• Users Online: 1400
  • Home
  • Print this page
  • Email this page

 Table of Contents  
Year : 2017  |  Volume : 12  |  Issue : 11  |  Page : 1807-1808

Targeting mitoNEET with pioglitazone for therapeutic neuroprotection after spinal cord injury

1 Spinal Cord and Brain Injury Research Center, University of Kentucky, Lexington, KY; Departments of Physiology, University of Kentucky, Lexington, KY, USA
2 Spinal Cord and Brain Injury Research Center, University of Kentucky, Lexington, KY; Departments of Neuroscience, University of Kentucky, Lexington, KY; Veterans Administration Medical Center, University of Kentucky, Lexington, KY, USA

Date of Acceptance12-Oct-2017
Date of Web Publication6-Dec-2017

Correspondence Address:
Alexander G Rabchevsky
Spinal Cord and Brain Injury Research Center, University of Kentucky, Lexington, KY; Departments of Physiology, University of Kentucky, Lexington, KY
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1673-5374.219040

Rights and Permissions

How to cite this article:
Rabchevsky AG, Patel SP, Sullivan PG. Targeting mitoNEET with pioglitazone for therapeutic neuroprotection after spinal cord injury. Neural Regen Res 2017;12:1807-8

How to cite this URL:
Rabchevsky AG, Patel SP, Sullivan PG. Targeting mitoNEET with pioglitazone for therapeutic neuroprotection after spinal cord injury. Neural Regen Res [serial online] 2017 [cited 2022 Jan 24];12:1807-8. Available from: http://www.nrronline.org/text.asp?2017/12/11/1807/219040

There is mounting evidence that targeting mitochondrial dysfunction following neurotrauma could be key in developing effective therapeutic strategies since mitochondria are known to play a major role in cellular bioenergetics, function, and survival following traumatic spinal cord injury (SCI) (Rabchevsky et al., 2011). Our research group is one of the pioneers in targeting mitochondrial dysfunction to foster functional neuroprotection, having documented that pharmacological maintenance of mitochondrial function acutely results in long-term neuroprotection and improved functional recover. We have recently reported that treatment with the pleiotropic drug, pioglitazone, maintains acute mitochondrial integrity correlated with chronic tissue sparing and functional recovery after contusion SCI, but that this was not correlated with altered neuroinflammation (Patel et al., 2017). We herein propose that the mechanism(s) by which pioglitazone confers neuroprotection may not be entirely dependent upon its activation of peroxisome proliferator activated receptor (PPAR), a member of nuclear receptor superfamily that can heterodimerize in a ligand-dependent and -independent manner to regulate gene expression of multiple molecular processes. A class of drugs used to treat type 2 diabetes, called thiazolidinediones, can modulate PPAR-γ therapeutic effects. Also called glitazones, these drugs include pioglitazone, rosiglitazone, troglitazone and ciglitazone, which are reported to provide their therapeutic effects through varying interactions with PPAR-γ (Park et al., 2007).

While it has been hypothesized that PPAR-γ modulation of inflammation is the basis for reported therapeutic efficacy after neurotrauma, it is our contention that the noted anti-inflammatory effects of pioglitazone following neurotrauma are indirect and based, in part, on tissue preservation due to mitochondrial homeostasis and, consequently, greater functional neuroprotection. Similar to our recent report after SCI (Patel et al., 2017), we previously found that following contusion traumatic brain injury (TBI), pioglitazone attenuated mitochondria dysfunction and improved both tissue sparing and behavioral outcome, but without altering neuroinflammation (Sauerbeck et al., 2011). Accordingly, others used PPAR antagonists to show that the neuroprotective effects of pioglitazone treatment after TBI were independent of PPAR-γ activation (Thal et al., 2011). To further support our alternative hypothesis, studies have shown that pioglitazone binds to mitoNEET, a novel mitochondrial membrane protein, and that pioglitazone binding to mitoNEET is able to inhibit its [2Fe-2S] cluster transfer upon binding (see Tamir et al., 2015 and references within). However, the role of such a mechanism in providing therapy after central nervous system (CNS) injury is unknown, although it may be related to prevention of its dimerization.

MitoNEET is a protein localized in the brain, liver and skeletal muscles of rodents, a finding long after the discovery that pioglitazone has a binding affinity for the mitochondrial membrane that is mediated through a new m-17 kDa protein, later termed mitoNEET (Tamir et al., 2015). At the time of its discovery, mitoNEET was proposed to be a pivotal protein for mitochondrial metabolism that had the potential of being modulated by pioglitazone. Since its initial discovery, the exact role of mitoNEET in the cell remains uncertain. However, a handful of groups have studied mitoNEET's protein dynamics and suggested one possible role is to be a shuttle protein for the mitochondria (Tamir et al., 2015). Additionally, in mitoNEET knockout mice the mitochondria have decreased oxidative capacity, which suggests that it may be pivotal in controlling the rate of mitochondrial respiration, notably as a redox-sensitive protein that can be reduced by biological thiols such as glutathione (GSH), reversing the effect of mitoNEET oxidation (Tamir et al., 2015). This may account for our demonstration that novel GSH precursors prevent mitochondrial dysfunction and afford neuroprotection following traumatic SCI and TBI (Pandya et al., 2014; Patel et al., 2014), and we have more recently reported on the identification of small molecules that bind to mitoNEET that might be targeted pharmacologically after CNS trauma (Geldenhuys et al., 2016; Yonutas et al., 2016). These ligands are built on the glitazone backbone by truncating the PPAR binding moiety (Tamir et al., 2015), allowing these novel compounds to target mitoNEET directly without any subsequent direct PPAR activation.

While we have documented that pioglitazone administered at 15 minutes or 3 hours after SCI significantly maintains mitochondrial respiration 24 hours post-injury [Figure 1]A, our recent findings indicate that pioglitazone is neuroprotective following SCI by maintaining mitochondrial homeostasis via direct interactions with mitoNEET. Specifically, pioglitazone administration to mitoNEET knockout (KO) (–/–) mice does not maintain mitochondrial function following SCI [Figure 1]B. Therefore, unlike beneficial effects seen in wild-type (WT) mice, pioglitazone treatment was ineffective at improving mitochondrial respiration in mitoNEET KO mice.
Figure 1: Pioglitazone (Pio) is ineffective at maintaining mitochondrial state III respiration (OCR) in mitoNEET knockout (KO) mice.
(A) At 24 hours after traumatic spinal cord injury (SCI) (vehicle) in wild-type (WT) mice, there was a significant reduction in OCR (oxidative phosphorylation), as well as NADH-linked electron transport system (ETS) (state V–I) capacity. Administration of Pio (10 mg/kg) at 15 minutes or 3 hours post-injury followed by a booster at 24 hours significantly maintained mitochondrial respiration at 25 hours post-injury (Patel et al., 2017). (B) Compared to sham, SCI also resulted in reduced mitochondrial respiration in mitoNEET KO mice. However, unlike WT, similar treatment with 10 mg/kg Pio in injured mitoNEET KO mice did not restore mitochondrial respiration at 25 hours post-SCI. Bars represent the mean ± SEM, n = 7–10/group (A), 3/group (B). *P < 0.05, vs. sham group; #P < 0.05, vs. vehicle group.1,000

Click here to view

Collectively, our data provide a foundation for the novel hypothesis that pioglitazone benefits following SCI are dependent upon its interactions with mitoNEET. Accordingly, ongoing experiments are directly testing this hypothesis to establish, mechanistically, the basis for pioglitazone neuroprotection with the ultimate goal of using novel specific mitoNEET ligands as novel therapeutics for both SCI and TBI, as well as a wide range of neurological disease states.

This work was funded by NIH R21NS096670 (AGR), Craig H. Neilsen Foundation 476719 (AGR), Kentucky Spinal Cord and Head Injury Research Trust #15-14A (PGS), Veterans Affairs Merit Review Award #I01BX003405 (PGS), University of Kentucky Spinal Cord and Brain Injury Center Chair Endowments (AGR & PGS), NIH/NINDS 2P30NS051220.[10]

Plagiarism check: Checked twice by iThenticate.

Peer review: Externally peer reviewed.

Open peer review reports:

Reviewer 1: Joaquin Martí-clúa, Universitat Autònoma de Barcelona, Spain.

Comments to authors: After carefully reading this manuscript, my view is that this work has been very well carried out. It is suitable for publication in the Neural Regeneration Research. The continuation of this work may provide a novel strategy of benefit to patients with spinal cord injury.

Reviewer 2: Paul Lu, University of California San Diego, USA.

Comments to authors: This is a prospect following a recent publication titled “Pioglitazone treatment following spinal cord injury maintains acute mitochondrial integrity and increases chronic tissue sparing and functional recovery” in Exp Neurol by Dr. Alexander Rabchevsky's group. This study shows different mechanism of pioglitazone treatment after SCI: maintenance of acute mitochondrial bioenergetics. A recent study demonstrates that pioglitazone can bind to a mitochondrial membrane protein called mitoNEET, which may involve maintenance of mitochondrial respiration. This prospect is well-written and discusses the future direction to exploit this potential treatment for spinal cord injury.

  References Top

Geldenhuys WJ, Yonutas HM, Morris DL, Sullivan PG, Darvesh AS, Leeper TC (2016) Identification of small molecules that bind to the mitochondrial protein mitoNEET. Bioorg Med Chem Lett 26:5350-5353.  Back to cited text no. 1
Pandya JD, Readnower RD, Patel SP, Yonutas HM, Pauly JR, Goldstein GA, Rabchevsky AG, Sullivan PG (2014) N-acetylcysteine amide confers neuroprotection, improves bioenergetics and behavioral outcome following TBI. Exp Neurol 257:106-113.  Back to cited text no. 2
Park SW, Yi JH, Miranpuri G, Satriotomo I, Bowen K, Resnick DK, Vemuganti R (2007) Thiazolidinedione class of peroxisome proliferator-activated receptor gamma agonists prevents neuronal damage, motor dysfunction, myelin loss, neuropathic pain, and inflammation after spinal cord injury in adult rats. J Pharmacol Exp Ther 320:1002-1012.  Back to cited text no. 3
Patel SP, Cox DH, Gollihue JL, Bailey WM, Geldenhuys WJ, Gensel JC, Sullivan PG, Rabchevsky AG (2017) Pioglitazone treatment following spinal cord injury maintains acute mitochondrial integrity and increases chronic tissue sparing and functional recovery. Exp Neurol 293:74-82.  Back to cited text no. 4
Patel SP, Sullivan PG, Pandya JD, Goldstein GA, VanRooyen JL, Yonutas HM, Eldahan KC, Morehouse J, Magnuson DS, Rabchevsky AG (2014) N-acetylcysteine amide preserves mitochondrial bioenergetics and improves functional recovery following spinal trauma. Exp Neurol 257:95-105.  Back to cited text no. 5
Rabchevsky AG, Patel SP, Springer JE (2011) Pharmacological interventions for spinal cord injury: where do we stand? How might we step forward? Pharmacol Ther 132:15-29.  Back to cited text no. 6
Sauerbeck A, Gao J, Readnower R, Liu M, Pauly JR, Bing G, Sullivan PG (2011) Pioglitazone attenuates mitochondrial dysfunction, cognitive impairment, cortical tissue loss, and inflammation following traumatic brain injury. Exp Neurol 227:128-135.  Back to cited text no. 7
Tamir S, Paddock ML, Darash-Yahana-Baram M, Holt SH, Sohn YS, Agranat L, Michaeli D, Stofleth JT, Lipper CH, Morcos F, Cabantchik IZ, Onuchic JN, Jennings PA, Mittler R, Nechushtai R (2015) Structure-function analysis of NEET proteins uncovers their role as key regulators of iron and ROS homeostasis in health and disease. Biochim Biophys Acta 1853:1294-1315.  Back to cited text no. 8
Thal SC, Heinemann M, Luh C, Pieter D, Werner C, Engelhard K (2011) Pioglitazone reduces secondary brain damage after experimental brain trauma by PPAR-gamma-independent mechanisms. J Neurotrauma 28:983-993.  Back to cited text no. 9
Yonutas HM, Vekaria HJ, Sullivan PG (2016) Mitochondrial specific therapeutic targets following brain injury. Brain Res 1640:77-93.  Back to cited text no. 10


  [Figure 1]

This article has been cited by
1 Rescuing mitochondria in traumatic brain injury and intracerebral hemorrhages - A potential therapeutic approach
Meenakshi Ahluwalia,Manish Kumar,Pankaj Ahluwalia,Scott Rahimi,John R. Vender,Raghavan P. Raju,David C. Hess,Babak Baban,Fernando L. Vale,Krishnan M. Dhandapani,Kumar Vaibhav
Neurochemistry International. 2021; : 105192
[Pubmed] | [DOI]
2 Cardiac-specific loss of mitoNEET expression is linked with age-related heart failure
Takaaki Furihata,Shingo Takada,Naoya Kakutani,Satoshi Maekawa,Masaya Tsuda,Junichi Matsumoto,Wataru Mizushima,Arata Fukushima,Takashi Yokota,Nobuyuki Enzan,Shouji Matsushima,Haruka Handa,Yoshizuki Fumoto,Junko Nio-Kobayashi,Toshihiko Iwanaga,Shinya Tanaka,Hiroyuki Tsutsui,Hisataka Sabe,Shintaro Kinugawa
Communications Biology. 2021; 4(1)
[Pubmed] | [DOI]
3 Clinically relevant mitochondrial-targeted therapy improves chronic outcomes after traumatic brain injury
W Brad Hubbard, Malinda L Spry, Jennifer L Gooch, Amber L Cloud, Hemendra J Vekaria, Shawn Burden, David K Powell, Bruce A Berkowitz, Werner J Geldenhuys, Neil G Harris, Patrick G Sullivan
Brain. 2021; 144(12): 3788
[Pubmed] | [DOI]
4 Defects in CISD-1, a mitochondrial iron-sulfur protein, lower glucose level and ATP production in Caenorhabditis elegans
Kuei-Ching Hsiung,Kuan-Yu Liu,Ting-Fen Tsai,Sawako Yoshina,Shohei Mitani,Bertrand Chin-Ming Tan,Szecheng J. Lo
Biomedical Journal. 2020;
[Pubmed] | [DOI]
5 Bioenergetic restoration and neuroprotection after therapeutic targeting of mitoNEET: New mechanism of pioglitazone following traumatic brain injury
Heather M. Yonutas,W. Brad Hubbard,Jignesh D. Pandya,Hemendra J. Vekaria,Werner J. Geldenhuys,Patrick G. Sullivan
Experimental Neurology. 2020; 327: 113243
[Pubmed] | [DOI]
6 Mitochondria focused neurotherapeutics for spinal cord injury
Alexander G. Rabchevsky,Felicia M. Michael,Samir P. Patel
Experimental Neurology. 2020; 330: 113332
[Pubmed] | [DOI]
7 Diabetes Mellitus and Parkinsonęs Disease: Shared Pathophysiological Links and Possible Therapeutic Implications
Abdallah Hassan,Rajan Sharma Kandel,Rohi Mishra,Jeevan Gautam,Amer Alaref,Nusrat Jahan
Cureus. 2020;
[Pubmed] | [DOI]
8 The Relevance of Insulin Action in the Dopaminergic System
Francesca Fiory,Giuseppe Perruolo,Ilaria Cimmino,Serena Cabaro,Francesca Chiara Pignalosa,Claudia Miele,Francesco Beguinot,Pietro Formisano,Francesco Oriente
Frontiers in Neuroscience. 2019; 13
[Pubmed] | [DOI]
9 Cell cycle and complement inhibitors may be specific for treatment of spinal cord injury in aged and young mice: Transcriptomic analyses
Ming Hao,Xin-ran Ji,Hua Chen,Wei Zhang,Li-cheng Zhang,Li-hai Zhang,Pei-fu Tang,Ning Lu
Neural Regeneration Research. 2018; 13(3): 518
[Pubmed] | [DOI]
10 Efficacy of chitosan and sodium alginate scaffolds for repair of spinal cord injury in rats
Zi-ang Yao,Feng-jia Chen,Hong-li Cui,Tong Lin,Na Guo,Hai-ge Wu
Neural Regeneration Research. 2018; 13(3): 502
[Pubmed] | [DOI]


Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

  In this article
Article Figures

 Article Access Statistics
    PDF Downloaded348    
    Comments [Add]    
    Cited by others 10    

Recommend this journal