Restoration of Ca²⁺-inhibited oxidative phosphorylation in cardiac mitochondria by mitochondrial Ca²⁺ unloading

Mitochondria, the major source of cellular ATP, display high vulnerability to metabolic stress, in particular to excessive Ca²⁺ loading. Here, we show that Ca²⁺-inhibited mitochondrial ATP generation could be restored through stimulated Ca²⁺ discharge from mitochondrial matrix. This was demonstrated using a Ca²⁺ ionophore or through Na⁺/Ca²⁺ exchange-mediated decrease of mitochondrial Ca²⁺ load. Furthermore, diazoxide, a mitochondrial potassium channel opener, which maintained mitochondrial Ca²⁺ homeostasis, also restored Ca²⁺-inhibited ATP synthesis and preserved the structural integrity of Ca²⁺-challenged mitochondria. Thus, under conditions of excessive mitochondrial Ca²⁺ overload targeting mitochondrial Ca²⁺ transport pathways restores oxidative phosphorylation required for vital cellular processes. This study, therefore, identifies an effective strategy capable to rescue Ca²⁺-disrupted mitochondrial energetics.