Summary
Ischemia leads to mitochondrial dysfunction. This is reversible if ischemia is of brief duration, but secondary mitochondrial damage is observed after longer periods of ischemia, particularly in selectively vulnerable neuronal populations. This damage is triggered during the period of ischemia, but secondary factors lead to its “maturation”. Probably, the most important of these factors is gradual accumulation of calcium in the mitochondria. The mechanisms involved encompass phospholipase A2-mediated breakdown of the lipid skeleton of membranes, and free-radical-mediated oxidation of its lipid and protein components. However, the immediate trigger may be the opening (“assembly”) of a mitochondrial permeability transition (MPT) pore, which is followed by calcium release, collapse of the electrochemical gradient for H+ and a burst of production of reactive oxygen species (ROS). The ensuing bioenergetic compromise and the mitochondrial production of ROS probably constitute important causes of cell death. Recent results suggest that mitochondrial dysfunction is a leading event in the cascade of events that cause apoptotic and necrotic cell death. Very likely, the trigger is the release of cytochrome c from depolarized or otherwise compromised mitochondria. By activating caspase-3, cytochrome c can initiate terminal events encompassing activation of proteases, endonucleases and poly (ADP-ribose) polymerase. Therefore, the type of enzyme activated may determine whether cell death is of the apoptotic or necrotic type.
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Siesjö, B.K., Ouyang, Y., Kristián, T., Elmér, E., Li, PA., Uchino, H. (1999). Role of Mitochondria in Immediate and Delayed Reperfusion Damage. In: Ito, U., Fieschi, C., Orzi, F., Kuroiwa, T., Klatzo, I. (eds) Maturation Phenomenon in Cerebral Ischemia III. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-58602-6_26
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DOI: https://doi.org/10.1007/978-3-642-58602-6_26
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