Differential effects of verapamil and flunarizine on cardiac L-type and T-type Ca channels

Classification of calcium channels and calcium antagonists: progress report

The molecular biology and electrophysiology of calcium channels is proceeding apace, partially driven by the clinical success of the drugs classed as "calcium antagonists." Indeed, there are now more than 70 drugs in development that have been claimed to be "calcium antagonists" of one type or another. In order to ensure that there is a logical nomenclature for the channels and the drugs acting at the channels, an international committee has met over the last 2 years to classify the channels and the drugs. This report consists of an overview of current thinking, which will be finalized in a document submitted to the IUPHAR (International Union of Pharmacologists) nomenclature committee.

Flunarizine inhibits a high-threshold inactivating calcium channel (N-type) in isolated hippocampal neurons

The action of flunarizine on the high-threshold inactivating calcium channel (N-type) in hippocampal neurons of the rat was investigated using the whole-cell voltage clamp technique. Flunarizine reduced the currents at all test potentials, without shifting the peak of the current-voltage relationship along the voltage-axis. The drug did not affect the activation curve, but drastically decreased the slope conductance in the linear region of the current-voltage relationship. Block of the current by flunarizine occurred in a use-dependent way. Flunarizine was without effect when applied intracellulary, and the onset of action, when applied extracellularly, was slow (range of minutes). The Kd for the block by flunarizine obtained after 6 repetitive depolarizations at 0.2 Hz (pulse duration 150 ms) from -90 mV to 0 mV was 0.8 microM. In conclusion, we present electrophysiological evidence that flunarizine blocks the high-threshold inactivating Ca channel of hippocampal neurons of the rat. We discuss the possibility that flunarizine might inhibit neuronal transmitter release by means of this effect.

Separation of two pathways for calcium entry into chromaffin cells

1. The effects of various drugs on 45Ca + 40Ca uptake into cultured bovine adrenal chromaffin cells evoked by 1,1-dimethyl-4-phenylpiperazinium (DMPP) or high K, were studied. In the presence of 1 mM external 40Ca, with 45Ca as a radiotracer, unstimulated cells took up an average of 0.13 fmol/cell 40Ca and 772 c.p.m./10(6) cells of 45Ca (n = 76). Upon stimulation with DMPP (100 microM for 60 s) or K (59 mM for 60 s), Ca uptake increased to 0.92 and 1 fmol/cell, respectively. 2. Flunarizine behaved as a potent blocker of both DMPP- and K-evoked Ca uptake (IC50 of 1.76 and 1.49 microM, respectively for DMPP and K). A similar picture emerged with Cd ions, though Cd exhibited an IC50 against K (1.86 microM) slightly lower than the IC50 against DMPP (8.14 microM). 3. Clear cut differences were observed with amiloride, guanethidine, nimodipine and nisoldipine which behaved as selective blockers of DMPP-mediated Ca uptake responses: IC50 values to block DMPP effects were 290, 27, 1.1 and 1.63 microM respectively for amiloride, guanethidine, nimodipine and nisoldipine. Amiloride blocked K-evoked Ca uptake by only 35% and guanethidine did not affect it. Nisoldipine inhibited K-evoked Ca uptake only partially at low concentrations (about 30%); a second blocking component was observed at the highest concentration used (10 microM). At 10 microM, nimodipine blocked K-evoked Ca uptake by 50%. 4. Thus, it seems that the nicotinic receptor mediated Ca uptake pathway can be pharmacologically separated from the K-activated pathway. The results are compatible with the hypothesis that in cultured bovine adrenal chromaffin cells, stimulation of nicotinic receptors recruits a single type of Ca channel which is sensitive to flunarizine, Cd, amiloride, guanethidine, nimodipine and nisoldipine. The results also suggest that K depolarization might be recruiting in addition to this channel, another Ca channel which is highly sensitive to Cd and flunarizine, resistant to nisoldipine, nimodipine and amiloride, and insensitive to guanethidine.

Developmental changes in the calcium currents in embryonic chick ventricular myocytes

Using the patch-clamp technique, we recorded whole-cell calcium current from isolated cardiac myocytes dissociated from the apical ventricles of 7-day and 14-day chick embryos. In 70% of 14-day cells after 24 hr in culture, two component currents could be separated from total ICa activated from a holding potential (Vh) of -80 mV. L-type current (IL) was activated by depolarizing steps from Vh -30 or -40 mV. The difference current (IT) was obtained by subtracting IL from ICa. IT could also be distinguished pharmacologically from IL in these cells. IT was selectively blocked by 40-160 microM Ni2+, whereas IL was suppressed by 1 microM D600 or 2 microM nifedipine. The Ni2(+)-resistant and D600-resistant currents had activation thresholds and peak voltages that were near those of IT and IL defined by voltage threshold, and resembled those in adult mammalian heart. In 7-day cells, IT and IL could be distinguished by voltage threshold in 45% (S cells), while an additional 45% of 7-day cells were nonseparable (NS) by activation voltage threshold. Nonetheless, in most NS cells, ICa was partly blocked by Ni2+ and by D600 given separately, and the effects were additive when these agents were given together. Differences among the cells in the ability to separate IT and IL by voltage threshold resulted largely from differences in the position of the steady-state inactivation and activation curves along the voltage axis. In all cells at both ages in which the steady-state inactivation relation was determined with a double-pulse protocol, the half-inactivation potential (V1/2) of the Ni2(+)-resistant current IL averaged -18 mV. In contrast, V1/2 of the Ni2(+)-sensitive IT was -60 mV in 14-day cells, -52 mV in 7-day S cells, and -43 mV in 7-day NS cells. The half-activation potential was near -2 mV for IL at both ages, but that of IT was -38 mV in 14-day and -29 mV in 7-day cells. Maximal current density was highly variable from cell to cell, but showed no systematic differences between 7-day and 14-day cells. These results indicate that the main developmental change that occurs in the components of ICa is a negative shift with embryonic age in the activation and inactivation relationships of IT along the voltage axis.

A combined study of sodium current and T-type calcium current in isolated cardiac cells

Sodium currents (INa) and T-type calcium currents (ICa,T) of isolated guinea-pig ventricular myocytes were recorded using the whole-cell voltage-clamp technique. Separation of the two currents was obtained by using the difference current method in the presence and absence of 2 mM extracellular Na (Nao). Time to peak and the time constant of inactivation of. INa were about 5 times faster than that of ICa,T (test potential -30 mV), and ICa,T had an activation range positive to -50 mV, were inactivated at -50 mV, and their current/voltage relationships peaked at -22.3 +/- 1.8 mV (n = 18) and -29.3 +/- 0.5 mV (n = 18) respectively, with a reversal potential of +40.3 +/- 4 mV (n = 18) and +30 +/- 10 mV (n = 18), respectively [2 mM Nao; 5.4 mM extracellular Ca (Cao)]. INa was blocked by 30 microM tetrodotoxin (TTX), 500 microM lidocaine, partly inhibited by 1 mM amiloride, but not affected by 100 microM nickel (Ni). ICa,T was neither affected by 30 microM TTX nor 500 microM lidocaine, but blocked by 100 microM Ni, 1 mM amiloride, 10 microM R 56865 and use-dependently reduced by 5 microM flunarizine. Adenosine (500 microM) affected neither INa nor ICa,T, whereas 1 microM isoprenaline did not affect ICa,T, but slightly increased INa. Our results demonstrate that the characteristics of ICa,T are not affected by the concomitant activation of INa, and vice versa. We conclude that ICa,T are not Ca currents through Na channels.

Activators and inactivators of calcium channels: effects in the central nervous system

The interactions of calcium antagonists or channel activators with the different classes of calcium channel are reviewed with particular emphasis on interactions with neuronal tissue; reasons for the failure of calcium antagonists to inhibit neurotransmitter release under normal circumstances are outlined. Calcium antagonists may be protective in several pathological situations and the possibilities of protection against ischaemic damage in the central nervous system are evaluated.

The differential effect of calcium antagonists on the positive inotropic effects induced by calcium and monensin in cardiac preparations of rats and guinea-pigs

It was the aim of the present study to gain more insight into the role of extracellular calcium and of calcium from intracellular sources in the development of contractile force in the mammalian heart. In rat Langendorff hearts the effect of nifedipine, verapamil, diltiazem, bepridil and lidoflazine as well as of the intracellularly acting calcium antagonists ryanodine and TMB-8 on the increase of the left ventricular pressure induced by calcium and the sodium ionophore monensin, respectively, was studied. In rat and guinea-pig papillary muscles the influence of nifedipine, ryanodine and lidoflazine on the effect of monensin on the force of contraction was evaluated. Calcium and monensin concentration-dependently increased the left ventricular pressure in rat Langendorff hearts. The calcium-induced effect was characterized by a sharp initial rise of the left ventricular pressure which stabilized at a lower level while monensin elicited a gradual rise of the left ventricular pressure. Nifedipine, verapamil and diltiazem, applied at the EC50 and the EC80 for the reduction of the left ventricular pressure under control conditions, shifted the concentration-response curves for calcium and monensin into the right. Ryanodine, TMB-8, lidoflazine and bepridil, applied at the EC50, displaced the concentration-response curves for calcium and monensin to the right but reduced the maximal increase of the left ventricular pressure. At the EC80, these drugs almost completely abolished the positive inotropic effects elicited by calcium and monensin, respectively. In rat papillary muscles monensin did not influence the basal force of contraction. A clear positive inotropic effect was only observed in the presence of nifedipine.(ABSTRACT TRUNCATED AT 250 WORDS)

Functional, behavioral, and histological changes induced by transient global cerebral ischemia in rats: effects of cinnarizine and flunarizine

Temporary cerebral ischemia (15 min) produced by "four-vessel occlusion" in the rat causes neurological disorders, changes in behavior (locomotor hyperactivity), and neuronal damage in the neocortex, striatum, and especially the CA1 zone of the hippocampus. We have studied the effects of two calcium overload blockers, flunarizine (50 mg/kg p.o. twice a day) and cinnarizine (100 mg/kg p.o. twice a day), on these alterations. Cinnarizine markedly improved the functional abnormalities of ischemia but had little or no effect upon the neuronal damage. In contrast, flunarizine provided far greater neuronal protection but with less obvious effects upon behavioral parameters. However, there was evidence of sedation 2 h after treating animals with this dose of flunarizine that might have masked any positive effect of the drug on behavior. We conclude that under the present experimental conditions, there is no correlation between the early and late behavioral changes observed following a temporary cerebral ischemic episode and the histological damage observed in certain vulnerable neurons, particularly in the hippocampus, 72 h after the insult.

Termination of ouabain-induced ventricular tachycardia by flunarizine in conscious dogs

The ability of flunarizine to terminate ouabain-induced ventricular tachycardia was investigated in conscious dogs. These arrhythmias result from triggered activity based on delayed afterdepolarizations. Sustained ventricular tachycardia was induced by ouabain (48 +/- 6 micrograms/kg) and pacing in 13 animals with surgically induced complete atrioventricular block. Flunarizine was administered i.v. when the arrhythmia had persisted for at least 20 min. Flunarizine induced an increase of the R-R interval from 300 +/- 30 to 410 +/- 50 ms (P less than or equal to 0.001) in all dogs. Flunarizine (2 mg/kg) terminated ventricular tachycardia with long R-R intervals (330 +/- 20 ms) in seven dogs. An additional dose of flunarizine (1 mg/kg) resulted in termination of the faster tachycardias (280 +/- 15 ms). The arrhythmias were not induced again by pacing for 27 +/- 18 min. Reinitiated tachycardias could be suppressed again by flunarizine. In conclusion, flunarizine (1) slows and terminates arrhythmias resulting from delayed afterdepolarizations, and (2) prevents their reinitiation.