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Chronichigh-dosemorphinetreatmentpromotes SH-SY5Y
cell apoptosisviac-JunN-terminal kinase-mediated
activation ofmitochondria-dependent pathway
Xin Lin
1,
*, Yu-Jun Wang
2,
*, Qing Li
2
, Yuan-Yuan Hou
1
, Min-Hua Hong
1
, Ying-Lin Cao
2
, Zhi-Qiang
Chi
1
and Jing-Gen Liu
1
1 State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, China
2 School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University, China
Opioids, in addition to their well-recognized analgesic
effects, may act as modulators ofcell proliferation and
cell death. It has been shown that opioids can protect
astrocytes from apoptosis triggered by apoptosis-
promoting agents [1], delay neuronal death in the
avian ciliary ganglion [2], and promote the growth of
tumor cells [3–5]. On the other hand, opioids have also
been demonstrated to induce apoptosisof immuno-
cytes [6,7], cancer cells [8,9], neuroblastoma cells such
as SK-N-SH, NG108-15 and PC12 cells [10–12], and
neuronal cells [13,14], as well as human microglia [15].
The effects of opioid-mediated cell proliferation and
death appear to be dependent on the concentrations
and durations employed for treatment. Growth-
Keywords
apoptosis; JNK signaling; mitochondria;
morphine; ROS
Correspondence
J G. Liu, State Key Laboratory of Drug
Research, Shanghai Institute of Materia
Medica, Chinese Academy of Sciences,
Shanghai 201203, China
Fax: +86 21 50807088
Tel: +86 21 50807588
E-mail: jgliu@mail.shcnc.ac.cn
*These authors contributed equally to this
work
(Received 4 December 2008, revised 22
January 2009, accepted 28 January 2009)
doi:10.1111/j.1742-4658.2009.06938.x
Chronic high doses ofmorphine inhibit the growth of various human
cancer cell lines. However, the mechanisms by which such high-dose
morphine inhibits cell proliferation and induces cell death are not fully
understood. Here we show that c-JunN-terminal kinase (JNK) plays a
pivotal role in high-dose morphine-induced apoptosisofSH-SY5Y cells in
a mitochondria-dependent manner. Activationof JNK by morphine led to
reactive oxygen species (ROS) generation via the mitochondrial permeabil-
ity transition pore, because the mPTP inhibitor cyclosporin A significantly
inhibited ROS generation. ROS in turn exerted feedback regulation on
JNK activation, as shown by the observations that cyclosporin A and the
antioxidant N-acetylcysteine significantly inhibited the phosphorylation of
JNK induced by morphine. ROS-amplified JNK induced cytochrome c
release and caspase-9 ⁄ 3 activation through enhancement of expression of
the proapoptotic protein Bim and reduction of expression of the antiapop-
totic protein Bcl-2. All of these effects ofmorphine could be suppressed by
the JNK inhibitor SP600125 and N-acetylcysteine. The key role of the
JNK pathway in morphine-induced apoptosis was further confirmed by the
observation that decreased levels of JNK in cells transfected with specific
small interfering RNA resulted in resistance to the proapoptotic effect of
morphine. Thus, the present study clearly shows that morphine-induced
apoptosis in SH-SY5Y cells involves JNK-dependent activationof the
mitochondrial death pathway, and that ROS signaling exerts positive feed-
back regulation of JNK activity.
Abbreviations
ALP, allopurionol; CsA, cyclosporin A; DCFH
2
-DA, 2,7-dichlorodihydrofluorescein diacetate; DPI, diphenylene iodonium; FITC, fluorescein
isothiocyanate; HE, hydroethidine; JNK, c-JunN-terminal kinase; mPFC, medial prefrontal cortex; mPTP, mitochondrial permeability transition
pore; NAC, N-acetylcysteine; PI, propidium iodide; PTX, pertussis toxin; ROS, reactive oxygen species; SEM, standard error of the mean;
siRNA, small interfering RNA; SRB, sulforhodamine B; VTA, ventral tegmental area.
2022 FEBS Journal 276 (2009) 2022–2036 ª 2009 Shanghai Institute of Materia Medica, Chinese Academy of Sciences. Journal compilation ª 2009 FEBS
promoting effects occur at low concentrations or single
doses of opioids, whereas growth-inhibitory effects
occur with chronic opioid treatment or relatively high
in vitro concentrations [16]. For example, it was
reported by previous studies that morphine and its
derivatives inhibited the growth of various human
cancer cells, including neuroblastoma cells, with IC
50
values over the millimolar level [17,18].
For humans, high plasma concentration of opioids
occur under two circumstances. One is the application
of high doses of opioids for pain treatment in cancer
patients. Chronichigh-dosemorphine therapy has been
widely used for severe cancer pain in palliative care
[19]. The other is the abuse of opioids. In support of
this, it was reported that, in animal models of addic-
tion, the plasma concentration ofmorphine is as high
as 2.5 mm [20]. It is possible that such high plasma
concentrations of opiate could result in neuronal toxic-
ity and death. Indeed, accumulating evidence demon-
strates that chronic exposure to morphine or other
opiates leads to alterations in the morphology, struc-
ture and function of neurons in certain brain regions
associated with the development of opioid dependence,
such as the ventral tegmental area (VTA), nucleus
accumbens, and medial prefrontal cortex (mPFC). For
example, chronicmorphine exposure has been found
to reduce the size of neurons and spine density in the
VTA [21], and decrease the number of dendritic spines
and alter the complexity of dendritic branches in the
nucleus accumbens and mPFC [22]. Also, reduction of
the immunodensity of neurofilament proteins, the
major intermediate filaments of the neuronal cytoskele-
ton, has been observed in the VTA of brains from
chronic morphine-treated rats [23], and in the mPFC
from chronic opioid abusers [24]. In addition, a signifi-
cant loss of ventricular and cortical volume was found
in the brains of human opioid addicts in a clinical
study [25]. All of these findings suggest that the abuse
of opioids may induce neuronal toxicity and affect
neuronal survival.
Although opioids have been clearly shown to modu-
late cell proliferation and cell death, the molecular
mechanisms have not been fully elucidated. We
recently found that morphine at relatively low concen-
trations was able to inhibit doxorubicin-induced apop-
tosis through inhibition of reactive oxygen species
(ROS) accumulation and mitochondrial cytochrome c
release, and blockade of nuclear factor-jB transcrip-
tional activation, in SH-SY5Y cells [26]. The present
study was undertaken to study the mechanisms by
which chronic high doses ofmorphine inhibit cell pro-
liferation and induce cell death in SH-SY5Y cells,
which constitute a subclone derived from the parent
SK-N-SH cell line, a human neuroblastoma cell line
that possesses the growth, biochemical and cytogenetic
properties of neurons [27] and expresses both d-opioid
and l-opioid receptors [28]. SH-SY5Y cells have
been used extensively in the study of neuronal death
[29–31].
Results
Morphine inhibited SH-SY5Ycell proliferation
and induced cell apoptosis
Previous studies reported that morphine inhibited the
growth of various human cancer cells, including neuro-
blastoma cells, with IC
50
values of 2.7–8.8 mm [17,18].
To assess the effect ofmorphine on SH-SY5Ycell pro-
liferation, equal numbers of cells were treated with
various concentrations ofmorphine (0.5–4 mm) for
48 h. Cell viability was detected by the sulforhod-
amine B (SRB) assay. As shown in Fig. 1A, morphine
(0.5–4 mm) caused dose-dependent inhibition of cell
proliferation, with a significant reduction at 0.5 mm
and an almost 80% reduction at 4 mm.
The cell death caused by morphine could be medi-
ated by several different mechanisms. To determine
whether cell death was caused by apoptosis, an
extreme consequence of neurotoxicity, we examined
the apoptotic percentage of morphine-treated cells by
flow cytometric analysis of permeabilized cells double
stained with annexin V–fluorescein isothiocyanate
(FITC) ⁄ propidium iodide (PI). SH-SY5Y cells were
treated with morphine (1–4 mm) or left untreated (con-
trol) for 48 h. As shown in Fig. 1B, morphine-treated
cells exhibited significantly greater apoptosis than
control cells. In the presence of 4 mm morphine, the
percentage of apoptotic cells reached 60%, which
confirmed the results obtained using the SRB assay.
To determine whether morphine mediates its effect
on inhibition ofcell proliferation and induction of
apoptosis via an opioid receptor-related mechanism,
SH-SY5Y cells were treated for 48 h with morphine in
the presence of the opioid receptor antagonist nalox-
one (0.1 mm) or the Gi ⁄ o protein inhibitor pertussis
toxin (PTX, 0.1 lgÆmL
)1
), and cell viability and the
apoptotic percentage of morphine-treated cells were
then assessed. The inhibitory effects ofmorphine on
cell growth were not antagonized by either 0.1 mm nal-
oxone or 0.1 lgÆmL
)1
PTX (Fig. 1C). Even naloxone
up to 1 mm and PTX up to 0.4 lgÆmL
)1
had no effect
on morphine-induced inhibition ofcell proliferation
(data not shown). Furthermore, the results from flow
cytometric analysis and SRB assay agreed well with
each other, showing that naloxone and PTX pretreat-
X. Lin et al. Role of JNK signaling in morphine-induced apoptosis
FEBS Journal 276 (2009) 2022–2036 ª 2009 Shanghai Institute of Materia Medica, Chinese Academy of Sciences. Journal compilation ª 2009 FEBS 2023
ment were not able to block morphine-induced apop-
tosis in SH-SY5Y cells (Fig. 1D), suggesting that a
typical opioid receptor-related mechanism was not
involved, consistent with previous findings that an
opioid receptor-related mechanism is not involved in
opioid-induced apoptosisof tumor cells [9,32].
Morphine treatment induced release of
cytochrome c and activationof caspase-9
and caspase-3
Previous studies have shown that a mitochondria-
dependent pathway is implicated in morphine-induced
apoptosis in neuroblastoma cells and neurons [12,14].
To determine the molecular pathway for morphine-
induced apoptosis, we examined the effects of
morphine treatment on the release of cytochrome c and
the activationof caspase-9 and caspase-3 in SH-SY5Y
cells by western blot analysis. Because activation of
caspase-9 and caspase-3 is required for mitochondria-
dependent apoptosis [33], we first detected activation
of caspase-9 and caspase-3 upon morphine treatment.
Activation of caspases can be manifested either by a
reduction in the amount of procaspase (inactive form)
or by an increase in the amount of cleaved caspase
(active form). As shown in Fig. 2A,B, a concentration-
dependent decrease in procaspase-3 or procaspase-9
expression and an increase in cleaved caspase-3 expres-
sion were observed in SH-SY5Y cells treated with
morphine (1–4 mm) for 48 h, indicative of caspase-9
and caspase-3 activation. Release of cytochrome c
from mitochondria to the cytosol is essential for cas-
pase-9 activation [34]. Next, we examined the effect of
morphine treatment on cytochrome c release. The
cytosolic fractions from cells were isolated, and the
presence of cytochrome c was detected by antibody
against cytochrome c. Treatmentof cells with
morphine (1–4 mm) for 48 h led to large amounts of
cytochrome c release into the cytosol, as compared
with control cells (Fig. 2C).
Cytochrome c release is a common event in the cell
death pathway, initiated by diverse apoptosis-inducing
agents. Cytochrome c can be either a trigger or a con-
sequence of caspase activation. Although cytochrome c
release occurs mostly upstream of caspase activation,
in some models of apoptosis, such as death receptor-
80
60
40
Apoptosis (%)
20
0
80
100
120
A
C
B D
60
40
Cell viability (%)
20
0
80
100
140
120
60
40
Cell viability (%)
20
0
80
60
Mor
0.1 µg·mL
–1
PTX + Mor
0.1 m
M Nx + Mor
Mor
0.1 µg·mL
–1
PTX + Mo
r
0.1 mM Nx + Mor
40
Apoptosis (%)
20
0
Con
Concentration (mM)
Concentration of Mor
(
mM
)
1 3 2 4
Con
Concentration (mM)
1 0.5 3 2
4
4
0
Concentration of Mor (mM)
2
0
Fig. 1. Morphine-induced cell death in a naloxone-irreversible and PTX-irreversible manner in SH-SY5Y cells. (A) Cells were treated with vari-
ous concentrations ofmorphine (Mor) for 48 h, and cell viability was determined using the SRB assay as described in Experimental proce-
dures. (B) Cells were treated with various concentrations ofmorphine for 48 h, and then permeabilized, double stained with
annexin V–FITC ⁄ PI, and detected by flow cytometry as described in Experimental procedures. (C) Cells were treated with 2 m
M morphine in
the absence or presence of 0.1 m
M naloxone or 0.1 lgÆmL
)1
PTX, as indicated, for 48 h. (D) Cells were treated with 4 mM morphine in the
absence or presence of 0.1 m
M naloxone or 0.1 lgÆmL
)1
PTX, as indicated, for 48 h. Data are expressed as a percentage of the untreated
control cell samples, and represent means ± SEMs for at least three independent experiments performed in triplicate.
Role of JNK signaling in morphine-induced apoptosis X. Lin et al.
2024 FEBS Journal 276 (2009) 2022–2036 ª 2009 Shanghai Institute of Materia Medica, Chinese Academy of Sciences. Journal compilation ª 2009 FEBS
dependent apoptosis, caspase activation is upstream of
cytochrome c release [35,36]. To examine the sequence
of the process of cytochrome c release and caspase
activation, we examined the effect of zVAD-fmk, a
broad-spectrum caspase inhibitor, on morphine-
induced cytochrome c release. SH-SY5Y cells were
treated with morphine alone or concomitantly with
morphine and zVAD-fmk for 24 h. As shown in
Fig. 2D, cotreatment of cells with zVAD-fmk led to a
significant decrease in cleaved caspase-3 levels in mor-
phine-treated cells, but had no effect on the cytosolic
accumulation of cytochrome c, suggesting that active
caspases are not required for cytochrome c release in
morphine-induced cell death, and that cytochrome c
release is upstream of caspase activation during mor-
phine-induced apoptosis in SH-SY5Y cells. Thus,
mitochondria may be direct targets of death signals
initiated by morphine. The results are consistent with
previous studies showing that SH-SY5Y cells do not
express caspase-8 [37], an essential mediator of CD95-
triggered apoptosis [38].
ROS were generated in SH-SY5Y cells following
morphine treatment
It has been reported that ROS are implicated in the
mediation of caspase-dependent cellapoptosis by pro-
moting cytochrome c release [39]. Previous studies have
also demonstrated that morphine-induced apoptosis
requires the generation of ROS [40]. To investigate
whether ROS generation is one of the molecular events
upstream of release of cytochrome c, we detected ROS
generation in response to morphinetreatment for vary-
ing times. Using flow cytometry to assess ROS genera-
tion with the fluorescent indicators hydroethidine (HE)
and 2,7-dichlorodihydrofluorescein diacetate (DCFH
2
-
DA), to detect O
2
·
)
and H
2
O
2
, respectively, we found
that treatmentof cells with 4 mm morphine led to
increases in O
2
·
)
and H
2
O
2
levels. An increase in ROS
generation was detected as early as after 6 h of
morphine treatment, and the maximal enhancements of
O
2
·
)
and H
2
O
2
levels were detected after 24 h of
morphine treatment (Fig. 3A). N-Acetylcysteine (NAC)
A
B
D
C
Fig. 2. Morphinetreatment induced cytochrome c release and caspase-3 and caspase-9 activation. (A–C) Morphine (Mor) dose-dependently
activated caspase-3 and caspase-9, and released cytochrome c from mitochondria. Cells were treated with increasing concentrations of
morphine, as indicated, for 48 h. Extracts from whole cells or the cytosol were subjected to 12% SDS ⁄ PAGE, and immunoblotted with
antibodies against procaspase-3, procaspase-9, cleaved caspase-3, and cytochrome c. (D) zVAD-fmk was able to inhibit morphine-induced
caspase-3 activation, but unable to suppress cytochrome c release. Cells were treated with 4 m
M morphine for 24 h in the absence or
presence of 12 l
M zVAD-fmk, and then harvested for detection of cleaved caspase-3 and cytochrome c. (a) A representative image of
immunoblots for cleaved caspase-3 and cytochrome c. (b) Densitometric analysis of changes in levels of cleaved caspase-3 and cytosolic
cytochrome c. All images are representative of three independent experiments yielding similar results. Data are means ± SEMs for three
independent experiments. *P < 0.05 as compared with morphine.
X. Lin et al. Role of JNK signaling in morphine-induced apoptosis
FEBS Journal 276 (2009) 2022–2036 ª 2009 Shanghai Institute of Materia Medica, Chinese Academy of Sciences. Journal compilation ª 2009 FEBS 2025
(5 mm), a well-characterized antioxidant, significantly
inhibited the generation of O
2
·
)
in SH-SY5Y cells trea-
ted with morphine for 6 h. However, this effect of
morphine could not be suppressed by diphenylene
iodonium (DPI) (2 lm), an inhibitor of NADPH oxi-
dase, and allopurionol (ALP) (100 lm), an inhibitor of
xanthine oxidase (Fig. 3B), suggesting that mitochon-
dria may be the major source of ROS. In addition,
NAC (5 mm) also clearly inhibited the elevation of
intracellular O
2
·
)
and H
2
O
2
levels after 24 h of mor-
phine treatment (Fig. 3C). It has been suggested that
mitochondrial permeability transition pore (mPTP)
opening increases ROS production in vivo [41] and in
isolated mitochondria [42]. To determine whether ROS
came from the mitochondria, we examined the effect of
the mPTP inhibitor cyclosporin A (CsA) on morphine-
induced ROS generation. Treatment with CsA (1 lm)
alone had no effect on O
2
)
generation, but it signifi-
cantly inhibited morphine-induced O
2
)
generation
(Fig. 3D), supporting the idea that the mitochondria
were the source of ROS generation.
c-Jun N-terminal kinase (JNK) activation was
upstream of ROS generation and was in turn
regulated by ROS
Studies of JNK-induced neuronal apoptosis suggest that
JNK-induced phosphorylation of the transcription
factor c-Jun and the consequent expression of c-Jun-
induced genes mediate JNK-induced apoptosis [43,44].
As ROS activate the JNK cascade [45,46], apoptosis
induced by morphine may depend on activationof the
JNK pathway. To determine whether morphine-induced
ROS generation leads to activationof JNK and its sub-
strate target (c-Jun) in SH-SY5Y cells, we examined the
effect ofmorphinetreatment on the phosphorylation of
JNK and c-Jun by western blot analysis, using phospho-
specific antibodies. As shown in Fig. 4A, the phosphory-
lation of JNK and the phosphorylation ofc-Jun were
both increased by morphinetreatment (4 mm), starting
at 3 h and peaking at 24 h. However, no differences in
the phosphorylation of p38 were observed between
controls and morphine-treated cells.
A
B
C D
Fig. 3. Morphinetreatment increased intercellular O
2
·
)
and H
2
O
2
levels in SH-SY5Y cells. (A) Morphine (Mor) time-dependently induced
ROS generation. Cells were treated with 4 m
M morphine for the indicated time periods, and intracellular O
2
·
)
and H
2
O
2
levels were deter-
mined by flow cytometry using 5 l
M HE and 10 lM DCFH
2
-DA as fluorescent probes, as described in Experimental procedures. The figure is
representative of four independent experiments yielding similar results. (B, C) NAC, but not DPI and ALP, suppressed morphine-induced
ROS generation in SH-SY5Y cells. Cells were pretreated with 5 m
M NAC, 100 lM ALP and 2 lM DPI for 30 min prior to incubation with
4m
M morphine for 6 h, or pretreated with 5 mM NAC prior to incubation with 4 mM morphine for 24 h, and intracellular H
2
O
2
and O
2
·
)
levels were then detected. (a) A representative image of five independent experiments yielding similar results. (b) Quantification of O
2
·
)
and
H
2
O
2
generation. (D) CsA decreased morphine-induced enhancement of O
2
·
)
levels. Cells were treated with either 4 mM morphine alone or
with 4 m
M morphine in combination with 1 lM CsA for 6 h, and intracellular O
2
·
)
levels were then determined. Values are means ± SEMs for
at least three independent experiments performed in triplicate. **P < 0.01 as compared with morphine.
Role of JNK signaling in morphine-induced apoptosis X. Lin et al.
2026 FEBS Journal 276 (2009) 2022–2036 ª 2009 Shanghai Institute of Materia Medica, Chinese Academy of Sciences. Journal compilation ª 2009 FEBS
The results showed that JNK was activated as early
as after 3 h ofmorphine treatment; this preceded ROS
generation, which was detected after 6 h of morphine
treatment, indicating that JNK activation was located
upstream of ROS generation (Fig. 3A). To determine
whether JNK activation is involved in ROS genera-
tion, we detected the effect of SP600125, a selective
inhibitor of JNK that acts by binding to the ATP-
binding site, on O
2
)
generation induced by morphine
treatment. Pretreatment of cells with 20 lm SP600125
effectively attenuated O
2
)
generation (Fig. 4B), indicat-
ing that JNK activation is essential for ROS genera-
tion. Consistent with the absence ofactivationof p38
by morphine, the p38 mitogen-activated protein kinase
inhibitor SB203580 had no effect on morphine-induced
ROS generation (Fig. 4B). To obtain further evidence
that JNK activation precedes ROS generation, we
determined the effect of NAC on JNK activation
induced by 3 h ofmorphine treatment, because JNK
activation started at 3 h. NAC had no significant effect
on the phosphorylation of JNK induced by 3 h of
morphine treatment (Fig. 4C). These results support
the idea that JNK activation precedes ROS generation,
consistent with recent studies showing that ROS gener-
ation was regulated by the JNK signaling pathway
[47,48].
To determine whether ROS exert feedback regula-
tion on JNK activation, we next examined the effects
of the antioxidant NAC and the mPTP inhibitor CsA
on the phosphorylation of JNK and on its substrate
transcription factor c-Jun following prolonged mor-
phine treatment. Figure 4D shows that, in the presence
of 5 mm NAC, morphinetreatment for 12 h failed to
induce increases in the phosphorylation of JNK and
c-Jun. Additionally, in the presence of 1 lm CsA,
morphine treatment for 12 h also failed to induce JNK
A
E
C
D
B
Fig. 4. JNK activation induced by morphine (Mor) was upstream of ROS generation and was in turn regulated by ROS. (A) Morphine acti-
vated the JNK ⁄ c-Jun, but not the p38, signaling pathway. Cells were treated with 4 m
M morphine for increasing time periods, as indicated.
Extracts from whole cells were subjected to 12% SDS ⁄ PAGE and immunoblotted with antibodies against JNK, phospho-JNK, p38, phospho-
p38, c-Jun, phospho-c-Jun and actin. (B) SP600125, but not SB203580, blocked morphine-induced O
2
)
generation. Cells were treated with
4m
M morphine alone, or treated with 4 mM morphine in the presence of 20 lM SP600125 or 20 lM SB203580 for 6 h, and intracellular O
2
·
)
levels were then determined by flow cytometry. Values are means ± SEMs for at least three independent experiments performed in tripli-
cate. **P < 0.01 as compared with morphine. (C) NAC failed to suppress phosphorylation of JNK induced by 3 h ofmorphine treatment.
Cells were either treated with 4 m
M morphine alone or treated with 4 mM morphine in combination with 5 mM NAC for 3 h. (D) NAC and
SP600125 were able to inhibit phosphorylation of JNK and c-Jun induced by 12 h ofmorphine treatment. Cells were treated with 4 m
M mor-
phine for 12 h in the absence or presence of 5 m
M NAC or 20 lM SP600125. (E) CsA abolished phosphorylation of JNK induced by 12 h of
morphine treatment. Cells were treated with 4 m
M morphine for 12 h in the absence or presence of 1 lM CsA.
X. Lin et al. Role of JNK signaling in morphine-induced apoptosis
FEBS Journal 276 (2009) 2022–2036 ª 2009 Shanghai Institute of Materia Medica, Chinese Academy of Sciences. Journal compilation ª 2009 FEBS 2027
and c-Jun phosphorylation (Fig. 4E). The effect of
morphine on the phosphorylation of JNK and c-Jun
could also be inhibited by SP600125, an inhibitor of
JNK activation. These results support the idea that
ROS exert a positive feedback effect on JNK activa-
tion after prolonged morphine treatment. Altogether,
the findings suggest that morphine induces ROS accu-
mulation by activationof the JNK pathway, and that
ROS can, in turn, activate JNK in a positive feedback
fashion.
Morphine treatment differentially regulated the
expression of Bcl-2 family members
Bcl-2 family members are major regulators of mito-
chondrial integrity and mitochondria-initiated cyto-
chrome c release and caspase activation. The Bcl-2
family includes antiapoptotic members such as Bcl-2
and Bcl-XL, and proapoptotic members such as Bax,
Bak, and Bim. Bax and Bak are potent regulators of
cytochrome c release from mitochondria under a vari-
ety of stress conditions. JNK ⁄ c-Jun signaling has been
implicated in the induction of the BH3-only Bcl-2 fam-
ily member Bim (Bcl-interacting mediator of cell
death), a key mediator of Bax-dependent cytochrome c
release during neuronal apoptosis [49,50]. Next, we
investigated whether morphinetreatment caused induc-
tion of Bim in SH-SY5Y cells. As was expected, in
parallel with JNK activation, treatment with morphine
resulted in enhancement of Bim expression in a time-
dependent and dose-dependent manner (Fig. 5A,B).
Bcl-2 prevents release of cytochrome c by heterodimer-
izing with Bax [51,52]. Therefore, the effects of treat-
ment with morphine on the protein levels of Bcl-2 and
Bax were assessed. As shown in Fig. 5C, treatment of
cells with morphine induced a robust decrease in the
protein level of Bcl-2, but failed to produce a signifi-
cant change in the protein level of Bax. As a result,
the Bcl-2 ⁄ Bax ratio was decreased, which is indicative
of an increase in mitochondrial permeability.
Inhibitors of JNK and antioxidant suppressed
morphine-induced changes in Bim and Bcl-2
expression, cytochrome c release, and caspase-3
activation
The data presented above show that a positive feed-
back cycle operates in morphine-treated SH-SY5Y
cells, in which JNK activation causes ROS generation,
which, in turn, leads to further activationof JNK. We
thus hypothesized that JNK activation might play a
crucial role in morphine-induced cytochrome c release
and consequent caspase-3 activation by increasing the
expression of the BH3-only protein Bim and decreasing
A
B
C
Fig. 5. Morphine (Mor) treatment differentially regulated the expression of Bcl-2 family members. (A, B) Morphine dose-dependently and
time-dependently increased the expression of Bim. Cells were exposed to various concentrations ofmorphine for 24 h or 4 m
M morphine
for various times, as indicated. Extracts from cells were subjected to 12% SDS ⁄ PAGE and immunoblotted with antibody against Bim. (C)
Morphine decreased Bcl-2 levels in a dose-dependent manner. Cells were treated with various concentrations ofmorphine for 48 h, and
extracts from cells were subjected to 12% SDS ⁄ PAGE and immunoblotted with antibodies against Bax and Bcl-2. (a) Representative
immunoblots for Bcl-2 and Bax. (b) Densitometric analysis of changes in levels of Bcl-2 ⁄ Bax. All images are representative of at least three
independent experiments yielding similar results. Values are means ± SEMs for at least three independent experiments.
Role of JNK signaling in morphine-induced apoptosis X. Lin et al.
2028 FEBS Journal 276 (2009) 2022–2036 ª 2009 Shanghai Institute of Materia Medica, Chinese Academy of Sciences. Journal compilation ª 2009 FEBS
Bcl-2 levels. To test this hypothesis, we determined
whether the selective inhibitor of JNK SP600125 and
the antioxidant NAC suppressed morphine-induced
changes in Bim and Bcl-2 expression, cytochrome c
release, and caspase-3 activation. As shown in Fig. 6,
pretreatment of cells with 20 lm SP600125 or 5 mm
NAC alone had no effects on Bim and Bcl-2 expression,
cytochrome c release, and caspase-3 activation.
However, in the presence of SP600125 or NAC, treat-
ment of cells with 4 mm morphine for 24 h failed to
increase Bim expression, decrease Bcl-2 levels, increase
cytochrome c release, or activate caspase-3, indicating
that the positive feedback amplification of JNK
activation by ROS and the consequent changes in the
expression of Bim and Bcl-2 may contribute to
morphine-induced cytochrome c release and caspase-3
activation.
SP600125, small interfering RNA (siRNA) against
JNK and NAC attenuated morphine-induced
apoptosis
Accumulating evidence shows that activationof the
JNK ⁄ c-Junpathway with subsequent enhancement of
cytochrome c release via induction of Bim expression
and reduction of Bcl-2 expression are key events
required for neuronal apoptosis [50,53]. In this study,
we found that SP600125 could inhibit or prevent the
morphine-induced occurrence of these molecular
events. Therefore, the last set of experiments addressed
the question of whether JNK-mediated cytochrome c
release and caspase-3 activationvia alteration of Bim
and Bcl-2 was correlated with morphine-induced apop-
tosis in SH-SY5Y cells. SH-SY5Y cells were treated
with 4 mm morphine for 48 h in the absence or pres-
ence of 20 lm SP600125 or SB203580, which were
added 30 min before morphine. Apoptotic cells were
measured by flow cytometry and phase contrast
microscopy. Morphine at 4 mm caused drastic apopto-
sis, and this apoptosis was substantially inhibited by
preincubation of the cells with the JNK inhibitor
SP600125 (20 lm; Fig. 7A). The involvement of JNK
in morphine-induced apoptosis was further investigated
in SH-SY5Y cells that had been transiently transfected
with siRNA against JNK mRNA. Transfection of
JNK siRNAs resulted in a decrease in the basal pro-
tein level of JNK and markedly suppressed the apop-
tosis of cells in response to morphine treatment
(Fig. 7B), indicating a pivotal role of the JNK ⁄ c-Jun
pathway in morphine-induced apoptosis. Given the
role of ROS in feedback amplification of JNK activa-
tion, we next investigated the effect of the antioxidant
NAC on morphine-induced apoptosis. As shown in
Fig. 7C, treatmentof cells with 4 mm morphine for
A B
Fig. 6. SP600125 and NAC suppressed morphine-induced changes in Bim and Bcl-2 expression, cytochrome c release and caspase-3 activa-
tion in SH-SY5Y cells. Cells were either left untreated or treated with 4 m
M morphine for 24 h, in the presence or absence of 20 lM
SP600125 or 5 mM NAC. Extracts from whole cells or the cytosol were subjected to 12% SDS ⁄ PAGE and immunoblotted with antibodies
against Bim, Bcl-2, cytochrome c, and cleaved caspase-3. (A) A representative image of immunoblots for Bim, Bcl-2, cytochrome c, and
cleaved caspase-3. (B) Densitometric analysis of changes in levels of Bim, Bcl-2, cytochrome c, and cleaved caspase-3. All images are repre-
sentative of three independent experiments yielding similar results. Data are means ± SEMs for three independent experiments. *P < 0.05
as compared with morphine.
X. Lin et al. Role of JNK signaling in morphine-induced apoptosis
FEBS Journal 276 (2009) 2022–2036 ª 2009 Shanghai Institute of Materia Medica, Chinese Academy of Sciences. Journal compilation ª 2009 FEBS 2029
48 h in the presence of 5 mm NAC greatly reduced
morphine-induced apoptosis, by 35% (from 57% in
the absence of NAC to 22% in the presence of NAC),
supporting its role in the amplification of JNK acti-
vation.
Discussion
In the present study, we demonstrated that chronic
high-dose morphinetreatment was able to cause apop-
totic cell death ofSH-SY5Y cells in an opioid recep-
tor-independent manner, consistent with previous
studies [9,32]. Moreover, we found that JNK signaling
played a central role in the regulation ofSH-SY5Y cell
apoptosis viaactivationof the mitochondria-dependent
pathway. We also demonstrated that a positive feed-
back cycle operates in SH-SY5Y cells, in which
morphine-mediated JNK activation caused ROS
generation, which in turn led to further activation of
JNK.
The activationof JNK by morphine (starting after
3 h of treatment) preceded ROS generation (starting
after 6 h of treatment), indicating that the JNK activa-
tion occurred upstream of the ROS generation.
SP600125 almost completely inhibited the accumula-
tion of morphine-induced intracellular O
2
)
, further
Mock –
–
–
–
+
+
SiRNA
JNK
Apoptosis (%)
80
60
40
20
0
Apoptosis
(%)
80
60
40
20
0
0
Concentration (m
M)
Concentration
(
mM
)
4
0 4
Apoptosis (%)
80
Mor
Mor + Mor
SiRNA JNK + Mor
Mor
SP600125 + Mor
SP203580 + Mor
*
*
*
*
*
60
40
20
0
Con NAC Mor NAC
+
Mor
Action
1.2
1.0
0.8
0.6
0.4
0.2
0.0
Ratio JNK/β-action
Con
Mock
SiRNA
A B
(a)(a)
(b)
(b)
C
Fig. 7. SP600125, siRNA against JNK and NAC attenuated morphine-induced apoptosis. (A) SP600125, but not SB203580, attenuated
morphine-induced apoptosis. Cells were treated with 4 m
M morphine for 48 h in the absence or presence of 20 lM SP600125 or 20 lM
SB203580. (a) Representative phase contrast microscopy images. (b) The apoptotic cells were detected by flow cytometry. (B) JNK siRNA
markedly decreased morphine-induced apoptosis. (a) Cells were transfected with 200 n
M JNK1 ⁄ 2 siRNA or Mock, and the protein levels of
JNK were determined by western blot after transfection for 24 h, and densitometric analysis of changes in the basal protein levels of JNK,
with *P < 0.05 in comparison with both untransfected and mock-transfected cells. (b) Cells were transfected with 200 n
M JNK1 ⁄ 2 siRNA or
Mock for 24 h, and then treated with 4 m
M morphine for 48 h. The apoptotic cells were detected by flow cytometry as described in Experi-
mental procedures. (C) NAC inhibited morphine-induced apoptosis. Cells were treated with 4 m
M morphine for 48 h in the absence or pres-
ence of 5 m
M NAC, and the apoptotic cells were detected by flow cytometry. All images are representative of at least three independent
experiments yielding similar results. Values are means ± SEMs for at least three independent experiments performed in triplicate.
*P < 0.05, **P < 0.01 as compared with morphine.
Role of JNK signaling in morphine-induced apoptosis X. Lin et al.
2030 FEBS Journal 276 (2009) 2022–2036 ª 2009 Shanghai Institute of Materia Medica, Chinese Academy of Sciences. Journal compilation ª 2009 FEBS
indicating that ROS generation was JNK-dependent.
Additional evidence to support JNK activation prior
to ROS generation was that NAC, a well-characterized
antioxidant, failed to prevent JNK activation induced
by 3 h ofmorphine treatment. Regulation of ROS gen-
eration by JNK has also been observed recently in the
fibroblast and PC3 prostate carcinoma cell lines
[47,48]. Our study further demonstrated that ROS were
released from mitochondria through opening of the
mPTP because the mPTP inhibitor CsA, but not DPI
and ALP, robustly attenuated morphine-induced ROS
generation. These results are consistent with the find-
ings reported by previous studies, showing that mPTP
opening increases ROS production in vivo [41] and in
isolated mitochondria [42,54], and that mPTP is the
target downstream of JNK activation [55], and is
inhibited by SP600125 [56]. Moreover, we also demon-
strated that ROS could in turn activate JNK in a posi-
tive feedback fashion, because NAC significantly
attenuated prolonged JNK activation induced by 12 h
of morphine treatment. In addition, CsA also attenu-
ated prolonged JNK activation induced by 12 h of
morphine treatment. Therefore, this study clearly
shows a route from JNK activation by morphine to
initiation of ROS release from mitochondria, the ROS,
in turn, activating JNK in a positive feedback fashion.
This novel route is not consistent with that reported
by previous studies, in which ROS generation initiated
JNK activation [45,57,58].
JNK can be activated by various stress stimuli. In
the present study, we showed that morphine treatment
resulted in sustained activationof JNK, consistent
with previous studies showing that prolonged exposure
to morphine activates JNK in neurons and other cell
lines [59,60]. We further demonstrated that activation
of JNK was necessary for the morphine-induced apop-
tosis by using the pharmacological inhibitor SP600125.
Inhibition of JNK activity by SP600125 led to decrease
of apoptotic cell death in SH-SY5Y cells. Additionally,
downregulation of endogenous JNK with transfected
specific siRNA resulted in resistance to the proapop-
totic effect of morphine. Moreover, NAC, which was
shown to suppress ROS-amplified JNK activation, also
robustly attenuated morphine-induced apoptosis in
SH-SY5Y cells. These results strongly suggest that
JNK signaling plays a pivotal role in morphine-
induced apoptosis.
JNK is thought to induce apoptosisvia transcription-
dependent and transcription-independent mechanisms.
We found that JNK-mediated morphine-induced apop-
tosis appeared to be transcription-dependent. Activa-
tion of JNK by morphine led to a robust increase
in the expression of the BH3-only protein Bim via
activation of the transcription factor c-Jun, and
this effect could be suppressed by SP600125. In addi-
tion, NAC attenuated morphine-induced Bim expres-
sion, whereas it inhibited morphine-induced
phosphorylation of JNK and c-Jun. It has been shown
that, in sympathetic neurons, activationof the JNK ⁄
c-Jun pathway and increased expression of Bim are
key events required for cytochrome c release and apop-
tosis following nerve growth factor withdrawal [50].
There is strong evidence that Bax and Bak are potent
regulators of cytochrome c release from mitochondria
under a variety of stress conditions. Recent evidence
has shown that BH3-only proteins (e.g. Bim, Bad,
HRK, and Bid) are essential for Bax and Bak activa-
tion. Bim has been shown to potentiate the proapop-
totic effects of Bax and Bak while concomitantly
suppressing the prosurvival function of Bcl-2 [61,62].
In agreement with these findings, we also demonstrated
that activationof the JNK ⁄ c-Junpathway by mor-
phine caused dramatic enhancement of cytochrome c
release and caspase-3 activation, both of which were
inhibited by SP600125. NAC also suppressed mor-
phine-induced cytochrome c release and caspase-3 acti-
vation, through its inhibition of the morphine-
activated JNK ⁄ c-Jun pathway. Our findings thus indi-
cate that Bim may be involved in the release of cyto-
chrome c and initiation of the intrinsic death pathway
in response to prolonged morphine treatment.
In addition to enhancement of the expression of the
proapoptotic protein Bim, prolonged morphine treat-
ment also dose-dependently decreased the expression
of the antiapoptotic protein Bcl-2 in a JNK-dependent
manner. Activationof JNK has been reported to
induce the phosphorylation of Bcl-2, leading to Bcl-2
degradation through the proteasome pathway [63,64].
SP60025 could inhibit the morphine-induced reduction
of Bcl-2 expression. Decreases in Bcl-2 expression by
prolonged morphinetreatment have been observed in
cell lines and in rat brain in previous in vitro and
in vivo studies [13,14,65]. However, Bax expression was
not significantly altered following prolonged morphine
treatment. As a result, the Bcl-2 ⁄ Bax ratio was
decreased. Bcl-2 can block cytochrome c release by
heterodimerizing with Bax [51,52]. Conversely, Bim
promotes cytochrome c release by freeing Bax to be
incorporated into the mitochondrial membrane [62].
Also, Bim can interact with Bax and induce a confor-
mational change that facilitates the formation of chan-
nels for release of cytochrome c [61]. Thus, morphine
seems to promote the proapoptotic effect of Bax by
both enhancement of Bim expression and downregula-
tion of Bcl-2 expression, leading to cytochrome c
release, caspase-3 activation, and apoptosis.
X. Lin et al. Role of JNK signaling in morphine-induced apoptosis
FEBS Journal 276 (2009) 2022–2036 ª 2009 Shanghai Institute of Materia Medica, Chinese Academy of Sciences. Journal compilation ª 2009 FEBS 2031
[...]... that prolonged, high-dosemorphinetreatment leads to apoptotic cell death through a mitochondria-dependent apoptotic pathway in SH-SY5Y cells JNK plays a pivotal role in morphine- induced cellapoptosisvia enhancement of the expression of the proapoptotic protein Bim and reduction of the expression of the antiapoptotic protein Bcl-2 ROS signaling exerts positive feedback regulation of JNK activity... growing cells Cell viability assay Cells were plated at a density of 1 · 104 cells per well in 96-well plates and incubated overnight, and then either treated for 48 h with various concentrations ofmorphine (0.5–4 mm), or treated with various concentrations of naloxone or PTX in the absence or presence of 2 mm morphine for 48 h Naloxone and PTX were added 30 min before morphine administration Cell viability...Role of JNK signaling in morphine- induced apoptosis It is noteworthy that, although our findings indicated that a typical opioid receptor-related mechanism was not involved in high-dose morphine- induced inhibition of proliferation and induction of apoptosis, whether or which receptors play a role in such growth inhibition and apoptosis is unclear A possible explanation for the action ofmorphine on SH-SY5Y. .. subtypes of SSTR endogenously [68], and activationof SSTR2 or SSTR3 appears to be linked to the induction ofcell growth arrest and apoptosis [69] Thus, SSTR might be one of the potential candidates for involvement in the antiproliferative and proapoptotic effects ofhigh-dosemorphine Currently, the possible mechanisms underlying highdose morphineactivationof JNK signals are being investigated in... previously [26] A total of 10 000 cells were acquired per sample, and data were analyzed using cellquest software (BD Biosciences, San Jose, CA, USA) Cells in the early stages ofapoptosis were annexin V-positive, whereas cells that were annexin V-positive and PI-positive were in the late stages ofapoptosis H2O2 and O2) assay Cells were seeded in six-well plates at 2 · 105 cells per well and incubated... K & Colucci WS (2003) Beta-adrenergic receptor-stimulated apoptosis in cardiac myocytes is mediated by reactive oxygen species ⁄ c-Jun NH2-terminal kinase-dependent activationof the mitochondrial pathway Circ Res 92, 136–138 59 Fan XL, Zhang JS, Zhang XQ & Ma L (2003) Chronicmorphinetreatment and withdrawal induce up-regulation ofc-JunN-terminal kinase 3 gene expression in rat brain Neuroscience... Journal 276 (2009) 2022–2036 ª 2009 Shanghai Institute of Materia Medica, Chinese Academy of Sciences Journal compilation ª 2009 FEBS 2033 Role of JNK signaling in morphine- induced apoptosis 10 11 12 13 14 15 16 17 18 19 20 21 22 G (2003) G protein-independent G1 cell cycle block and apoptosis with morphine in adenocarcinoma cells: involvement of p53 phosphorylation Cancer Res 63, 1846–1852 Yin DL,... activationof mitochondrial apoptosis machinery by c-JunN-terminal kinase in adult cardiac myocytes J Biol Chem 277, 10244–10250 46 Saeki K, Kobayashi N, Inazawa Y, Zhang H, Nishitoh H, Ichijo H, Isemura M & Yuo A (2002) Oxidationtriggered c-JunN-terminal kinase (JNK) and p38 mito- Role of JNK signaling in morphine- induced apoptosis 47 48 49 50 51 52 53 54 55 56 57 gen-activated protein (MAP) kinase pathways... representative of three independent experiments Apoptosis assay Cells were plated at a density of 2 · 105 cells per well in sixwell plates and incubated overnight, and then treated with various concentrations ofmorphine (1–4 mm) in the absence or presence of 20 lm SP600125, 20 lm SB203580 or 5 mm NAC for 48 h NAC, SP600125 or SB203580 were added 30 min prior to morphine stimulation Apoptotic cells were... Selective stimulation of somatostatin receptor subtypes: differential effects on Ras ⁄ MAP kinase pathway and cell proliferation in human neuroblastoma cells FEBS Lett 481, 271–276 69 Teijeiro R, Rios R, Costoya JA, Castro R, Bello JL, Devesa J & Arce VM (2002) Activationof human somatostatin receptor 2 promotesapoptosis through a mechanism that is independent from induction of p53 Cell Physiol Biochem . Chronic high-dose morphine treatment promotes SH-SY5Y
cell apoptosis via c-Jun N-terminal kinase-mediated
activation of mitochondria-dependent pathway
Xin. effect of morphine on SH-SY5Y cell pro-
liferation, equal numbers of cells were treated with
various concentrations of morphine (0.5–4 mm) for
48 h. Cell viability