Cytotoxicity associated with pathophysiological Ca2؉ overload (e.g. in stroke) appears mediated by an event termed the mitochondrial permeability transition (mPT). We built and solved a kinetic model of the mPT in populations of isolated rat liver mitochondria that quantitatively describes Ca 2؉ -induced mPT as a two-step sequence of pre-swelling induction followed by Ca 2؉ -driven, positive feedback, autocatalytic propagation. The model was formulated as two differential equations, each directly related to experimental parameters (Ca 2؉ flux/mitochondrial swelling). These parameters were simultaneously assessed using a spectroscopic approach to monitor multiple mitochondrial properties. -induced effects on a downstream stage of mPT induction at a site distinct from the uniporter. The analytical approach was then applied to promethazine, an FDA-approved drug previously shown to inhibit both mPT and ischemia-reperfusion injury. Kinetic analysis revealed that promethazine delayed mPT induction in a manner qualitatively distinct from that of lower concentrations of Mg
2؉. In summary, we have developed a kinetic model to aid in the quantitative characterization of mPT induction. This model is consistent with/informative about the biochemistry of several mPT inhibitors, and its success suggests that this kinetic approach can aid in the classification of agents or targets that modulate mPT induction.Cytotoxicity resulting from pathological insults, such as cardiac ischemia-reperfusion injury, stroke (1), and excitotoxicity (2, 3), is known to involve both pathophysiological rises in intracellular Ca 2ϩ concentration and a mitochondria-associated process. These events have been hypothesized to be linked biochemically, because mitochondria are a major site for Ca 2ϩ sequestration, normally absorbing excess cytosolic Ca 2ϩ through the Ca 2ϩ uniporter (which is driven by the membrane potential ⌬ m ) 2 and releasing it via the Na ϩ /Ca 2ϩ and Ca 2ϩ /H ϩ exchangers, resulting in a slow, continuous cycling of Ca 2ϩ across the inner mitochondrial membrane. Experiments in multiple laboratories have provided evidence that a specific mitochondrial event triggered by Ca 2ϩ -overload, the mitochondrial permeability transition (mPT), might play causative roles in cell death in the presence of the above and other pathological insults (4 -7). These and related studies have further suggested that inhibition of the mPT might have potential therapeutic utility.The mPT has been classically defined in isolated liver mitochondria as the cyclosporin A-sensitive, Ca 2ϩ -mediated formation/opening of an mPT pore (mPTP) in the inner mitochondrial membrane, allowing free diffusion of water and solutes under 1500 daltons and subsequent large amplitude swelling of mitochondria and release of their sequestered Ca 2ϩ (8 -11). From a kinetic point of view, at least three conceptually distinct phases must be resolved during the mPT induction: (i) the initiation phase, which includes the initial intake of excess Ca 2ϩ via the Ca 2ϩ uniporter; (ii) the...