Cytochrome c Oxidase Inhibition by N-Retinyl-N-
retinylidene Ethanolamine, a Compound Suspected
to Cause Age-Related Macula Degeneration
Hamdy Shaban, Paolo Gazzotti, and Christoph Richter
1
Institute of Biochemistry, Swiss Federal Institute of Technology (ETH), Universita ¨ tstr. 16, CH-8092 Zurich, Switzerland
Received July 5, 2001, and in revised form July 23, 2001; published online September 12, 2001
The endogenous lipophilic and cationic compound
N-retinyl-N-retinylidene ethanolamine (A2E) is sus-
pected to cause age-related macula degeneration. It
inhibits cytochrome c oxidase, detaches proapoptotic
proteins from mitochondria, and induces apoptosis in
mammalian retinal pigment epithelial cells (M. Suter,
C. E. Reme ´ , C. Grimm, A. Wenzel, M. Ja ¨a ¨ ttela, P. Esser,
N. Kociok, M. Leist, and C. Richter, 2000, J. Biol. Chem.
275, 39625–39630). The inhibition of cytochrome c oxi-
dase is highly specific for A2E and is observed with the
solubilized and reconstituted enzyme. In the dark, in-
hibition is overcome by cardiolipin or other acidic
phospholipids. With illumination, inhibition is stron-
ger, becomes complete with prolonged exposure, and
is then no longer abrogated by cardiolipin. Cardio-
lipin effectively displaces A2E from cytochrome c oxi-
dase, suggesting noncovalent binding of A2E to the
enzyme. We conclude that A2E is a potent cytochrome
c oxidase-specific inhibitor which interferes with the
binding of cytochrome c to cytochrome c oxidase and,
in the light, causes persistent modifications of the en-
zyme. © 2001 Academic Press
Key Words: age-related macula degeneration; A2E;
apoptosis; cardiolipin; cytochrome c; cytochrome c
oxidase.
Age-related macular degeneration (AMD)
2
affects
about one-fifth of the population older than 65 years
and is one of the main causes of poor vision in the
elderly in industrialized nations (1). It is accompanied
by photoreceptor damage in the macula. The primary
lesion in AMD appears to reside in the retinal pigment
epithelium (RPE), possibly resulting from its high rate
of degradation. A better understanding of the patho-
genesis of AMD is needed to successfully prevent
and/or treat this disease.
Accumulation of the autofluorescent age pigment li-
pofuscin in RPE cell phagolysosomes is a predicament
for the development of AMD. Lipofuscin harbors two
retinoids, the lipophilic cations N-retinyl-N-retinyli-
dene ethanolamine (A2E) and its isoform, iso-A2E, first
isolated from eyes of old humans (2, 3). The molecules
can be synthesized in vitro from two retinals and one
ethanolamine (3), both components of the photorecep-
tor outer segment membranes, where 11-cis-retinal
serves as the chromophore of the visual pigment rho-
dopsin and phosphatidylethanolamine is an abundant
membrane phospholipid.
We recently showed that A2E induces apoptosis in
cultures of various mammalian cell types, including
RPE cells (4). A2E-induced apoptosis is preceeded by a
decline in mitochondrial activity and accompanied by
translocation of cytochrome c and apoptosis-inducing
factor into the cytoplasm and nucleus. A2E, but not
iso-A2E, targets the function of cytochrome c oxidase,
whereas respiratory chain activity upstream of cyto-
chrome c is not affected by A2E. cytochrome c oxidase
activity can be restored by added cardiolipin (1,3-
diphosphatidylglycerol, 1,3-DPG).
Here we investigate in more detail the inhibition of
cytochrome c oxidase by A2E. Inhibition is highly spe-
1
To whom correspondence should be addressed: Fax: +41-1-
6321121. E-mail: richter@bc.biol.ethz.ch.
2
Abbreviations used: AMD, age-related macular degeneration;
A2E, N-retinyl-N-retinylidene ethanolamine, 2-[2,6-dimethyl-8-
(2,6,6-trimethyl-1-cyclohexen-1-yl)-1E,3E,5E,7E-octatetraenyl]-1-
(2-hydroxyethyl)-4-[4-methyl-6-(2,6,6-trimethyl-1-cyclohexen-1-yl)-
1E,3E,5E-hexatrienyl]-pyridinium; 1,3-DPG, 1,3-diphosphatidyl-
glycerol, cardiolipin; IC
50
, concentration necessary to achieve 50%
inhibition; RPE, retinal pigment epithelium; TMPD, tetramethyl-p-
phenylenediamine.
0003-9861/01 $35.00 111
Copyright © 2001 by Academic Press
All rights of reproduction in any form reserved.
Archives of Biochemistry and Biophysics
Vol. 394, No. 1, October 1, pp. 111–116, 2001
doi:10.1006/abbi.2001.2535, available online at http://www.idealibrary.com on