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Physiological Reviews, Vol. 79, No. 4, October 1999, pp. 1127-1155
Copyright ©1999 by the American Physiological Society
Department of Biomedical Sciences, University of Padova, and Consiglio Nazionale delle Ricerche Center for the Study of Biomembranes, Padova, Italy
I. INTRODUCTION
A. Mechanism of Energy Conservation and Cation Transport
B. Membrane Potential and Equilibrium Cation Distribution
II. TRANSPORT OF MONOVALENT CATIONS
A. Exchangers (Antiports)
B. Channels (Uniports)
C. Physiological Role(s) of Mitochondrial K+ Cycle
III. TRANSPORT OF CALCIUM
A. Nonequilibrium Ca2+ Distribution
B. Pathways for Ca2+ Uptake
C. Pathways for Ca2+ Efflux
D. Mitochondria in Ca2+ Homeostasis
IV. PERMEABILITY TRANSITION
A. Regulation
B. Channel Kinetics and Population Dynamics
C. Consequences and Reversibility
D. Potential Role in Ca2+ Release
V. APPENDIX
A. Ca2+-Binding Proteins
B. Transport of Mg2+
C. Electrophysiology
D. Mitochondria and Cell Death
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ABSTRACT |
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Bernardi, Paolo
Mitochondrial Transport of Cations: Channels, Exchangers, and
Permeability Transition. Physiol. Rev. 79: 1127-1155, 1999.
This review provides a selective history of how
studies of mitochondrial cation transport (K+,
Na+, Ca2+) developed in relation to the major
themes of research in bioenergetics. It then covers in some detail
specific transport pathways for these cations, and it introduces and
discusses open problems about their nature and physiological function,
particularly in relation to volume regulation and Ca2+
homeostasis. The review should provide the basic elements needed to
understand both earlier mitochondrial literature and current problems
associated with mitochondrial transport of cations and hopefully will
foster new interest in the molecular definition of mitochondrial cation
channels and exchangers as well as their roles in cell physiology.
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I. INTRODUCTION |
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Despite an enormous amount of literature and the importance of the problem, very little information is available about the structural features of mitochondrial cation channels and exchangers, whereas a vast amount of information is available about the functional properties of these mitochondrial transport systems. The explanation for this state of affairs is largely historical. Studies of ion transport were mostly carried out in the same laboratories involved in clarifying the mechanisms of energy conservation in mitochondria and chloroplasts, and the two fields evolved in parallel. The more the debate on energy conservation became focused on the chemiosmotic hypothesis, the more studies of mitochondrial ion transport tended to become tests of the predictions of this theory, in particular about the existence of a membrane potential across the inner membrane. As a result, research on mitochondrial cation transport was shaped by the debate on chemiosmosis. Given the view, prevailing well into the 1980s, that mitochondria did not possess cation channels, it is not too surprising that research in this area did not yield results comparable to those obtained in the general field of membrane transport.
In this review, which is limited to mammalian mitochondria, I provide a selective history of how studies of mitochondrial cation transport (K+, Na+, and Ca2+) developed in relation to the major themes of energy conservation. This should provide the general reader with the basic elements needed to understand earlier mitochondrial literature and current problems associated with mitochondrial transport of cations. I then cover in more detail specific transport pathways for cations and discuss open problems about their nature and physiological function. This includes the mitochondrial permeability transition and its potential role in Ca2+ homeostasis. Topics that are not treated in the review (mitochondrial Ca2+-binding proteins, Mg2+ transport, electrophysiology, and mitochondrial involvement in cell death) are briefly covered in section V, where the interested reader can find essential bibliographic indications.
A. Mechanism of Energy Conservation and Cation Transport
The history of bioenergetics came to a turning point when the late Peter Mitchell proposed his chemiosmotic hypothesis of energy conservation (223, 225). In his "Summary of the basic postulates" Mitchell stated (225)
It will now be useful to summarise the basis of the chemiosmotic coupling hypothesis in the form of four essential postulates; for, these postulates can be used, on the one hand, for the further development of the theory of chemiosmotic coupling, and on the other hand, as the target for critical experiments designed to show that the chemiosmotic hypothesis may be untenable.
1) The membrane-located ATPase systems of
mitochondria and chloroplasts are hydro-dehydration systems with
terminal specificities for water and ATP; and their normal function is
to couple reversibly the translocation of protons across the membrane
to the flow of anhydro-bond equivalents between water and the
couple ATP/(ADP
Pi).
2) The membrane-located oxido-reduction chain systems of mitochondria and chloroplasts catalyse the flow of reducing equivalents, such as hydrogen groups and electron pairs, between substrates of different oxido-reduction potential; and their normal function is to couple reversibly the translocation of protons across the membrane to the flow of reducing equivalents during oxido-reduction.
3) There are present in the membrane of mitochondria and
chloroplasts substrate-specific exchange-diffusion carrier systems that permit the effective reversible transmembrane exchange of anions
against OH
and of cations against H+; and the
normal function of these systems is to regulate the pH and osmotic
differential across the membrane, and to permit entry and exit of
essential metabolites (e.g., substrates and phosphate acceptor) without
collapse of the membrane potential.
4) The systems of postulates 1, 2, and 3 are located in a specialised coupling membrane which has a low permeability to protons and to anions and cations generally.
The 1960s and early 1970s witnessed a heated debate over chemiosmotic energy coupling (226), which was largely centered over the very existence of a mitochondrial membrane potential.
It is today universally accepted that the initial event of energy
conservation is charge separation at the inner mitochondrial membrane.
Electrons deriving from intermediary metabolism are funneled to oxygen
through the respiratory chain in a process coupled to H+
ejection on the redox H+ pumps. Because the passive
permeability to H+ (the so-called H+ leak)
and to cations and anions is generally low, H+ ejection
results in the establishment of a H+ electrochemical
gradient (
H). The 
H can
be written as
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(1) |

denotes the membrane potential difference
(
in
out) in millivolts;
z, F, R, and T have their
standard meanings; and subscripts i and o refer to intramitochondrial
and extramitochondrial, respectively. The magnitude of the proton
electrochemical gradient is about
200 to 220 mV, and under
physiological conditions, most of the gradient is in the form of a
membrane potential (see Ref. 18 for a review).
The 
H is utilized for ATP synthesis via the
F0F1 ATPase (1, 224,
225). It must be stressed, however, that proton pumping and creation of the 
H, not ATP synthesis, is
the primary event. This concept is illustrated by conditions, such as
ischemia, under which mitochondria utilize glycolytic ATP to maintain
the 
H and rapidly turn from the major ATP
producers into the major ATP consumers of the cell, often precipitating
cell death (see Ref. 99 for a review). In additon to ATP synthesis, the

H is utilized for a variety of mitochondrial
processes. Some of these processes are a prerequisite for respiration
and ATP synthesis, such as import of respiratory chain and ATP synthase
subunits encoded by nuclear genes (a process requiring both 
and
ATP) (238); uptake of respiratory substrates and
Pi (driven by the
pH) (255); and uptake of
ADP in exchange for ATP (driven by the 
) (187). Others serve vital regulatory functions through transport processes such as volume homeostasis (K+, Na+, and
anions) (129), regulation of metabolism (Ca2+)
(287), and heat production (H+)
(279) and actually compete with ADP phosphorylation. For
example, when Ca2+ is added to energized, phosphorylating
mitochondria, ATP synthesis stops, and it only restarts after
Ca2+ has been taken up (294).
B. Membrane Potential and Equilibrium Cation Distribution
The existence of a respiration-dependent membrane potential,
negative inside, poses the major problem of mitochondrial cation distribution (15, 19, 215). Let
us consider the case of K+. The K+
electrochemical gradient can be defined as
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(2) |

K = 0) is
given by
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(3) |
The buildup of a K+ concentration gradient is also
prevented by the high permeability of the inner membrane to water so
that any net uptake (or loss) of K+ salts is accompanied by
osmotic swelling (or shrinkage). As noted by Garlid (127),
if the average valency of transported anions is taken to be 1.5, the
flux of 1 mol of K+ is accompanied by that of 1.67 osmol
solute, and the change in matrix K+ (nmol/mg) corresponds
to a change in matrix volume (
Vm, µl/mg) according to the relation
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(4) |
is the osmotic strength in mosM (127).
Thus, the K+ electrochemical gradient favors continuous
K+ accumulation, leading in turn to matrix swelling that
would result in breakdown of the outer membrane, release of cytochrome
c, and loss of mitochondrial function.
Mitchell was aware of this problem and proposed the existence of substrate-specific exchange-diffusion carrier systems permitting the reversible exchange of cations against H+ to regulate the osmotic differential across the membrane (postulate 3). The very existence of these H+-cation antiporters was a matter of debate for at least 20 years and is discussed in more detail in section II. It is important to stress here that the existence of the antiporters may in principle resolve the problem of K+ distribution and volume homeostasis but in turn creates that of energy dissipation. Indeed, electrophoretic influx of cations followed by their release via an electroneutral mechanism utilizing the proton chemical gradient would result in a futile cycle dissipating the membrane potential, as is experimentally observed by the addition of proper K+ ionophores. Respiring mitochondria in KCl media swell beyond the point of outer membrane rupture upon addition of valinomycin (which forms a charged complex with K+, thus allowing its rapid electrophoretic uptake). Simultaneous addition of excess nigericin (which promotes the electroneutral exchange of H+ and K+) does prevent swelling but causes in turn permanent uncoupling. This led Mitchell to contend that the specialized coupling membrane has a low permeability to protons and to anions and cations generally (postulate 4).
In summary, the chemiosmotic hypothesis of energy conservation demands both the existence of electroneutral H+-cation antiporters and a low permeability to K+ and Na+. This allows extrusion of cations entering mitochondria down their electrochemical gradient, thus preventing osmotic swelling. The overall energy dissipation in futile cation cycling is small because of the restricted membrane permeability to cations.
With few exceptions, studies of monovalent cation transport in mitochondria were long carried out to test these predictions of chemiosmotic principles. In particular, and until very recently, the requirement for a low cation permeability has been widely implied to mean that the inner mitochondrial membrane does not possess channels for K+ (and Na+). This assumption was consistent with the experimental findings that electrophoretic uptake of K+ and Na+ in isolated mitochondria is extremely slow and that isolated mitochondria respiring in KCl-based media do not swell unless valinomycin is added. However, today we know that mitochondria do possess channels for cations and that energy dissipation is limited by the predictable fact that they are tightly regulated. These transport pathways are covered in more detail in section II, whereas the problem of equilibrium distribution of divalent cations is discussed in section III.
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II. TRANSPORT OF MONOVALENT CATIONS |
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A vast amount of information on mitochondrial transport of monovalent cations has been obtained from kinetic measurements of the matching volume changes with optical methods (see, e.g., Refs. 13, 27, 49, 56, 58, 72, 107, 112, 130, 153, 216, 217, 227, 338, 339, 356). A major asset in these studies has been the availability of ionophores and the parallel elucidation of their transport properties in both model and natural membranes (272).
A. Exchangers (Antiports)
The quest for the H+/K+ exchanger (KHE) has characterized mitochondrial research on monovalent cation transport between the late 1960s and early 1980s. The scheme of Figure 1 introduces a powerful assay of cation transport based on changes of mitochondrial volume in the absence of respiration (passive swelling), which proved instrumental in studies of cation transport.
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The mitochondrial inner membrane is highly permeable to the protonated form of acetic acid (HAc). In the presence of a K+ concentration gradient (incubation in isotonic K+ acetate medium), the KHE should catalyze K+ accumulation in exchange for H+. The pH differential created by the electroneutral exchange would represent the driving force for accumulation of acetic acid, eventually causing matrix accumulation of K+ acetate. However, mitochondria incubated in K+ acetate only swell at a very slow rate, as indicated in Figure 1, unless the exogenous electroneutral KHE nigericin is added. The ensuing fast rate of swelling confirms the high permeability to acetic acid and indicates that these experimental conditions do allow, in principle, detection of Mitchell's postulated exchanger. Based on the low rate of swelling in the absence of nigericin, however, early critics of chemiosmosis concluded that the KHE probably did not exist.
An important point should be appreciated. Because of the low permeability of the inner membrane to charged species (K+, H+, and the acetate anion in this example), swelling does not follow the addition of either the protonophore carbonyl cyanide p-trifluoromethoxyphenylhydrazone (FCCP; Fig. 2, trace a) or the K+-selective ionophore valinomycin (Fig. 2, trace b), yet fast swelling ensues when valinomycin is added after FCCP, or when FCCP is added after valinomycin (Fig. 2, traces a and b, respectively). These examples indicate that overall electroneutral H+/K+ exchange can either be achieved through an antiporter type of mechanism (Fig. 1) or through coupling of independent electrical fluxes (Fig. 2). A number of studies represent the basis for the schemes depicted in Figures 1 and 2 (see in particular Refs. 16, 17, 49, 107, 227). I refer the reader to Garlid et al. (131) for the relevant transport equations and for discussion of earlier literature.
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In classical studies of mitochondrial H+/cation antiport with this method, the results depicted in Figure 3 were obtained (49, 107, 227). Rapid swelling was observed in Na+ acetate (Fig. 3, trace a), whereas swelling in K+ acetate was extremely slow (Fig. 3, trace b) yet measurable (compare with the traces typically seen in choline, Fig. 3, trace c). These studies suggest that mitochondria possess a very active H+/Na+ antiporter (NHE) and a sluggish KHE (76, 227, 256).
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Treatment with the electroneutral 2H+-divalent metal ion (Me2+) exchanger A-23187 is followed by relevant changes of mitochondrial K+ permeability, which were initially attributed to direct transport of K+ by A-23187 (268). Subsequent work indicated that these changes were rather due to activation of latent, endogenous pathway(s) for K+ transport following depletion of divalent cations (14, 20, 112, 356).
The swelling trace of Figure 4 depicts the typical results of a passive transport assay in K+ acetate. Mitochondria depleted of endogenous Me2+ (mostly Mg2+ and Ca2+) by treatment with A-23187 plus EDTA undergo a fast swelling process after a lag phase. The lag phase reflects the time required to achieve Me2+ depletion, whereas swelling indicates the activity of an overall electroneutral H+/K+ exchange. What the experiment cannot tell is whether the mechanism is intrinsically electroneutral [activation of the endogenous KHE (scheme 1)] or rather due to coupling of independent H+ and K+ conductances induced by Mg2+ depletion (scheme 2). This issue was addressed in experiments where K+ nitrate rather than acetate was used. Because the nitrate anion is readily permeant, addition of A-23187 should induce swelling if an increase of K+ permeability has occurred, but this was not observed (112). As shown in Figure 5, A-23187-treated mitochondria swell in K+ nitrate only in the presence of FCCP, suggesting the occurrence of obligatorily electroneutral exchange of H+ for K+ (112). Whether K+ transport is entirely due to an endogenous KHE, however, is still difficult to assess in these protocols. Indeed, after most A-23187 had been removed by an albumin wash, relevant swelling rates were recorded in the absence of FCCP (see Fig. 3B in Ref. 112), suggesting that a permeability to K+ had also developed, as confirmed by a subsequent study (36). Also, a direct contribution of A-23187 to K+ transport cannot be excluded (see discussion in Ref. 126).
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The scheme of Figure 6 represents the
unequivocal demonstration that isolated mitochondria do possess an
endogenous, electroneutral KHE that can be activated by depletion of
matrix Me2+ (106, 315). In this
example, mitochondria are energized by substrate oxidation and
incubated in a sucrose-based, low-K+ medium. Addition
of a very small concentration of valinomycin induces a phase of net
K+ uptake until a new steady-state
extramitochondrial K+ concentration is reached.
The effect of valinomycin demonstrates that under these conditions the
K+ electrochemical gradient is directed inward, largely
because of the transmembrane electrical potential difference. Addition of A-23187 perturbs the steady state and causes a phase of net K+ efflux until a new steady state is reached that cannot
be perturbed by a second addition of A-23187 (Fig. 6, trace
a). However, further K+ efflux can be elicited by
nigericin (Fig. 6, trace b), whereas more valinomycin causes
K+ reuptake (Fig. 6, trace c). Thus
1) A-23187 has unmasked an endogenous pathway for
K+ efflux (no further efflux can be induced by more
A-23187); 2) K+ efflux has occurred against the
K+ electrochemical gradient (increasing the valinomycin
concentration induces more uptake, indicating the direction of the

K); and 3) the actual
[K+]o represents a kinetic steady state where
the rate of electrophoretic uptake (mediated by valinomycin) matches
the rate of electroneutral efflux (mediated by the endogenous
exchanger) (see Refs. 106, 315 for the actual experiments). This
approach left little doubt that the molecular nature of the
H+/K+ exchange was intrinsically electroneutral
rather than due to indirect coupling of electrical H+ and
K+ fluxes. A number of studies have contributed to clarify
the nature and regulation of the mitochondrial H+/cation
exchange systems (see Refs. 53, 128 for reviews). In general, the
literature today agrees on the existence of two separate antiporters,
i.e., the Na+(Li+)-selective NHE that does not
transport K+ and the unselective KHE that transports
K+, Na+, and Li+.
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1. NHE
Mitochondria from all tissues tested possess a NHE that does not transport K+ and is inhibited by amiloride analogs (54), whereas it is not inhibited by Mg2+. The NHE has a broad pH optimum at pH 7.0, and its activity declines linearly at increasing pH (49, 55, 107, 234). The function of the NHE is probably related to the requirements of steady-state Ca2+ cycling in energized mitochondria, which largely occurs through coupling of electrophoretic influx via the Ca2+ uniporter and efflux via the Na+/Ca2+ antiporter (89), as discussed in section III.
A putative mitochondrial NHE has recently been identified (252). Yeast cells contain homologs of the human family of plasma membrane NHE (235). Screening of the Saccharomyces cerevisiae genome revealed open reading frames that encode protein sequences homologous to the plasma membrane H+/Na+ antiporter NHA1. The full-length YDR456w gene, which contained potential NH2-terminal signal sequences for the mitochondrial inner membrane, was isolated and used to identify a human NHE cDNA (NHE6), which encodes a 669-amino acid protein (predicted molecular mass 74,163 Da). NHE6 has high homology with both yeast and human plasma membrane NHE, particularly in the membrane-spanning region (252). A single ~5.5-kb mRNA is present in all adult human tissues tested, and the abundance of the transcript correlates with the relative abundance of mitochondria (252). The mitochondrial assignement is based on colocalization of the YDR456w gene product Nha2 fused to green fuorescent protein (GFP) with the stain 4',6-diamidino-2-phenylindole dihydrochloride in yeast cells and on colocalization of an overexpressed NHE-GFP chimera with Mito-Tracker Red CM-H2Xros in HeLa cells (252). Colocalization of the same YDR456w gene product fused to GFP with mitochondrial markers was not observed in unfixed yeast cells, however, where the NHE was exclusively found in prevacuolar compartments equivalent to the late endosome of animal cells (236), a finding that calls into question the unequivocal identification of NHE6 as a mitochondrial NHE.
A fraction highly enriched in a 59-kDa protein catalyzing Na+ transport with the properties expected of the NHE in a reconstituted system has been purified from beef heart mitochondria (134).
2. H+-K+ (Na+) exchanger
Although this exchanger is usually referred to as a
H+-K+ antiporter, one of its basic features is
the low selectivity for the species transported in exchange for
H+. The KHE does not discriminate between K+,
Na+, and Li+, and it also transports organic
cations such as tetrapropylammonium (46). Once activated,
it displays a maximum velocity (Vmax) in excess
of 300 nmol K+·mg
protein
1·min
1. The properties of KHE can
be summarized as follows: 1) the activity of the antiporter
increases with the decrease of free matrix Mg2+
(233), and this partly explains why the exchange activity
increases in hypotonic media (124) and after osmotic
swelling (125). 2) Activity of the KHE
increases at increasing pH, and KHE is inhibited by matrix
H+ (28, 57). 3) The
antiporter is fully inhibited by 0.5-1.0 mM quinine both in passive
swelling assays in K+ acetate (234) and in
energized mitochondria (36). 4) Although dicyclohexylcarbodiimide (DCCD) cannot be considered a specific ligand
of the exchanger, this reagent only inhibits the KHE after depletion of
matrix Mg2+ (131); this represented the basis
for selective labeling with [14C]DCCD of an 82-kDa
protein that, to date, still represents the best candidate for the KHE;
when incorporated in liposomes, this DCCD-reactive species
catalyzed K+ transport with the properties expected of the
KHE (200). 5) After complete depletion of
matrix Mg2+, the activity of the KHE could be further
stimulated by osmotic swelling of mitochondria, suggesting a direct
modulation by the increased membrane tension (40).
B. Channels (Uniports)
An assessment of the vast literature of electrophoretic transport of cations (K+ in particular) in mitochondria is complicated by two problems: 1) K+ uniports can be induced and modified by a variety of agents that also affect the electroneutral H+/cation exchangers (most notably Mg2+), and the relative contribution of the two transport modes is not always easy to dissect, particularly in papers published before 1980; and 2) comparison of the results obtained in different laboratories even in recent years is often difficult because of the different experimental conditions, which may affect the sensitivity to inhibitors and therefore the interpretation of the results in terms of the relevant transport pathway(s).
Although direct transport of Na+, K+ and
Rb+ can be studied by isotopic techniques
(105) or by atomic absorption spectroscopy after
separation of mitochondria, most studies of mitochondrial cation
uniport have taken advantage of the sensitive swelling technique
described before. As depicted in Figure
7, in energized mitochondria
electrophoretic cation uptake (exemplified here by K+
uptake catalyzed by valinomycin) is compensated by H+
extrusion. If buildup of a relevant
pH is prevented by acetate (or
phosphate), regeneration of the 
will allow cation uptake and
mitochondrial swelling, providing a convenient tool to study the
transport process. An obvious problem in these studies is posed by the
activity of the constitutive NHE in the case of Na+ and of
the inducible KHE in the case of K+, particularly in view
of the fact that the latter is stimulated by osmotic swelling and
matrix Mg2+ dilution. Indeed, electrophoretic uptake of
K+ in energized mitochondria is followed by cyclic
activation of the KHE, resulting in a train of damped volume
oscillations that complicate interpretation of the transport kinetics
(36). An alternative method is based on the study of the
depolarizing cation currents under conditions where activity of the KHE
is in excess and therefore no net cation accumulation takes place,
allowing measurements of the phenomenological conductance through the
channel (248).
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1. Na+ channel
Addition of EDTA to respiring mitochondria is followed by swelling in NaCl and LiCl but not KCl media, suggesting the existence of a Mg2+-modulated inner membrane channel with selectivity for Na+ and Li+ (12, 55, 314, 356). We have provided unambiguous evidence that Na+ and Li+ uptake after treatment of mitochondria with EDTA occurs via an electrophoretic mechanism (37). The fact that K+ is not transported, together with the high sensitivity of Na+ flux to nanomolar concentrations of Mg2+ and ruthenium red (RR), represents the best indications that flux occurs through a channel rather than through diffusive leaks.
The basic properties of the Na+ channel can be summarized
as follows (37). 1) The channel is selective
for Na+ and Li+ over K+, and the
Na+ (Li+) conductance is modulated by
surface-bound Mg2+. 2) Inhibition by
Mg2+ is competitive with Na+, and
Na+ fluxes can be elicited by the addition of physiological
concentrations of ATP. 3) Flux through the Na+
channel displays a broad optimum at pH 7.5-8.0, whereas it declines at
both higher and lower pH values. 4) Flux increases
exponentially with the 
and displays an apparent threshold at
approximately
140 mV; the maximum conductance we could measure is 0.2 nmol Na+·mg
protein
1·min
1·mV
1
(37), which is very close to the basal H+
conductance of isolated rat liver mitochondria (370).
5) The Na+ channel is inhibited by RR with an
inhibitory constant (Ki) of 40 nM
(184) and by the plasma membrane ATP-sensitive
K+ (KATP) channel blocker glibenclamide with a
Ki of 15 µM (333).
2. Nonselective K+ channel
In striking analogy with the KHE, electrophoretic flux of
monovalent cations 1) is potently activated by depletion of
matrix Mg2+ after treatment with EDTA+A-23187 and
2) displays no selectivity for K+ over
Na+ and Li+ (36,
356). Flux is demonstrably electrophoretic and can support energy-dependent K+ accumulation that is potentiated by
quinine (through inhibition of the KHE) and is accompanied by the
expected depolarization (36). The estimated maximum
conductance for K+ in Mg2+depleted
mitochondria is as high as 22.5 nmol K+ · mg
protein
1 · min
1 · mV
1,
but these values are not likely to be ever attained in vivo, since at
free [Mg2+] >0.3 µM flux became too low to be measured
reliably (248). Inhibition by nanomolar concentrations of
Mg2+ (248) and RR (184) and by
micromolar concentrations of the sulfonylurea glibenclamide
(333) and of the guanidine derivative U-37883A
(334) strongly suggests that cation flux is mediated by a
distinct but nonselective channel. Consistent with this, treatment with
EDTA+A-23187 does not lead to uncoupling in sucrose-based media,
indicating that the channel is not permeable to H+
(248).
Na+ flux through the unselective K+ channel is additive with flux on the Na+ channel, suggesting that the two pathways are distinct (248). On the other hand, both pathways are inhibited by Mg2+, RR (184), and glibenclamide (333). The problems posed by these findings and by those described in the following paragraphs are discussed at the end of this section.
3. Selective K+ channel(s)
In 1991, Inoue et al. (176) reported a patch-clamp study of rat liver mitoplasts where a K+-selective channel was described that could be inhibited by ATP (but not ADP) and by the plasma membrane KATP channel blockers 4-aminopyridine and glibenclamide (176). Plasma membrane KATP channels can be modulated by a variety of pharmacological compounds. Classical inhibitors are sulfonylurea derivatives such as glibenclamide and tolbutamide that have been widely employed as hypoglycemic agents (see Ref. 331 for a review). These compounds act through a specific receptor (4) that modulates the KATP channel (175). Nonsulfonylurea inhibitors are also known, such as the guanidine derivative U-37883A (138). A variety of structurally unrelated KATP channel openers have also been discovered, such as cromakalim, diazoxide, and pinacidil (113). Many of these compounds have been tested on mitochondria.
A) STUDIES WITH KATP channel openers. Induction of a K+-selective current (K+, Rb+ > Li+, Na+) has been reported after treatment of isolated mitochondria with pinacidil, RP-66471, and HOE-234 but not other K+ channel openers like nicorandil and aprykalim. The effects were observed both in energized mitochondria and in deenergized mitochondria incubated in thiocyanate-based media and did not require the presence of added ATP (31, 332, 336). These results suggest the existence of a mitochondrial K+-selective channel activated by some but not all plasma membrane KATP channel openers. Other openers like diazoxide and cromakalim also affect mitochondrial K+ channels under rather specific conditions, as described in detail in section IIB3C.
B) STUDIES WITH KATP channel inhibitors. The
effect of inhibitors of KATP channels on mitochondrial
cation fluxes is controversial. Glibenclamide (10 µM) has been shown
to be ineffective on K+ uptake in isolated mitochondria in
the presence of Mg2+ (29), whereas it inhibits
the partially purified mitochondrial KATP channel in a
reconstituted assay where the sensitivity to glibenclamide decreases at
increasing Mg2+ (258). On the other hand,
glibenclamide has been shown to inhibit both the Na+
channel and the nonselective K+ channel induced by
treatment of isolated mitochondria with EDTA and EDTA+A-23187,
respectively (333). High concentrations of glibenclamide
inhibit respiration, posing the question of whether inhibition of
cation fluxes by micromolar concentrations of glibenclamide is a
secondary event (178). However, 1) valinomycin
catalyzed K+ uptake in energized, glibenclamide-treated
mitochondria, proving that the 
K was still
directed inward (333); and 2) inhibition by
glibenclamide was observed also in nonrespiring mitochondria in
swelling assays based on thiocyanate diffusion (333). On
balance, these findings suggest that glibenclamide is an inhibitor of
mitochondrial Na+ and K+ channels but that the
sensitivity critically depends on the Mg2+ concentration,
possibly on the channel(s) involved and on other variables that depend
on the incubation conditions, in particular the presence of ATP and GTP
(see sect. IIB3C). A binding study of isotopically labeled glibenclamide to rat liver mitochondria and
submitochondrial particles has identified a single class of binding
sites that are only slightly affected by Mg2+ and ATP and a
single 28-kDa glibenclamide-binding protein that may be the
sulfonylurea receptor of the mitochondrial KATP channel (335).
C) MITOCHONDRIAL KATP channel. A series of papers specifically devoted to an ATP-stimulated mitochondrial K+ conductance (mitochondrial KATP channel) has been published. A substantial concordance exists for data obtained with isolated mitochondria and with a partially purified protein of 54 kDa that exhibits the properties expected of a mitochondrial KATP channel in reconstituted systems (29, 132, 133, 178, 258, 259). Its basic properties can be summarized as follows. 1) The channel is selective for K+ over Na+; in the presence of Mg2+ it is inhibited by both ATP and ADP but not GDP (29, 258). 2) The ATP-inhibited channel can be reactivated by the plasma membrane KATP channel openers cromakalim and diazoxide, the latter being much more potent with the mitochondrial than the plasma membrane channel (133). 3) The mitochondrial KATP channel is inhibited by palmitoyl-CoA and oleyl-CoA, and the palmitoyl-CoA or ATP (ADP)-inhibited channel can be reactivated by GTP and GDP, the former being more potent (259). 4) Only after reactivation of the Mg2+ and ATP-inhibited channel by diazoxide is the mitochondrial KATP channel potently inhibited by glibenclamide and 5-hydroxydecanoate both in a reconstituted system (132) and in isolated heart and liver mitochondria (178). It has been shown that diazoxide exerts a marked cardioprotective effect in a rat heart global ischemia model and that cardioprotection can be reverted by glibenclamide and 5-hydroxydecanoate (132). Because 5-hydroxydecanoate has little effect on the sarcolemmal KATP channels, and because diazoxide is 2,000 times more potent at activating mitochondrial than sarcolemmal KATP channels, it has been proposed that the cardioprotective effects exerted by diazoxide are due to activation of the mitochondrial KATP channel, although the mechanism remains obscure (132). In this context, it must be mentioned that Halestrap et al. (153) reported a K+-selective, energy-dependent swelling process elicited by treatment of energized rat liver mitochondria with EGTA-Ca2+ buffers giving free [Ca2+] in the range 0.2-1.0 µM in the presence of 2.5 mM Mg2+. Because swelling could be inhibited by MgATP and MgADP, it appears possible that the KATP channel described above was responsible for the observed K+ flux.
D) HOW MANY MITOCHONDRIAL CATION CHANNELS? The
existence of an electrophoretic K+ flux in isolated,
"native" mitochondria in the presence of physiological concentrations of Mg2+ is well established. The
steady-state membrane potential of energized rat liver
mitochondria decreased in a K+-dependent manner
(248), with a measured conductance of 0.11 nmol
K+ · mg
protein
1 · min
1 · mV
1
(92), which is comparable to the basal H+
conductance of 0.2 nmol · mg
protein
1 · min
1 · mV
1
(370). What is harder to assess at present is the
relationship between this native K+ conductance and the
cation channels listed above. A major problem is that the mitochondrial
cation channels characterized so far in isolated mitochondria need to
be activated by treatments such as Mg2+ depletion
(37, 248, 356) or by incubation
in hypotonic media (29). This, in turn, poses the question
of whether inferences can be safely made on the pathways for cation
transport in vivo. These issues cannot be resolved at present. Current
ambiguities about the number of cation channels and their regulation by
physiological and pharmacological ligands will hopefully be resolved by
the molecular definition of the species involved.
C. Physiological Role(s) of Mitochondrial K+ Cycle
A concerted interplay between K+ uptake via one or more channels and K+ efflux via the KHE controls mitochondrial volume homeostasis in vitro and in vivo, as first suggested by Brierley more than 20 years ago (see Ref. 53 for a review). It is obvious that the existence of regulated pathways for both K+ uptake and release allows, in principle, a very fine tuning of mitochondrial volume and that the energy diverted into the K+ cycle need not be high in view of the restricted electrophoretic K+ flux. Although the role of the KHE is immediately obvious, however (preventing the osmotic burst of mitochondria in the face of K+ uptake), the requirement for K+ channel(s) mediating volume increase is less apparent. One situation where such a pathway would be clearly useful is during mitochondrial biogenesis, since K+ is the main intramitochondrial cation. The most intriguing hypothesis, however, links mitochondrial volume to metabolism through an effect on the respiratory chain (149).
Incubation in hypotonic media greatly stimulates the rate of
mitochondrial pyruvate metabolism (2) and of
-oxidation
(150), effects that can be mimicked by 1 nM valinomycin
(162). Like the Ca2+-mobilizing hormones
phenylephrine and vasopressin, 1 nM valinomycin also activates fatty
acid oxidation and stimulates gluconeogenesis through a mechanism that
does not depend on activation of carnitine palmitoyltransferase (see
Ref. 149 for review). Halestrap (149) has proposed a
unifying hypothesis for these observations that is based on the
increased rates of substrate oxidation following an increase of matrix
volume in a relatively narrow range. The effect is observed only with
electron donors to the ubiquinone pool, suggesting a specific site of
regulation (149). If mitochondrial K+ channels
are regulated by Ca2+-mobilizing hormones in vivo, this
would account for increased oxidation of fatty acids that are not
translocated by carnitine palmitoyltransferase (337). The
molecular definition of the pathways involved will certainly increase
our understanding of the basic mechanisms and provide tools that will
eventually clarify the details of channel operation in vivo.
| |
III. TRANSPORT OF CALCIUM |
|---|
|
|
|---|
Studies of Ca2+ transport in isolated mitochondria began in the 1960s (95, 349), and the reader can find an account of this early work in Reference 194. In this period, the prevailing view about the mechanism of transport was one where uptake was an active process linked to a high-energy intermediate of oxidative phosphorylation (71) and efflux was a passive process giving rise to steady-state Ca2+ cycling (108). Throughout the 1960s and early 1970s, researchers in the field mainly focused on the properties of the energy-dependent process of Ca2+ uptake and defined many of its basic features (67, 146, 230, 278, 305, 313, 347, 353). The parallel emergence of chemiosmotic principles (225) posed the question of the link between membrane potential and energy-dependent Ca2+ uptake.
A. Nonequilibrium Ca2+ Distribution
Nonrespiring mitochondria take up Ca2+ in response to
a K+ diffusion potential, 1 mol Ca2+ being
accumulated per 2 mol K+ lost to the medium
(305). Ca2+ is also accumulated in
thiocyanate- but not acetate-based media, suggesting accumulation
via an electrophoretic mechanism or via a direct
Ca2+/K+ exchange (313). The latter
mechanism could be ruled out because Ca2+ uptake in
energized mitochondria is not accompanied by K+ extrusion,
nor is it modified by changing extramitochondrial [K+]
(274). Finally, manipulation of the membrane potential
with proper ionophores in the range of
75 to
100 mV suggested that Ca2+ was equilibrating with the membrane potential through
an electrophoretic process with a net charge transfer of 2 (297). These early studies established that mitochondria
possess a specific Ca2+ transport system that has all the
properties of a channel that was and still is defined as the
"Ca2+ uniporter." A major problem soon emerged, however.
The Ca2+ electrochemical gradient
(
Ca) can be expressed as
|
(5) |

Ca = 0) is then given by
|
(6) |
Moyle and Mitchell (232) argued that Ca2+ was
not being transported with a charge of 2 but rather in symport with
Pi with a net positive charge of 1, which would have
accounted for the observed accumulation ratio. Although a
Ca2+-Pi symport could conclusively be ruled out
by experiments and by theoretical considerations (15,
240, 270), the issue of the net charge of
Ca2+ translocation in respiring mitochondria, and hence the
quantitative dependence of flux on the membrane potential, is not an
easy problem to address. A critical point is that Ca2+
uptake depolarizes the inner membrane, and this makes measurements of
transport at constant voltage problematic. Wingrove et al. (359) tackled this problem by using three levels of
buffered Ca2+ (0.5, 1.0, and 1.5 µM) and modified 
by adding increasing concentrations of malonate to
succinate-energized mitochondria. The low, buffered [Ca2+]o ensured that the rate of
Ca2+ uptake was not limited by the rate of H+
pumping, and direct measurements indicated that 
remained
constant throughout the uptake process. Although these studies can only be applied to a limited range of Ca2+ concentrations, the
data consistently indicated transport with z = 2. Transport spanned the entire transmembrane potential region between
about
80 and
180 mV, and it was offset by the effect of local fixed
charges (139, 359).
The general problem of the disequilibrium between steady-state Ca2+ distribution and transmembrane potential is even more dramatic in the light of subsequent determinations of [Ca2+]m by direct methods. In isolated mitochondria, values between the submicromolar and low micromolar range were consistently found (147, 218, 231, 355), whereas typical resting values between 100 and 240 nM were found in intact cells (100, 101, 228). The Ca2+ concentration gradient maintained by energized mitochondria thus appears to oscillate between 0 and 10, rather than being maintained at the value of 106 that would be predicted by thermodynamic considerations. This displacement from equilibrium is due to the fact that Ca2+ distribution represents a kinetic steady state where electrophoretic Ca2+ uptake is precisely matched by Ca2+ efflux on at least two separate pathways. These were identified in the 1970s as a Na+-dependent Ca2+ efflux pathway, most likely a Na+/Ca2+ exchanger (69, 85, 90, 91), and a Na+-independent Ca2+ efflux pathway (143, 240, 274) (see Refs. 84, 139, 144, 145, 241, 302 for reviews).
An exhaustive treatment of the vast literature on mitochondrial Ca2+ transport is beyond the scope of the present work, and the interested reader is referred to earlier reviews for further reference (65, 84, 139, 144, 145, 241, 302).
B. Pathways for Ca2+ Uptake
In the following paragraphs I summarize the properties of
mitochondrial electrophoretic Ca2+ transport systems that
catalyze Ca2+ uptake in energized mitochondria. In
principle, the direction of Ca2+ flux should only depend on
the 
Ca. Yet, for reasons that should become
clear later, Ca2+ flux via the uniporter is not readily
reversible upon depolarization (260), suggesting that the
physiological role of the uniporter may be that of mediating
Ca2+ uptake.
1. Ca2+ uniporter
A problem that was not appreciated in earlier studies of the
Ca2+ uniporter is that the kinetics of Ca2+
uptake in respiring mitochondria become rapidly limited by the rate of
H+ pumping (i.e., by the rate at which the membrane
potential can be regenerated) as [Ca2+]o is
raised above ~10 µM. This led to a serious underestimation of both
the Vmax and the apparent Michaelis constant
(Km) for Ca2+ (see Refs. 51, 163 and
comments therein). Azzone and co-workers (51)
circumvented these problems 1) by using a K+
diffusion potential induced by the addition of a vast excess of
valinomycin to respiratory-inhibited mitochondria as the driving force for Ca2+ uptake, so as to make Ca2+
transport rate-limiting even at high
[Ca2+]o; 2) by measuring the
initial rate of K+ efflux rather than that of
Ca2+ uptake, which would have required different methods
for Ca2+ detection in different ranges of
[Ca2+]o; and 3) by using proper
Ca2+ buffers in the low micromolar range of
[Ca2+]o (51). With this method,
the Vmax at 30°C was established to be in
excess of 1,400 nmol Ca2+ · mg
protein
1 · min
1, whereas the apparent
Km was <10 µM in sucrose-based media.
The Ca2+ uniporter is regulated by a number of modulators (inhibitors and activators), and this partly explains the wide variation of kinetic parameters reported in earlier literature (139, 145). To add further complexity, some of these modulators behave as uniporter inhibitors or activators depending on their concentration. I do not even attempt to provide an exhaustive compilation of the known factors, which can be found in previous reviews (65, 84, 139, 144, 145, 241, 302). I will rather discuss these effectors through selected examples.
A first class is represented by ruthenium compounds. Owing to the large
electrochemical gradient for accumulation of the ruthenium cation in
energized mitochondria, slow uptake may take place, but the transport
rate is <2 pmol · mg protein
1 · min
1
(43). In the presence of crude or partially purified RR,
Ca2+ flux on the uniporter is completely blocked,
inhibition being of the noncompetitive type (43,
277, 348). In liver mitochondria, Ca2+ flux is inhibited by 50% with ~30 pmol RR/mg
protein, but the titer is different in mitochondria from other sources.
On the basis of inhibition by RR, the number of uniporter molecules has been estimated to be between 1 and 10 pmol/mg mitochondrial protein (221, 277). More recent studies show that the
uniporter is inhibited by pure Ru-360 (366) and indicate
that the most active inhibitor present in "RR" recrystallized from
commercial sources may in fact not be the predominant red component
(60).
A second class of inhibitors is represented by divalent cations that are themselves transported by the uniporter like Sr2+ (67), Mn2+, Ba2+ (109), and lanthanides (221). Inhibition by these cations is generally competitive in type, but not all of the effects are necessarily exerted at the transport site(s) because the uniporter is also regulated by Me2+ binding sites that modulate the affinity of the uniporter for Ca2+.
This third class of effectors is best exemplified by Mg2+ and Mn2+. In the low millimolar range, Mg2+ transforms the relationship between rate of Ca2+ transport and [Ca2+]o from hyperbolic to sigmoidal, decreases the Vmax, and increases the apparent Km for Ca2+ from 10 to ~50 µM (6, 51, 353). Mg2+ best represents a class of ionic modulators that affect the kinetics of Ca2+ transport by binding to regulatory site(s) rather than to the transport site(s). Indeed, Mg2+ is not transported by the uniporter; it does not affect the Ca2+ conductance (163), and its effects can be mimicked by ~50-fold higher concentrations of monovalent cations like Li+ (51). A second example is represented by Mn2+, which under specific conditions can stimulate rather than inhibit the kinetics of Ca2+ transport (166), with an effect that counteracts that of Mg2+ through a mixed-type competition (7). These experiments suggest that Mn2+ can displace Mg2+ from its binding site(s) and therefore that Mn2+ can interact both with the Me2+ regulatory site and with the transport site. This may result in either stimulation or inhibition of Ca2+ flux depending on the concentration of Mn2+ and on the presence or absence of Mg2+ (7). Interestingly, the Ca2+ uniporter is activated by external Ca2+ itself so that the uniporter undergoes deactivation upon removal of extramitochondrial Ca2+ (e.g., after Ca2+ accumulation) (190). Thus, at low [Ca2+]o values (comparable to those prevailing in the cytosol), the activity of the uniporter may be extremely low. It appears possible that activation of the uniporter by spermine (191, 239) is mediated by modulation of Me2+ binding sites and/or by screening effects on surface fixed charges. Finally, recent work indicates that the uniporter is inhibited by adenine nucleotides in the order ATP > ADP > AMP, through an effect that is independent of ATP hydrolysis, and of changes of Ca2+ and Mg2+ concentrations (201).
In the presence of an outwardly directed Ca2+ electrochemical gradient, the uniporter should catalyze Ca2+ efflux, and Ca2+ release is indeed observed upon addition of a respiratory inhibitor and/or an uncoupler after energy-dependent accumulation of Ca2+. However, Ca2+ release is largely insensitive to RR (43, 183). At variance with our earlier suggestion (43), this depends on the fact that depolarization of Ca2+-loaded mitochondria causes opening of an additional pathway for Ca2+ release, the voltage-dependent mitochondrial permeability transition pore (MTP) that is insensitive to RR (33, 168, 173, 183). When MTP opening is prevented by cyclosporin A (CsA), fast mitochondrial Ca2+ efflux is not observed despite depolarization, indicating that flux via the uniporter is not readily reversible (260). This behavior can be explained by the low [Ca2+]o at the onset of depolarization, which deactivates the uniporter (173, 190), and by the fact that a high membrane potential may be required to maintain the uniporter in a transport-competent conformation (185).
2. Rapid uptake mode
Mitochondria in vivo are exposed to cyclic changes of cytosolic [Ca2+] ([Ca2+]c) that have the appearance of pulses, whereas the most accurate results concerning the kinetics of mitochondrial Ca2+ uptake have been obtained by using Ca2+ buffers (e.g., Refs. 51, 359). To study whether the amplitude and frequency of Ca2+ pulses affect the properties of transport, Gunter and co-workers (322, 323) devised a pulse-generating and monitoring system that allows precise modulation of these parameters. These studies revealed that Ca2+ uptake was more efficient when mitochondria were exposed to trains of Ca2+ pulses of physiological height (~400 nM) rather than to an identical steady [Ca2+]o for the same overall time. This mechanism (dubbed the rapid uptake mode, or RaM) can be reset in <0.75 s by a decrease of [Ca2+]o between 100 and 200 nM (323). Like the Ca2+ uniporter, the RaM is inhibited by RR (but inhibition requires much higher concentrations) and stimulated by ATP and spermine; unlike the uniporter, it is not affected by Mg2+ (323). Gunter and co-workers (322, 323) favor the idea that the RaM is mediated by a specific transport mechanism that might be responsible for mitochondrial Ca2+ uptake from [Ca2+]c transients in vivo, as reviewed in detail elsewhere (141).
C. Pathways for Ca2+ Efflux
After the uptake of moderate Ca2+ loads (typically 10-30 nmol/mg protein), respiring mitochondria retain Ca2+ and maintain steady-state [Ca2+]o at a constant value of 0.5-1.0 µM. If enough RR is added to fully inhibit the Ca2+ uniporter, a process of Ca2+ efflux ensues that is commonly interpreted as evidence that RR-insensitive Ca2+ efflux, coupled to uniporter-mediated reuptake, was also occurring before the addition of RR. Inhibition of the uniporter by RR would then allow the study of this pathway for mitochondrial Ca2+ efflux in isolation. This system, the still elusive "Na+-independent pathway for Ca2+ efflux" (NICE) (70, 119, 143, 270, 274), has been the subject of a vast amount of work and of considerable controversy over the years.
After the addition of RR, the rate of Ca2+ efflux can be stimulated by the addition of Na+, the extent of stimulation being variable depending on the source of mitochondria (69, 89-91). This pathway, the "Na+-dependent pathway for Ca2+ efflux" (NCE), has likewise been the subject of a large number of studies (e.g., Refs. 8, 9, 22, 74, 75, 93, 135, 136, 159-161, 164, 182, 283, 296, 303, 308, 318, 363) and of a recent debate about the Na+-Ca2+ stoichiometry (23, 180, 361). The two pathways are distinct, since their kinetics are completely different, in that NICE is second order whereas NCE is first order in [Ca2+] (360, 361).
1. NICE
Under the most simple incubation conditions NICE is slow
(typically between 1 and 2 nmol Ca2+ · mg
protein
1 · min
1) and occurs without
detectable changes of the membrane potential (240). These
findings suggested that maintenance of the steady-state [Ca2+]o by energized mitochondria depends on
"Ca2+ cycling" via separate pathways, i.e., uptake via
the uniporter and efflux via NICE, possibly a
H+/Ca2+ antiporter (see Ref. 241 for review).
The rate of RR-insensitive Ca2+ efflux can be
considerably increased by a variety of agents, most notably
Pi and oxidants of both glutathione and/or pyridine nucleotides (PN) (156, 195,
275). This led to the suggestion that mitochondrial
Ca2+ efflux via the putative
H+/Ca2+ antiporter was stimulated by oxidation
(120) or hydrolysis (205) of PN.
In principle, RR-insensitive Ca2+ release can occur via an entirely different mechanism. If, in the steady state, a small fraction of mitochondria undergoes reversible depolarization due to opening of the Ca2+-dependent MTP, Ca2+ released from this permeabilized fraction would be taken up by the polarized mitochondria. Addition of RR would prevent this type of Ca2+ redistribution among mitochondrial subpopulations and thus result in net Ca2+ efflux (282). This possibility is strongly supported by the occurrence of transient, nonsynchronized depolarizations in individual isolated mitochondria (169), which matches the spontaneous oscillations of the mitochondrial membrane potential observed in living cells (204).
The nature of the effects of oxidants and other compounds that stimulate RR-insensitive Ca2+ efflux (and the related problems of the nature and of the very existence of this pathway) remained controversial for a number of years (26, 30, 32, 38, 39, 41, 45, 62, 120, 140, 142, 183, 206, 254, 281, 285, 295, 301, 316, 340, 350-352, 360, 369). I think that there can be little doubt that many early studies of RR-insensitive Ca2+ efflux in mitochondria have been complicated by the unrecognized contribution of the permeability transition (PT), which may be extremely difficult to detect for reasons that are addressed in a specific study of Riley and Pfeiffer (282). Unless proper measures are taken, RR-insensitive Ca2+ efflux is a complex measure of both NICE and of Ca2+ efflux from mitochondria undergoing PT (25, 242, 245, 273, 282, 362). It can be hardly coincidental that, with no exception, factors reported to stimulate or inhibit RR-insensitive Ca2+ efflux also affect the PT in the same direction (see the specific discussion in Refs. 44, 249 and section IV).
In the light of the above concerns, Gunter and co-workers
(140, 360) reassessed the problem of the
Na+-independent pathways for Ca2+ efflux in rat
liver mitochondria under conditions where occurrence of a PT could be
reasonably excluded. These studies indicated that NICE saturates at
Ca2+ loads of 25 nmol/mg protein, that its
Vmax is not influenced by the concentration of
Pi and does not exceed a rate of 1.2 nmol Ca2+ · mg protein
1 · min
1
(360), and that this system is able to extrude
Ca2+ against a gradient that is much higher than
thermodynamically permissible to an electroneutral
H+/Ca2+ exchanger (140). Thus NICE
is either a nH+/Ca2+ exchanger with
n > 2, or it has an active component that may be
directly linked to electron flux (293). These conclusions are entirely consistent with the earlier demonstration that inverted vesicles (293) or deenergized mitochondria
(38, 301) do not display a RR-insensitive
H+/Ca2+ exchange activity even when a large
pH is demonstrably provided and that NICE is inhibited by
mitochondrial depolarization in the range between
180 and
140 mV
(39, 41). Initiation of oxidative
phosphorylation causes net Ca2+ accumulation through
inhibition of Ca2+ efflux via this pathway
(41), and this is precisely what would be expected to
stimulate matrix Ca2+-dependent dehydrogenases, as
discussed in section IIID.
In summary, it appears safe to conclude that mitochondria possess a
NICE that requires a transmembrane potential as a component of its
driving force. This pathway saturates at very low Ca2+
loads and is extremely slow. For practical purposes, a contribution of
the PT to RR-insensitive Ca2+ efflux should be
suspected for rates above ~2 nmol · mg
protein
1 · min
1.
2. NCE
The existence of a NCE mediating steady-state Ca2+ cycling in mitochondria has never been questioned (69, 89-91). Early work indicated its absence in mitochondria from some tissues such as liver, kidney, and lung (91), a finding that was challenged by subsequent studies (159, 164, 237). Experimental discrepancies were settled with the demonstration that NCE in liver mitochondria is inhibited by RR itself (above ~5 nmol/mg protein), by Mg2+ (50% inhibition at ~1 mM), and by very low concentrations (50% inhibition ~0.2 µM) of the widely used membrane potential probe triphenylmethylphosphonium (361). Complications arising from the PT (see sect. IIIC1) are generally negligible in studies of NCE because the efflux rate via the Na+-independent pathways (NICE and PT) is always subtracted, and conditions are normally selected so that their contribution is minimal. A considerable amount of information exists about this pathway, which is widely considered as a Na+/Ca2+ exchanger that mediates physiological Ca2+ cycling through a concerted interplay with the NHE (89).
The kinetic parameters for Ca2+ efflux are somewhat
variable for mitochondria from different sources. The
Vmax value varies between a minimum of 2.6 and a
maximum of 18 nmol Ca2+ · mg
protein
1 · min
1 in liver and heart
mitochondria, respectively (91, 361). The dependence on Na+ is sigmoidal, with typical
Km values centered at ~8-10 mM
Na+, and Na+ can be substitued by
Li+ (85). Ca2+ efflux is inhibited
by Sr2+ (303), Ba2+
(207, 208), Mg2+
(361), Mn2+ (135), and by a
variety of compounds of pharmacological interest such as amiloride
(182, 308, 318), trifluoperazine
(160), diltiazem (74, 75,
283), verapamil (363), clonazepam, and bepridil (74), whereas it is stimulated by short-chain
alcohols (296). A prominent modulatory effect by matrix pH
has been reported, with a sharp optimum at pH 7.6 (22),
and NCE is stimulated by treatment with glucagon and
-adrenergic
agonists (136).
The rate of Ca2+ efflux via NCE is significantly inhibited by both antimycin A and protonophores, suggesting that it may be favored by the transmembrane potential (85, 90). The related issue of the Na+-Ca2+ stoichiometry is complex, and data in the literature are contradictory. The dependence on external Na+ has been reported to fit both the cube (85) and the square of [Na+]o (90), and an overall electroneutral exchange has been initially suggested on both kinetic (3) and thermodynamic grounds (52). This issue has been recently reexamined in studies where matrix pH and [Ca2+] were directly monitored with fluorescent probes, a technique that was not available in earlier studies. The results indicate that NCE is not electroneutral and that a stoichiometry of 3Na+:1Ca2+ appears more plausible (23, 180). A 110-kDa protein able to catalyze electroneutral, diltiazem-sensitive Na+/Ca2+ exchange has been purified from beef heart mitochondria (199), and this is currently the only candidate as the protein mediating NCE.
3. Ca2+ cycling and the problem of net Ca2+ release
Coupling of electrophoretic Ca2+ uptake with
Ca2+ efflux on separate pathways in energized mitochondria
allows fine regulation of [Ca2+]o and
[Ca2+]m and is illustrated in Figure
8. Note that energy in the form of a

H is required both for Ca2+ uptake
and for Ca2+ release, owing to 1) the
electrophoretic nature of transport on both the uniporter and RaM;
2) the 3Na+:1Ca2+ stoichiometry of
NCE and energy dependence of NICE, tentatively depicted here as a
3H+/1Ca2+ exchanger; and 3) the
requirement for H+ extrusion posed by operation of NHE and
possibly NICE itself. Steady-state
[Ca2+]o can be increased (and
[Ca2+]m decreased to an extent that also
depends on matrix Ca2+ buffering) by increasing the
activity of the efflux systems, or by decreasing the activity of the
uptake systems, or both (241, 244). The
energetic consequences are quite different depending on whether the
former or the latter mechanism prevails, however. If net efflux results
from stimulation of the efflux pathways, the increase of
[Ca2+]o will stimulate the kinetics of the
uniporter and RaM. In turn, this will 1) limit the increase
of [Ca2+]o and 2) cause an
increased rate of Ca2+ cycling, and therefore of energy
drain, which is a steep function of [Ca2+]o.
This is experimentally observed by adding the electroneutral 2H+-Ca2+ ionophore A-23187 to respiring
mitochondria that have accumulated Ca2+, a condition where
all the respiratory capacity can be diverted into Ca2+
cycling (see, e.g., Refs. 45, 163). Thus, and as long as the membrane
potential is high, net Ca2+ efflux through stimulation of
the efflux pathways has both a low efficiency and a high energetic
cost. The low Vmax and early saturation of the
efflux pathways by [Ca2+]m are probably
designed to pose an upper limit to the energy that can be spent in
regulation of [Ca2+]m and
[Ca2+]o through Ca2+ cycling. On
the other hand, because the rate of uptake is extremely fast when
[Ca2+]o increases, this situation exposes
mitochondria to the risks of Ca2+ overload. This may be
prevented by opening of the MTP, which mediates mitochondrial
depolarization and fast Ca2+ release in vitro
(44) and perhaps in vivo. This aspect is discussed more in
detail in section IV.
|
D. Mitochondria in Ca2+ Homeostasis
Ca2+ modulates three intramitochondrial enzymes involved in energy metabolism, i.e., the pyruvate dehydrogenase complex (97), the NAD+-linked isocitrate dehydrogenase (98), and the 2-oxoglutarate dehydrogenase (219). This led to the hypothesis that mitochondrial Ca2+ uptake upregulates the activity of these enzymes, hence energy production, following an increase of [Ca2+]c (96). Convincing evidence has accumulated that this is the case in different systems (e.g., Refs. 110, 118, 148, 299), and today it can be hardly doubted that one of the main functions of mitochondrial Ca2+ transport is to relay an increased metabolic demand through a Ca2+ signal (see Refs. 155, 287 for reviews).
On the other hand, the role of mitochondria in intracellular Ca2+ homeostasis has been more controversial, with consensus following a cyclic pattern. The [Ca2+]c transients visualized by means of aequorin luminescence showed that diffusion of Ca2+ through the cytosol is so constrained that a rise in [Ca2+]c, produced by local Ca2+ entry through cell membrane or by local Ca2+ injection, was confined to the immediate vicinity of these sites. The diffusion constraints were lifted by treatment with cyanide or RR, suggesting that energized Ca2+ sequestering by mitochondria was the dominant factor in the constraints (292). Throughout the late 1970s and early 1980s, measurements with intracellular microelectrodes and microinjected probes gave values for [Ca2+]c after stimulation that were mostly compatible with a role of mitochondria in regulation of [Ca2+]c homeostasis (see Ref. 346 for an excellent review of the resting and stimulated values).
In the early 1980s, fluorescent Ca2+ indicators became available that could be loaded into cells without disruption of the plasma membrane (342-345). This powerful technique allowed measurements of [Ca2+]c in virtually any cell and revealed that resting values are typically centered at or below ~100 nM (271). Cytosolic [Ca2+] does increase upon activation of specific signaling pathways and gives rise to Ca2+ transients the amplitude and frequency of which depends on the type of stimulus and on the type of cell (341). The maximum amplitude of the [Ca2+]c rise rarely exceeds 1 µM, however, whereas the frequency can vary widely (see Ref. 144 for representative examples). The range of variations of [Ca2+]c measured with this approach is well below the Km of the mitochondrial Ca2+ uniporter, and this has been used as an argument against a role of mitochondrial Ca2+ transport in cellular Ca2+ homeostasis under physiological conditions (68). As a result, throughout the 1980s and early 1990s, mitochondria were mostly presumed to come into play only after sustained elevations of [Ca2+]c, such as those observed in pathological conditions (117, 253). More recent results have completely changed this picture and indicated that mitochondria play a key role in cellular Ca2+ homeostasis.
In 1990, bright fluorescent spots were observed in fluorescent ratio images of fura 2-loaded quiescent cardiac myocytes. The fluorescence intensity of these Ca2+ "hot spots" could be increased by agents that deplete Ca2+ in the sarcoplasmic reticulum and decreased by uncouplers of oxidative phosphorylation and respiratory inhibitors, suggesting Ca2+ compartmentation inside mitochondria (358). In the first quantitative measurement of [Ca2+]m, Miyata et al. (228) reported a resting level of <100 nM in cardiac myocytes that was increased to 600 nM, over the course of many contractions, as the pacing frequency was increased to 4 Hz (228). A strong indication that mitochondrial Ca2+ fluxes are fast enough in vivo to change [Ca2+]m and [Ca2+]c during the cardiac contraction cycle came from a study based on shock-freezing of ventricular myocytes at defined stages of systole and diastole, followed by electron-probe microanalysis. This study revealed that the mitochondrial Ca2+ content changed during each individual contraction cycle and that a substantial amount of Ca2+ was taken up during the systole and released during later systole and diastole (177). Finally, mitochondrially targeted aequorin was introduced as a tool to monitor changes of [Ca2+]m in situ (286, 300). Inositol 1,4,5-trisphosphate (IP3)-induced Ca2+ mobilization from intracellular stores caused increases of intramitochondrial aequorin fluorescence the speed and amplitude of which could not be accounted for by the relatively small increases in mean [Ca2+]c (284). This indicated a direct link between mitochondria and intracellular stores and suggested that mitochondria sense microdomains of high [Ca2+]c located close to the IP3-sensitive channels (284). These findings perfectly match the premonition that "in cell regions where the sequestering machinery is sufficiently dense, different Ca2+ message functions inside a cell may be effectively segregated, permitting private-line intracellular communication" (292).
Ample evidence that mitochondria play a key role in physiological intracellular Ca2+ homeostasis is today available, as demonstrated by an ever-increasing number of studies in different cell types (see, e.g., Refs. 21, 64, 165, 170, 179, 203, 357). These findings will hopefully attract novel interest in the molecular mechanisms that mediate mitochondrial Ca2+ transport.
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IV. PERMEABILITY TRANSITION |
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As a result of Ca2+ accumulation (or simply as a consequence of in vitro aging), energized mitochondria may undergo a sudden permeability increase of the inner membrane to solutes of molecular mass up to ~1,500 Da (214), the PT. In the past, the apparent lack of solute selectivity has been widely taken to imply that the permeability pathway lacked specificity and that it was likely to represent a form of "unspecific membrane damage," as also suggested from the protective effects of phospholipase A2 inhibitors (306). A series of more recent findings indicates that the PT may in fact be mediated by opening of a specific, nonselective high-conductance inner membrane channel, the MTP.
1) The PT is inhibited by nanomolar concentrations of the cyclic immunosuppressant peptide CsA (59, 88, 123). Because CsA does not inhibit phospholipase A2, the popular hypothesis that the PT could be formed by acyllysophospholids after Ca2+-dependent activation of phospholipase A2 (25, 173, 269) was largely dismissed.
2) The inner mitochondrial membrane possesses ion channels that can be studied by electrophysiology (186, 266, 319; see Refs. 211, 320 for reviews). Among these, the high-conductance (~1 nS) "mitochondrial megachannel" (MMC) (186, 266) is inhibited by CsA (328) and responds to inducers and inhibitors in the same way as does the PT (47, 327, 329). This left little doubt that the MMC and MTP coincide and that the PT is due to opening of proteinaceous pores. This hypothesis had already been proposed by Haworth and Hunter (157, 158, 167, 168), who carried out a thorough characterization of inducers and inhibitors of the PT that stood the test of time. I think that the early dismissal of the pore theory of the PT was an indirect consequence of the Nobel Prize award to Peter Mitchell in 1978 and of the widespread conviction that mitochondria did not possess ion channels at all.
The MTP is not cation selective, yet it exhibits a prominent Ca2+ dependence that explains its traditional coverage in reviews of mitochondrial Ca2+ transport (144, 145). I think that its discussion here is fully justified by a plausible role in mitochondrial Ca2+ homeostasis that may be of relevance in a variety of forms of cell death. Space limitations prevent an extensive coverage of the huge literature on the PT, which can be found in a specific review (371).
A. Regulation
The MTP can be defined as a voltage-dependent, CsA-sensitive, high-conductance inner membrane channel of unknown molecular structure. The voltage dependence appears to be an intrinsic property of the pore. It has been demonstrated in isolated mitochondria with depolarizing H+ (33) or K+ currents (312) and in single-channel measurements by modulating the applied voltage (330). In the fully open state, the apparent pore diameter is ~3 nm, based on both solute exclusion (157, 214) and conductance measurements (328). The pore open-closed transitions are highly regulated by multiple effectors at discrete sites (see Refs. 34, 42, 144, 145, 371 for reviews). Factors that affect the PT can be conveniently classified into matrix and membrane effectors as schematically illustrated in Figure 9.
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1. Matrix effectors
Pore opening is favored by increases of [Ca2+]m, an effect that can be counteracted by other Me2+ like Mg2+, Sr2+, and Mn2+ (157). Inhibition is competitive, suggesting Me2+ interactions at a common site (47).
Pore opening is strongly promoted by an oxidized state of PN and of critical dithiols at discrete sites, and both effects can be separately reversed by proper reductants (73, 81). The dithiol-disulfide interconversions correlate with the redox state of glutathione and can be blocked by 1-chloro-2,4-dinitrobenzene, suggesting that the dithiol is in redox equilibrium with matrix glutathione (73). This finding easily accounts for the PT-inducing effects of both peroxides and redox cycling agents (83, 188, 262) and for the corresponding inhibition with monofunctional thiol reagents like N-ethylmaleimide (189, 262) and monobromobimane (80).
Opening of the MTP is inhibited by CsA (59, 88, 123) most likely after binding to cyclophilin D (CyP-D), a matrix peptidyl-prolyl cis,trans-isomerase (PPIase) (78, 364) which would be the endogenous MTP modulator (79, 246). As a result of CsA binding, the PPIase activity of CyP-D is inhibited, but this may not be relevant for MTP inhibition (311). Likewise (and at variance from immunosuppression), the effect of CsA does not involve inhibition of calcineurin (246). Cyclosporin A is not a true pore blocker, however, and inhibition is transient in longer time-frame experiments (61). Inhibition by CsA can be largely relieved by increasing [Ca2+] (47, 48), and it depends on matrix ADP (251) and Mg2+ (250), which both are pore inhibitors per se (167).
Inhibition of MTP can also be observed with bongkrekate (198), whereas atractylate opens the pore (167, 198). Because atractylate and bongkrekate are selective inhibitors of the adenine nucleotide translocase (ANT), these experiments led to the suggestion that the MTP may be directly formed by the ANT (151), an issue that is discussed in section IVA3.
Finally, the PT is potently inhibited at matrix pH below ~7.0 (47) via reversible protonation of critical histidyl residues that can be blocked by diethylpyrocarbonate (247). This finding represented the first indication that the pore can be modulated by proton pumping and paved the way for the demonstration that the MTP is voltage dependent (33). Inorganic phosphate is a powerful MTP inducer whose effect can be only partly explained by buffering of matrix pH (193).
2. Membrane effectors
A high (inside-negative) membrane potential tends to stabilize the MTP in the closed conformation (33, 260, 261). We have postulated the existence of a voltage sensor that decodes the changes of both the transmembrane voltage (261) and of the surface potential (42, 61) into changes of the MTP open probability. This would easily account for pore opening after depolarization as such (33, 312, 330) and for the effects of a large variety of membrane-perturbing agents that can either inhibit or promote the PT. In general, amphipathic anions (like fatty acids produced by phospholipase A2) favor the PT, with an effect that cannot be explained by depolarization (61, 261). Conversely, polycations like spermine (192), amphipathic cations like sphingosine and trifluoperazine (61), and positively charged peptides (280) inhibit pore opening (see Ref. 42 for review). The putative voltage sensor may comprise critical arginine residues, as suggested by the recent finding that mitochondria treated with the arginine-selective reagents 2,3-butanedione or phenylglyoxal became resistant to pore opening by Ca2+ plus depolarization (114).
We recently described direct MTP regulation by electron flux within respiratory chain complex I, with an increased open probability when flux increases (121). This led to the discovery that the PT is regulated by quinones, most likely through a specific binding site whose occupancy profoundly affects the open-closed transitions depending on the bound species. Binding of ubiquinone 0 (Ub0) or decylubiquinone prevents Ca2+-dependent pore opening irrespective of the inducing agent, and the inhibitory effect of Ub0 and decylubiquinone (but not that of CsA) can be relieved by pore-inactive quinones like ubiquinone 5 (122). I have tentatively assigned a membrane site of action to Ub0 in the scheme of Figure 9, which might correspond to a binding site on respiratory chain complex I (122).
3. Molecular nature
Largely because of the effects of bongkrekate and atractylate on the PT, the early suggestion had been made that the pore may be formed by the ANT (151), possibly after oxidant-dependent dimerization (154). The ANT reconstituted in giant liposomes exhibits a striking high-conductance (but CsA-insensitive) channel activity that is stimulated by Ca2+ and displays a marked voltage dependence with prominent gating effects (63) that are consistent with the reported voltage dependence of the pore in intact mitochondria (261, 262, 312). Furthermore, after reconstitution in liposomes, the ANT can catalyze Ca2+-dependent (but CsA-insensitive) malate transport that is inhibited by ADP and favored by atractylate (298). Although these observations certainly demonstrate that the ANT can form large channels in reconstituted systems, their relevance to the PT is less obvious. Most pore inducers and inhibitors, including CsA, do not affect the activity and the conformation of the translocase; MTP opening by a variety of oxidants (with the possible exception of diamide) is not accompanied by dimerization of the ANT (82); and it should be considered that the transition of the very abundant ANT from the "m" (bongkrekate-bound) to the "c" conformation (atractylate-bound) (310) is accompanied by major structural rearrangements (210) that may profoundly affect general membrane properties like the surface potential and thus modulate the PT indirectly (see discussion in Ref. 42). Our recent demonstration that specific quinones inhibit the PT (121) irrespective of the mode of induction (122) adds further questions because the only known mitochondrial ligands of quinones are the respiratory complexes involved in the Q cycle (115).
Because no single candidate protein can currently account for the complexity of PT modulation in isolated mitochondria, there has been a tendency to increase the number of the MTP putative components to include matrix CyP-D, the inner membrane ANT, the outer membrane porin, peripheral benzodiazepine receptor and Bcl-2, hexokinase bound to porin, and intermembrane creatine kinase. I think that we should recognize that the structural basis for the PT remains undefined at present and that the related issue of whether the PT can be fully accounted for by a single channel modulated by multiple effectors remains an open question. Although it is conceivable that the MTP is a supramolecular structure involving (or regulated by) more than one protein, its molecular nature remains a matter for future work.
B. Channel Kinetics and Population Dynamics
The MMC (MTP) flickers between closed and open states (186, 266, 328-330), but transient, reversible MTP openings would be missed in a population of isolated mitochondria unless these are synchronized, a condition that has so far been achieved only under rather selective incubation conditions in hypotonic media (170, 171) and in digitonin-treated Ehrlich ascites cells (116).
Changes in 
resolved in individual mitochondria loaded with a
fluorescent probe demonstrated transient, asynchronous cycles of
depolarization-repolarization in individual mitochondria. After a
variable length of time, depolarizations became long lasting and were
accompanied by permeabilization to calcein (molecular mass ~620 Da)
(169). Pharmacological evidence suggests that both the
reversible depolarizations (which are not accompanied by calcein diffusion) and the long-lasting, irreversible depolarizations are
due to MTP opening (169). It appears conceivable that the MTP can open for times that are too short for diffusion of calcein (which is well below the MTP cutoff of 1,500 Da) and/or that the MTP
can open in a form that displays a lower cutoff, which would correspond
to a lower conductance state. The latter possibility is supported by
the finding that during the synchronized cycles of MTP
opening-closure in mitochondrial suspensions, the MTP is permeable
to ions (H+, Ca2+, K+) but not to
sucrose (170). This might correspond to a lower conductance state of the pore (172), as discussed more in
detail below.
Synchronized MTP opening in isolated mitochondria in suspension can be
achieved in protocols that exploit the pore voltage dependence. Graded
depolarizations recruit increasing fractions of mitochondria to open
the MTP (261), suggesting that either 1) the
threshold potential for pore opening (the "gating potential") is
heterogeneous, and represents a continuum in a population of mitochondria in suspension, or 2) the resting 
in a
population of energized mitochondria is heterogeneous, and therefore a
smaller depolarization is required for pore opening in the subfractions with lower 
(261). The two explanations are not
mutually exclusive. In Figure
10A, I follow the second
interpretation for simplicity, in an example where the threshold is
arbitrarily set at
160 mV and mitochondria initially maintain a range
of membrane potentials above the threshold and therefore a closed pore
(left). A moderate depolarization will recruit to the PT
only mitochondria that are close enough to the threshold (Fig.
10A, middle), a condition where mixed populations
of mitochondria with closed and open pores coexist (261);
a deeper depolarization will then open the MTP in the whole population
(Fig. 10A, right). A second situation can be
envisioned in which the threshold rather than the resting 
is
changed and brought closer to the resting potential for example by an
increased Ca2+ load (Fig. 10B). In this case,
mitochondria with the lowest 
(or the highest gating potential)
will open the pore first and undergo collapse of 
with
Ca2+ release (Fig. 10B, middle).
Ca2+ will be taken up by polarized mitochondria, raise
their gating potential, and cause further spreading of the PT until all
the population undergoes a PT (Fig. 10B, right).
Finally, inhibitors (like ADP or H+) can move the gating
potential in the opposite direction and further away from the resting

(Fig. 10C, left). In this case, depolarization may not be followed by a PT at all (Fig. 10C,
middle and right).
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Thus a PT may be either the consequence of depolarization (Fig. 10A) or its cause (Fig. 10B). Although a PT is always followed by depolarization (Fig. 10B), depolarization is not always followed by a PT (Fig. 10C), and whether a PT will occur or not under a given in vivo condition is not easy to predict. The MTP open-closed transitions are combinatorial events reflecting 1) the conflicting inputs of inducing an inhibitory factors acting at the same time and 2) the relative control strength exerted by each level of modulation.
C. Consequences and Reversibility
The consequences of the PT and the issue of its reversibility can only be addressed in studies in vitro and largely depend on the experimental conditions. In the following discussion I distinguish primary consequences of the PT, i.e., those that are intrinsically linked to opening of the MTP, and secondary consequences, i.e., those depending on additional variables that can be manipulated in vitro but are much less predictable in vivo. The issue of reversibility, and its very definition, largely depends on understanding these variables.
The only primary consequence of MTP opening is mitochondrial depolarization, followed by equilibration of the (electro)chemical gradients of ions and of solutes with molecular masses below the pore cutoff. It must be stressed that collapse of ion gradients occurs irrespective of whether the MTP opens in a lower conductance state, whereas diffusion of larger solutes can be critically affected by either the pore size or the open time (169, 263, 264). Onset of the PT in vitro is followed by loss of matrix Mg2+ and of adenine and pyridine nucleotides (e.g., Ref. 282), which will tend to stabilize the MTP in the open conformation and convey the impression that opening is essentially an "irreversible" phenomenon. This is not the case, however. Closure of MTP is followed by mitochondrial resealing (86, 87) and repolarization (265), indicating that no permanent change of inner membrane permeability occurs as a consequence of a PT.
Although common PT assays in vitro are based on swelling, swelling is not a necessary consequence of pore opening. Swelling results from solute and water flux from the intermembrane/intercristal spaces to the matrix only if there is an osmotic imbalance, but it does not occur for very short open times and/or for lower conductance states of the MTP (61, 169, 170). Permeability transition-dependent swelling in vitro can be completely prevented if the incubation medium contains low concentrations [e.g., 25 mM polyethylene glycol 3,400 (267)] of pore-impermeant solutes (267, 350). Thus whether swelling and outer membrane rupture occur after a PT in vivo is extremely hard to predict because of the high content of macromolecules of the cytosol and of the highly structured nature of the mitochondria themselves (212). In any case, it must be stressed that mitochondria are able to shrink and fully recover energy-linked functions even after PT-dependent large-amplitude swelling with outer membrane rupture in saline media, provided that cytochrome c is added back (265). This indicates that no permanent damage to mitochondria occurs even after large-amplitude swelling, which remains one of the most useful tools to analyze the kinetics of MTP opening in individual mitochondria in vitro (213).
The PT causes secondary consequences on in vitro respiration that
depend on the substrate. With PN-linked substrates (like pyruvate,
glutamate, and malate), MTP opening is followed by respiratory inhibition because matrix PN are readily lost at the onset of the PT
(354), and respiration can be at least partially restored by the addition of NAD+ (121). With complex
II-linked substrates (like succinate), the PT is rather followed by
uncoupling (e.g., Ref. 121). The consequences of a PT on respiration in
vivo will therefore depend on whether, and to what extent, PN depletion
and subsequent hydrolysis by intermembrane glycohydrolase take place
(50). Irrespective of whether respiration is inhibited or
stimulated, the collapse of the 
H caused by the
PT will curtail ATP synthesis as long as the pore is open.
D. Potential Role in Ca2+ Release
If a Ca2+ concentration gradient exists between the matrix and the external medium (or the cytosol), onset of the PT will lead to Ca2+ release. The possibility that the PT might serve as a mitochondrial Ca2+ release channel has been discussed in the field (145), but until very recently, major conceptual obstacles prevented serious consideration and experimental testing of this idea. As discussed above, many of these hurdles (like pore reversibility and onset of structural damage) have probably been overestimated. The lack of channel selectivity and its large size deserve a separate comment (see also Ref. 44).
1) Emergence of channels with different ion selectivity has been an evolutionary process, which is reflected by the high degree of homology among the main channel subfamilies. For example, an ancestral K+ channel may have given rise to both the voltage-gated and the cyclic nucleotide-gated K+ channels, followed by further evolution of the latter into the more complex voltage-gated Ca2+ and Na+ channels by small mutations coupled to gene duplication events (304). However, only the existence of Ca2+ and Na+ gradients across the plasma membrane, which could be exploited for signal transduction, conferred an evolutionary advantage to the independent emergence of different ion selectivities. As discussed in section II, no K+ and Na+ concentration gradients exist across the inner membrane. Thus MTP opening may lead to selective Ca2+ release without major consequences on K+ and Na+ homeostasis, whereas no evolutionary pressure existed for the development of cation selectivity. In this respect, the MTP is similar to the Ca2+ release channel of the sarcoplasmic reticulum, which operates as a selective channel despite the large size (>38 Å), the high conductance for monovalent cations (~1 nS at saturating K+), the permeability to solutes like glucose (220), and the low permeability ratio when both K+ and Ca2+ are present (PCa/PK ~6) (317).
2) Even after complete depolarization, Ca2+
efflux down its concentration gradient via a selective channel (like
the uniporter) is opposed by the buildup of a Ca2+
diffusion potential (5). According to the Nernst equation, the maximal magnitude of the Ca2+ diffusion potential is
30 mV/decade, which will be reduced (with a proportional increase of
the Ca2+ efflux rate) by the sum of all
charge-compensating currents (influx of positive charges, efflux of
negative charges, or both). Because the inner membrane has a very low
permeability to charged species in general, the basal rate of
Ca2+ efflux would be extremely low and could only be
increased by independent modulation of the membrane ion permeability as
can be achieved in vitro, e.g., by increasing the H+
conductance (43). A nonselective pore of large size
confers the clear advantage of providing charge compensation within the channel itself, thus allowing maximal Ca2+ flux (i.e., at
zero potential). This would guarantee fast Ca2+ release
even for vanishingly small [Ca2+] gradients, with
regulation being directly achieved through modulation of the pore open time.
These concepts are summarized in Figure
11. As a consequence of a
Ca2+ signal (and/or of the accompanying depolarization and
matrix pH increase), MTP opening occurs (Fig. 11, right).
Fast Ca2+ efflux ensues that is compensated by
H+ flux within the channel (the same result could be
achieved by K+ or Na+ influx, or by anion
efflux). The drop of 
H would be followed by ATP
hydrolysis, with increase of matrix [ADP] and [Mg2+].
The combination of these events would result in MTP closure and
repolarization (Fig. 11, left). This could be the basis for transient MTP openings in vivo, a possibility that is supported by
recent studies based on a calcein entrapment technique that may reveal
pore openings even when the 
is apparently constant (263, 264), and by the finding that the
mitochondrial 
may oscillate in vivo (204,
291). It is hopeful that the increased understanding of
pore regulation in vitro, and the development of better methods of
detection (264) and of more selective inhibitors (122, 246), will allow rigorous testing of
this working hypothesis in intact cells.
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V. APPENDIX |
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A. Ca2+-Binding Proteins
Several Ca2+-binding proteins have been purified from mitochondrial fractions that facilitate electrical Ca2+ fluxes in reconstituted systems, but their molecular structure remains to be elucidated (11, 222, 321, 368). A new member of the mitochondrial metabolite carrier superfamily (Aralar), which binds Ca2+ through EF-hand binding domains, has been recently cloned (94). Finally, an association with mitochondria has been reported for synexin (annexin VII), a widely distributed member of the annexin gene family that forms Ca2+ channels and drives Ca2+-dependent membrane fusion (324).
B. Transport of Mg2+
Mitochondria can take up and extrude Mg2+ through pathways that remain largely undefined (104, 181). A cAMP-dependent pathway for fast release of mitochondrial Mg2+ that may be hormonally regulated has been described (288-290). This issue has been the subject of some controversy (10), and the interested reader is referred to References 104, 181 for general reviews.
C. Electrophysiology
In addition to the already-mentioned MMC-MTP (186, 266) and the KATP channel (176), other inner membrane channels have been characterized by electrophysiology, but none could be assigned to the cation transport pathways described in this review. For these, the reader can consult Reference 320 and the Journal of Bioenergetics and Biomembranes Special Issue on Mitochondrial Channels (volume 28, number 2, 1996). For the outer membrane voltage-dependent anion channel, see also the specific review by Colombini et al. (77), while an account of the channel activity of members of the Bcl2 protein family, which largely localize to the outer membrane, can be found in Reference 309.
D. Mitochondria and Cell Death
Largely because of the PT, mitochondria became the focus of intense research in toxic, hypoxic, and ischemic cell injury (111, 174, 257). This was followed by studies addressing the role of the PT in glucocorticoid-induced apoptosis (367) and of its potential role in the release of an intermembrane apoptogenic protein (325). The discovery that cytochrome c is required for apoptosis in a cell-free system (202, 372), and that its release regulates apoptosis (209, 365), led to an explosion of the interest in mitochondria and cell death. Coverage of this fast-moving field is outside the scope of this review but is specifically addressed in Reference 46a. The interested reader can find a detailed account of the many facets of mitochondrial involvement in cell death in the Biochimica et Biophysica Acta Bioenergetics Special Issue Mitochondria in Cell Death (35), which includes Ca2+ signaling (141, 172, 287), oxidative stress and ischemia-reperfusion injury (102, 152, 197), excitotoxicity (229, 243), Bcl-2 proteins (276), cytochrome c (66), the PT (137, 196, 326), and neuromuscular and neurodegenerative diseases (24, 103, 307).
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ACKNOWLEDGMENTS |
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I thank Prof. Giovanni Felice Azzone for introducing me to the study of mitochondrial cation transport and for encouragement and support throughout my scientific career.
Research in my laboratory is supported by the Ministero per l'Universita' e la Ricerca Scientifica e Tecnologica, Progetto "Bioenergetica e Trasporto di Membrana" and fondi 60%; Consiglio Nazionale delle Ricerche Dotazione Centro Biomembrane and Grant 98.00413.CT04; Telethon-Italy Grant 1141; National Institutes of Health (USA) Grant 1-R21-GM-58792; and the Giovanni Armenise-Harvard Foundation.
Address for reprint requests and other correspondence: P. Bernardi, Dipartimento di Scienze Biomediche Sperimentali, Viale Giuseppe Colombo 3, I-35121 Padova, Italy (E-mail: bernardi{at}civ.bio.unipd.it).
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NOTE ADDED IN PROOF |
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Two additional papers on the PT should be considered. Crompton and co-workers (Eur. J. Biochem. 258: 729-735, 1998) have described a CsA-sensitive permeabilization of liposomes reconstituted with CyP-D together with the ANT and porin that copurified on a CyP-D affinity column. On the other hand, Kinnally and co-workers (J. Biol. Chem. 271: 4846-4849, 1996) have recorded a MMC in yeast mitochondria where expression of all ANT isoforms had demonstrably been knocked out. These findings add to the open questions about the nature of the PT and its relationships with the ANT.
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M. Johans, E. Milanesi, M. Franck, C. Johans, J. Liobikas, M. Panagiotaki, L. Greci, G. Principato, P. K. J. Kinnunen, P. Bernardi, et al. Modification of Permeability Transition Pore Arginine(s) by Phenylglyoxal Derivatives in Isolated Mitochondria and Mammalian Cells: STRUCTURE-FUNCTION RELATIONSHIP OF ARGININE LIGANDS J. Biol. Chem., April 1, 2005; 280(13): 12130 - 12136. [Abstract] [Full Text] [PDF] |
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I. Szabo, J. Bock, A. Jekle, M. Soddemann, C. Adams, F. Lang, M. Zoratti, and E. Gulbins A Novel Potassium Channel in Lymphocyte Mitochondria J. Biol. Chem., April 1, 2005; 280(13): 12790 - 12798. [Abstract] [Full Text] [PDF] |
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M. Saotome, H. Katoh, H. Satoh, S. Nagasaka, S. Yoshihara, H. Terada, and H. Hayashi Mitochondrial membrane potential modulates regulation of mitochondrial Ca2+ in rat ventricular myocytes Am J Physiol Heart Circ Physiol, April 1, 2005; 288(4): H1820 - H1828. [Abstract] [Full Text] [PDF] |
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M. R Fowler and M. Hunter Mitochondrial Ca2+ transport in frog early distal tubule Exp Physiol, March 1, 2005; 90(2): 195 - 201. [Abstract] [Full Text] [PDF] |
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S. A. Oakes, L. Scorrano, J. T. Opferman, M. C. Bassik, M. Nishino, T. Pozzan, and S. J. Korsmeyer Proapoptotic BAX and BAK regulate the type 1 inositol trisphosphate receptor and calcium leak from the endoplasmic reticulum PNAS, January 4, 2005; 102(1): 105 - 110. [Abstract] [Full Text] [PDF] |
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E. Aneiros, S. Philipp, A. Lis, M. Freichel, and A. Cavalie Modulation of Ca2+ Signaling by Na+/Ca2+ Exchangers in Mast Cells J. Immunol., January 1, 2005; 174(1): 119 - 130. [Abstract] [Full Text] [PDF] |
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W.-K. Lee, U. Bork, F. Gholamrezaei, and F. Thevenod Cd2+-induced cytochrome c release in apoptotic proximal tubule cells: role of mitochondrial permeability transition pore and Ca2+ uniporter Am J Physiol Renal Physiol, January 1, 2005; 288(1): F27 - F39. [Abstract] [Full Text] [PDF] |
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G. Petrosillo, F. M. Ruggiero, M. Pistolese, and G. Paradies Ca2+-induced Reactive Oxygen Species Production Promotes Cytochrome c Release from Rat Liver Mitochondria via Mitochondrial Permeability Transition (MPT)-dependent and MPT-independent Mechanisms: ROLE OF CARDIOLIPIN J. Biol. Chem., December 17, 2004; 279(51): 53103 - 53108. [Abstract] [Full Text] [PDF] |
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V. Koshkin, G. Bikopoulos, C. B. Chan, and M. B. Wheeler The Characterization of Mitochondrial Permeability Transition in Clonal Pancreatic {beta}-Cells: MULTIPLE MODES AND REGULATION J. Biol. Chem., October 1, 2004; 279(40): 41368 - 41376. [Abstract] [Full Text] [PDF] |
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P. Xu, J. Wang, R. Kodavatiganti, Y. Zeng, and I. S. Kass Activation of Protein Kinase C Contributes to the Isoflurane-Induced Improvement of Functional and Metabolic Recovery in Isolated Ischemic Rat Hearts Anesth. Analg., October 1, 2004; 99(4): 993 - 1000. [Abstract] [Full Text] [PDF] |
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H.-J. Visch, G. A. Rutter, W. J. H. Koopman, J. B. Koenderink, S. Verkaart, T. de Groot, A. Varadi, K. J. Mitchell, L. P. van den Heuvel, J. A. M. Smeitink, et al. Inhibition of Mitochondrial Na+-Ca2+ Exchange Restores Agonist-induced ATP Production and Ca2+ Handling in Human Complex I Deficiency J. Biol. Chem., September 24, 2004; 279(39): 40328 - 40336. [Abstract] [Full Text] [PDF] |
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U. De Marchi, S. Campello, I. Szabo, F. Tombola, J.-C. Martinou, and M. Zoratti Bax Does Not Directly Participate in the Ca2+-induced Permeability Transition of Isolated Mitochondria J. Biol. Chem., September 3, 2004; 279(36): 37415 - 37422. [Abstract] [Full Text] [PDF] |
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K. AYUB and M. B. HALLETT The mitochondrial ADPR link between Ca2+ store release and Ca2+ influx channel opening in immune cells FASEB J, September 1, 2004; 18(12): 1335 - 1338. [Abstract] [Full Text] [PDF] |
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R. A. Robergs, F. Ghiasvand, and D. Parker Biochemistry of exercise-induced metabolic acidosis Am J Physiol Regulatory Integrative Comp Physiol, September 1, 2004; 287(3): R502 - R516. [Abstract] [Full Text] [PDF] |
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M. E. Soriano, L. Nicolosi, and P. Bernardi Desensitization of the Permeability Transition Pore by Cyclosporin A Prevents Activation of the Mitochondrial Apoptotic Pathway and Liver Damage by Tumor Necrosis Factor-{alpha} J. Biol. Chem., August 27, 2004; 279(35): 36803 - 36808. [Abstract] [Full Text] [PDF] |
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R. Rudolf, M. Mongillo, P. J. Magalhaes, and T. Pozzan In vivo monitoring of Ca2+ uptake into mitochondria of mouse skeletal muscle during contraction J. Cell Biol., August 16, 2004; 166(4): 527 - 536. [Abstract] [Full Text] [PDF] |
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A. KAASIK, F. JOUBERT, R. VENTURA-CLAPIER, and V. VEKSLER A novel mechanism of regulation of cardiac contractility by mitochondrial functional state FASEB J, August 1, 2004; 18(11): 1219 - 1227. [Abstract] [Full Text] [PDF] |
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K. Nowikovsky, E. M. Froschauer, G. Zsurka, J. Samaj, S. Reipert, M. Kolisek, G. Wiesenberger, and R. J. Schweyen The LETM1/YOL027 Gene Family Encodes a Factor of the Mitochondrial K+ Homeostasis with a Potential Role in the Wolf-Hirschhorn Syndrome J. Biol. Chem., July 16, 2004; 279(29): 30307 - 30315. [Abstract] [Full Text] [PDF] |
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N. B. Pivovarova, H. V. Nguyen, C. A. Winters, C. A. Brantner, C. L. Smith, and S. B. Andrews Excitotoxic Calcium Overload in a Subpopulation of Mitochondria Triggers Delayed Death in Hippocampal Neurons J. Neurosci., June 16, 2004; 24(24): 5611 - 5622. [Abstract] [Full Text] [PDF] |
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D. Penzo, V. Petronilli, A. Angelin, C. Cusan, R. Colonna, L. Scorrano, F. Pagano, M. Prato, F. Di Lisa, and P. Bernardi Arachidonic Acid Released by Phospholipase A2 Activation Triggers Ca2+-dependent Apoptosis through the Mitochondrial Pathway J. Biol. Chem., June 11, 2004; 279(24): 25219 - 25225. [Abstract] [Full Text] [PDF] |
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F. Orsini, E. Migliaccio, M. Moroni, C. Contursi, V. A. Raker, D. Piccini, I. Martin-Padura, G. Pelliccia, M. Trinei, M. Bono, et al. The Life Span Determinant p66Shc Localizes to Mitochondria Where It Associates with Mitochondrial Heat Shock Protein 70 and Regulates Trans-membrane Potential J. Biol. Chem., June 11, 2004; 279(24): 25689 - 25695. [Abstract] [Full Text] [PDF] |
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X. J. Chen Sal1p, a Calcium-Dependent Carrier Protein That Suppresses an Essential Cellular Function Associated With the Aac2 Isoform of ADP/ATP Translocase in Saccharomyces cerevisiae Genetics, June 1, 2004; 167(2): 607 - 617. [Abstract] [Full Text] [PDF] |
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M. R. Fowler, G. J. Cooper, and M. Hunter Regulation and identity of intracellular calcium stores involved in membrane cross talk in the early distal tubule of the frog kidney Am J Physiol Renal Physiol, June 1, 2004; 286(6): F1219 - F1225. [Abstract] [Full Text] [PDF] |
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