The mitochondrial permeability transition pore (mPTP or MPTP; also referred to as PTP, mTP, or MTP) is a protein pore complex that forms in the inner mitochondrial membrane under certain pathological conditions such as traumatic brain injury, ischemia, and stroke. Opening of the pore causes an increase in the permeability of the mitochondrial membrane to solutes with a molecular mass less than 1,500 daltons, leading to loss of membrane potential, swelling of the organelle, rupture of the outer membrane, and eventual cell death. The mPTP is thought to be regulated by multiple mitochondrial proteins. Historically, Cyclophilin D and the TSPO (formerly the peripheral benzodiazepine receptor) have been considered central components. In 2025, the AAA+ ATPase protein ATAD3A was identified as a novel upstream regulator of mPTP opening. Loss of ATAD3A was shown to prevent calcium-induced pore formation and render mitochondria insensitive to cyclosporin A, suggesting it acts upstream of Cyclophilin D and is essential for permeability transition under stress.
Roles in pathology The MPTP was originally discovered by Haworth and Hunter in 1979 and has been found to be involved in neurodegeneration, hepatotoxicity from Reye-related agents, cardiac necrosis and nervous and muscular dystrophies among other deleterious events inducing cell damage and death. MPT is one of the major causes of cell death in a variety of conditions. For example, it is key in neuronal cell death in excitotoxicity, in which overactivation of glutamate receptors causes excessive calcium entry into the cell. MPT also appears to play a key role in damage caused by ischemia, as occurs in a heart attack and stroke. However, research has shown that the MPT pore remains closed during ischemia, but opens once the tissues are reperfused with blood after the ischemic period, playing a role in reperfusion injury. MPT is also thought to underlie the cell death induced by Reye's syndrome, since chemicals that can cause the syndrome, like salicylate and valproate, cause MPT. MPT may also play a role in mitochondrial autophagy. Cells exposed to toxic amounts of Ca2+ ionophores also undergo MPT and death by necrosis.
Structure While the MPT modulation has been widely studied, little is known about its structure. Initial experiments by Szabó and Zoratti proposed the MPT may comprise Voltage Dependent Anion Channel (VDAC) molecules. Nevertheless, this hypothesis was shown to be incorrect as VDAC−/− mitochondria were still capable to undergo MPT. Further hypothesis by Halestrap's group convincingly suggested the MPT was formed by the inner membrane Adenine Nucleotide Translocase (ANT), but genetic ablation of such protein still led to MPT onset. Thus, the only MPTP components identified so far are the TSPO (previously known as the peripheral benzodiazepine receptor) located in the mitochondrial outer membrane and cyclophilin-D in the mitochondrial matrix. Mice lacking the gene for cyclophilin-D develop normally, but their cells do not undergo Cyclosporin A-sensitive MPT, and they are resistant to necrotic death from ischemia or overload of Ca2+ or free radicals. However, these cells do die in response to stimuli that kill cells through apoptosis, suggesting that MPT does not control cell death by apoptosis. Recent findings have identified ATAD3A, an inner mitochondrial membrane AAA+ ATPase, as a critical upstream modulator of mPTP formation, acting via regulation of mitochondrial cholesterol transport and cyclophilin D localization.
Factors in MPT induction Various factors enhance the likelihood of MPTP opening. In some mitochondria, such as those in the central nervous system, high levels of Ca2+ within mitochondria can cause the MPT pore to open. This is possibly because Ca2+ binds to and activates Ca2+ binding sites on the matrix side of the MPTP. MPT induction is also due to the dissipation of the difference in voltage across the inner mitochondrial membrane (known as transmembrane potential, or Δψ). In neurons and astrocytes, the contribution of membrane potential to MPT induction is complex, see. The presence of free radicals, another result of excessive intracellular calcium concentrations, can also cause the MPT pore to open. Other factors that increase the likelihood that the MPTP will be induced include the presence of certain fatty acids, and inorganic phosphate. However, these factors cannot open the pore without Ca2+, though at high enough concentrations, Ca2+ alone can induce MPT. Stress in the endoplasmic reticulum can be a factor in triggering MPT. Conditions that cause the pore to close or remain closed include acidic conditions, high concentrations of ADP, high concentrations of ATP, and high concentrations of NADH. Divalent cations like Mg2+ also inhibit MPT, because they can compete with Ca2+ for the Ca2+ binding sites on the matrix and/or cytoplasmic side of the MPTP.
… excerpt ends here. Continue reading the full article.
