Extracellular mtDNA activates NF-κB via toll-like receptor 9 and induces cell death in cardiomyocytes

  • Marte Bliksøen
  • Lars Henrik Mariero
  • May Kristin Torp
  • Anton Baysa
  • Kirsti Ytrehus
  • Fred Haugen
  • Ingebjørg Seljeflot
  • Jarle Vaage
  • Guro Valen
  • Kåre-Olav StensløkkenEmail author
Original Contribution


Acute myocardial infarction (AMI) causes sterile inflammation, which exacerbates tissue injury. Elevated levels of circulating mitochondrial DNA (mtDNA) have been associated with AMI. We hypothesized that mtDNA triggers an innate immune response via TLR9 and NF-κB activation, causing cardiomyocyte injury. Murine cardiomyocytes express TLR9 mRNA and protein and were able to internalize fluorescently labeled mouse mtDNA. Incubation of human embryonic kidney cells with serum from AMI patients containing naturally elevated levels of mtDNA induced TLR9-dependent NF-κB activity. This effect was mimicked by isolated mtDNA. mtDNA activated NF-κB in reporter mice both in vivo and in isolated cardiomyocytes. Moreover, incubation of isolated cardiomyocytes with mtDNA induced cell death after 4 and 24 h. Laser confocal microscopy showed that incubation of cardiomyocytes with mtDNA accelerated mitochondrial depolarization induced by reactive oxygen species. In contrast to mtDNA, isolated total DNA did not activate NF-κB nor induce cell death. In conclusion, mtDNA can induce TLR9-dependent NF-κB activation in reporter cells and activate NF-κB in cardiomyocytes. In cardiomyocytes, mtDNA causes mitochondrial dysfunction and death. Endogenous mtDNA in the extracellular space is a danger signal with direct detrimental effects on cardiomyocytes.


Mitochondrial DNA mtDNA Inflammation TLR9 NF-κB Myocardial infarction 



Harald Carlsen and Jan Øivind Moskaug, Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, kindly provided NF-κB luciferase reporter mice. The authors acknowledge the expertise of Gerbrand Koster for technical advice (NorMIC imaging cluster, Department of Biosciences, University of Oslo) and technical assistance was expertly performed by Torun Flatebø and Sowmya Sanjeevini.


This work was supported by the Norwegian Health Association, UNIFOR, the Norwegian Research Council, the University of Oslo, and the Novo Nordisk Foundation. Marte Bliksøen was supported by a grant from South-Eastern Regional Health Trust.

Compliance with ethical standards

Conflict of interest


Supplementary material

395_2016_553_MOESM1_ESM.tif (1 mb)
Supplementary material 1 (TIFF 1029 kb) Figure S1 legend: 1 % agarose gel with SYBR Safe DNA gel stain (Invitrogen) showing DNA isolated from murine liver or from mitochondrial extracts from murine liver, eluted in buffer and subjected to sonication for 2 × 30 s or sham treatment with the same sample handling but without sonication. Arrow: heavy DNA band present in unsonicated mitochondrial DNA sample (mtDNA), which is absent from the sonicated samples (mtDNAs), indicating DNA fragmentation. There is evidence of some DNA degradation in the non-sonicated samples, but the mtDNAs sample shows denser smearing in the ~ 300 bp region. mtDNA (mitochondrial DNA), mtDNAs (sonicated mtDNA), tDNA (total DNA), tDNAs (sonicated total DNA) and 1 kb ladder
395_2016_553_MOESM2_ESM.tif (505 kb)
Supplementary material 2 (TIFF 505 kb) Figure S2 legend: Figure shows remaining primary mouse cardiomyocytes after different DNA agonist treatment for 4 and 24 h. There is a decrease in the number of viable cells after 24 h in control, but the number of cells lost is significantly higher in the cardiomyocytes treated either with mtDNA (B) or CpGC (D). Statistical differences was tested with Wilcoxon matched-pairs signed rank test (* p < 0.05)
395_2016_553_MOESM3_ESM.avi (42 mb)
Supplementary material 3 (AVI 43012 kb) Video S3 The video shows a confocal Z-stack with mouse cardiomyocytes exposed to Cy-5 tagged mtDNA. The mtDNA is present in the peri-nuclear area, but also in the cytosol


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Marte Bliksøen
    • 1
    • 2
    • 5
    • 6
  • Lars Henrik Mariero
    • 1
    • 2
  • May Kristin Torp
    • 1
    • 2
  • Anton Baysa
    • 1
    • 2
  • Kirsti Ytrehus
    • 3
  • Fred Haugen
    • 1
    • 2
  • Ingebjørg Seljeflot
    • 2
    • 4
    • 6
  • Jarle Vaage
    • 5
    • 6
  • Guro Valen
    • 1
    • 2
  • Kåre-Olav Stensløkken
    • 1
    • 2
    • 7
    Email author
  1. 1.Department of Molecular Medicine, Faculty of Medicine, Institute of Basic Medical SciencesUniversity of Oslo (UiO)OsloNorway
  2. 2.Center for Heart Failure Research, UiOOsloNorway
  3. 3.Cardiovascular Research Group, Department of Medical Biology, Faculty of Health SciencesUniversity of TromsøTromsøNorway
  4. 4.Department of Cardiology, Center for Clinical Heart ResearchOslo University HospitalOsloNorway
  5. 5.Department of Emergency Medicine and Intensive CareOslo University HospitalOsloNorway
  6. 6.Institute of Clinical Medicine, UiOOsloNorway
  7. 7.Division of Physiology, Department of Molecular MedicineInstitute of Basic Medical ScienceOsloNorway

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