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Circulation Research. 1996;78:492-498

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(Circulation Research. 1996;78:492-498.)
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Articles

Protein Kinase C Activates ATP-Sensitive K+ Current in Human and Rabbit Ventricular Myocytes

Keli Hu, Dayue Duan, Gui-Rong Li, Stanley Nattel

From the Department of Medicine and Research Center, Montreal Heart Institute (G.-R.L., S.N.), the Department of Medicine, University of Montreal (G.-R.L., S.N.), and the Department of Pharmacology and Therapeutics, McGill University (K.H., D.D., S.N.), Montreal, Quebec, Canada.

Correspondence to Dr Stanley Nattel, Montreal Heart Institute, 5000 Belanger St E, Montreal, Quebec, Canada H1T 1C8.


*    Abstract
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*Abstract
down arrowIntroduction
down arrowMaterials and Methods
down arrowResults
down arrowDiscussion
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Abstract Mediators involved in ischemic preconditioning, such as adenosine and norepinephrine, can activate protein kinase C (PKC), and a variety of observations suggest that both PKC and ATP-sensitive K+ current (IKATP) play essential roles in ischemic preconditioning. PKC is therefore a candidate to link receptor binding to IKATP activation, but it has not been shown whether and how PKC can activate IKATP in the heart. The present study was designed to determine whether PKC can activate IKATP in rabbit and human ventricular myocytes. Under conditions designed to minimize Na+ and Ca2+ currents, dialysis of rabbit ventricular myocytes with pipette solutions containing reduced [ATP] elicited IKATP, with a 50% effective concentration (EC50) of 260 µmol/L. In cells that failed to show IKATP under control conditions, superfusion with 1 µmol/L phorbol 12,13-didecanoate (PDD) elicited IKATP in a fashion that depended on pipette [ATP], with an [ATP] EC50 of 601 µmol/L. PDD-induced IKATP activation was concentration dependent, with an EC50 of 7.1 nmol/L. The highly selective PKC inhibitor bisindolylmaleimide totally prevented IKATP activation by PDD, and in blinded experiments, 1 µmol/L PDD elicited IKATP in eight of nine cells, whereas its non–PKC-stimulating analogue 4{alpha}-PDD failed to elicit IKATP in any of the five cells tested (P=.003). Similar experiments were conducted in human ventricular myocytes and showed that 0.1 µmol/L PDD elicited IKATP at pipette [ATP] of 100 and 400 µmol/L (five of five cells at each concentration) but not at 1 mmol/L [ATP] (none of five cells). We conclude that PKC activates IKATP in rabbit and human ventricular myocytes by reducing channel sensitivity to intracellular ATP. This finding has potentially important implications for understanding the mechanisms of ischemic preconditioning.


Key Words: ischemic preconditioning • myocardial ischemia • cardioprotection • myocardial infarction • G proteins


*    Introduction
up arrowTop
up arrowAbstract
*Introduction
down arrowMaterials and Methods
down arrowResults
down arrowDiscussion
down arrowReferences
 
Ischemic preconditioning, the ability of brief ischemic episodes to protect the heart against subsequent prolonged ischemia, was first demonstrated in dogs by Murry et al1 in 1986 and has subsequently been shown to occur in a wide variety of species.2 3 The precise mechanisms of ischemic preconditioning remain to be elucidated. The KATP channel appears to play an important role in the cardioprotective effects of ischemic preconditioning in dogs,4 5 6 7 rabbits,8 pigs,9 and humans.10 More recent evidence points to an essential role of PKC in ischemic preconditioning.11 12 13 Since PKC can be activated by the stimulation of a variety of receptors involved in ischemic preconditioning, including {alpha}1-adrenoceptors13 and adenosine receptors,4 6 7 14 PKC is a strong potential candidate to link receptors stimulated by mediators released during ischemia to the activation of KATP channels. The purpose of the present experiments was to determine whether PKC can activate KATP channels, as determined by effects on whole-cell currents in myocytes isolated from rabbit and human ventricular tissue.


*    Materials and Methods
up arrowTop
up arrowAbstract
up arrowIntroduction
*Materials and Methods
down arrowResults
down arrowDiscussion
down arrowReferences
 
Rabbit ventricular myocytes were isolated from adult New Zealand White rabbits (1.4 to 1.8 kg) by enzymatic dissociation, with methods similar to those previously described.15 In brief, hearts were excised and retrogradely perfused via the aorta with oxygenated (100% O2) Tyrode's solution containing (mmol/L) NaCl 126, KCl 5.4, CaCl2 1.0, MgCl2 1.0, NaH2PO4 0.33, HEPES 10, and glucose 10 at 37°C. The perfusate was then changed to a Tyrode's solution that was nominally Ca2+ free but otherwise had the same composition. When cardiac contraction had ceased, the hearts were perfused with the same solution containing collagenase (0.03%, type II, Sigma Chemical Co) and bovine serum albumin (1.0%, Sigma) for 7 to 9 minutes. Softened ventricular tissues were removed, cut into small pieces, and mechanically dissociated by trituration. The isolated cells were kept in a storage solution containing (mmol/L) KCl 20, KH2PO4 10, glucose 10, potassium glutamate 70, ß-hydroxybutyric acid 10, taurine 10, mannitol 5, and EGTA 5, along with 1% albumin.

Explanted hearts were obtained at the time of heart transplantation from two patients, aged 31 and 54 years. In both patients, the underlying heart disease was congestive cardiomyopathy. Subsequent examination of the right ventricle by a cardiac pathologist revealed each of the two to be macroscopically normal, with microscopic abnormalities consisting of interstitial fibrosis in one heart and subendocardial fibrosis in the other. Both hearts were initially placed in cold (4°C) oxygenated Krebs' solution and then transferred to cardioplegic solution for dissection and coronary artery cannulation. A portion of the free wall of the right ventricle ({approx}2x4 to 2x5 cm) was removed along with the coronary artery branch irrigating it, with dissection and arterial cannulation completed within 20 minutes of excision of the heart. The free wall was perfused with oxygenated nominally Ca2+-free Tyrode's solution for 20 to 30 minutes. The solution was then changed to one containing 200 to 300 U/mL collagenase (CLS II, Worthington Biochemical) for 60 to 100 minutes. The digested tissue was cut into small ({approx}1.5- to 2-mm3) pieces, placed in the same high-K+ storage solution as used for rabbit cells, and gently triturated with a Pasteur pipette. The isolated myocytes were kept in the medium at least 1 hour before use.

All the cells studied were rod-shaped and showed clear cross striations. A small aliquot of the solution containing the isolated cells was placed in an open perfusion chamber (1 mL) mounted on the stage of an inverted microscope. After they had adhered to the bottom of the chamber, the cells were perfused at 3 mL/min with an oxygenated solution containing (mmol/L) NaCl 135, KCl 5.4, MgCl2 1.0, CaCl2 1.0, NaH2PO4 0.33, HEPES 10, and glucose 10 at pH 7.4 (pH adjusted with NaOH). CdCl2 (0.2 mmol/L, Sigma) and 4-aminopyridine (2 mmol/L, Sigma) were added to the external solution to inhibit Ca2+ current and transient outward current, respectively. All experiments were conducted at room temperature (22°C to 25°C). The pipette solution contained (mmol/L) KCl 140, MgCl2 1.0, HEPES 10, EGTA 5, and GTP 0.1 at pH 7.3 (pH adjusted with KOH). Varying amounts of K2ATP were added to pipette solutions to obtain the final concentrations desired. The PKC activator PDD and its non–PKC-stimulating homologue 4{alpha}-PDD were purchased from ICN Biochemicals. PDD, 4{alpha}-PDD, and the IKATP blocker glibenclamide (glyburide, Sigma) were prepared as stock solutions in DMSO at concentrations of 1 mmol/L for PDD and 4{alpha}-PDD and 10 mmol/L for glibenclamide. The highly selective PKC inhibitor BIM hydrochloride16 was obtained from Calbiochem-Novabiochem International and prepared as a stock solution of 0.75 mmol/L in DMSO.

Membrane currents were studied with the whole-cell configuration of the voltage-clamp technique. Data were sampled at 13.3 kHz with an A/D converter (Digidata 1200, Axon Instruments) and stored on the hard disk of a computer for subsequent analysis. The recordings were filtered with a low-pass corner frequency of 2 kHz. Borosilicate glass electrodes (outer diameter, 1.5 mm) with resistances of 2 to 5 M{Omega} when filled were connected to a patch-clamp amplifier (Axopatch 200A, Axon Instruments). Junction potentials were zeroed before the pipette touched the cell. The cell membrane was held at -40 mV, and 100-millisecond voltage steps to potentials between -100 and +60 mV were applied at 0.5 Hz in 10-mV increments. Pipette series resistance was compensated to minimize the duration of the capacitive transient upon 5 mV hyperpolarizations from -40 mV. Mean series resistance before and after compensation averaged 6.86±0.36 (mean±SE) and 2.56±0.16 M{Omega}, respectively, in rabbit cells and 6.80±0.37 and 2.59±0.15 M{Omega}, respectively, in human cells. The capacitive time constant averaged 710±50 microseconds (capacitance, 103.8±7.0 pF) before and 240±20 microseconds after capacitance compensation in rabbit myocytes. Corresponding values in human myocytes were 770±20 microseconds (capacitance, 120.0±6.4 pF) and 290±10 microseconds.

To allow sufficient time for dialysis of cell contents by the pipette solution, the first control recordings were obtained at least 10 minutes after membrane rupture. Currents were measured at the end of each clamp step, as a value relative to zero current. Leakage compensation was not used. IKATP was defined as a current that reversed between -90 and -70 mV, showed inward rectification at potentials positive to 0 mV, was associated with a positive shift in holding current at -40 mV, and was strongly inhibited by 10 µmol/L glibenclamide.

Data are presented as mean±SE. Repeated measures comparisons were performed by ANOVA with Scheffé's range test. Contingency data were analyzed with Fisher's exact test. Differences with a two-tailed value of P<.05 were considered statistically significant. Nonlinear curve fitting of concentration-response data was performed with commercially available software that uses a Marquardt procedure for parameter estimation (Sigmaplot, Jandel Scientific).


*    Results
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up arrowAbstract
up arrowIntroduction
up arrowMaterials and Methods
*Results
down arrowDiscussion
down arrowReferences
 
Effects of PKC Activation on IKATP in Rabbit Ventricular Myocytes
Fig 1ADown illustrates the effects of 0.1 µmol/L PDD on currents recorded from a typical rabbit myocyte in the presence of 400 µmol/L ATP in the pipette. Twenty minutes after membrane rupture, there was no evidence of spontaneous activation of IKATP, and the currents recorded showed strong inward rectification (Fig 1ADown, a). Within 3 minutes of exposure to PDD, a large increase in membrane conductance was observed. Currents in the presence of PDD (Fig 1ADown, b) continued to show some inward rectification, but the latter was less intense than under control conditions. The addition of 10 µmol/L glibenclamide strongly and rapidly reversed the conductance-enhancing effects of PDD (Fig 1ADown, c). Fig 1BDown shows the I-V relations from the same cell. Under control conditions, the current reverses at {approx}-80 mV and shows strong inward rectification. In the presence of PDD, the reversal potential is {approx}-75 mV, and the slope conductance increases. In contrast to control conditions, under which strong inward rectification begins at the reversal potential, rectification is less intense and begins closer to 0 mV. Glibenclamide strongly inhibits PDD-induced currents and returns the I-V relation to a pattern resembling that seen under control conditions.



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Figure 1. A, Current recordings from one rabbit myocyte obtained with [ATP]p of 400 µmol/L before (control [CTRL]) (a) and during exposure to 0.1 µmol/L PDD (b) and during subsequent exposure to both 0.1 µmol/L PDD and 10 µmol/L glibenclamide (GLIB) (c). Membrane currents were elicited by 100-millisecond steps from the holding potential (-40 mV) to the levels indicated in increments of 10 mV. Zero current levels are indicated by horizontal lines. B, I-V relations obtained from the same cell under each condition. C, Time course of step current recorded from cells studied with ({diamond} and {blacktriangleup}, five cells) or without ({circ}, four cells) exposure to 1 µmol/L PDD beginning 20 minutes after the onset of recording. The currents (measured relative to zero current) were elicited by steps (100 milliseconds) from -40 to 0 mV. Step current was significantly increased by PDD, an action inhibited by GLIB (**P<.01 vs CTRL).

Fig 1CUp shows the time course of mean (±SE) currents recorded upon depolarization to 0 mV from five cells exposed to PDD 20 minutes after the onset of recording and from four control cells followed in an identical fashion without PDD. In the absence of PDD, there was no change in current amplitude over 20 minutes, and cells not exposed to PDD showed no change in current over the subsequent 15 minutes. Currents over the first 20 minutes were not different in control cells compared with cells subsequently exposed to 1 µmol/L PDD. Within 5 minutes of the addition of PDD, however, a marked increase in current was noted. After 10 minutes of superfusion with PDD alone (30 minutes after the onset of recording), 10 µmol/L glibenclamide was added to the PDD-containing superfusate. A marked reduction in current toward control values was observed within 5 minutes. Note that a reduction in current was seen even before glibenclamide exposure. In three cells followed for an additional 10 minutes in the presence of PDD without exposure to glibenclamide, the current decreased from a peak value of 3.6±0.7 to 1.4±0.2 nA. Nevertheless, the latter value was substantially larger than currents in cells exposed to glibenclamide in the presence of PDD for a comparable period of time (mean current, 0.35±0.08 nA; P=.001), indicating that the response to glibenclamide cannot be attributed to current rundown.

PDD did not result in IKATP activation when [ATP]p was >1 mmol/L, suggesting that the compound shifts the sensitivity of the current to intracellular ATP rather than activating it directly. To evaluate further the dependence of PDD action on [ATP]i, we determined the frequency of IKATP activation in cells studied with a variety of [ATP]p in the presence and absence of 1 µmol/L PDD. IKATP was defined as described in "Materials and Methods." All cells not exposed to PDD were followed for at least 20 minutes, because in our experience, if IKATP is not activated spontaneously within 20 minutes of recording, it fails to activate thereafter in the absence of interventions. Cells exposed to PDD were followed for at least 20 minutes before exposure to ensure that there was no spontaneous IKATP activation. The results are shown in Fig 2ADown. Under control conditions, 16 of 21 cells (76%) showed spontaneous IKATP activation at [ATP]p of 100 µmol/L. At [ATP]p of 200 µmol/L, 6 of 11 cells (55%) showed IKATP. In the presence of PDD, all 10 cells at either of these [ATP]p levels showed IKATP. When [ATP]p was increased to 400 µmol/L, PDD resulted in IKATP activation in 80% of cells, whereas spontaneous IKATP activation was seen in only 16% of cells. As [ATP]p was increased further, the prevalence of IKATP activation by PDD decreased, and no IKATP activation occurred at [ATP]p of 1 mmol/L. The data shown in Fig 2ADown were fitted to the equation given in the figure legends, providing the curves shown in the figure. In the absence of PDD, the [ATP]p associated with a 50% maximal incidence of IKATP activation was 260 µmol/L. The half-maximal prevalence of IKATP activation by PDD occurred at [ATP]p of 601 µmol/L. The Hill coefficient was increased by 47% (from 3.0 to 4.4) in the presence of PDD, compatible with a small change in cooperativity. These results show that PDD activates IKATP in a fashion that depends on [ATP]i and suggest that PDD acts by modifying the sensitivity of the channel receptor for ATP.



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Figure 2. Concentration-response curves in rabbit ventricular myocytes. Each symbol represents percentage of cells showing IKATP. The bracketed numbers beside each symbol indicate the number of cells tested. The curves were fit by nonlinear regression to a sigmoidal function of the following form: effect=1/[1+(Kd/[C])n], where effect is the percentage of cells showing IKATP, C is concentration, Kd is the concentration for half-maximal effect, and n is a constant. A, Concentration-response curves for IKATP from cells with various [ATP]p values in the presence ({circ}) or absence ({triangleup}) of 1 µmol/L PDD. Kd values for [ATP]p in control (CTRL) and PDD groups were 260 and 601 µmol/L, respectively, and the Hill coefficients were 2.97 and 4.36, respectively. B, Concentration-response curves for PDD-induced IKATP activation at [ATP]p of 400 µmol/L. The Kd for PDD is 7.1 nmol/L.

We further characterized the actions of PDD by studying the concentration dependence of PDD-induced IKATP activation. Cells that showed no spontaneous IKATP activation over 20 minutes of observation in the presence of 400 µmol/L [ATP]p were exposed to PDD at each of the concentrations shown in Fig 2BUp, with one drug concentration studied for each cell. The prevalence of IKATP activation was a function of PDD concentration, with a half-maximal effective concentration (EC50) of 7.1 nmol/L and near-maximal effects seen at a concentration of 100 nmol/L.

To establish the role of PKC in IKATP activation by PDD, we performed the experiments illustrated in Fig 3Down. We first evaluated the changes in PDD action caused by the highly selective PKC inhibitor BIM. Cells showing no spontaneous IKATP in the presence of 400 µmol/L [ATP]p were exposed to 30 nmol/L BIM. Five minutes later, PDD was added to the superfusate at a concentration of 100 nmol/L. As shown in Fig 3ADown, BIM had no effect on membrane currents but fully prevented IKATP activation by PDD. Similar results were obtained in all five cells studied with this protocol. In the next series of experiments, we compared the effects of PDD at the maximal concentration used (1 µmol/L) with those of the inactive congener 4{alpha}-PDD at the same concentration. These experiments were performed in a blinded fashion, with coded stock solutions of either PDD or 4{alpha}-PDD prepared by a third party, so that the investigators were unaware of the identity of the solutions until the series of experiments was completed. Although PDD activated IKATP in eight of nine cells, 4{alpha}-PDD failed to elicit IKATP in any of the five cells to which it was administered (P=.003 versus PDD, Fisher's exact test). Fig 3BDown shows currents before and after exposure to 4{alpha}-PDD in a typical experiment.



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Figure 3. A, Effects of BIM on the response to PDD in a cell studied with [ATP]p of 400 µmol/L. Currents shown were recorded under control conditions (a), then in the presence of 30 nmol/L BIM (b), and finally in the presence of BIM+0.1 µmol/L PDD (c). Similar results were obtained in all five cells studied with this protocol. B, Current recordings from a representative experiment before (control, a) and during exposure to 0.1 µmol/L 4{alpha}-PDD (b). In these experiments, PDD or 4{alpha}-PDD was administered at 0.1 µmol/L in a blinded fashion. Similar results were obtained in all five cells exposed to 4{alpha}-PDD. Zero current levels are indicated by horizontal lines.

Activation of IKATP by PDD in Human Ventricular Myocytes
To determine the potential relevance of our findings to humans, we studied the effects of PDD superfusion on human ventricular myocytes. Myocytes without spontaneous IKATP after 20 minutes of observation were exposed to 100 nmol/L PDD for 10 minutes, and then 10 µmol/L glibenclamide was added to the superfusate. Fig 4ADown shows an example from a typical cell studied at [ATP]p of 400 µmol/L. Under control conditions (Fig 4ADown, a), inwardly rectifying currents were seen at potentials negative to 0 mV, and an outwardly rectifying current was present at more positive potentials. A small transient outward current was also present, consistent with previous reports of incomplete block of this current by 2 mmol/L 4-aminopyridine in human atrium.17 Five minutes after PDD was added to the superfusate, a substantial increase in membrane conductance was noted (Fig 4ADown, b). Five minutes after the addition of glibenclamide, there was strong inhibition of the conductance induced by PDD (Fig 4ADown, c). Fig 4BDown shows the I-V relations for the cell whose results are presented in Fig 4ADown. In the presence of PDD, large outward currents that rectify inwardly at voltages positive to +10 mV were seen, and the reversal potential was {approx}-75 mV. Glibenclamide returned the I-V relation to a form resembling that under control conditions, with a decrease in current amplitudes. Mean currents recorded at 0 mV are shown in Fig 4CDown for human cells studied with this protocol: five cells at [ATP]p of 100 µmol/L and five cells at [ATP]p of 400 µmol/L. PDD caused significant increases in current, which were reversed almost completely by the addition of glibenclamide. In five additional cells studied at [ATP]p of 1 mmol/L, PDD failed to activate IKATP in any, indicating that in human cells, as in the rabbit, PDD only activates IKATP at reduced [ATP]i.



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Figure 4. Evidence for PKC activation of IKATP in human ventricular cells. A, Currents recorded from one cell with [ATP]p of 400 µmol/L before exposure (control [CTRL]) (a), during exposure to 0.1 µmol/L PDD (b), and during exposure to 0.1 µmol/L PDD in the presence of 10 µmol/L glibenclamide (GLIB) (c). Zero current levels are indicated by horizontal lines. B, I-V relations obtained from the same cell before exposure ({circ}), during exposure to PDD ({bullet}), and during exposure to both PDD and GLIB ({triangleup}). C, Mean±SE currents elicited by depolarization from -40 to 0 mV under control conditions (C), during exposure to 0.1 µmol/L PDD, and during exposure to PDD (0.1 µmol/L) and 10 µmol/L GLIB (G). Currents were significantly increased by PDD, an effect reversed by GLIB (**P<.01 and ***P<.001 vs control; n=5 cells for each).


*    Discussion
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up arrowAbstract
up arrowIntroduction
up arrowMaterials and Methods
up arrowResults
*Discussion
down arrowReferences
 
We have shown that a PKC-activating phorbol ester (PDD) induces currents with properties of IKATP at reduced [ATP]i in rabbit and human ventricular myocytes. The effect is related to [PDD] (EC50 of 7.1 nmol/L) and is mediated by the activation of PKC, as indicated by the lack of effect of a high concentration of a structural analogue without PKC-stimulating properties (4{alpha}-PDD) and by the ability of a PKC inhibitor to prevent IKATP activation. These results indicate that PKC-induced phosphorylation can activate IKATP and thereby provide a link between ligands that bind to PKC-coupled membrane receptors and IKATP-mediated cardioprotection induced by ischemic preconditioning.

Potential Role of PKC in Modulating IKATP
A variety of lines of evidence suggest that PKC may couple receptor stimulation to IKATP activation. Ischemic preconditioning in dogs, swine, and rabbits appears to be due to the activation of IKATP resulting from adenosine receptor stimulation.6 7 8 9 14 Inhibition of PKC prevents ischemic preconditioning in rabbit hearts,11 suggesting that PKC is an essential mediator for ischemic preconditioning mediated by adenosine receptor stimulation. A recent publication indicates that repeated acetylcholine exposure activates IKATP by a PKC-mediated mechanism.18

PKC has been shown to regulate IKATP activity in insulinoma cells.19 20 21 Two studies demonstrated that IKATP was activated by phorbol esters,19 20 whereas one study showed inhibition.21 Recently, Light et al22 showed that brief exposure to a purified constitutively active preparation containing four PKC isoforms inhibited IKATP in inside-out patches from rabbit ventricle, while reducing the Hill coefficient from 2.2 to 1.2 without changing the Ki for ATP.22 The change in Hill coefficient suggests that, at ATP concentrations >100 µmol/L, PKC should increase IKATP, a prediction confirmed in subsequent experiments (P. Light and R. French, personal communication) and consistent with our results. Recent studies by Dunne23 also demonstrate that PKC can either increase or decrease IKATP. The latter showed that short exposure of permeabilized insulinoma cells to PMA inhibits IKATP, whereas longer exposures (>5 minutes) produce important stimulation. It is probable that there is variability in the effect of different PKC isoforms, with the net response observed depending on the mix of isoforms present and/or activated by an intervention, experimental conditions, and the relative time course of inhibitory and stimulatory actions. We did not observe inhibitory actions in our experiments, but we did not study very low ATP concentrations (<100 µmol/L) and the effects of brief exposure to PDD, conditions that would have favored the demonstration of inhibitory effects of PKC. The present study is the first of which we are aware demonstrating directly that PKC activates IKATP in cardiac ventricular myocytes. Since PKC acted by shifting IKATP sensitivity to [ATP]i, this mechanism would be expected to operate only under conditions of reduced high-energy phosphate concentration, such as in acute myocardial ischemia.

Kirsch et al24 were the first to show that activated {alpha}-subunits of inhibitory G proteins can stimulate IKATP, an action that occurs under conditions of reduced [ATP]i. Ito et al25 subsequently showed that muscarinic receptor stimulation can similarly activate IKATP channels. Terzic et al26 showed that exogenous G protein subunits and adenosine or acetylcholine (in the presence of GTP) activate IKATP in inside-out patches from guinea pig ventricles, but only in the presence of ATP at reduced [ATP]i. More recently, Ito et al27 demonstrated that GTP-{gamma}-S in the bath activates IKATP in inside-out patches from guinea pig ventricular myocytes by shifting the EC50 for ATP inhibition of channel opening from 19.5 to 110 µmol/L without changing the Hill coefficient. Bath application of GTP in the presence of pipette adenosine or acetylcholine activated IKATP in a way similar to GTP{gamma}S. In many systems, the actions of inhibitory G proteins are mediated by the activation of phospholipase C and PKC,28 and PKC mediates pertussis toxin–sensitive G protein–dependent preconditioning in rabbit and rat hearts.11 13 29 Therefore, it is possible that there is an important cardioprotective signal transduction system involving the activation of membrane receptors by ligands (adenosine, acetylcholine, and {alpha}-receptor agonists) that are coupled by inhibitory G proteins to PKC, which in turn activates IKATP in settings of impaired myocardial metabolism that cause reduced [ATP]i.

Potential Importance of Our Findings
A variety of factors are known to modulate IKATP activity by decreasing the sensitivity of the channel to [ATP]i. These include intracellular concentrations of ADP, protons and lactate, metabolic inhibition, and K+ channel openers.30 31 32 33 34 The present study adds an additional potential modulator to this list. PKC differs from previously described modulators of IKATP in being part of the signal transduction system for endogenous ligands released during acute myocardial ischemia, making it a potential mediator for endogenous cardioprotective mechanisms like ischemic preconditioning.

Ischemic preconditioning occurs in humans,35 36 37 and there is evidence that it plays a role in limiting infarct size among patients who experience angina before their infarctions.38 39 Clinically important manifestations of ischemic preconditioning are likely to occur in a variety of other situations.3 Both endogenous adenosine receptor stimulation37 and IKATP activation10 appear to be essential for ischemic preconditioning to occur in humans, as is the case for rabbits. Adenosine receptor blockade and inhibition of PKC block ischemic preconditioning in rabbit cardiomyocytes in vitro.40 Our observation that PKC activates IKATP in rabbit ventricular myocytes sheds light on the mechanism of these previous findings by suggesting that PKC may be the mechanism underlying IKATP activation. Since we observed comparable phenomena in human ventricular myocytes, it is quite possible that PKC plays a similar role in linking adenosine receptor activation to IKATP in humans.

Potential Limitations
We used the whole-cell patch-clamp method for these experiments, as have many previous investigators studying IKATP.34 41 42 This system has the advantage of stability and relative lack of IKATP rundown, which is common in excised-patch single-channel experiments.43 On the other hand, the whole-cell system has a number of important limitations that must be recognized. PKC activation must be produced indirectly by phorbol esters, requiring careful controls with PKC inhibitors and inactive analogues. The intracellular milieu is controlled by dialysis of pipette contents, which requires time to achieve a steady state and results in some uncertainty about precise intracellular contents. Finally, at positive voltages, the very large currents carried by IKATP can result in a significant voltage drop across the series resistance and impaired voltage control. We dealt with the latter by performing all statistical analyses on the basis of current elicited by a depolarization from -40 to 0 mV, during which voltage control was always adequate.

We found that IKATP induced by PDD showed rundown over time. Possible contributing mechanisms may include the spontaneous rundown of IKATP channels,43 a time-dependent desensitization to PDD, and deleterious effects of large transmembrane currents passed in the presence of IKATP on membrane and/or cellular function. In addition, time-dependent currents such as the inward rectifier K+ current at negative voltages and inward tail currents upon return from negative potentials to the holding potential decreased when IKATP was activated (eg, see Fig 1AUp, b, and Fig 4AUp, b). Inward tails partially recovered when IKATP was inhibited with glibenclamide, but time-dependent currents at negative potentials showed little, if any, recovery (Fig 1AUp, c, and Fig 4AUp, c). These types of changes were noted in all experiments. In the absence of IKATP activation, currents remained stable over time (eg, see Fig 3AUp and 3BUp). Changes in time-dependent currents in the presence of IKATP may reflect channel cross talk, direct effects of large currents on the membrane and/or cell, or other unidentified mechanisms. The mechanisms underlying these changes and their potential relevance to ischemic preconditioning remain to be established in future work.


*    Selected Abbreviations and Acronyms
 
[ATP]p = pipette [ATP]
BIM = bisindolylmaleimide
DMSO = dimethyl sulfoxide
I-V = current-voltage
IKATP = ATP-sensitive K+ current
KATP channel = ATP-sensitive K+ channel
PDD = phorbol 12,13-didecanoate
PKC = protein kinase C


*    Acknowledgments
 
This study was supported by operating grants from the Medical Research Council of Canada, the Quebec Heart Foundation, and the Fonds de Recherche de l'Institut de Cardiologie de Montréal. Dr Li is a Fonds de la Recherche en Santé du Québec (FRSQ) Research Scholar. Dr Duan was supported by a Medical Research Council postgraduate studentship. The authors thank Ling-Yu Ye for technical assistance, Dr Carrier for help in obtaining human ventricular tissue samples, and Luce Bégin for secretarial help with the manuscript.

Received August 8, 1995; accepted November 30, 1995.


*    References
up arrowTop
up arrowAbstract
up arrowIntroduction
up arrowMaterials and Methods
up arrowResults
up arrowDiscussion
*References
 
1. Murry CE, Jennings RB, Reimer KA. Preconditioning with ischemia: a delay of lethal cell injury in ischemic myocardium. Circulation. 1986;74:1124-1136. [Abstract/Free Full Text]

2. Downey JM. Ischemic preconditioning: nature's own cardioprotective intervention. Trends Cardiovasc Med. 1992;2:170-176.

3. Kloner RA, Yellon D. Does ischemic preconditioning occur in patients? J Am Coll Cardiol. 1994;24:1133-1142. [Abstract]

4. Grover GJ, Sleph PG, Dzwonczyk S. Role of myocardial ATP-sensitive potassium channels in mediating preconditioning in the dog heart and their possible interaction with adenosine A1-receptors. Circulation. 1992;86:1310-1316. [Abstract/Free Full Text]

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P. E. Light, A. A. Sabir, B. G. Allen, M. P. Walsh, and R. J. French
Protein Kinase C–Induced Changes in the Stoichiometry of ATP Binding Activate Cardiac ATP-Sensitive K+ Channels: A Possible Mechanistic Link to Ischemic Preconditioning
Circ. Res., September 1, 1996; 79(3): 399 - 406.
[Abstract] [Full Text]


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Circ. Res.Home page
C. Vahlhaus, R. Schulz, H. Post, R. Onallah, and G. Heusch
No Prevention of Ischemic Preconditioning by the Protein Kinase C Inhibitor Staurosporine in Swine
Circ. Res., September 1, 1996; 79(3): 407 - 414.
[Abstract] [Full Text]


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