Articles |
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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-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 |
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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 |
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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 (
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 (
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 nonPKC-stimulating homologue
4
-PDD were purchased from ICN Biochemicals. PDD, 4
-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
-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
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
, respectively, in rabbit cells and
6.80±0.37 and
2.59±0.15 M
, 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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-80 mV and shows strong
inward rectification. In the presence of PDD, the reversal potential is
-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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Fig 1C
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 2A
.
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 2A
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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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 2B
, 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 3
. 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 3A
, 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
-PDD at the same concentration. These experiments were performed in
a blinded fashion, with coded stock solutions of either PDD or 4
-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
-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 3B
shows currents before and
after exposure
to 4
-PDD in a typical experiment.
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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 4A
shows an example from a
typical cell studied at [ATP]p of 400 µmol/L. Under
control conditions (Fig 4A
, 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 4A
,
b).
Five minutes after the addition of glibenclamide, there was strong
inhibition of the conductance induced by PDD (Fig 4A
, c). Fig
4B
shows
the I-V relations for the cell whose results are presented in
Fig 4A
. In the presence of PDD, large outward currents that
rectify
inwardly at voltages positive to +10 mV were seen, and the reversal
potential was
-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
4C
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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| Discussion |
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-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
-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-
-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
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 toxinsensitive G proteindependent 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
-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 1A
, b, and Fig
4A
,
b). Inward tails partially recovered when IKATP was
inhibited with glibenclamide, but time-dependent currents at
negative potentials showed little, if any, recovery (Fig 1A
, c,
and Fig 4A
, c). These types of changes were noted in all
experiments. In the
absence of IKATP activation, currents remained stable over
time (eg, see Fig 3A
and 3B
). 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 |
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| Acknowledgments |
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Received August 8, 1995; accepted November 30, 1995.
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