Irreversible ischemic cell injury. Prevention by chlorpromazine of the aggregation of the intramembranous particles of rat liver plasma membranes.

Ischemic rat liver tissue has been shown previously to exhibit a markedly accelerated rate of phospholipid degradation, producing a loss of almost one half the total cellular phospholipid with 3 hours of ischemia. Pretreatment of the rats with chlorpromazine completely prevented the disturbed phospholipid metabolism at the same time that it prevented the cell death associated with as much as 3 hours of ischemia. Lipid-depleted microsomal membranes were shown previously to manifest alterations in their structure and function. The present report documents that similar structural alterations are evident in ischemic liver cell plasma membranes. The technique of freeze-fracture electron microscopy was used to examine the morphology of ischemic liver cell plasma membranes. Freeze-fracture replicas of whole tissue fragments exhibited a diffuse aggregation of the intramembranous particles in the P face of the plasma membranes. The incidence of this change correlated with the duration of ischemia. Pretreatment of the rats with chlorpromazine (20 mg/kg) for 30 minutes before inducing ischemia prevented the aggregation of the membrane-associated particles. These findings establish the existence of plasma membrane alterations in ischemic liver cells. The time course of these changes, their prevention by chlorpromazine, and their similarity to the previously described structural alterations in the microsomal membranes suggest that they are related to the loss of liver cell phospholipid. The data in the present report support the hypothesis that an accelerated phospholipid degradation and its resultant membrane dysfunction are the critical alterations that produce irreversible liver cell injury and, ultimately, cell death in ischemia.