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Circulation Research. 2000;87:460-466

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(Circulation Research. 2000;87:460.)
© 2000 American Heart Association, Inc.


Integrative Physiology

Opening of Mitochondrial KATP Channels Triggers the Preconditioned State by Generating Free Radicals

Tilley Pain, Xi-Ming Yang, Stuart D. Critz, Yankun Yue, Atsushi Nakano, Guang S. Liu, Gerd Heusch, Michael V. Cohen, James M. Downey

From the Departments of Physiology (T.P., X.-M.Y., A.N., G.S.L., G.H., M.V.C., J.M.D.), Cell Biology and Neuroscience (S.D.C., Y.Y.), and Medicine (M.V.C.), College of Medicine, University of South Alabama, Mobile, Ala, and Department of Pathophysiology (G.H.), University of Essen Medical School, Essen, Germany.

Correspondence to James M. Downey, PhD, MSB 3024, Department of Physiology, College of Medicine, University of South Alabama, Mobile, AL 36688.

Abstract—The critical time for opening mitochondrial (mito) KATP channels, putative end effectors of ischemic preconditioning (PC), was examined. In isolated rabbit hearts 29±3% of risk zone infarcted after 30 minutes of regional ischemia. Ischemic PC or 5-minute exposure to 10 µmol/L diazoxide, a mito KATP channel opener, reduced infarction to 3±1% and 8±1%, respectively. The mito KATP channel closer 5-hydroxydecanoate (200 µmol/L), bracketing either 5-minute PC ischemia or diazoxide infusion, blocked protection (24±3 and 28±6% infarction, respectively). However, 5-hydroxydecanoate starting 5 minutes before long ischemia did not affect protection. Glibenclamide (5 µmol/L), another KATP channel closer, blocked the protection by PC only when administered early. These data suggest that KATP channel opening triggers protection but is not the final step. Five minutes of diazoxide followed by a 30-minute washout still reduced infarct size (8±3%), implying memory as seen with other PC triggers. The protection by diazoxide was not blocked by 5 µmol/L chelerythrine, a protein kinase C antagonist, given either to bracket diazoxide infusion or just before the index ischemia. Bracketing preischemic exposure to diazoxide with 50 µmol/L genistein, a tyrosine kinase antagonist, did not affect infarction, but genistein blocked the protection by diazoxide when administered shortly before the index ischemia. Thus, although it is not protein kinase C-dependent, the protection by diazoxide involves tyrosine kinase. Bracketing diazoxide perfusion with N-(2-mercaptopropionyl) glycine (300 µmol/L) or Mn(III)tetrakis(4-benzoic acid) porphyrin chloride (7 µmol/L), each of which is a free radical scavenger, blocked protection, indicating that diazoxide triggers protection through free radicals. Therefore, mito KATP channels are not the end effectors of protection, but rather their opening before ischemia generates free radicals that trigger entrance into a preconditioned state and activation of kinases.


Key Words: diazoxide • 5-hydroxydecanoate • ischemic preconditioning • KATP channels • myocardial infarction




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M. A. Moses, P. D. Addison, P. C. Neligan, H. Ashrafpour, N. Huang, M. Zair, A. Rassuli, C. R. Forrest, G. J. Grover, and C. Y. Pang
Mitochondrial KATP channels in hindlimb remote ischemic preconditioning of skeletal muscle against infarction
Am J Physiol Heart Circ Physiol, February 1, 2005; 288(2): H559 - H567.
[Abstract] [Full Text] [PDF]


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Am. J. Physiol. Heart Circ. Physiol.Home page
Y. Shi, W. C. Hutchins, J. Su, D. Siker, N. Hogg, K. A. Pritchard Jr., A. Keszler, J. S. Tweddell, and J. E. Baker
Delayed cardioprotection with isoflurane: role of reactive oxygen and nitrogen
Am J Physiol Heart Circ Physiol, January 1, 2005; 288(1): H175 - H184.
[Abstract] [Full Text] [PDF]


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Br J AnaesthHome page
H. Barthel, D. Ebel, J. Mullenheim, D. Obal, B. Preckel, and W. Schlack
Effect of lidocaine on ischaemic preconditioning in isolated rat heart
Br. J. Anaesth., November 1, 2004; 93(5): 698 - 704.
[Abstract] [Full Text] [PDF]


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Anesth. Analg.Home page
L. M. Ludwig, K. Tanaka, J. T. Eells, D. Weihrauch, P. S. Pagel, J. R. Kersten, and D. C. Warltier
Preconditioning by Isoflurane Is Mediated by Reactive Oxygen Species Generated from Mitochondrial Electron Transport Chain Complex III
Anesth. Analg., November 1, 2004; 99(5): 1308 - 1315.
[Abstract] [Full Text] [PDF]


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Am. J. Physiol. Cell Physiol.Home page
A. Hassouna, B. M. Matata, and M. Galinanes
PKC-{epsilon} is upstream and PKC-{alpha} is downstream of mitoKATP channels in the signal transduction pathway of ischemic preconditioning of human myocardium
Am J Physiol Cell Physiol, November 1, 2004; 287(5): C1418 - C1425.
[Abstract] [Full Text] [PDF]


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CirculationHome page
M.W. Broadhead, R.K. Kharbanda, M.J. Peters, and R.J. MacAllister
KATP Channel Activation Induces Ischemic Preconditioning of the Endothelium in Humans In Vivo
Circulation, October 12, 2004; 110(15): 2077 - 2082.
[Abstract] [Full Text] [PDF]


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Am. J. Physiol. Heart Circ. Physiol.Home page
Q. Qin, X.-M. Yang, L. Cui, S. D. Critz, M. V. Cohen, N. C. Browner, T. M. Lincoln, and J. M. Downey
Exogenous NO triggers preconditioning via a cGMP- and mitoKATP-dependent mechanism
Am J Physiol Heart Circ Physiol, August 1, 2004; 287(2): H712 - H718.
[Abstract] [Full Text] [PDF]


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Am. J. Physiol. Heart Circ. Physiol.Home page
D. J. Hausenloy, D. M. Yellon, S. Mani-Babu, and M. R. Duchen
Preconditioning protects by inhibiting the mitochondrial permeability transition
Am J Physiol Heart Circ Physiol, August 1, 2004; 287(2): H841 - H849.
[Abstract] [Full Text] [PDF]


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J. Pharmacol. Exp. Ther.Home page
D. A. Liem, C. C. Gho, B. C. Gho, S. Kazim, O. C. Manintveld, P. D. Verdouw, and D. J. Duncker
The Tyrosine Phosphatase Inhibitor Bis(Maltolato)Oxovanadium Attenuates Myocardial Reperfusion Injury by Opening ATP-Sensitive Potassium Channels
J. Pharmacol. Exp. Ther., June 1, 2004; 309(3): 1256 - 1262.
[Abstract] [Full Text] [PDF]


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Am. J. Physiol. Heart Circ. Physiol.Home page
Z. Xu, X. Ji, and P. G. Boysen
Exogenous nitric oxide generates ROS and induces cardioprotection: involvement of PKG, mitochondrial KATP channels, and ERK
Am J Physiol Heart Circ Physiol, April 1, 2004; 286(4): H1433 - H1440.
[Abstract] [Full Text] [PDF]


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Circ. Res.Home page
B. O'Rourke
Evidence for Mitochondrial K+ Channels and Their Role in Cardioprotection
Circ. Res., March 5, 2004; 94(4): 420 - 432.
[Abstract] [Full Text] [PDF]


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Am. J. Physiol. Heart Circ. Physiol.Home page
M. Canton, I. Neverova, R. Menabo, J. Van Eyk, and F. Di Lisa
Evidence of myofibrillar protein oxidation induced by postischemic reperfusion in isolated rat hearts
Am J Physiol Heart Circ Physiol, March 1, 2004; 286(3): H870 - H877.
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Am. J. Physiol. Heart Circ. Physiol.Home page
B. N. Eigel, H. Gursahani, and R. W. Hadley
ROS are required for rapid reactivation of Na+/Ca2+ exchanger in hypoxic reoxygenated guinea pig ventricular myocytes
Am J Physiol Heart Circ Physiol, March 1, 2004; 286(3): H955 - H963.
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Cardiovasc ResHome page
A. P Halestrap, S. J Clarke, and S. A Javadov
Mitochondrial permeability transition pore opening during myocardial reperfusion--a target for cardioprotection
Cardiovasc Res, February 15, 2004; 61(3): 372 - 385.
[Abstract] [Full Text] [PDF]


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Cardiovasc ResHome page
M. Galinanes and A. G Fowler
Role of clinical pathologies in myocardial injury following ischaemia and reperfusion
Cardiovasc Res, February 15, 2004; 61(3): 512 - 521.
[Abstract] [Full Text] [PDF]


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Circ. Res.Home page
E. Murphy
Primary and Secondary Signaling Pathways in Early Preconditioning That Converge on the Mitochondria to Produce Cardioprotection
Circ. Res., January 9, 2004; 94(1): 7 - 16.
[Abstract] [Full Text] [PDF]


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Am. J. Physiol. Heart Circ. Physiol.Home page
T. Miura, Y. Ohnuma, A. Kuno, M. Tanno, Y. Ichikawa, Y. Nakamura, T. Yano, T. Miki, J. Sakamoto, and K. Shimamoto
Protective role of gap junctions in preconditioning against myocardial infarction
Am J Physiol Heart Circ Physiol, January 1, 2004; 286(1): H214 - H221.
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Am. J. Physiol. Heart Circ. Physiol.Home page
O. Oldenburg, Q. Qin, T. Krieg, X.-M. Yang, S. Philipp, S. D. Critz, M. V. Cohen, and J. M. Downey
Bradykinin induces mitochondrial ROS generation via NO, cGMP, PKG, and mitoKATP channel opening and leads to cardioprotection
Am J Physiol Heart Circ Physiol, January 1, 2004; 286(1): H468 - H476.
[Abstract] [Full Text] [PDF]


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Anesth. Analg.Home page
W. de Ruijter, R. J.P. Musters, C. Boer, G. J. M. Stienen, W. S. Simonides, and J. J. de Lange
The Cardioprotective Effect of Sevoflurane Depends on Protein Kinase C Activation, Opening of Mitochondrial K+ATP Channels, and the Production of Reactive Oxygen Species
Anesth. Analg., November 1, 2003; 97(5): 1370 - 1376.
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Br J AnaesthHome page
M. Zaugg, E. Lucchinetti, M. Uecker, T. Pasch, and M. C. Schaub
Anaesthetics and cardiac preconditioning. Part I. Signalling and cytoprotective mechanisms
Br. J. Anaesth., October 1, 2003; 91(4): 551 - 565.
[Abstract] [Full Text] [PDF]


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Physiol. Rev.Home page
D. M. YELLON and J. M. DOWNEY
Preconditioning the Myocardium: From Cellular Physiology to Clinical Cardiology
Physiol Rev, October 1, 2003; 83(4): 1113 - 1151.
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J Am Coll CardiolHome page
J. F. Huizar, L. A. Gonzalez, J. Alderman, and H. S. Smith
Sulfonylureas attenuate electrocardiographic ST-segment elevation during an acute myocardial infarction in diabetics
J. Am. Coll. Cardiol., September 17, 2003; 42(6): 1017 - 1021.
[Abstract] [Full Text] [PDF]


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Circ. Res.Home page
J. N. Weiss, P. Korge, H. M. Honda, and P. Ping
Role of the Mitochondrial Permeability Transition in Myocardial Disease
Circ. Res., August 22, 2003; 93(4): 292 - 301.
[Abstract] [Full Text] [PDF]


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Am. J. Physiol. Heart Circ. Physiol.Home page
G. J. Gross and J. N. Peart
KATP channels and myocardial preconditioning: an update
Am J Physiol Heart Circ Physiol, August 7, 2003; 285(3): H921 - H930.
[Abstract] [Full Text] [PDF]


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J. Thorac. Cardiovasc. Surg.Home page
S. Ghosh and M. Galinanes
Protection of the human heart with ischemic preconditioning during cardiac surgery: role of cardiopulmonary bypass
J. Thorac. Cardiovasc. Surg., July 1, 2003; 126(1): 133 - 142.
[Abstract] [Full Text] [PDF]


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J. Thorac. Cardiovasc. Surg.Home page
Y. Uchiyama, H. Otani, T. Okada, T. Uchiyama, H. Ninomiya, M. Kido, H. Imamura, S. Nakao, and K. Shingu
Integrated pharmacological preconditioning in combination with adenosine, a mitochondrial KATP channel opener and a nitric oxide donor
J. Thorac. Cardiovasc. Surg., July 1, 2003; 126(1): 148 - 159.
[Abstract] [Full Text] [PDF]


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Am. J. Physiol. Heart Circ. Physiol.Home page
P. Korge, H. M. Honda, and J. N. Weiss
Effects of fatty acids in isolated mitochondria: implications for ischemic injury and cardioprotection
Am J Physiol Heart Circ Physiol, June 5, 2003; 285(1): H259 - H269.
[Abstract] [Full Text] [PDF]


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Am. J. Physiol. Heart Circ. Physiol.Home page
M. M. da Silva, A. Sartori, E. Belisle, and A. J. Kowaltowski
Ischemic preconditioning inhibits mitochondrial respiration, increases H2O2 release, and enhances K+ transport
Am J Physiol Heart Circ Physiol, June 5, 2003; 285(1): H154 - H162.
[Abstract] [Full Text] [PDF]


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Cardiovasc ResHome page
J. Peart and J. P Headrick
Adenosine-mediated early preconditioning in mouse: protective signaling and concentration dependent effects
Cardiovasc Res, June 1, 2003; 58(3): 589 - 601.
[Abstract] [Full Text] [PDF]


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Am. J. Physiol. Heart Circ. Physiol.Home page
Y. Nakae, W.-M. Kwok, Z. J. Bosnjak, and M. T. Jiang
Isoflurane activates rat mitochondrial ATP-sensitive K+ channels reconstituted in lipid bilayers
Am J Physiol Heart Circ Physiol, May 1, 2003; 284(5): H1865 - H1871.
[Abstract] [Full Text] [PDF]


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J. Thorac. Cardiovasc. Surg.Home page
S. B. Digerness, P. S. Brookes, S. P. Goldberg, C. R. Katholi, and W. L. Holman
Modulation of mitochondrial adenosine triphosphate-sensitive potassium channels and sodium-hydrogen exchange provide additive protection from severe ischemia-reperfusion injury
J. Thorac. Cardiovasc. Surg., April 1, 2003; 125(4): 863 - 871.
[Abstract] [Full Text] [PDF]


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Cardiovasc ResHome page
T. Krieg, M. Landsberger, M. F. Alexeyev, S. B. Felix, M. V. Cohen, and J. M. Downey
Activation of Akt is essential for acetylcholine to trigger generation of oxygen free radicals
Cardiovasc Res, April 1, 2003; 58(1): 196 - 202.
[Abstract] [Full Text] [PDF]


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J. Physiol.Home page
M. Das, J. E Parker, and A. P Halestrap
Matrix volume measurements challenge the existence of diazoxide/glibencamide-sensitive KATP channels in rat mitochondria
J. Physiol., March 15, 2003; 547(3): 893 - 902.
[Abstract] [Full Text] [PDF]


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Ann. Thorac. Surg.Home page
J. D. McCully and S. Levitsky
The mitochondrial KATP channel and cardioprotection
Ann. Thorac. Surg., February 1, 2003; 75(2): S667 - 673.
[Abstract] [Full Text] [PDF]