Brief substrate deprivation resulted in high mortality of superior cervical ganglion neurons in culture, assayed 2 hr later by trypan blue exclusion. Involvement of superoxide anions was indicated by several observations. Survival was increased significantly by prior treatment that induced cells to take up superoxide dismutase. During starvation, neurons reduced nitroblue tetrazolium to form the blue precipitate formazan, and the color change was blocked in neurons preloaded with superoxide dismutase. The incidence of staining was comparable to the mortality. In many cells, brief starvation caused the appearance of fluorescence due to oxidation of 2',7'-dichlorofluorescin to dichlorofluorescein, which indicates that oxidants were generated intracellularly. In some cells fluorescence was transient, as would be caused by membrane breakdown, and these cells were then shown to be dead. Superoxide generation caused by substrate deprivation may contribute importantly to cell damage in a variety of pathological conditions. products because of the large ratio of solution to tissue volume.Earlier studies with whole animals indicated that intravenous superoxide dismutase (SOD; superoxide:superoxide oxidoreductase, EC 1.15.1.1) protected beagle puppies from intraventricular hemorrhage after a hemorrhagic hypotension/volume expansion insult (13) and prevented death in gerbils due to seizures induced by cerebral ischemia (8). We wished to analyze the role of O°-at a cellular level. Since generation of O°-is the result of univalent reduction of oxygen, we did not expect generation of 02-during anoxia.Thus, we focused our interest on Oy-formation and protection against it during starvation. Our data indicate that neuronal death caused by starvation involves generation of O°-, since the cytotoxicity can be markedly reduced by SOD.Cytochemical procedures also indicate production of Oj-or other oxidants. Preliminary accounts of this work have appeared (14,15).Substrate deprivation occurs in brain during ischemia due to stroke, cardiac arrest, and trauma and under severe hypoglycemic conditions such as insulin shock. Biochemical changes that accompany ischemia include formation of free radicals such as the superoxide anion 0,-, and these highly reactive substances may be an important cause of neuronal damage (1). In support of this hypothesis, tissue concentrations of nonspecific free-radical scavengers (e.g., reduced glutathione, ascorbic acid, a-tocopherol, and ubiquinone) decrease significantly during partial ischemia or reperfusion after total ischemia (1-4). Also, reversible global ischemia induces lipid peroxidation (5), which is a reaction initiated by free radicals. Moreover, pretreatment with free-radical scavengers or blockers of metabolic reactions that yield free radicals protects against damage due to concussive injury or brain ischemia (6-8). In these studies, protection was attributed mainly to action at the level of the vascular endothelium, and it was unclear whether free radicals were generated in dying n...