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(Circulation Research. 2006;98:970.)
© 2006 American Heart Association, Inc.

Clinical Research

Positive Inotropic Effects by Uridine Triphosphate (UTP) and Uridine Diphosphate (UDP) via P2Y₂ and P2Y₆ Receptors on Cardiomyocytes and Release of UTP in Man During Myocardial Infarction

Anna-Karin Wihlborg^*, Johanna Balogh^*, Lingwei Wang, Catharina Borna, Ying Dou, Bhalchandra V. Joshi, Eduardo Lazarowski, Kenneth A. Jacobson, Anders Arner, David Erlinge

From the Departments of Cardiology (A.-K.W., L.W., C.B., D.E.) and Experimental Medical Science (J.B., A.A.), Lund University, Sweden; the Molecular Recognition Section (B.V.J., K.A.J.), National Institutes of Health, Bethesda, Md; the Department of Medicine (E.L.), University of North Carolina, School of Medicine, Chapel Hill; and the Department of Physiology and Pharmacology (Y.D., A.A.), Karolinska Institutet, Stockholm, Sweden.

Correspondence to Dr Anna-Karin Wihlborg, Department of Cardiology, Tornavägen 10 BMC:C12, Lund 22237, Sweden. E-mail anna-karin.wihlborg{at}kard.lu.se

The aim of this study was to examine a possible role for extracellular pyrimidines as inotropic factors for the heart. First, nucleotide plasma levels were measured to evaluate whether UTP is released in patients with coronary heart disease. Then, inotropic effects of pyrimidines were examined in isolated mouse cardiomyocytes. Finally, expression of pyrimidine-selective receptors (a subgroup of the P2 receptors) was studied in human and mouse heart, using real time polymerase chain reaction, Western blot, and immunohistochemistry. Venous plasma levels of UTP were increased (57%) in patients with myocardial infarction. In electrically stimulated cardiomyocytes the stable P2Y_2/4 agonist UTPS increased contraction by 52%, similar to ß₁-adrenergic stimulation with isoproterenol (65%). The P2Y₆-agonist UDPßS also increased cardiomyocyte contraction (35%), an effect abolished by the P2Y₆-blocker MRS2578. The phospholipase C inhibitor U73122 inhibited both the UDPßS and the UTPS-induced inotropic effect, indicating an IP₃-mediated effect via P2Y₆ receptors. The P2Y₁₄ agonist UDP-glucose was without effect. Quantification of mRNA with real time polymerase chain reaction revealed P2Y₂ as the most abundant pyrimidine receptor expressed in cardiomyocytes from man. Presence of P2Y₆ receptor mRNA was detected in both species and confirmed at protein level with Western blot and immunohistochemistry in man. In conclusion, UTP levels are increased in humans during myocardial infarction, giving the first evidence for UTP release in man. UTP is a cardiac inotropic factor most likely by activation of P2Y₂ receptors in man. For the first time we demonstrate inotropic effects of UDP, mediated by P2Y₆ receptors via an IP₃-dependent pathway. Thus, the extracellular pyrimidines (UTP and UDP) could be important inotropic factors involved in the development of cardiac disease.

Key Words: P2-receptors • inotropy • heart • UTP • UDP

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