from Sigma (St. Louis, MO), unless
otherwise indicated. Antibodies against COX subunits I and IV were from
Molecular Probes (Eugene, OR); against cytochrome c (clone
7H8.2C12) and caspases 3 and 9 from PharMingen (San Diego, CA); against
PARP from Roche Biochemicals (Indianapolis, IN); against GAPDH (clone
6C5) from Research Diagnostics, Inc. (Flanders, NJ); and against
citrate synthase from Chemicon International, Inc. (Temecula, CA).
Anti-VDAC antibody was a gift from Dr. C.A. Mannella, (Wadsworth
Center, Albany, NY) and anti-manganous superoxide dismutase
antibody was a gift from Dr. J. A. Melendez (Albany Medical
College, Albany, NY). A complete cocktail of protease inhibitors
was purchased from Roche Biochemicals (Indianapolis, IN).
Cell Culture.
Human breast carcinoma MDA-MB-231 were cultured in IMEM medium
supplemented with penicillin, streptomycin, glutamate (2
mM), and 10% fetal bovine serum at 37°C in a
humidified atmosphere of 5% CO2 in air.
Separation of Attached and Floating Cells.
During the process of cell death, MDA-MB-231 cells detached from the
culture flask and floated in the medium. We exploited this phenomenon
as an easy way to separate attached/living cells from floating/dead
cells. Thus, floating cells were collected from the culture supernatant
by centrifugation (5 min at 1200 rpm), whereas the attached cells were
harvested by trysinization. Viability of floating and attached cells
was determined by PI staining and microscopic evaluation. Only samples
of attached cells with >85% of viable cells were used for additional
studies. The floating cell population was 100% PI-positive.
DNA Fragmentation Analysis.
For DNA fragmentation analysis, 3 x 106 MDA-MB-231 cells were exposed to teniposide
(10 µM) for 24, 48, or 72 h. Attached and floating
cells were harvested and combined, washed with cold PBS, and
resuspended in 400 µl of hypotonic lysis buffer A [10 mM
Tris/HCl (pH 7.5), 1 mM EDTA, and 0.2% Triton X-100]. The
cell lysates were centrifuged at 13,000 rpm for 15 min in a
microcentrifuge. The supernatant (350 µl) was then incubated
with 106 µl of lysis buffer B [150 mM NaCl, 10
mM Tris-HCl (pH 8.0), 40 mM EDTA, 1% SDS, and
0.2 mg/ml proteinase K, final concentrations] for 4 h at 37°C.
The DNA was extracted with phenol/chloroform/isoamyl alcohol (25:25:1,
v/v/v) and ethanol precipitated for 1218 h. After centrifugation for
5 min at 13,000 rpm and 4°C, the DNA pellet was washed with 500 µl
of 70% ethanol and resuspended in 15 µl of 10 mM
Tris/HCl (pH 8.5), 1 mM EDTA containing 50 µg/ml RNase,
and incubated for 1 h at 37°C. Each DNA sample was then analyzed
on a 1% agarose gel containing 0.1 µg/ml ethidium bromide. The same
amount of DNA, as assessed by spectrophotometric measurement, was
loaded in each lane. A mixture of HaeIII-digested
X174
DNA and HindIII-digested
DNA was run as size markers. DNA
fragmentation was also measured by quantitation of hypoploid nuclei
after DNA staining with PI. After teniposide treatment and harvesting
as above, cells were fixed with 70% cold ethanol at 4°C overnight.
After centrifugation, the fixed cells were resuspended in 1 ml PI
staining solution (5 µg/ml PI in 0.1% sodium citrate and 0.1%
Triton X-100) and incubated for 30 min at 4°C. Stained nuclei were
analyzed on a FACScan (Becton Dickinson Immunocytometry System, San
Jose, CA). Hypoploid cells appear as a sub-G1
peak.
COX Activity in Whole Cells.
COX activity was measured as described (16)
. MDA-MB-231
cells were treated with teniposide (10 µM) for 24, 48, or
72 h. After the indicated time, the floating cells were removed.
The attached cells were harvested and resuspended in respiration buffer
[0.25 M sucrose, 0.1% BSA, 10 mM
MgCl2, 10 mM K+
HEPES, 5 mM
KH2PO4 (pH 7.2)] at a
final concentration of 4 x 107
cells/ml. One-half ml of the cell suspension was injected into a
chamber containing 3.5 ml of air-saturated respiration buffer and 1
mM ADP at 37°C. The cells were permeabilized with
digitonin (final concentration, 0.005%), and substrates and inhibitors
were added in the following order and final concentrations:
(a) antimycin A, 50 nM; (b)
ascorbate, 1 mM; and (c) TMPD, 0.4
mM. Antimycin A was used to inhibit autologous
mitochondrial electron transport. TMPD is an electron donor that
reduces cytochrome c nonenzymatically. Therefore, when TMPD
is used as a substrate, changes in O2 uptake
rates reflect changes in COX activity. Ascorbate was used to reduce
TMPD. The oxygen concentration was calibrated with air-saturated
buffer, assuming 390 ng-atoms of oxygen/ml of buffer. Rates of
potassium cyanide-sensitive oxygen consumption are expressed as
ng-atoms of oxygen/min/2 x 107
cells.
Western Blot Analysis of Cytosolic and Mitochondrial Fractions.
Cytosolic and mitochondrial fractions were prepared as described
(17)
. Floating and attached MDA-MB-231 cells were
collected separately, washed twice with ice-cold PBS (pH 7.4), and
resuspended in 600 µl of extraction buffer containing 220
mM mannitol, 68 mM sucrose, 50 mM
PIPES-KOH (pH 7.4), 50 mM KCl, 5 mM EGTA, 2
mM MgCl2, 1 mM DTT, and
protease inhibitors. After 30 min incubation on ice, cells were
homogenized with a Teflon homogenizer for 3 min at 300 rpm. Cell
homogenates were centrifuged at 14,000 x g
for 15 min, and the cytosolic supernatants removed and stored at
-70°C. The quality of the cytosolic fraction was routinely monitored
by Western blotting for cytochrome oxidase subunit I as a marker of
mitochondrial contamination, whereas the mitochondrial fraction was
routinely monitored for dihydrofolate reductase as a marker of
cytoplasmic contamination. The pellet containing the mitochondria was
resuspended in extraction buffer and stored at -70°C. Twenty-five
µg of cytosolic or mitochondrial proteins were separated on a 15%
denaturing SDS-PAGE minigel. After protein transfer, the membrane was
incubated with various primary antibodies as indicated for 1 h.
Anti-cytochrome c, anti-COX subunits I and IV, anti-PARP,
anti-caspases 3 and 9, anti-VDAC, and anti-citrate synthase antibodies
were all diluted 1:1,000. Anti-GAPDH antibody was diluted 1:5,000. The
membrane was then incubated with the appropriate secondary antibody
coupled to horseradish peroxidase at 1:10,000 dilution. The specific
protein complexes were identified by chemiluminescence using the
"Supersignal" substrate reagent (Pierce, Rockford, IL).
Measurement of Mitochondrial Membrane Potential by Flow
Cytometry.
Changes in the mitochondrial membrane potential

m were analyzed using JC-1 (Molecular
Probes, Inc., Eugene, OR). This cyanine dye accumulates in the
mitochondrial matrix under the influence of the

m and forms J-aggregates that have
characteristic absorption and emission spectra (18)
. The
JC-1 staining method is reported to provide more accurate estimates of

m than DiOC6 (Refs. 3
and
19
). Untreated controls and cells treated with teniposide
(10 µM) for 24, 48, or 72 h were incubated in 0.4 ml
of IMEM with 0.5 µM JC-1 for 10 min. As a positive
control for reduction of 
m, control cells
were treated with the uncoupling agent CCCP (1 µM)
before labeling with JC-1. Cell suspensions were prepared for flow
cytometry, and the 488-nm line of an argon ion laser was used for
excitation. Red and green emitted fluorescence was collected through
585/42 (FL2) and 530/30-nm (FL1) bandpass filters, respectively. Flow
cytometry was performed on a Coulter Elite flow cytometer. After gating
out small-sized debris, 10,000 events were collected for each analysis.
The ratio of FL2 versus FL1 was used to analyze

m. Forward scatter was used to
differentiate live from dead cells.
Immunostaining and Microscopy.
For immunostaining, MDA-MB-231 cells were seeded onto 18 x 18 mm no. 1 glass coverslips and grown for 2448 h in IMEM
supplemented with 10% FBS. In some experiments, cells were treated
with teniposide for 48 h. To differentiate between live and dead
cells, the "Dead Red" reagent (Molecular Probes, Eugene, OR) was
added to the cells 10 min before fixation. For immunostaining, cells
were fixed in 3.8% paraformaldehyde for 5 min at room temperature,
permeabilized in 0.1% saponin for 5 min, and stained with
anti-cytochrome c antibody diluted at 1:100. FITC-conjugated
goat antimouse secondary antibody (Sigma, St. Louis, MO) was used at
1:100. DNA was stained using Hoechst 33342 at 0.4 µg/ml. Preparations
were mounted in FluoroGard antifade reagent (Bio-Rad, Hercules, CA) and
analyzed using a Nikon Diaphot microscope, equipped with a QuadFluor
epi-fluorescence attachment. Images were recorded with a Photometrics
PXL cooled charge-coupled device camera.
Protein Determinations.
Protein concentrations were determined by the Bradford assay
(20)
.
Statistical Analysis.
All results are expressed as means ± SD unless stated
otherwise. The unpaired Students t test was used to
evaluate the significance of differences between groups, accepting
P < 0.05 as the level of significance.
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RESULTS
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Characterization of Teniposide-induced Cell Death in MDA-MB-231
Cells.
In agreement with previous reports demonstrating that teniposide and
other anticancer drugs can induce apoptosis in various cell lines, flow
cytometric analysis of MDA-MB-231 cells treated with teniposide
demonstrated that cell death was accompanied by a significant increase
in the percentage of sub-G1 cells with a
subdiploid DNA content (Fig. 1A)
. Furthermore, internucleosomal DNA degradation was also
demonstrated by the appearance of DNA ladders (Fig. 1B)
.
Both of these features are considered typical of apoptosis, suggesting
that teniposide-treated MDA-MB-231 cells underwent a form of cell death
characterized by features common to the apoptotic pathway.

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Fig. 1. Time course of teniposide-induced DNA fragmentation in
MDA-MB-231 cells. Cells were treated with 10 µM
teniposide and both attached and floating cells were harvested together
at 24, 48, or 72 h. A, cells with a hypodiploid DNA
content (sub-G1) were detected by PI staining and flow
cytometry. The numbers represent the means ± SD from
three independent experiments, whereas the histograms are
representatives from one of three experiments. B,
internucleosomal DNA fragmentation was evaluated by agarose gel
electrophoresis. Lane 1, DNA from the control cells.
Lanes 2, 3, and 4, DNA
from cells treated with teniposide for 24, 48, or 72 h,
respectively. Lane 5, DNA molecular weight markers.
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Teniposide Induces Increased Mitochondrial Cytochrome
c Expression.
Recent work on apoptosis and necrosis revealed that cytochrome
c is released from the mitochondria into the cytoplasm
during cell death (4, 5, 6, 7)
. To examine whether cytochrome
c release also occurred after teniposide treatment, we
analyzed cytosolic and mitochondrial fractions from attached and
floating cells separately by Western blot for the presence of
cytochrome c. As shown in Fig. 2A
, increasing amounts of cytochrome c were
detected in the cytosol from attached MDA-MB-231 cells in a
time-dependent manner after treatment with teniposide. Surprisingly,
however, the analysis of the corresponding mitochondrial fractions from
the same cells did not show a depletion of cytochrome c as
one might expect if this protein were released into the cytoplasm.
Rather, the levels of cytochrome c increased almost 10-fold
within 24 h after treatment with teniposide (Fig. 2B)
.
Similarly, levels of cytochrome oxidase subunits I and IV, two other
respiratory chain proteins, also increased, though to a somewhat
smaller extent. The increase of these proteins was dose-dependent and
reached a maximum at 10 µM teniposide (Fig. 2C)
. In contrast, no changes were detected in either the
mitochondrial matrix protein citrate synthase or the outer membrane
protein VDAC. These results suggested that the effect of teniposide on
mitochondrial proteins might be specific. Furthermore, as the data in
Fig. 2B
show, the increase in mitochondrial cytochrome
c occurred 24 h before that in the cytosol, suggesting
a possible cause-and-effect relationship.

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Fig. 2. Effect of teniposide on cytochrome c and
COX subunits I and IV levels in mitochondria and the cytoplasm.
A, Western blot analysis of cytosolic and mitochondrial
fractions from attached MDA-MB-231 cells treated with 10
µM teniposide for 24, 48, or 72 h. Attached cells
were harvested, cytosolic and mitochondrial fractions were prepared,
and proteins were separated by SDS-PAGE as described in "Materials
and Methods." Membrane blots were incubated with antibodies against
the various proteins as indicated. The last right lane
contained 10 ng of horse heart cytochrome c as a
standard. Pictures are representative from one of three studies.
Cytosolic and mitochondrial gels and blots were processed in parallel
and exposed for the same amount of time onto the same film.
B, densitometric quantitation of cytochrome
c ( ) and COX subunits I ( )
and IV ( ) levels in mitochondria and of cytochrome
c (... . . . ... . . .) in the
cytosol after teniposide treatment. Results are expressed as
means ± SD from three independent
experiments. C, dose response of the increase in
mitochondrial protein levels. Cells were treated with increasing
concentrations of teniposide as indicated for 48 h. Attached
cells were harvested, and mitochondrial fractions were prepared. The
levels of cytochrome c, COX I, COX IV, and citrate
synthase were determined by Western blot analysis as described in
"Materials and Methods." Pictures are representative from one of three studies.
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In contrast with what was seen with attached cells, in floating cells
cytochrome c disappeared from the mitochondrial fraction as
it appeared in the cytosolic fraction (Fig. 3)
. Similarly, there also was a loss of citrate synthase from the
mitochondrial fraction, suggesting that the extensive release of
cytochrome c was associated with mitochondrial
disintegration.

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Fig. 3. Cytochrome c and COX subunits I and IV
levels in attached versus floating cells. Western blot
analysis of cytosolic and mitochondrial extracts from MDA-MB-231 cells
treated with 10 µM teniposide for 24, 48, or 72 h.
Attached and floating cells were harvested separately, and cytosolic
and mitochondrial fractions were prepared as described in "Materials
and Methods." Membrane blots were incubated with antibodies against
the various proteins as indicated. The last right lane
contains 10 ng of horse heart cytochrome c as a
standard. Pictures are representative from one of three studies.
Cytosolic and mitochondrial gels and blots were processed in parallel
and exposed for the same amount of time onto the same film.
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Because the data in the attached cells suggested that there was a net
increase in total cellular cytochrome c protein, we tested
whether the increase in cytochrome c was transcriptional or
translational. Cells were treated with teniposide in the absence or
presence of cycloheximide (a protein synthesis inhibitor) or DRB (a
transcription inhibitor; Fig. 4
). The results showed that cycloheximide, but not DRB, prevented the
teniposide-induced increase in cytochrome c levels in the
mitochondrial fraction. These data suggested that this phenomenon was
dependent on de novo protein synthesis.

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Fig. 4. Mitochondrial cytochrome c up-regulation is
attributable to new protein synthesis. MDA-MB-231 cells were treated
for 24 h with 10 µM teniposide in the absence and
presence of cycloheximide (0.1 mM) or DRB (0.1
mM). Attached cells were harvested and mitochondrial
fractions were prepared. The levels of cytochrome c and
citrate synthase were determined by Western blot analysis as described
in "Materials and Methods." The results shown are representative
from one of three separate experiments.
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Taken together, these results indicate that teniposide induced a dose-
and protein synthesis-dependent increase in respiratory chain proteins
before cells died. Essentially the same results were obtained with HeLa
cells treated with teniposide (data not shown) and Jurkat cells treated
with camptothecin (21)
, suggesting that this is a more
general phenomenon.
Immunofluorescence Microscopy.
To confirm the finding that cytochrome c is released into
the cytosol in living cells, the cellular localization of cytochrome
c protein was examined by immunofluorescence microscopy in
MDA-MB-231 cells treated with teniposide for 48 h. At this stage
we found live and dead cells, which allowed us to compare the different
cytochrome c expression patterns in both populations. To
distinguish between live and dead cells, we used the Dead Red
dye, which is a cell-impermeant red fluorescent nucleic acid stain that
labels only dead cells (22)
. By using this stain,
viability staining can take place before para-formaldehyde treatment
(fixation) without disrupting the distinctive
immunofluorescence-staining pattern. Untreated cells demonstrated a
punctate pattern for cytochrome c consistent with its
mitochondrial localization (Fig. 5A)
. Upon teniposide treatment, a brighter punctate, as well
as a somewhat diffuse, staining was seen throughout the live cells
(Fig. 5B)
. Together with the Western blot data, these
results support the conclusion that there was an increased amount of
cytochrome c in the mitochondria and some release of
cytochrome c from the mitochondria to the cytosol before
cell death. In contrast, the staining in dead cells was far more
diffuse and mostly without a punctate pattern (see short
arrow in Fig. 5B
), which is in agreement with our
observation by Western blot that mitochondria are depleted of
cytochrome c after cell death. Similar results were also
obtained in teniposide-treated HeLa cells (data not shown).

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Fig. 5. Immunolocalization of cytochrome c.
Teniposide-treated (48 h) and untreated MDA-MB-231 cells were stained
for cytochrome c (cyto-c) by indirect
immunofluorescence as described in "Materials and Methods."
Staining with Hoechst 33343 was used to visualize the nucleus, whereas
the Dead Red dye was used to identify dead cells. A representative
field from both untreated (A) and treated
(B) cells is shown.
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The Teniposide-induced Increase in Cytochrome c Is
Functional.
To test if the teniposide-induced up-regulation of mitochondrial
respiratory chain protein expression was accompanied by a functional
increase in the transport of electrons through the respiratory chain,
we examined COX-dependent oxygen uptake in teniposide-treated
MDA-MB-231 cells (Fig. 6)
. The results showed a significant increase in COX activity, consistent
with the observed up-regulation of components of the respiratory chain,
and suggested that the newly synthesized proteins were functional.

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Fig. 6. Effect of teniposide treatment on COX-dependent oxygen
uptake in MDA-MB-231. MDA-MB-231 cells were treated with 10
µM teniposide for 24, 48, or 72 h. Attached cells
were harvested and placed into an oxygen electrode cuvette. Oxygen
consumption was measured using ascorbate/TMPD as the electron donor.
Values are given as means ± SD of three independent
experiments. *, P < 0.001 between
control and treated cells.
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Various Chemotherapeutic Drugs Induced Increased Levels of
Cytochrome c and Cytochrome Oxidase Subunits I and IV.
To assess if the teniposide-mediated increase in mitochondrial
respiratory chain protein levels was specific to this drug, we also
treated MDA-MB-231 cells with various other anticancer drugs for
24 h, and determined levels of cytochrome c and
subunits I and IV of COX proteins in the mitochondrial fraction. As
seen in Fig. 7
, all of the drugs tested had a similar effect on the levels of these
proteins, suggesting that it might be a more general response to drug
treatment.

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Fig. 7. Effect of various anticancer agents on mitochondrial
protein levels. MDA-MB-231 cells were treated for 24 h with
teniposide, doxorubicin, taxol, camptothecin, vincristine, and
methotrexate, as indicated. Attached cells were harvested and
mitochondrial fractions were prepared. The levels of cytochrome
c, COX I, COX IV, and citrate synthase were determined
by Western blot analysis as described in "Materials and Methods."
Pictures are representative from one of three studies.
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Teniposide Did Not Induce 
m Reduction in Attached
Cells.
Previous studies have suggested that a decline of the mitochondrial
membrane potential 
m may be an early event
in the process of cell death. Therefore, we determined

m at various times after teniposide
treatment in MDA-MB-231 cells. For this purpose we used the membrane
potential-sensitive probe JC-1, which forms monomers (green
fluorescence) at low membrane potential and J-aggregates (red
fluorescence) at higher membrane potential. The ratio between the red
and the green signals is indicative of the

m. JC-1 fluorescence ratios remained
essentially unchanged during the entire incubation time in the attached
cell population (Fig. 8)
. In contrast, there was a dramatic drop of the red fluorescence in the
floating cells, indicating a loss of 
m. To
confirm that the JC-1 dye was sensitive to mitochondrial transmembrane
depolarization, control MDA-MB-231 cells were treated with the
mitochondrial uncoupling agent CCCP (1 µM). Within 10
min, essentially the entire population exhibited a decline of red
fluorescence, indicative of a loss of 
m.
These results indicate that the mitochondrial membrane potential
remained intact in the attached population.
Caspase Activation and PARP Cleavage Occurred in Floating, but not
in Attached, Cells.
Recent studies have demonstrated that the release of cytochrome
c from mitochondria leads to activation of the caspase
cascade in the cytosol (3
, 10
, 11
, 23)
. To assess whether
the appearance of cytochrome c in the cytosol of
teniposide-treated MDA-MB-231 cells led to the activation of caspases 9
and 3, cytosolic fractions from both attached and floating cells were
analyzed by immunoblotting with anti-caspases 9 and 3 antibodies (Fig. 9)
. Significant amounts of both caspases were detected in the cytoplasm,
but there was no apparent activation of either caspase in the attached
cell population. In contrast, however, clear activation of both
caspases was detected in the cytosol of the floating cells.
Furthermore, PARP cleavage was observed in the cytosol of the floating,
but not the attached, cells as indicated by the appearance of the
Mr 85,000 fragment and consistent with
the activation pattern of the caspases. Thus, it appeared that caspase
activation was associated with cell death but did not correlate with
the release of cytochrome c into the cytoplasm of attached
cells.

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Fig. 9. Caspase activation and PARP cleavage in MDA-MB-231 cells
after teniposide treatment. Western blot analysis of cytosolic extracts
from attached and floating MDA-MB-231 cells treated with 10
µM teniposide for 24, 48, or 72 h. The blots were
probed with antibodies against caspase-9, caspase-3, and PARP as
indicated. Activation of pro-caspase 9 and pro-caspase 3 is seen as a
loss of their proforms or as the detection of their active form as
indicated by arrows. Pictures are representative from
one of three studies.
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DISCUSSION
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In the present study we demonstrated that anticancer drug
treatment resulted in an early increase in mitochondrial respiratory
chain protein levels, in particular cytochrome c, that
preceded cytochrome c release into the cytosol. In
mitochondria, cytochrome c is required as an electron
carrier during oxidative phosphorylation, where cytochrome c
shuttles electrons from complex III to complex IV of the respiratory
chain (24)
. The electron transport between these complexes
generates a proton gradient across the inner mitochondrial membrane,
which is required to maintain 
m. Thus, the
release of cytochrome c from the electron transport chain is
expected to result in impairment of the electron flow and a decrease in

m. The data in the present study indicate,
however, that even when cytochrome c enters the cytosol,

m is maintained for a substantial time
afterward. In this context, our observation that teniposide treatment
also induced an increase in several other mitochondrial respiratory
proteins, in particular subunits I and IV of COX, may help us to
understand how cells can maintain a high 
m
despite the release of cytochrome c from the mitochondria.
New synthesis of mitochondrial cytochrome c may serve to
prevent its levels from falling below a critical threshold required to
maintain 
m. Although the exact signal that
leads to cytochrome c protein synthesis is not known, one
possible hypothesis is that the initial release of cytochrome
c itself functions as the feedback signal that
triggers new synthesis of mitochondrial proteins in a kind of
compensatory reaction. Alternatively, it is possible that mitochondrial
cytochrome c synthesis and enrichment is the primary event
and cytochrome c release (or leakage) is simply a
consequence of the higher levels of this protein. The fact that only a
small amount of cytochrome c was detected in the cytosol at
24 h, a time when mitochondria were already maximally enriched
with cytochrome c (Fig. 2B)
, suggests that
up-regulation of cytochrome c expression is the primary
event. The physiological and/or pathological significance of this
effect in anticancer drug-treated cells is currently unknown. However,
this effect does not seem to be unique to the present studys model
system, because increased cytochrome c levels were also
observed within 12 h of staurosporine treatment of HeLa cells (data
not shown) or camptothecin treatment of Jurkat cells (21)
.
Recently, Skulachev (25)
has proposed that the role of
cytochrome c in apoptosis might represent one of the
anti-oxidant functions inherent in this protein. First, cytochrome
c can operate as an enzyme, oxidizing free oxygen radicals
(O2-.) back to
O2. The reduced cytochrome c is then
reoxidized by COX. Second, the intermembrane cytochrome c
can activate the electron transport chain in the outer mitochondrial
membrane. This bypasses the initial and middle part of the main
respiratory chain, which produces, as a rule, the major portion of
reactive oxygen species in the cell. The fact that teniposide also
up-regulated the mitochondrial expression of manganous superoxide
dismutase suggested that free radicals are involved in the pathological
changes observed. In this context, therefore, up-regulation of
cytochrome c levels in mitochondria may play a protective
role during the initial response of cells to drug treatment.
Different models have been proposed to explain the mechanism of
cytochrome c release from the intermembrane space of
mitochondria during apoptosis or necrosis. Swelling and subsequent
rupture of the outer mitochondrial membrane have been proposed as a
mechanism for the release of cytochrome c into the cytosol
(26)
, events which are usually associated with the
mitochondrial PT (27
, 28) and with a loss of

m (28)
. However, cytochrome
c appeared in the cytoplasm of teniposide-treated cells with
a normal 
m. Furthermore, using electron
microscopy, predominantly hyperdense and condensed mitochondria were
observed after teniposide treatment of MDA-MB231 cells (data not
shown), suggesting that the swelling of mitochondria is unlikely to be
the primary mechanism of cytochrome c release. Together,
these data suggest that mitochondrial depolarization was not required
for cytochrome c release, a conclusion that is also
consistent with previous results reported by us and by others
(17
, 29)
.
In conclusion, the present work demonstrated that teniposide and other
chemotherapeutic drugs can induce an increase in cytochrome
c and other mitochondrial respiratory chain proteins. We
have also shown that cytochrome c release from mitochondria
to the cytosol is an early event preceding the drop of

m and caspase activation. We propose that
mitochondrial cytochrome c enrichment may play a critical
role in the initial defense response of a cell and precedes the final
events leading to extensive cytochrome c release, a drop of

m, caspase activation, plasma membrane
disruption, and eventually to cell death.
 |
ACKNOWLEDGMENTS
|
|---|
We thank Renji Song and Robert Dilwith for their help with the
flow cytometry and Dr. Jeff Ault for help with the electronmicroscopy.
We acknowledge the videomicroscopy, cellular and molecular immunology,
and electron microscopy core facilities of the Wadsworth Center, as
well as Jan Galligan from the photography department for help with the
figures.
 |
FOOTNOTES
|
|---|
The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked advertisement in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
1 This study was supported by NIH Grants CA72455
and CA25933. 
2 To whom requests for reprints should be
addressed, at Wadsworth Center, Empire State Plaza, Albany, NY 12201.
Phone: (518) 474-2088; Fax: (518) 474-1850; E-mail: schneid{at}wadsworth.org 
3 The abbreviations used are: PT, permeability
transition; COX, cytochrome c oxidase; GAPDH,
glyceraldehyde-3-phosphate dehydrogenase; TMPD,
tetramethyl-p-phenylenediamine; JC-1,
5,5',6,6'-tetrachloro-1,1',3,3'-tetraethylbenzimidazolecarbocyanine
iodide; PARP, poly(ADP-ribose) polymerase; PI, propidium iodide;
VDAC, voltage-dependent anion channel; DRB, 5,6-dichlorobenzimidazole
riboside; IMEM, improved minimum essential medium (Richters
modification); CCCP, carbonyl cyanide m-chlorophenyl-hydrazone. 
Received 3/20/00.
Accepted 11/21/00.
 |
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