Sodium as the major mediator of NO-induced cell death in cultured hepatocytes.

NO has been shown to induce cellular injury via inhibition of the mitochondrial respiratory chain and/or oxidative/nitrosative stress. Here, we studied which mechanism and downstream mediator is responsible for NO toxicity to hepatocytes. When cultured rat hepatocytes were incubated with spermineNONOate (0.01-2 mM) at 2, 5, 21 and 95% O(2) in Krebs-Henseleit buffer (37 degrees C), spermineNONOate caused concentration-dependent hepatocyte death (lactate dehydrogenase release, propidium iodide uptake) with morphological features of both apoptosis and necrosis. Increasing O(2) concentrations protected hepatocytes from NO-induced injury. Steady-state NO concentrations were lower at higher O(2) concentrations, suggesting formation of reactive nitrogen oxide species. Despite this, the scavenger ascorbic acid was hardly protective. In contrast, at equal NO concentrations loss of viability was higher at lower O(2) concentrations and inhibitors of hypoxic injury, fructose and glycine (10 mM), strongly decreased NO-induced injury. Upon addition of spermineNONOate, the cytosolic Na(+) concentration rapidly increased. The increase in sodium depended on the NO/O(2) ratio and was paralleled by hepatocyte death. Sodium-free Krebs-Henseleit buffer strongly protected from NO-induced injury. SpermineNONOate also increased cytosolic calcium levels but the Ca(2+) chelator quin-2-AM did not diminish cell injury. These results show that - in analogy to hypoxic injury - a sodium influx largely mediates the NO-induced death of cultured hepatocytes. Oxidative stress and disturbances in calcium homeostasis appear to be of minor importance for NO toxicity to hepatocytes.