The most important new observations reported in this study are that hyperoxic resuscitation after cardiac arrest reduces hippocampal PDHC enzyme activity and elevates 3-nitrotyrosine immunoreactivity compared to values obtained with sham-operated control animals or those resuscitated using normal arterial O
2 levels. The finding that hippocampal 3-nitrotyrosine immunoreactivity measured by ELISA is elevated after hyperoxic but not normoxic resuscitation is consistent with results we obtained with 3-nitrotyrosine immunohistochemistry [
14] and with the observation that hyperoxic resuscitation increases brain oxidized free fatty acyl groups in this model [
15]. More importantly, the exacerbation of tyrosine nitration during early reperfusion by hyperoxic resuscitation is associated with worse neurologic outcome [
15] and greater hippocampal cell death compared to that observed after normoxic resuscitation [
14]. These relationships add to the body of evidence that protein tyrosine nitration contributes to a wide range of neuropathologies, including traumatic brain injury [
30,
31], focal ischemia [
32], global ischemia [
33,
34], and neurodegenerative diseases [
35,
36].
The chemical basis for increased tyrosine nitration in the hippocampus after hyperoxic resuscitation is most likely linked to the stimulation of peroxynitrite formation by increased production of superoxide and (or) nitric oxide, the two substrates required for peroxynitrite formation. Whereas prolonged hyperoxia can stimulate the expression of inducible nitric oxide synthase [
37], increased levels of this protein are not likely to occur within the 2-h reperfusion period used in our measurements. Elevated brain tissue O
2 tension could, however, directly increase the rate of existing redox protein-mediated production of both nitric oxide and superoxide. For example, several studies indicate that mitochondrial superoxide production is directly related to [O
2] (between normal
pO
2 up to 100% O
2 saturation) [
38,
39]. Although reports indicate that severe hypoxia can also stimulate superoxide production [
40–
42], promotion of superoxide generation by high brain tissue
pO
2 is a more likely explanation for the increased 3-nitrotyrosine immunoreactivity in the hyperoxic-resuscitated animals. In addition, the
Km of O
2 for nitric oxide synthases has been reported to be as low as micromolar or as high as millimolar concentrations, suggesting that elevated tissue O
2 tension could also directly stimulate nitric oxide production [
37,
43,
44]. As microdialysis measurements indicate that total end products of nitric oxide generation are elevated within 20–60 min of reperfusion after transient global cerebral ischemia [
45], it follows that hyperoxic resuscitation should increase markers of peroxynitrite production, e.g., 3-nitrotyrosine immunoreactivity.
Although many cellular proteins are vulnerable to tyrosine nitration, several factors may predispose PDHC toward tyrosine nitration and inactivation in situ within the mitochondrial environment. When mitochondria are exposed to nitrating agents, the mitochondrial matrix, where PDHC is located, exhibits the greatest nitration compared to other mitochondrial fractions (i.e., outer membrane, inner membrane, and inter-membrane space) [
46]. PDHC is closely associated with Complex I of the electron transport chain [
47] where much of the endogenous superoxide production is thought to occur. PDHC and α-ketoglutarate dehydrogenase complex may also be important sources of superoxide and, consequently, peroxynitrite [
48,
49]. The free radical pathways leading to nitration are initiated secondary to the reaction of peroxynitrite with carbon dioxide [
50] and PDHC is one of the main sources of carbon dioxide within the mitochondria [
51]. The relative sensitivity of PDHC to tyrosine nitration after cerebral ischemia and reperfusion is at this juncture unknown. A proteomic analysis, such as those that have identified PDHC as a highly nitrated protein in other paradigms [
46,
52,
53] would likely resolve this question.
Several other laboratories have also reported postischemic impairment of PDHC activity. Decreased activity of the PDHC in the dorsolateral striatum differentiates this region from ischemia-resistant areas during early recirculation in a rat model of transient ischemia, providing additional evidence for a relationship between PDHC inactivation and selective neuronal cell death [
8]. Whereas in our present study we observed a significant loss of PDHC activity in the hippocampus but not the frontal cortex (), results obtained previously with a different reperfusion protocol demonstrated loss of activity in the cortex [
5]. Depending on the experimental conditions, reperfusion-dependent inhibition of PDHC may therefore occur in several brain regions but is greater in the hippocampus compared to the cortex using the hyperoxic resuscitation protocol employed in this study. Our findings that hyperoxic reperfusion in vivo and exposure to peroxynitrite in vitro inhibit PDHC activity are likely attributed to one or more of the following causes: (1) phosphatase activity is inhibited, maintaining PDHC in the inactive state; (2) PDH kinase activity is enhanced, forming phosphorylated (inactive) PDHC; (3) dephosphorylation of the enzyme is prohibited by oxidative modification of the enzyme; or (4) maximal activity of dephosphorylated (active) PDHC is lost. Addition of exogenous phosphatase in the presence of Mg
2+ and Ca
2+ did not increase enzyme activity, indicating that PDH phosphatase activity is not impaired in these animals. Similarly, because the assay conditions promote maintenance of the enzyme in its dephosphorylated (active) state and the presence of dichloroacetate, an inhibitor of PDHC phosphorylation, had no effect on PDHC activities (not shown), impaired kinase activity is not responsible for the inhibition of activity after hyperoxic reperfusion. It is nevertheless possible that the phosphorylated enzyme is targeted by peroxynitrite and modified such that it is no longer susceptible to dephosphorylation. However, given our in vitro experiments that show that “active” purified PDHC is targeted and inactivated by peroxynitrite, the most likely mechanism of enzyme inhibition is that PDHC in its active, dephosphorylated form is susceptible to attack and subsequent inactivation by peroxynitrite. In addition, loss of PDHC activity after cerebral ischemia and reperfusion in rat arterial occlusion models is the result of impaired maximal activity rather than covalent inhibition caused by increased protein phosphorylation [
21,
54].
The results obtained in vivo suggesting that peroxynitrite mediates postischemic PDHC enzyme inhibition are supported by in vitro experimentation in which incubation of purified PDHC with SIN-1 is associated with decreased PDHC activity and increased 3-nitrotyrosine immunoreactivity (–). Tyrosine nitration is involved in many postischemic modifications [
55–
57]. Examples of proteins susceptible to inactivation by tyrosine nitration include mitochondrial superoxide dismutase [
58,
59] and several enzymes involved in oxidative energy metabolism, including aconitase [
60], glutamate dehydrogenase [
46], α-ketoglutarate dehydrogenase [
61], and PDHC [
46]. Because PDHC and α-ketoglutarate dehydrogenase complex share similar reaction mechanisms and an identical polypeptide subunit (E3), it is not surprising that they are both sensitive to enzyme inhibition by tyrosine nitration. However, Park et al. showed that
in vitro nitration of tyrosines present in the α-ketoglutarate dehydrogenase complex was associated with loss of immunoreactivity for the E1 and E2 subunits [
61], whereas we observed no loss of immunoreactivity for subunits of SIN-1-treated PDHC (). Nevertheless, hippocampal PDHC immunoreactivity is lost during hyperoxic reperfusion, coincident with an increase in 3-nitrotyrosine immunoreactivity [
14]. Loss of immunoreactivity in vivo could, however, be due to degradation by proteases, e.g., the mitochondrial Lon protease, which targets oxidatively modified proteins [
62].
The inactivation of PDHC by peroxynitrite, in vitro, is primarily due to tyrosine nitration, although the small protection afforded by DTT indicates that S-nitrosation also contributes to enzyme inhibition (). Previously, Bogaert et al. reported that PDHC enzyme activity is inhibited by the hydroxyl radical [
5]. This study establishes that PDHC activity is also impaired in the presence of ONOO
−, another species strongly implicated in oxidative tissue injury [
63]. The fact that PDHC enzyme activity can be inhibited by both the hydroxyl radical and peroxynitrite poses the question of which species is responsible for inhibition of this enzyme in the hippocampus during reperfusion. Although the results of our study do not answer this question, the finding that PDHC subunit immunoreactivity is elevated in anti-nitrotyrosine-immunoprecipitated hippocampal proteins suggests that tyrosine nitration contributes to enzyme inhibition in vivo. Although tyrosine nitration of PDHC may account for postischemic alterations in metabolism, parallel changes resulting from the effects of peroxynitrite on other cellular components could also contribute to inhibition of cerebral energy metabolism. For example, oxidative stress can damage other proteins, including TCA cycle enzymes [
61,
64]. Moreover, electron transport chain Complexes I and II are also very sensitive to inhibition caused by reactive oxygen and nitrogen species, including peroxynitrite [
65]. The observation that the pyridine nucleotide (NAD(P)H) redox state is hyperoxidized during the first hour of reperfusion after global cerebral ischemia in rats suggests that a reaction before the electron transport chain is the limiting factor in postischemic oxidative energy metabolism [
66]. Experiments are in progress to determine if the PDHC reaction is indeed the rate-limiting step.
The molecular mechanisms by which PDHC enzymatic activity is inhibited by peroxynitrite are at this juncture unknown. Whereas many enzymes are subject to inhibition by peroxynitrite, the contribution of tyrosine nitration, S-nitrosation, and other mechanisms to inactivation varies considerably [
67–
70]. DTT only partially protected against PDHC inhibition, suggesting that tyrosine nitration is the primary mechanism of inactivation. Another possible target is the lipoamide residue located on the E2 subunit of PDHC. The E2 (dihydrolipoyl transacetylase) subunit may be particularly susceptible to inactivation as the immunoreactivity of this protein is high in anti-nitrotyrosine immunoprecipitates from the hippocampi of hyperoxic resuscitated animals (). Moreover, the E2 subunit of the PDHC was also identified as a target for nitration by Elfering et al. when mitochondria were incubated under conditions of enhanced endogenous nitric oxide production [
46]. PDHC is composed of multiple subunits with many different potential targets of peroxynitrite, indicating that several mechanisms of inactivation may be involved.
As we previously demonstrated for inhibition of PDHC by the hydroxyl radical, sensitivity to inhibition by peroxynitrite is modulated by the presence of certain enzyme substrates and cofactors. The protection by pyruvate could be due to either its effects on protein conformation and amino acid availability for oxidation or a direct antioxidant effect of pyruvate that can both scavenge superoxide and react directly with peroxynitrite [
71]. Protection afforded by coenzyme A is less likely to be due to antioxidant effects. The relatively low levels of pyruvate and coenzyme A and other PDHC substrates during reperfusion after cerebral ischemia could therefore exacerbate oxidative enzyme inhibition.
Current standards of emergent care after cardiac arrest encourage the use of 100% oxygen during resuscitation. This practice has been questioned by results obtained with animal models demonstrating improved neurologic outcome using postischemic ventilation with O
2 concentrations as low as 21% [
15,
16,
72]. Our present findings demonstrating reduced hippocampal protein tyrosine nitration and retention of PDHC enzyme activity with normoxic resuscitation support the need for additional preclinical and clinical studies to resolve this issue. The concept that hyperoxia worsens oxidative tissue damage and neurologic outcome after acute brain injury may not, however, apply to other forms of injury, e.g., stroke and trauma, as evidence suggests that hyperoxia can under some circumstances be beneficial [
73–
77]. The time during which the brain is exposed to high O
2 can also determine whether hyperoxia is helpful or detrimental. We found that when dogs were exposed to hyperbaric 100% O
2 1–2 h after cardiac arrest and resuscitation, both histologic and neurologic outcome were better than in animals maintained under normobaric and normoxic conditions [
18]. Abnormally high brain O
2 levels may therefore be toxic primarily during the first 30–60 min after global cerebral ischemia, when abnormal intracellular conditions, e.g., high Ca
2+ and low pH, promote the production of reactive O
2 and N
2 species. Later, high tissue O
2 could promote recovery, particularly if brain oxygenation rather than the activity of metabolic enzymes limits cerebral energy metabolism.