Inflammatory neurodegeneration is neuronal degeneration due to inflammation, and is thought to contribute to neuronal loss in infectious, ischemic, traumatic and neurodegenerative brain pathologies. We have identified three mechanisms by which inflamed glia kill neurons: iNOS, PHOX and phagocytosis. Inflamed microglia (brain macrophages) and astrocytes express inducible nitric oxide synthase (iNOS), producing high levels of NO, which inhibits mitochondrial respiration at cytochrome oxidase in competition with oxygen, sensitising neurons to hypoxic death. In addition, NO-derivatives peroxynitrite and S-nitrosothiols inactivate mitochondrial complex I, stimulating oxidant production by mitochondria. The phagocyte NADPH oxidase (PHOX) is constitutively expressed by microglia, and we find that H2O2 from PHOX activation is required for inflammatory activation of microglia. Alternatively, superoxide from PHOX can react with NO from iNOS to produce peroxynitrite that induces reversible phosphatidyserine (PS) exposure on neurons, which induces microglia to phagocytose viable neurons. We found inflammatory activation of neuronal-glial co-cultures with LPS, LTA, TNF-αor α-amyloid, or in vivo with LPS results, in progressive loss of neurons, accompanied by microglial phagocytosis of neurons, and is prevented by blocking phagocytosis or knockout of PS-binding adaptor protein MFG-E8. Cell death by primary phagocytosis may constitute a novel form of cell death: ‘phagoptosis’. References M. Fricker, J.J. Neher, J.W. Zhao, C. Thery, A.M. Tolkovsky, G.C. Brown, MFG-E8 mediates primary phagocytosis of viable neurons during neuroinflammation. J Neurosci. 32 (2012) 2657–2666. J.J. Neher, U. Neniskyte, Z.W. Zhao, A. Bal-Price, A.M. Tolkovsky, G.C. Brown, Inhibition of microglial phagocytosis is sufficient to prevent inflammatory neuronal death. J. Immunol. 186 (2011) 4973–4983. G.C. Brown, J.J. Neher, Inflammatory neurodegeneration and mechanisms of microglial killing of neurons. Mol. Neurobiol. 41 (2010) 242–247. G.C. Brown, Nitric oxide and neuronal death. Nitric Oxide 23 (2010) 153–165.
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