Glycation proteomics identifies creatine kinase as a mediator of the effects of methylglyoxal on mitochondrial permeability transition.

Opening of the mitochondrial permeability transition (PT) pore is an important step in necrotic cell death in various pathologic conditions such as ischemia-reperfusion injury. Methylglyoxal (MGO) is a byproduct of glycolysis that covalently modifies proteins (i.e., glycation) and is widely regarded as toxic (glycative stress), contributing to the pathology of diabetes. Paradoxically, MGO has been shown to inhibit PT pore opening, but the mechanism of this effect is poorly understood. Herein we show that glycation is elevated in various cardioprotective scenarios. Furthermore, building on a serendipitous finding of the ability of phosphate to block MGO's effect on the PT pore, we used proteomics to map potential sites mediating this effect. From this analysis, mitochondrial creatine kinase (CK) emerged as a phosphate-sensitive MGO target with links to the PT pore. Although MGO inhibited CK activity, this did not appear to be important for its effect on the PT pore. Rather, MGO modified sites on CK that are important for its membrane binding, which likely mediates the combined effects of MGO and phosphate on the PT pore. Furthermore, a consensus sequence for MGO modifications in mitochondria is reported.