Reactive oxygen species (ROS) have been proposed to participate in the induction of cardiac preconditioning. However, their source and mechanism of induction are unclear. We tested whether brief hypoxia induces preconditioning by augmenting mitochondrial generation of ROS in chick cardiomyocytes. Cells were preconditioned with 10 min of hypoxia, followed by 1 h of simulated ischemia and 3 h of reperfusion. Preconditioning decreased cell death from 47 ± 3% to 14 ± 2%. Return of contraction was observed in 3/3 preconditioned versus 0/6 non-preconditioned experiments. During induction, ROS oxidation of the probe dichlorofluorescin (sensitive to H2O2) increased ∼2.5-fold. As a substitute for hypoxia, the addition of H2O2 (15 μmol/liter) during normoxia also induced preconditioning-like protection. Conversely, the ROS signal during hypoxia was attenuated with the thiol reductant 2-mercaptopropionyl glycine, the cytosolic Cu,Zn-superoxide dismutase inhibitor diethyldithiocarbamic acid, and the anion channel inhibitor 4,4′-diisothiocyanato-stilbene-2,2′-disulfonate, all of which also abrogated protection. ROS generation during hypoxia was attenuated by myxothiazol, but not by diphenyleneiodonium or the nitric-oxide synthase inhibitor l-nitroarginine. We conclude that hypoxia increases mitochondrial superoxide generation which initiates preconditioning protection. Furthermore, mitochondrial anion channels and cytosolic dismutation to H2O2 may be important steps for oxidant induction of hypoxic preconditioning. Reactive oxygen species (ROS) have been proposed to participate in the induction of cardiac preconditioning. However, their source and mechanism of induction are unclear. We tested whether brief hypoxia induces preconditioning by augmenting mitochondrial generation of ROS in chick cardiomyocytes. Cells were preconditioned with 10 min of hypoxia, followed by 1 h of simulated ischemia and 3 h of reperfusion. Preconditioning decreased cell death from 47 ± 3% to 14 ± 2%. Return of contraction was observed in 3/3 preconditioned versus 0/6 non-preconditioned experiments. During induction, ROS oxidation of the probe dichlorofluorescin (sensitive to H2O2) increased ∼2.5-fold. As a substitute for hypoxia, the addition of H2O2 (15 μmol/liter) during normoxia also induced preconditioning-like protection. Conversely, the ROS signal during hypoxia was attenuated with the thiol reductant 2-mercaptopropionyl glycine, the cytosolic Cu,Zn-superoxide dismutase inhibitor diethyldithiocarbamic acid, and the anion channel inhibitor 4,4′-diisothiocyanato-stilbene-2,2′-disulfonate, all of which also abrogated protection. ROS generation during hypoxia was attenuated by myxothiazol, but not by diphenyleneiodonium or the nitric-oxide synthase inhibitor l-nitroarginine. We conclude that hypoxia increases mitochondrial superoxide generation which initiates preconditioning protection. Furthermore, mitochondrial anion channels and cytosolic dismutation to H2O2 may be important steps for oxidant induction of hypoxic preconditioning. Myocardial preconditioning was initially described as an adaptive response of the heart to brief episodes of ischemia that decreased necrosis during subsequent prolonged ischemia (1Murry C.E. Jennings R.B. Reimer K.A. Circulation. 1986; 74: 1124-1136Crossref PubMed Scopus (7173) Google Scholar). Reactive oxygen species (ROS 1The abbreviations used are: ROS, reactive oxygen species; BSS, balanced salt solution; PI, propidium iodide; DCF, dichlorofluorescein; DHE, dihydroethidium; Eth, ethidium; SOD, superoxide dismutase; NOS, nitric-axide synthase; DCFH-DA, 2′,7′-dichlorofluorescin diacetate ; DCFH, 2′,7′-dichlorofluorescin; 2-MPG, 2-mercaptopriopionyl glycine; DPI, diphenyleneiodonium; DDC, diethyldithiocarbamic acid; DIDS, 4,4′-diisothiocyanato-stilbene-2,2′-disulfonate. ;e.g. superoxide, H2O2, hydroxyl radicals) generated from brief ischemia/reperfusion have been recognized as possible "triggers" in the initiation of preconditioning (2Baines C.P. Goto M. Downey J.M. J. Mol. Cell. Cardiol. 1997; 29: 207-216Abstract Full Text PDF PubMed Scopus (419) Google Scholar). Evidence for this role includes intact heart studies where exposure to superoxide or H2O2caused preconditioning-like protection (2Baines C.P. Goto M. Downey J.M. J. Mol. Cell. Cardiol. 1997; 29: 207-216Abstract Full Text PDF PubMed Scopus (419) Google Scholar, 3Tritto I. D'Andrea D. Eramo N. Scognamiglio A. De Simone C. Violante A. Esposito A. Chiariello M. Ambrosio G. Circ. Res. 1997; 80: 743-748Crossref PubMed Scopus (256) Google Scholar), and other studies demonstrating that antioxidants abolished the induction of preconditioning (4Tanaka M. Fujiwara H. Yamasaki K. Sasayama S. Cardiovasc. Res. 1994; 28: 980-986Crossref PubMed Scopus (130) Google Scholar, 5Osada M. Takeda S. Sato T. Komori S. Tamura K. Jpn. Circ. J. 1994; 58: 259-263Crossref PubMed Scopus (30) Google Scholar). Few studies have directly measured ROS generation during brief hypoxia or ischemia induction (6Zhou X. Zhai X. Ashraf M. Circulation. 1997; 93: 1177-1184Crossref Scopus (175) Google Scholar). Such direct measures are needed to clarify important questions that remain regarding the role of ROS as inducing agents, including their source, where they are metabolized, and the relative contributions of different oxidant species to the induction of preconditioning protection. Within the intact heart, possible sources of ROS include the cardiomyocytes, endothelial cells, neutrophils, or the auto-oxidation of catecholamines (7Ferrari R. Ceconi C. Curello S. Alfieri O. Visioli O. Eur. Heart. J. 1993; 14: 25-30Crossref PubMed Scopus (23) Google Scholar, 8Hess M.L. Manson N.H. J. Mol. Cell. Cardiol. 1984; 16: 969-985Abstract Full Text PDF PubMed Scopus (482) Google Scholar). Within cardiomyocytes, sources of ROS could include superoxide generation from NAD(P)H or other oxidases such as cytochrome P450 (9Thannickal V.J. Fanburg B.L. J. Biol. Chem. 1995; 270: 30334-30338Abstract Full Text Full Text PDF PubMed Scopus (386) Google Scholar, 10Griendling K.K. Minieri C.A. Ollerenshaw J.D. Alexander R.W. Circ. Res. 1994; 74: 1141-1148Crossref PubMed Scopus (2433) Google Scholar, 11Mohazzab-H K.M. Kaminski P.M. Wolin M.S. Circulation. 1997; 96: 614-620Crossref PubMed Scopus (138) Google Scholar), the mitochondrial electron transport chain (12Ambrosio G. Zweier J.L. Duilio C. Kuppusamy P. Santoro G. Elia P.P. Tritto I. Cirillo P. Condorelli M. Chiarello M. J. Biol. Chem. 1993; 268: 18532-18541Abstract Full Text PDF PubMed Google Scholar), or even nitric-oxide synthase under conditions where arginine is depleted (13Kitakaze M. Node K. Komamura K. Minamino T. Inoue M. Hori M. Kamada T. J. Mol. Cell. Cardiol. 1995; 27: 2149-2154Abstract Full Text PDF PubMed Scopus (73) Google Scholar, 14Kelly R.A. Balligand J.L. Smith T.W. Circ. Res. 1996; 79: 363-380Crossref PubMed Scopus (634) Google Scholar, 15Xia Y. Dawson V.L. Dawson T.M. Snyder S.H. Zweier J.L. Proc. Natl. Acad. Sci. U. S. A. 1996; 93: 6770-6774Crossref PubMed Scopus (657) Google Scholar). Although it is likely that superoxide is the initial oxidant generated from these systems, the relative importance of superoxide, or its reduced products H2O2 or hydroxyl radical, in the signal transduction system involved in preconditioning is not known. Some evidence suggests that either superoxide or hydrogen peroxide can initiate preconditioning (2Baines C.P. Goto M. Downey J.M. J. Mol. Cell. Cardiol. 1997; 29: 207-216Abstract Full Text PDF PubMed Scopus (419) Google Scholar, 16Gopalakrishna R. Anderson W.B. Proc. Natl. Acad. Sci. U. S. A. 1989; 86: 6758-6762Crossref PubMed Scopus (381) Google Scholar,17Downey J.M. Cohen M.V. Marber M.M. Yellon D.M. Ischaemia: Preconditioning and Adaptation. 1996: 21-34Google Scholar), so it is conceivable that H2O2 is the active signaling agent in this process. The purpose of our study was to investigate the role of mitochondrial ROS in the induction of hypoxic preconditioning, and to clarify which ROS are required for the preconditioning response. For this study, we used chick cardiomycytes, which have been shown to precondition with brief hypoxia (18Liang B.T. Am. J. Physiol. 1996; 271: H1769-H1777PubMed Google Scholar, 19Strickler J. Jacobson K.A. Liang B.T. J. Clin. Invest. 1996; 98: 1773-1779Crossref PubMed Scopus (117) Google Scholar). Embryonic ventricular cardiac myocytes were prepared as described previously (20Vanden Hoek T.L. Shao Z. Li C. Zak R. Schumacker P.T. Becker L.B. Am. J. Physiol. 1996; 270: H1334-H1341PubMed Google Scholar). Heart ventricles from 10-day-old chick embryos were dissected, minced, enzymatically dispersed with 0.025% trypsin (Life Technologies, Inc.), and centrifuged differentially to yield 5–6 × 105cells/embryo. Cells (0.7 × 106) were pipetted onto coverslips, incubated, and grown into contractile layers. Synchronous contractions were seen by the third day in culture. Cultures were checked for non-muscle cell contamination (greater than 95% of cells stain with anti-myosin heavy chain monoclonal antibodies, CCM-52). Experiments were performed with 3–5-day cardiac cell cultures, at which point viability exceeded 99%. Coverslips with synchronously contracting cells were placed inside a Sykes-Moore chamber (1.2-ml volume, Bellco Glass Inc., Vineland, NJ). The chamber and inflow tubing were maintained at 37 °C. Flow rate (0.25 ml/min), pH, and oxygen tension (PO2) of the perfusate were controlled. Hypoxic conditions were verified with an optical method of phosphorescence quenching (Oxyspot, Medical Systems Inc, Greenvale, NY) (21Lo L.W. Koch C.J. Wilson D.F. Anal. Biochem. 1996; 236: 153-160Crossref PubMed Scopus (228) Google Scholar). An extracellular Pd-porphine dye bound to albumin (1–10 μm) was added to the perfusate, and the PO2-dependent phosphorescence decay was recorded in response to pulsed excitation light. Perfusion with hypoxic media resulted in measured PO2 values of 3 torr within the chamber during steady state perfusion. Tubing supplying perfusate to the chamber was of low O2 permeability, constructed of PharMed (Cole-Parmer Instrument Co., Chicago, IL) or stainless steel to minimize O2 leaks. Standard perfusion media consisted of oxygenated balanced salt solution (BSS) with a PO2 of 100 torr, PCO2 of 40, pH of 7.4, [K+] of 4.0 mEq/liter, and a glucose of 5.6 mm. Simulated ischemia consisted of BSS containing no glucose, with 2-deoxyglucose (20 mm) added to inhibit glycolysis and a [K+] of 8.0 mEq/liter. This was bubbled with 80% N2 gas and 20% CO2 to produce a PO2 of less than 3 torr, a PCO2 of 144 torr, and a final pH of 6.8. Hypoxic media used for preconditioning consisted of BSS with no glucose, bubbled with 95% N2 gas and 5% CO2. Reperfusion was with standard media unless stated otherwise. Cells were imaged with an Olympus IMT-2 inverted phase/epifluorescent microscope equipped with Hoffman Modulation optics to accentuate surface topology of the cells. This facilitated detection of contractile movement in the confluent layer of cells. Phase-contrast images were recorded for contraction analysis with a CCD camera. Fluorescence was measured using a cooled Hamamatsu slow-scanning PC-controlled camera (Hamamatsu, Hamamatsu City, Japan) coupled with Image-One software (Image Pro Plus) for quantification of changes in emission fluorescence. Measurements of propidium iodide (PI) fluorescence to assess membrane integrity were made using an excitation of 540 nm, with 580-nm long pass and 590-nm band pass filters. Dichlorofluorescein (DCF) fluorescence used to assess oxidant generation was measured using excitation light of 480 nm, with 510-nm long pass and 520-nm band pass filters. An additional marker of oxidant generation, dihydroethidium (DHE), which becomes oxidized and bound as the fluorescent complex ethidium-DNA, was measured using the same filter settings used to visualize PI. To prevent interference between PI and DHE oxidation measurements, separate studies were conducted with one or the other of these probes. Cell viability was quantified over time using the nuclear stain PI (5 μm, Molecular Probes, Eugene, OR), an exclusion fluorescent dye that binds to chromatin upon loss of membrane integrity. This method is similar in principle to trypan blue staining, and has been reported to predict the transition from reversible to irreversible cell injury in cultured cardiomyocytes (22Bond J.M. Herman B. Lemasters J.J. Res. Commun. Chem. Pathol. Pharm. 1991; 71: 195-208PubMed Google Scholar). PI is not toxic to cells over a course of 8 h, permitting its addition to the perfusate throughout the experiment. At the end of each experiment using PI, all nuclei in a field of approximately 500 cells were stained by permeabilizing cells with digitonin (300 μm). Percent loss of viability (i.e. cell death) over time was expressed relative to the maximal value seen after digitonin exposure (100%). Intracellular oxidant stress was monitored by measuring changes in fluorescence resulting from intracellular probe oxidation. DHE (1–10 μm, Molecular Probes) enters the cell and can be oxidized by ROS including superoxide and/or hydroxyl radical to yield fluorescent ethidium (Eth). Eth binds to DNA (Eth-DNA), further amplifying its fluorescence (23Carter W.O. Narayanan P.K. Robinson J.P. J. Leukocyte Biol. 1994; 55: 253-258Crossref PubMed Google Scholar). Eth-DNA fluorescence is generally stable, but can be decreased with severe hydroxyl radical attack (24Prutz W.A. Radiat. Environ. Biophys. 1984; 23: 1-18Crossref PubMed Scopus (33) Google Scholar). Thus, increases in DHE oxidation to Eth-DNA (i.e. increases in Eth-DNA fluorescence) are suggestive of superoxide generation (25Vanden Hoek T.L. Li C. Shao Z. Schumacker P.T. Becker L.B. J. Mol. Cell. Cardiol. 1997; 29: 2571-2583Abstract Full Text PDF PubMed Scopus (338) Google Scholar). The probe 2′,7′-dichlorofluorescin diacetate (DCFH-DA, 5 μm, Molecular Probes) enters the cell and the acetate group on DCFH-DA is cleaved by cellular esterases, trapping the nonfluorescent 2′,7′-dichlorofluorescin (DCFH) inside. Subsequent oxidation by ROS, particularly hydrogen peroxide (H2O2) and hydroxyl radical, yields the fluorescent product DCF (23Carter W.O. Narayanan P.K. Robinson J.P. J. Leukocyte Biol. 1994; 55: 253-258Crossref PubMed Google Scholar). Thus, increases in DCFH oxidation to DCF (i.e. increases in DCF fluorescence) are suggestive of H2O2 or hydroxyl generation (25Vanden Hoek T.L. Li C. Shao Z. Schumacker P.T. Becker L.B. J. Mol. Cell. Cardiol. 1997; 29: 2571-2583Abstract Full Text PDF PubMed Scopus (338) Google Scholar). The reported specificities of these two probes for different ROS have been verified in multiple cuvette and chick cardiomyocyte experiments, and have been described previously (25Vanden Hoek T.L. Li C. Shao Z. Schumacker P.T. Becker L.B. J. Mol. Cell. Cardiol. 1997; 29: 2571-2583Abstract Full Text PDF PubMed Scopus (338) Google Scholar). Cell contractions were observed as described previously (26Vanden Hoek T.L. Shao Z. Li C. Schumacker P.T. Becker L.B. J. Mol. Cell. Cardiol. 1997; 29: 2441-2450Abstract Full Text PDF PubMed Scopus (145) Google Scholar). The criteria for a return of contraction was met if observable contractions were seen throughout the field of cells following the 3-h period of reperfusion. A single field of cells was monitored for contractions throughout each experiment. In the ischemia/reperfusion protocol, cardiomyocytes were exposed to 1 h of simulated ischemia (simultaneous hypoxia, hypercarbic acidosis, hyperkalemia, and substrate deprivation) followed by 3 h of reperfusion. Previous work has shown that this yields significant cell death during reperfusion that appears to result from oxidant injury (20Vanden Hoek T.L. Shao Z. Li C. Zak R. Schumacker P.T. Becker L.B. Am. J. Physiol. 1996; 270: H1334-H1341PubMed Google Scholar, 25Vanden Hoek T.L. Li C. Shao Z. Schumacker P.T. Becker L.B. J. Mol. Cell. Cardiol. 1997; 29: 2571-2583Abstract Full Text PDF PubMed Scopus (338) Google Scholar). To induce preconditioning, cardiomyocytes were exposed to 10 min of hypoxia (PO2 = 3 torr) without glucose, followed by 10 min of normoxic recovery in BSS prior to subsequent ischemia/reperfusion. Cell viability, contraction, and oxidant generation were measured during preconditioning induction and during subsequent ischemia and reperfusion. These results were compared with non-preconditioned cells studied under identical conditions. Data were collected and simple descriptive analyses were performed. An individual experiment (n) was the result of observations of a single field of approximately 500 cells on a coverslip. Replicates were performed on separate coverslips. Results are reported as means plus or minus S.E. For tests of significance, analysis of variance and two-tailed paired t tests were performed, with p < 0.05 considered to be significant. As reported previously, cell death in this model of simulated ischemia/reperfusion occurred primarily during the reperfusion phase, whereas minimal cell death was seen during the ischemia phase (20Vanden Hoek T.L. Shao Z. Li C. Zak R. Schumacker P.T. Becker L.B. Am. J. Physiol. 1996; 270: H1334-H1341PubMed Google Scholar). After 1 h of ischemia, cell death (PI uptake) in the present study was 1.2 ± 0.1% (n = 3) in hypoxia-preconditioned cells, which was not different from controls (1.6 ± 0.3% cell death, n = 6; p= 0.51) (Fig. 1). After 3 h of reperfusion, PI uptake in hypoxia-preconditioned cells averaged 14.4 ± 2.0% versus 47.4 ± 3.3% in non-preconditioned cells (p < 0.001). In the preconditioned studies, strong contractile activity returned (3 out of 3) after 3 h reperfusion compared with 0 out of 6 in control experiments (data not shown). Thus, treatment with 10 min of hypoxia prior to simulated ischemia/reperfusion significantly reduced cell death and enhanced the return of contraction. We next tested the role of ROS generation during hypoxic preconditioning. Fig. 2 shows DCF fluorescence during preconditioning with hypoxia. Brief hypoxia caused a rapid and significant increase in ROS generation compared with controls (p < 0.001). Of note, ROS generation occurred during preconditioning hypoxia, and decreased during recovery prior to ischemia. As seen in Fig. 3 the ROS generation during hypoxia was attenuated with the thiol-reducing agent 2-mercaptopriopionyl glycine (2-MPG, 400 μm) (p = 0.003). Inhibition of nitric-oxide synthase (NOS, a potential nitric oxide and superoxide source during hypoxia) usingN-nitro-l-arginine (100 μm) (reported to inhibit both nitric oxide and superoxide formation from NOS (27Zweier J.L. Wang P. Samouilov A. Kuppusamy P. Nat. Med. 1995; 1: 804-809Crossref PubMed Scopus (686) Google Scholar)) increased ROS generation during preconditioning hypoxia (Fig. 3).Figure 3Effect ofN-nitro-l-arginine or 2-MPG on DCFH oxidation during hypoxic preconditioning. ROS generation during 10 min of hypoxic preconditioning, suggested by increased DCFH oxidation, was attenuated by 2-MPG (400 μm), added during base-line conditions for 40 min and hypoxic preconditioning. However, the NOS inhibitor N-nitro-l-arginine (100 μm) had the opposite effect, increasing DCFH oxidation and DCF fluorescence.View Large Image Figure ViewerDownload (PPT) Fig. 4 shows the effect of the NAD(P)H oxidase inhibitor diphenyleneiodonium (DPI, 10 μm). DPI has also been reported to inhibit superoxide formation from the flavin moiety of nitric-oxide synthase (28Wever R.M.F. van Dam T. van Rijn H.J. de Groot F. Rabelink T.J. Biochem. Biophys. Res. Commun. 1997; 237: 340-344Crossref PubMed Scopus (247) Google Scholar). DPI failed to inhibit the ROS increase seen during hypoxic preconditioning. By contrast, the mitochondrial site III electron transport inhibitor myxothiazol attenuated this ROS generation during hypoxia in a dose-dependent fashion. These results suggested that mitochondria were the source of ROS generation during hypoxic preconditioning. Mitochondria have been shown to generate superoxide via univalent electron transfer to O2, especially at the ubisemiquinone site (29Turrens J.F. Alexandre A. Lehninger A.L. Arch. Biochem. Biophys. 1985; 237: 408-414Crossref PubMed Scopus (1085) Google Scholar). This superoxide may be converted to H2O2 by superoxide dismutase (SOD) in the mitochondria or in the cytosol (Fig. 5). To test whether hypoxia generates superoxide that is dismuted by Cu,Zn-superoxide dismutase (Cu,Zn-SOD) in the cytosol, we assessed ROS generation using two fluorescent probes (DHE, 10 μm; and DCFH, 5 μm) to measure superoxide and H2O2 generation. The Cu,Zn-SOD inhibitor diethyldithiocarbamic acid (10 mm, DDC) was used to inhibit the cytosolic conversion of superoxide to H2O2 (30Misra H.P. J. Biol. Chem. 1979; 254: 11623-11628Abstract Full Text PDF PubMed Google Scholar). As seen in Fig. 6 A, DDC abolished the increase in DCF fluorescence seen during hypoxic preconditioning (p < 0.001). By contrast, DDC augmented the extent of DHE oxidation during hypoxic preconditioning (p < 0.001) (Fig. 6 B). These results suggest that superoxide generated by mitochondria during hypoxic preconditioning can enter the cytosol, where it is converted to H2O2 by Cu,Zn-SOD. Inhibition of Cu,Zn-SOD with DDC led to an increased oxidation of the superoxide-sensitive probe DHE, and a decrease in oxidation of H2O2-sensitive DCFH.Figure 6Effects of DDC on ROS generation during hypoxic preconditioning. DDC (1 mm) was added 20 min prior to and during 10 min hypoxic preconditioning. A, DCF fluorescence increases during hypoxic preconditioning were attenuated by DDC. B, ethidium fluorescence was increased by DDC. These results suggest that cytosolic SOD is involved in metabolizing superoxide generated by hypoxic preconditioning to H2O2.View Large Image Figure ViewerDownload (PPT) To further study the importance of cytosolic SOD for the induction of preconditioning, DDC was given during preconditioning hypoxia and the effect on subsequent preconditioning protection was measured. As shown above, this inhibition should increase the lifetime of superoxide while decreasing H2O2 formation. Thus, if superoxide radical was sufficient to activate preconditioning protection, SOD inhibition could augment this protection. By contrast, if H2O2 was the active signaling species, then Cu,Zn-SOD inhibition should abolish preconditioning protection. As seen in Fig. 7, transient addition of DDC during hypoxic preconditioning abolished preconditioning protection. No difference in PI uptake was detected at the end of ischemia/reperfusion between preconditioned cells given DDC during preconditioning and non-preconditioned cells. Moreover, there was no return of contraction in any of the preconditioned cells treated with DDC. DDC by itself was not associated with directly toxic effects. In this regard, the same extent of cell death was seen when DDC was given prior to ischemia/reperfusion (in non-preconditioned cells) and in cells exposed to ischemia/reperfusion without preexposure to DDC (46.6 ± 8.6% cell death after ischemia/reperfusion with pre-exposure to DDC, n = 3; versus 47.4 ± 3.3% in non-preconditioned cells). Finally, cardiomyocytes exposed continuously for 4 h to DDC showed no significant increase in PI uptake and continued to exhibit vigorous contractions (results not shown). The results with DDC suggested that H2O2, rather than superoxide, was primarily responsible for the induction of preconditioning. We therefore tested whether low levels of exogenous H2O2 given prior to ischemia/reperfusion could elicit preconditioning-like protection. Cardiomyocytes were superfused with BSS containing H2O2 (15 μmol/liter) for 10 min followed by a 10-min washout prior to ischemia/reperfusion. Exposure to H2O2 for 10 min during normoxia resulted in significant protection against cell death during subsequent ischemia/reperfusion (p < 0.001) (Fig. 8). In addition, 3/3 H2O2-treated groups showed a return of contraction compared with 0/6 untreated control experiments. We next attempted to prevent preconditioning using the thiol reductant 2-MPG at a concentration shown previously to attenuate the ROS signal generated during hypoxia (Fig. 3). By maintaining the cytosolic pool of reduced glutathione, 2-MPG is presumed to enhance the scavenging of H2O2 (Fig. 5). Addition of 2-MPG during the first 40 min of equilibration and 10 min of hypoxic preconditioning abolished preconditioning protection (43.3 ± 4.5% cell death in 2-MPG-treated hypoxic preconditioned cells, n = 3;versus 14.4 ± 2.0% in nontreated hypoxic preconditioned cells; p < 0.01) (Fig. 8). In addition, 0/3 2-MPG-treated hypoxic preconditioned studies showed a return of contraction compared with 3/3 nontreated hypoxic-preconditioned experiments. These results further support the role of H2O2 in the induction phase of preconditioning in cardiomyocytes. Previous reports suggest that membrane anion channels may be required for transit of superoxide across cell membranes (31Takahashi M. Asada K. Arch. Biochem. Biophys. 1983; 226: 558-566Crossref PubMed Scopus (281) Google Scholar), and that this transit can be inhibited by 4,4′-diisothiocyanato-stilbene-2,2′-disulfonate (DIDS) (32Paky A. Michael J.R. Burke-Wolin T.M. Wolin M.S. Gurtner G.H. J. Appl. Physiol. 1993; 74: 2868-2874Crossref PubMed Scopus (91) Google Scholar). As illustrated in Fig. 5, superoxide generated in the mitochondria may enter the cytosol, where it may be dismutated by Cu,Zn-SOD to H2O2, which then activates subsequent mediators of preconditioning. If mitochondrial anion channels are involved in superoxide movement into the cytosol, then inhibitors of those channels should attenuate H2O2 generation in the cytosol and prevent preconditioning protection. To test this, cardiomyocytes were superfused with BSS containing DIDS (200 μm) during 10 min of hypoxic preconditioning. As seen in Fig. 9 A, DIDS during hypoxic preconditioning abolished ROS generation as measured by DCF fluorescence. DIDS given during hypoxic preconditioning also abolished preconditioning protection (Fig. 9 B). DIDS exhibited no apparent toxicity, as evidenced by an absence of increased PI uptake after 4 h of superfusion under normoxic conditions (data not shown). Our results show that 10 min of hypoxia in chick cardiomyocytes elicits a transient increase in ROS generation, predominantly H2O2. This ROS signal was attenuated by the mitochondrial site III electron transport inhibitor myxothiazol, but not NAD(P)H oxidase or nitric-oxide synthase inhibitors. These results suggest that the ROS generated during hypoxia originated from the mitochondria. Protection against subsequent ischemia and reperfusion was reversed by agents that attenuated this H2O2 signal. In that regard, the thiol-reducing agent 2-MPG, the cytosolic SOD inhibitor DDC, and the anion channel inhibitor DIDS all abolished preconditioning protection. Finally, transient exogenous H2O2 administration during normoxia induced preconditioning-like protection. We conclude that ROS participate in the signal transduction pathways involved in hypoxic preconditioning in this model. These ROS appear to originate as superoxide from the mitochondrial electron transport chain, which enter the cytosol via anion channels. There, dismutation by Cu,Zn-SOD appears to be necessary for the activation of subsequent steps involved in preconditioning protection. Our data are consistent with studies that have indirectly implicated ROS as signaling agents that elicit preconditioning. Most previous studies have been done in intact hearts and show that antioxidants given during ischemic preconditioning abrogate its protective effect against ischemia/reperfusion injury (4Tanaka M. Fujiwara H. Yamasaki K. Sasayama S. Cardiovasc. Res. 1994; 28: 980-986Crossref PubMed Scopus (130) Google Scholar, 33Murry C.E. Richard V.J. Jennings R.B. Reimer K.A. Circulation. 1988; 78 (abstr.): 77Google Scholar). However, our study extends previous work by identifying mitochondria as the source of ROS responsible for induction, and by showing that these ROS are generated during hypoxic preconditioning rather than at reoxygenation. Some previous studies were not able to abolish preconditioning with antioxidants (5Osada M. Takeda S. Sato T. Komori S. Tamura K. Jpn. Circ. J. 1994; 58: 259-263Crossref PubMed Scopus (30) Google Scholar, 34Richard V. Tron C. Thuillez C. Cardiovasc. Res. 1993; 27: 2016-2021Crossref PubMed Scopus (46) Google Scholar), raising the possibility that the type of antioxidant, its dose, or the timing of administration did not attenuate the oxidant signal responsible for induction. Our measurements of ROS generation indicated that the antioxidant compounds were acting as expected, and more directly support a role for ROS in the induction of hypoxic preconditioning. Our results show that hypoxic preconditioning is associated with significant oxidation of DCFH (sensitive to H2O2), and with significant DHE oxidation (sensitive to superoxide) when Cu,Zn-SOD is inhibited. Thus, a predominant ROS pathway during hypoxic preconditioning appears to involve H2O2 generated from superoxide metabolism. However, the specificity of these fluorescent probes for different reactive species is limited, so the precise delineation of each ROS is not possible. Nevertheless, the suggested role of H2O2 as the ROS trigger for preconditioning is supported by the observations that exogenous H2O2 can induce preconditioning-like protection during normoxia and that SOD inhibition, which increases superoxide (DHE oxidation) generation relative to H2O2formation, abolishes the protective effects of preconditioning. These results are consistent with other studies showing that exogenous superoxide or H2O2 can produce preconditioning-like protection in the intact heart (2Baines C.P. Goto M. Downey J.M. J. Mol. Cell. Cardiol. 1997; 29: 207-216Abstract Full Text PDF PubMed Scopus (419) Google Scholar, 3Tritto I. D'Andrea D. Eramo N. Scognamiglio A. De Simone C. Violante A. Esposito A. Chiariello M. Ambrosio G. Circ. Res. 1997; 80: 743-748Crossref PubMed Scopus (256) Google Scholar, 35Pathak S.K. Qian Y.Z. Hess M.L. Kukreja R.C. Circulation. 1995; 92 (abstr.): I-717Google Scholar). Both superoxide and H2O2 have been shown to activate putative mediators of preconditioning such as protein kinase C and phospholipase D (16Gopalakrishna R. Anderson W.B. Proc. Natl. Acad. Sci. U. S. A. 1989; 86: 6758-6762Crossref PubMed Scopus (381) Google Scholar, 36Larsson R. Cerutti P. Cancer Res. 1989; 49: 5627-5632PubMed Google Scholar, 37Natarajan V. Taher M.M. Roehm B. Parinandi N.L. Schmid H.H.O. Kiss Z. Garcia J.G.N. J. Biol. Chem. 1993; 268: 930-937Abstract Full Text PDF PubMed Google Scholar). As with our study, it is possible that superoxide could have induced preconditioning in those studies via increased intracellular [H2O2]. However, previous studies involving exogenous superoxide did not employ an SOD inhibitor, so it is difficult to know whether superoxide itself or H2O2 was responsible for eliciting preconditioning protection. Generally, H2O2would appear to be a more likely signaling element because it can cross intracellular membranes more readily than superoxide, and has been shown to directly modify the regulatory domain of protein kinase C resulting in its activation (16Gopalakrishna R. Anderson W.B. Proc. Natl. Acad. Sci. U. S. A. 1989; 86: 6758-6762Crossref PubMed Scopus (381) Google Scholar). Many potential sites of ROS production exist in the intact heart (8Hess M.L. Manson N.H. J. Mol. Cell. 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Our data, along with the work of others, implicate the mitochondrial electron transport chain as an important source of free radicals in isolated cells (7Ferrari R. Ceconi C. Curello S. Alfieri O. Visioli O. Eur. Heart. J. 1993; 14: 25-30Crossref PubMed Scopus (23) Google Scholar, 40Dawson T.L. Gores G.J. Nieminen A.L. Herman B. Lemasters J.J. Am. J. Physiol. 1993; 264: C961-C967Crossref PubMed Google Scholar). The mitchondrial inhibitor myxothiazol decreased the ROS generation during hypoxic preconditioning, suggesting that these ROS originated from the cytochrome b-c 1 segment of complex III in the respiratory chain (41Thierbach G. Reichenbach H. Biochim. Biophys. Acta. 1981; 638: 282-289Crossref PubMed Scopus (205) Google Scholar). This result is consistent with work by others who have found that two segments of the respiratory chain are primarily responsible for superoxide generation: the reduced flavin mononucleotide of NADH dehydrogenase in complex I (42Turrens J.F. Boveris A. 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Physiol. 1993; 74: 2868-2874Crossref PubMed Scopus (91) Google Scholar), and have been described on both the outer and inner mitochondrial membranes (43Sampson M.J. Lovell R.S. Craigen W.J. J. Biol. Chem. 1997; 272: 18966-18973Abstract Full Text Full Text PDF PubMed Scopus (184) Google Scholar, 44Beavis A.D. Davatol-Hag H. J. Bioenerg. Biomembr. 1996; 28: 207-214Crossref PubMed Scopus (61) Google Scholar). No studies to date have investigated the importance of such channels to the induction of preconditioning, but further studies are needed to clarify their importance. Although previous studies have demonstrated the potentially destructive role of ROS generated during prolonged ischemia/reperfusion (12Ambrosio G. Zweier J.L. Duilio C. Kuppusamy P. Santoro G. Elia P.P. Tritto I. Cirillo P. Condorelli M. Chiarello M. J. Biol. Chem. 1993; 268: 18532-18541Abstract Full Text PDF PubMed Google Scholar), a growing body of data suggests that signaling levels of ROS generated by mitochondria may activate intracellular signaling cascades involved in protective responses. In this regard, recent studies have shown that mitochondrial ROS generated during prolonged, moderate hypoxia appear to participate in the reversible suppression of ATP utilization and contraction in cardiomyocytes (45Duranteau J. Chandel N.S. Kulisz A. Shao Z. Schumacker P.T. J. Biol. Chem. 1998; 273 (in press)Abstract Full Text Full Text PDF Scopus (580) Google Scholar). The present study extends those findings by revealing that mitochondrial ROS generated during brief anoxia can also activate signaling cascades involved in protecting cardiomyocytes from subsequent ischemia/reperfusion injury.