Tian et al. Cell Death and Disease (2020) 11:375 https://doi.org/10.1038/s41419-020-2577-y Cell Death & Disease ARTICLE Open Access Suppressed expression of LDHB promotes age- related hearing loss via aerobic glycolysis Chunjie Tian1,YeonJuKim2,SaiHali3, Oak-Sung Choo2,4,Jin-SolLee2,5,Seo-KyungJung2,5, Youn-Uk Choi6, Chan Bae Park6 and Yun-Hoon Choung 2,4,5 Abstract Age-dependent decrease of mitochondrial energy production and cellular redox imbalance play significant roles in age-related hearing loss (ARHL). Lactate dehydrogenase B (LDHB) is a key glycolytic enzyme that catalyzes the interconversion of pyruvate and lactate. LDH activity and isoenzyme patterns are known to be changed with aging, but the role of LDHB in ARHL has not been studied yet. Here, we found that LDHB knockout mice showed hearing loss at high frequencies, which is the typical feature of ARHL. LDHB knockdown caused downregulation of mitochondrial functions in auditory cell line, University of Bristol/organ of Corti 1 (UB/OC1) with decreased NAD+ and increased hypoxia inducing factor-1α. LDHB knockdown also enhanced the death of UB/OC1 cells with ototoxic gentamicin treatment. On the contrary, the induction of LDHB expression caused enhanced mitochondrial functions, including changes in mitochondrial respiratory subunits, mitochondrial membrane potentials, ATP, and the NAD+/NADH ratio. Thus, we concluded that suppression of LDHB activity may be closely related with the early onset or progression of ARHL. 1234567890():,; 1234567890():,; 1234567890():,; 1234567890():,; Introduction as hereditary susceptibility, autophagic stress, inflamma- Age-related hearing loss (ARHL) that occurs in tion, and oxidative stress5. response to aging is a universal disorder in modern Decreased mitochondrial function with age has been society. ARHL is characterized by an age-associated defect documented in multiple mammalian species. Studies on in hearing function, which begins with an increased mitochondria isolated from human muscle biopsies or hearing threshold in the high-frequency region and rodent muscles support the existence of an intrinsic, spreads toward the low-frequency region. Histologically, aging-dependent mitochondrial defect associated with this process is characterized by the loss of hair cells and adenosine triphosphate (ATP) production6.Mitochon- spiral ganglion neurons (SGNs) in the cochlea with dria are the main source of ATP and a direct intrinsic by- – age1 3. The process of ARHL depends on many mole- product of this ATP production is reactive oxygen spe- cular, physiological, and biochemical changes4. Although cies (ROS). Under normal conditions, ROS are easily the exact mechanism remained unclear, ARHL is caused scavenged by various endogenous antioxidant enzymes by cumulative effect of extrinsic and intrinsic factors, such activities, such as superoxide dismutase (MnSOD), cat- alase (CAT), and glutathione peroxidise (GPX). How- ever, during aging, damaged mitochondria induced less Correspondence: Chan Bae Park ([email protected])or ATP production and aberrant ROS generation, leading Yun-Hoon Choung ([email protected]) to oxidative stress and cellular senescence7. 1Department of Otolaryngology, Dali Bai Autonomous Prefecture People’s Hospital, Dali, Yunnan 671000, China Pyruvate is the substrate used for mitochondrial ATP 2Department of Otolaryngology, Ajou University School of Medicine, Suwon production and is the product of the final step of glycolysis. 16499, Republic of Korea In the presence of oxygen, pyruvate is further metabolized Full list of author information is available at the end of the article These authors contributed equally: Chunjie Tian, Yeon Ju Kim, Sai Hali in the citric acid cycle to produce NADH and FADH2 for Edited by G. Melino © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a linktotheCreativeCommons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. Official journal of the Cell Death Differentiation Association Tian et al. Cell Death and Disease (2020) 11:375 Page 2 of 13 oxidative phosphorylation in the mitochondrion8. Lactate In this regard, one study showed that a decreased level + dehydrogenase (LDH) catalyzes the interconversion of of nuclear NAD contribute to mitochondria defects + pyruvate and lactate using nicotinamide adenine dinucleo- during skeletal muscle aging in a NAD -dependent dea- + tide (NAD ) and NADH as a cofactor during the last step cetylase, sirtuin 1 (SIRT1)-dependent manner. Moreover, + of glycolysis. LDH is a homo- or hetero-tetrameric enzyme calorie restriction slowed aging process by raising NAD + composed of two subunits, M (muscle) and H (heart), and SIRT113. In addition, augmentation of NAD by + which are encoded by the LDHA and LDHB genes, β-lapachone, a known modulator of cellular NAD by + respectively9. Five different isozymes can be formed conversion of NADH to NAD , effectively prevented depending on the ratio of the M and H subunits. The major ARHL through the reducing inflammation and oxidative isozyme in skeletal muscle and liver, with four “M” LDHA stress, mitochondrial damage in rodents14. However, the subunits, is called LDH5 and mainly contributes to the functional significance of the LDHB in ARHL is unclear. generation of lactate from pyruvate. Meanwhile, the major Therefore, the purposes of this study were to elucidate the isozyme in heart muscles, known as LDH1, contains four metabolic changes in ARHL using LDHB knockout (KO) heart “H” LDHB subunits and functions in the production mice and to determine the significance of LDHB in the of pyruvate from lactate. Isozymes that contain more LDHA process of ARHL. subunits will generally undergo reactions to produce lactate from pyruvate, whereas isozymes with more LDHB react to Results produce pyruvate from lactate. Other variants contain both Generation of whole-body LDHB KO mice types of subunits (M3H1:LDH4, M2H2:LDH3, and M1H4: To create LDHB gene knockout mouse strains, we first LDH2)10. The organ of Corti in the inner ear contains generated LDHB floxed (LDHB loxP/+) mice using LDH1 (LDHB) rather than LDH5 (LDHA) due to its high- homologous recombination in mouse embryonic stem energy requirements11. (ES) cells (Fig. 1a). Southern blot analysis revealed ES cells Conversion from lactate to pyruvate depends on an with the target LDHB locus (Fig. 1b). We generated whole- LDHB-containing isozyme, which is important in main- body LDHB gene KO mice by crossing LDHB floxed taining a high level of pyruvate and is highly expressed in (LDHB loxP/+) mice with protamine-cre (PRM-cre) mice, tissues with high-energy demands. If the conversion from which express Cre recombinase in sperm. The resulting lactate to pyruvate is disrupted, the substrate concentration double heterozygous mice (LDHB +/loxP, +/PRM-cre) for mitochondrial ATP production will decrease, resulting were mated with wild-type (WT) mice to generate het- in mitochondrial dysfunction12. erozygote whole-body LDHB knockout (LDHB +/−) Fig. 1 Generation of LDHB KO mice. a Targeting of the LDHB gene was performed by floxing exon 3 of the LDHB gene with the PGK-neo cassette containing Frt sites. b Screening of target ES cells for LDHB with the probe indicated in Fig. 1a. Control (c) and target (T) ES cells. c, d Confirmation of LDHB knockout in the heart and kidney through western blot analysis (c) and gel LDH isomer activity assay (d). Official journal of the Cell Death Differentiation Association Tian et al. Cell Death and Disease (2020) 11:375 Page 3 of 13 mice, and homozygote LDHB knockout (LDHB −/−) mice at 5 months had normal hearing thresholds across mice were generated by crossing the heterozygote LDHB frequencies (10.0 ± 0.0 dB/12.0 ± 2.6 dB/13.0 ± 4.2 dB at 8/ knockout (LDHB +/−) mice. The generation of whole- 16/32 kHz, respectively). By contrast, LDHB KO mice body homozygote LDHB (LDHB −/−) mice was con- exhibited an early onset of progressive hearing loss, with firmed based on complete deficiency of LDHB protein their mean thresholds increasing to 15.0 ± 5.3 dB/24.5 ± (Fig. 1c) and LDH 1–4 isozymes (Fig. 1d) in the heart and 8.0 dB/28.0 ± 9.2 dB at 8/16/32 kHz, respectively. The kidney of each KO mouse. In the cochlea, LDHB was differences between the two groups were statistically broadly expressed throughout the organ of Corti, spiral significant at 16 kHz (P < 0.05) and 32 kHz (P < 0.01) (Fig. limbus, spiral ganglion, and spiral ligament, and LDHB KO 3a). By 10 months of age, ARHL developed at high fre- mice did not contain detectable LDHB protein (Supple- quencies in the WT mice, with increased hearing mentary Fig. 1). thresholds of 15.0 ± 3.3 dB/26.0 ± 4.0 dB/30.0 ± 3.3 dB at 8/16/32 kHz. The LDHB-KO mice showed worsening of LDH activity and body weight growth of LDHB KO mice hearing thresholds, reaching 18.0 ± 2.6 dB/39.0 ± 4.6 dB/ LDHB is important for maintaining a high level of 43.0 ± 4.8 dB at 8/16/32 kHz. Hearing ability decreased for pyruvate and is highly expressed in tissues with high- high-frequency sound, while the low-frequency area was energy demands, such as the heart and kidney. In preserved. At the age of 10 months, LDHB KO mice response to KO, LDH activity from the lactate side of the showed more severe hearing loss than WT mice.