One of the most devastating effects of ethanol exposure during development is the loss of neurons in selected brain areas. The underlying cellular/molecular mechanisms remain unclear. The endoplasmic reticulum (ER) is involved in posttranslational protein processing and transport. The accumulation of unfolded or misfolded proteins in the ER lumen triggers ER stress, which is characterized by translational attenuation, synthesis of ER chaperone proteins such as GRP78, and activation of transcription factors such as ATF4, ATF6, and CHOP. Sustained ER stress ultimately leads to cell death. ER stress response can be induced experimentally by treatment with tunicamycin and thapsigargin. Using SH-SY5Y neuroblastoma cells and primary cerebellar granule neurons as in vitro models, we demonstrated that exposure to ethanol alone had little effect on the expression of markers for ER stress; however, ethanol drastically enhanced the expression of GRP78, CHOP, ATF4, ATF6, and phosphorylated PERK and elF2α when induced by tunicamycin and thapsigargin. Consistently, ethanol promoted tunicamycin-and thapsigargininduced cell death. Ethanol rapidly caused oxidative stress in cultured neuronal cells; antioxidants blocked ethanol's potentiation of ER stress and cell death, suggesting that the ethanol-promoted ER stress response is mediated by oxidative stress. CHOP is a proapoptotic transcription factor. We further demonstrated that CHOP played an important role in ethanol-promoted cell death. Thus, the effect of ethanol may be mediated by the interaction between oxidative stress and ER stress.
Keywordsalcohol; apoptosis; cerebellum; development; fetal alcohol syndrome Alcohol exposure alters the structure and physiology of the brain in many ways. During development, alcohol-induced structural and physiological alterations contribute to the brain dysfunction of children with fetal alcohol syndrome (FAS). FAS is the most common nonhereditary cause of mental retardation (May and Gossage, 2001). One of the most prominent alcohol-induced neuropathological changes in the developing brain is the loss of neurons (West et al., 1990;Luo and Miller, 1998;Ikonomidou et al., 2000; Goodlet and © 2007 Horn, 2001). In adults, heavy alcohol consumption also causes neuronal loss in selected brain regions (Kril et al., 1997;Gotz et al., 2001;Ikegami et al., 2003). The mechanisms underlying ethanol-induced neuronal loss, however, remain incompletely elucidated. Oxidative stress is caused by the disruption of intracellular redox homeostasis. The generation of reactive oxygen species (ROS) initiates this process and may cause neuronal death (Mattson et al., 2001;Watts et al., 2005;Loh et al., 2006). Alcohol exposure may induce oxidative stress in the central nervous system (Marino et al., 2004;Kumral et al., 2005;Chu et al., 2007), and the brain is particularly susceptible to ROS-induced damage (Annunziato et al., 2003). Oxidative stress has been proposed to be a potential mechanism for ethanol-induced damage (Sun et al., 2001;Chu et al., 2...