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      Mechanism of succinate efflux upon reperfusion of the ischaemic heart

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          Abstract

          Aims 

          Succinate accumulates several-fold in the ischaemic heart and is then rapidly oxidized upon reperfusion, contributing to reactive oxygen species production by mitochondria. In addition, a significant amount of the accumulated succinate is released from the heart into the circulation at reperfusion, potentially activating the G-protein-coupled succinate receptor (SUCNR1). However, the factors that determine the proportion of succinate oxidation or release, and the mechanism of this release, are not known.

          Methods and results 

          To address these questions, we assessed the fate of accumulated succinate upon reperfusion of anoxic cardiomyocytes, and of the ischaemic heart both ex vivo and in vivo. The release of accumulated succinate was selective and was enhanced by acidification of the intracellular milieu. Furthermore, pharmacological inhibition, or haploinsufficiency of the monocarboxylate transporter 1 (MCT1) significantly decreased succinate efflux from the reperfused heart.

          Conclusion 

          Succinate release upon reperfusion of the ischaemic heart is mediated by MCT1 and is facilitated by the acidification of the myocardium during ischaemia. These findings will allow the signalling interaction between succinate released from reperfused ischaemic myocardium and SUCNR1 to be explored.

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          Most cited references44

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          Ischaemic accumulation of succinate controls reperfusion injury through mitochondrial ROS

          Ischaemia-reperfusion (IR) injury occurs when blood supply to an organ is disrupted and then restored, and underlies many disorders, notably heart attack and stroke. While reperfusion of ischaemic tissue is essential for survival, it also initiates oxidative damage, cell death, and aberrant immune responses through generation of mitochondrial reactive oxygen species (ROS) 1-5 . Although mitochondrial ROS production in IR is established, it has generally been considered a non-specific response to reperfusion 1,3 . Here, we developed a comparative in vivo metabolomic analysis and unexpectedly identified widely conserved metabolic pathways responsible for mitochondrial ROS production during IR. We showed that selective accumulation of the citric acid cycle (CAC) intermediate succinate is a universal metabolic signature of ischaemia in a range of tissues and is responsible for mitochondrial ROS production during reperfusion. Ischaemic succinate accumulation arises from reversal of succinate dehydrogenase (SDH), which in turn is driven by fumarate overflow from purine nucleotide breakdown and partial reversal of the malate/aspartate shuttle. Upon reperfusion, the accumulated succinate is rapidly re-oxidised by SDH, driving extensive ROS generation by reverse electron transport (RET) at mitochondrial complex I. Decreasing ischaemic succinate accumulation by pharmacological inhibition is sufficient to ameliorate in vivo IR injury in murine models of heart attack and stroke. Thus, we have identified a conserved metabolic response of tissues to ischaemia and reperfusion that unifies many hitherto unconnected aspects of IR injury. Furthermore, these findings reveal a novel pathway for metabolic control of ROS production in vivo, while demonstrating that inhibition of ischaemic succinate accumulation and its oxidation upon subsequent reperfusion is a potential therapeutic target to decrease IR injury in a range of pathologies.
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            CRC Handbook of Chemistry and Physics

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              A Unifying Mechanism for Mitochondrial Superoxide Production during Ischemia-Reperfusion Injury.

              Ischemia-reperfusion (IR) injury occurs when blood supply to an organ is disrupted--ischemia--and then restored--reperfusion--leading to a burst of reactive oxygen species (ROS) from mitochondria. It has been tacitly assumed that ROS production during IR is a non-specific consequence of oxygen interacting with dysfunctional mitochondria upon reperfusion. Recently, this view has changed, suggesting that ROS production during IR occurs by a defined mechanism. Here we survey the metabolic factors underlying IR injury and propose a unifying mechanism for its causes that makes sense of the huge amount of disparate data in this area and provides testable hypotheses and new directions for therapies.
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                Author and article information

                Journal
                Cardiovasc Res
                Cardiovasc Res
                cardiovascres
                Cardiovascular Research
                Oxford University Press
                0008-6363
                1755-3245
                01 April 2021
                07 August 2020
                07 August 2020
                : 117
                : 4
                : 1188-1201
                Affiliations
                [1 ] MRC Mitochondrial Biology Unit, University of Cambridge, The Keith Peters Building, Cambridge Biomedical Campus , Hills Road, Cambridge CB2 0XY, UK
                [2 ]Department of Medicine, University of Cambridge , Addenbrookes Hospital, Hills Road, Cambridge CB2 0QQ, UK
                [3 ] Department of Surgery, University of Cambridge, Cambridge NIHR Biomedical Research Centre, Biomedical Campus , Hills Road, Cambridge CB2 0QQ, UK
                [4 ]MRC Cancer Unit, University of Cambridge, Hutchison/MRC Research Centre, Cambridge Biomedical Campus , PO Box 197, Cambridge CB2 0XZ, UK
                [5 ] Bristol Medical School and Translational Biomedical Research Centre, Faculty of Health Science, University of Bristol , Level 7, Bristol Royal Infirmary, Upper Maudlin Street, Bristol BS2 8HW, UK
                [6 ]Département de Physiologie, Université de Lausanne , 7 Rue du Bugnon, 1005 Lausanne, Switzerland
                [7 ] King’s College London, British Heart Foundation Centre of Excellence, The Rayne Institute, St Thomas’ Hospital , Lambeth Palace Road, London SE1 7EH, UK
                [8 ] Centre de Résonance Magnétique des Systèmes Biologiques, UMR5536 CNRS, LabEx TRAIL-IBIO, Université de Bordeaux , 146 Rue Leo Saignat, Bordeaux 33076, France
                [9 ] Inserm U1082, Université de Poitiers , 2 Rue de la Miletrie, Poitiers 86021, France
                [10 ] William Harvey Research Institute, Barts and The London School of Medicine and Dentistry , Queen Mary University of London, Charterhouse Square, London, UK
                [11 ] Centre for inflammation and Therapeutic Innovation , Queen Mary University of London, Charterhouse Square, London, UK
                Author notes

                Hiran A Prag and Anja V Gruszczyk authors contributed equally to the study.

                Corresponding author. Tel: +44 20 7882 6973, E-mail: d.aksentijevic@ 123456qmul.ac.uk
                Author information
                http://orcid.org/0000-0002-4753-8567
                http://orcid.org/0000-0003-3060-4107
                http://orcid.org/0000-0001-5277-863X
                http://orcid.org/0000-0002-1831-3473
                http://orcid.org/0000-0003-3843-2442
                http://orcid.org/0000-0001-8045-5619
                http://orcid.org/0000-0001-9418-3589
                http://orcid.org/0000-0001-6242-7585
                http://orcid.org/0000-0002-0633-3696
                http://orcid.org/0000-0002-3293-7397
                http://orcid.org/0000-0002-5192-580X
                http://orcid.org/0000-0003-1115-9618
                http://orcid.org/0000-0002-8480-6727
                Article
                cvaa148
                10.1093/cvr/cvaa148
                7983001
                32766828
                c5fd4926-aa31-4765-a7f6-e7c704a57090
                © The Author(s) 2020. Published by Oxford University Press on behalf of the European Society of Cardiology.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 06 March 2020
                : 13 April 2020
                : 28 July 2020
                Page count
                Pages: 14
                Funding
                Funded by: Barts Charity, DOI 10.13039/100015652;
                Funded by: School of Biological and Chemical Sciences;
                Funded by: Medical Research Council UK;
                Award ID: MC_U105663142
                Funded by: Wellcome Trust Investigator award;
                Award ID: 110159/Z/15/Z
                Funded by: National Institute for Health Research Blood and Transplant Research Unit;
                Funded by: Organ Donation and Transplantation PhD studentship;
                Funded by: Medical Research Council UK;
                Award ID: MRC_MC_UU_12022/6
                Funded by: Department of Physiology, University of Lausanne, Switzerland and IdEx Bordeaux;
                Award ID: ANR-10-IDEX-03-02
                Funded by: British Heart Foundation, DOI 10.13039/501100000274;
                Award ID: RG/17/15/33106
                Funded by: Medical Research Council UK;
                Award ID: MR/L012723/1
                Funded by: British Heart Foundation, DOI 10.13039/501100000274;
                Award ID: IG/14/2/30991
                Funded by: Bristol NIHR Biomedical Research Centre;
                Categories
                Original Articles
                Myocardial Infarction and Ischaemia/Reperfusion Injury
                AcademicSubjects/MED00200

                Cardiovascular Medicine
                ischaemia/reperfusion injury,succinate,mct1 transporter,mitochondria,sucnr1

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