Editorials |
From the Department of Molecular Biophysics and Physiology, Rush University, Chicago, Ill.
Correspondence to Thomas R. Shannon, Rush University, Department of Molecular Biophysics and Physiology, 1750 W Harrison, Chicago, IL 60612. E-mail tshannon{at}rush.edu
See related article, pages 617–626
Key Words: adrenergic stimulation arrhythmia Ca2+ handling ryanodine receptor sarcoplasmic reticulum
| Introduction |
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Among the striking features of this SR Ca2+ release is its steep nonlinear dependence on the total concentration of Ca2+ found in the lumen of the SR ([Ca2+]SRT). The degree of release at diastolic [Ca2+]i is very low when the [Ca2+]SRT is approximately 50% of the level usually found in an isolated cardiac myocyte.2 However, it increases dramatically as [Ca2+]SRT increases toward its normal level.
| Functional Consequences of Luminal Ca2+ Regulation of SR Release |
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Defective SR luminal Ca2+ regulation of release also increases SR Ca2+ leak and may increase the tendency to generate arrhythmias in this manner. For instance, humans who are homozygous for nonsense calsequestrin (CSQ) mutations exhibit catecholaminergic polymorphic ventricular tachycardia (CPVT). The reason why catecholamines increase the tendency to demonstrate this arrhythmia is still a matter of debate.3
| The Mechanism of SR Luminal Ca2+ Release Regulation |
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| Free SR [Ca2+] |
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| Regulation by Calsequestrin |
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The most well supported model of this type is that proposed by the Gyorke-Jones group.5 According to this theory, CSQ is normally bound to the RyR through junctin or triadin at low [Ca2+]SR. The PO of the RyR channel is, therefore, correspondingly low in planar lipid bilayers at low trans (ie, SR luminal). As [Ca2+]SR rises, CSQ dissociates from the receptor and increases the PO of the channel (and thus SR Ca2+ leak) via release of inhibition.
| Addressing the Molecular Mechanism Experimentally |
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There were, however, characteristics of the CSQ–/– phenotype which limited the conclusions which could be drawn from the study. Chief among these was a change in the expression of other SR proteins such as triadin and junctin in the phenotype, making it very difficult to attribute the luminal dysregulaton of the RyR to the absence of CSQ. In addition, although the phenotype displayed the increase in SR Ca2+ leak, and therefore RyR activity, the effects could not differentiate between an effect of the CSQ on the RyR and the effect of the decrease in buffering capacity within the SR lumen.
One thing was, however, very clear. The total absence of CSQ did not eliminate the dependence of the SR Ca2+ leak on luminal SR [Ca2+]. The leak, though higher at any given [Ca2+]SRT, continued to increase with luminal [Ca2+] in a steeply nonlinear fashion. It was apparent that whatever the effect of CSQ on release, the whole story would likely involve other players, perhaps including direct actions of the [Ca2+]SR on the process as described above.
The beauty of the study in the current issue is that it uses the unique characteristics of the mice which are heterozygous for the CSQ2 deletion (CSQ+/–) to take the results from the previous study further. These mice exhibited a much milder form of the phenotype with only a 25% decrease in CSQ2 expression. This change was not severe enough to induce a change in SR volume and, though the functional [Ca2+]SRT measured by the height of caffeine transients was not different from wild-type in unchallenged myocytes, it was lower in isoproterenol-challenged myocytes.
Perhaps more importantly, there was no change in the levels of either junctin or triadin compared with wild-type in the CSQ+/– mice. Despite this, an increase in SR Ca2+ leak was still detected. Indeed, despite the relatively mild phenotype in the presence of isoproterenol the mice continued to exhibit higher rates of ventricular ectopy and significantly higher rates of spontaneous SR Ca2+ release and triggered beats in isolated ventricular myocytes. These results strengthen the CSQ–/– results above by eliminating the possibility that the decrease in junctin/triadin played a role in the susceptibility to CPVT.
The major remaining mechanistic problem was that the authors could not distinguish between the possibility that the CSQ was interacting with the RyR to change its behavior from the possibility that the altered buffering capacity of the SR was responsible. In other words, though the SR Ca2+ leak was higher at any given [Ca2+]SRT, they could not tell whether a higher [Ca2+]SR, rather than the reduced CSQ was responsible. To differentiate between these possibilities, the authors measured the SR Ca2+ leak and the [Ca2+]SR simultaneously (Figure). The SR Ca2+ leak remained higher in the CSQ+/– at the same [Ca2+]SR, thus supporting the hypothesis that the CSQ was interacting with and regulating the RyR even at the same [Ca2+]SR.
These data go a long way toward validating the theory that CSQ regulates SR Ca2+ release through the RyR. They complement previous experimental data using adult ventricular myocytes which were transfected with antisense cDNA to reduce CSQ levels.8 The technique used here has significant advantages, however, in that the authors have avoided the potential artifacts associated with culturing cardiac myocytes and have measured electrical anomalies in the whole heart which accompany the cellular changes.
Though the typical tendency is to consider heterozygote transgenic animals to be an unwanted side effect of the production of more "pure" homozygote animals, the manuscript emphasizes the importance of considering all of the tools available in an effort to produce a picture which may at first seem less cut and dried but which may be in the end more complete.
| Remaining Questions |
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A related issue to be resolved is the luminal Ca2+-dependence of the CSQ mediated regulation. Clearly the effect of CSQ on the RyR is Ca2+-dependent both in 45Ca2+ overlay experiments and in planar lipid bilayers. Its dependence in intact myocytes under physiological conditions and at physiological luminal SR [Ca2+] remains unclear.
Finally, though CSQ affects the process of diastolic release, the effect of CSQ on the mechanism of active release remains unclear. This determination is complicated by the numerous processes involved in excitation contraction coupling and Ca2+ homeostasis in the cardiac myocyte. The most critical mechanistic question regards the role of the luminal Ca2+ in the termination of SR Ca2+ release.9 For instance, as the SR [Ca2+] falls during contraction, could the CSQ act dynamically within the relevant timeframe to reduce the probability of opening of the RyR such that it closes rather than continuing as a regenerative process? If so, does it accomplish this by switching off Ca2+-dependent cytosolic activation or by facilitating a cytosolic inactivation mechanism?
Although these questions remain unanswered, it is clear that with well thought out and well executed studies such as the present, we can expect to address them in a fashion which will eventually give reasonable and relevant results. Such data will lead to better ways to target the process of SR Ca2+ release to more effectively treat cardiac arrhythmias.
| Acknowledgments |
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T.S. is supported by NIH R01 HL071893-04.
Disclosures
None.
| Footnotes |
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| References |
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2. Shannon TR, Pogwizd SM, Bers DM. Elevated sarcoplasmic reticulum Ca2+ leak in intact ventricular myocytes from rabbits in heart failure. Circ Res. 2003; 93: 592–594.
3. Sipido KR. CaM or cAMP. Linking ß-adrenergic stimulation to leaky RyRs. Circ Res. 2007; 100: 296–298.
4. Herzog A, Szegedi C, Jona I, Herberg FW, Varsanyi M. Surface plasmon resonance studies prove the interaction of skeletal muscle sarcoplasmic reticular Ca(2+) release channel/ryanodine receptor with calsequestrin. FEBS Lett. 2000; 472: 73–77.[CrossRef][Medline] [Order article via Infotrieve]
5. Gyorke I, Hester N, Jones LR, Gyorke S. The role of calsequestrin, triadin, and junctin in conferring cardiac ryanodine receptor responsiveness to luminal calcium. Biophys J. 2004; 86: 2121–2128.[Medline] [Order article via Infotrieve]
6. Chopra N, Kannankeril PJ, Yang T, Hlaing T, Holinstat I, Ettensohn K, Pfeifer K, Akin B, Jones LR, Franzini-Armstrong C, Knollmann BC. Modest reductions of cardiac calsequestrin increase sarcoplasmic reticulum Ca2+ leak independent of luminal Ca2+ and trigger ventricular arrhythmias in mice. Circ Res. 2007; 101: 617–626.
7. Knollmann BC, Chopra N, Hlaing T, Akin B, Yang T, Ettensohn K, Knollmann BE, Horton KD, Weissman NJ, Holinstat I, Zhang W, Roden DM, Jones LR, Franzini-Armstrong C, Pfeifer K. Casq2 deletion causes sarcoplasmic reticulum volume increase, premature Ca2+release, and catecholaminergic polymorphic ventricular tachycardia. J Clin Invest. 2006; 116: 2510–2520.[CrossRef][Medline] [Order article via Infotrieve]
8. Terentyev D, Viatchenko-Karpinski S, Gyorke I, Volpe P, Williams SC, Gyorke S. Calsequestrin determines the functional size and stability of cardiac intracellular calcium stores: Mechanism for hereditary arrhythmia. Proc Natl Acad Sci U S A. 2003; 100: 11759–11764.
9. Stern MD, Cheng H. Putting out the fire: what terminates calcium-induced calcium release in cardiac muscle? Cell Calcium. 2004; 35: 591–601.[CrossRef][Medline] [Order article via Infotrieve]
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Circ. Res. 2007 101: 617-626.
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