Characterization of endothelin receptor subtypes mediating Ca2+ mobilization and contractile response in rabbit iris dilator muscle

Complications of cataract surgery in patients with BPH treated with alpha 1A-blockers

The prevalence of benign prostate hyperplasia (BPH) and cataract increases with age. Both diseases may develop concomitantly and may affect almost 50% of elderly men as comorbidities. Cataract is treated surgically and it has been reported that there may be an association between use of alpha-blockers for BPH, particularly alpha1A-adrenergic receptor selective drugs, and complications of cataract surgery known as Intraoperative Floppy Iris Syndrome (IFIS). The article reviews literature published on this topic and provides recommendations on how to reduce incidence of iatrogenic IFIS or its severity and outcomes in patients with BPH.

α-Blockers in Benign Prostatic Hyperplasia: The Problem of “Floppy Iris Syndrome”. Results of a Case-Control Study to Evaluate the Surgical Risk through the Meausurement of Pupil Diameter

Objectives

α-blockers are a group of α-adrenoceptor antagonists used by urologists to treat lower urinary tract symptoms suggestive of benign prostatic hyperplasia. Recent studies have suggested that these drugs – tamsulosin in particular – are involved in the development of iris complications during phacoemulsification. The objective of this study is to investigate the effects of α-blockers – especially tamsulosin – on pupil diameter.

Materials and Methods

We measured the photopic, mesopic and post-dilatation pupil diameters in both eyes of 24 patients (46 eyes in total), 16 of them treated with α-blockers and 8 of them (16 eyes in total) not treated with any drugs (controls).

Results

All patients treated with tamsulosin showed minor photopic, mesopic and post-dilatation diameters compared to controls. Patients treated with other α-blockers did not show any difference compared to controls.

Conclusions

Even if a small number of eyes was evaluated, our study shows that tamsulosin - through its selective effect on α1A receptors - is the most involved drug in the Intraoperative Floppy Iris Syndrome.

α1-Adrenergic Receptor Antagonists and the Iris: New Mechanistic Insights into Floppy Iris Syndrome

Understanding the role of adrenergic receptors in iris biology has gained widespread interest due to the recently described intraoperative floppy iris syndrome sometimes encountered during cataract surgery. alpha(1)AR-mediated iris dilator smooth muscle contraction occurs via alpha(1a)ARs whereas alpha(1b)ARs mediate iris arteriolar contraction. Because alpha(1)AR antagonists are first-line therapy for benign prostatic hyperplasia and lower urinary tract symptoms, more elderly patients requiring cataract surgery now receive these drugs. After reviewing intraoperative floppy iris syndrome, strengths/weaknesses of supporting data, and reviewing iris biology, a case is made that rather than being drug specific (alpha(1)AR antagonists), intraoperative floppy iris syndrome may represent the "tip of the iceberg." Relaxed iris dilator muscle resistant to adrenergic agonists should be expected with clinical drugs shown to relax the iris dilator (e.g., antagonists at alpha(1)AR, endothelin-A, angiotensin receptors, nitric oxide donors such as nitrates), and/or diseases associated with endothelial dysregulation (e.g., congestive heart failure, diabetes, hypertension). Rather than a rare, unexpected, unpredictable syndrome due to one drug, a careful medical history should elucidate intraoperative floppy iris syndrome predisposition. Just as anticoagulants are discontinued prior to elective surgery, conservative management of elderly patients suggests discontinuation of drugs that relax iris dilator muscle, in consultation with the patient's primary physician, should be considered prior to cataract surgery.

Endothelin-1 increases intracellular Ca(2+) in rabbit pulmonary artery smooth muscle cells through phospholipase C

In freshly isolated rabbit pulmonary artery smooth muscle cells, endothelin (ET)-1 induced a transient increase in intracellular Ca(2+) concentration ([Ca(2+)](i)) followed by a return to the initial [Ca(2+)](i). This response was not abolished by the voltage-dependent Ca(2+) channel blocker nicardipine or removal of Ca(2+) from the bath solution but was inhibited by ryanodine and thapsigargin. This finding suggested that the increase in [Ca(2+)](i) induced by ET-1 was attributable to release of Ca(2+) from ryanodine- and inositol 1,4,5-trisphosphate-sensitive intracellular Ca(2+) stores. The transient increase in [Ca(2+)](i) induced by ET-1 was also inhibited by pretreatment with antagonists of ET type A and B (ET(A) and ET(B)) receptors (BQ-123 and BQ-788, respectively). Furthermore, the ET(B) receptor agonist IRL-1620 induced an increase in [Ca(2+)](i) that was followed by a sustained increase in [Ca(2+)](i); the sustained increase in [Ca(2+)](i) was blocked by nicardipine. Using the nystatin-perforated patch-clamp technique, we found that IRL-1620 caused an increase in Ca(2+) current that was inhibited by addition of ET-1. ET-1 did not inhibit Ca(2+) current when cells were pretreated with BQ-123. These results suggested that when both receptor types are activated, the opposing responses lead to abolition of the sustained [Ca(2+)](i) increases induced by ET(B) receptor activation. Western blot analysis confirmed expression of ET(A) and ET(B) receptors. Finally, U-73122 inhibited the ET-1-induced [Ca(2+)](i) increase, indicating that phospholipase C was involved in modulation of the ET-1-induced [Ca(2+)](i) increase in rabbit pulmonary artery smooth muscle cells.

Eyeing endothelins: a cellular perspective

Endothelin is an endogenous vasoactive peptide that is considered among the most potent vasoconstrictor substances known. In addition to its vascular effects, endothelins and their receptors have been shown to be present in the eye and to have a number of ocular actions that may be important for ocular homeostasis, but, in excess can be a potential contributor to ocular neuropathy in glaucoma. The current review focuses on the cellular and molecular aspects of endothelins and its receptors in the eye with an emphasis on its relationship to ocular function and its potential role in the etiology of glaucoma pathophysiology.

Sodium-calcium exchange influences the response to endothelin-1 in lens epithelium

Studies were conducted to examine the possible involvement of Na+-Ca2+ exchanger in determining the magnitude of the endothelin-1 (ET-1)-receptor-mediated calcium signal in porcine lens epithelial cells. Cytoplasmic calcium concentration was measured in primary cultured cells loaded with Fura-2. ET-1 (100 nM) caused cytoplasmic calcium to increase transiently to approximately 250 nM from a baseline of approximately 65 nM. The calcium increase decayed to a sustained plateau 35-45 nM above the baseline. Both the peak and plateau component of the ET-1 calcium response were abolished by PD145065, an ET receptor antagonist, and by cyclopiazonic acid (CPA) (10 microM). In calcium-free bathing solution, only the plateau was abolished. In the presence of ouabain, low-sodium bathing solution or bepridil, a sodium-calcium exchange inhibitor, peak height more than doubled. Bepridil also increased the peak height of the calcium response to ATP. The half-time for decay of the ET-1 and ATP calcium peak was increased several folds by bepridil, ouabain and low-sodium conditions. Measurements of ionomycin-releasable calcium suggested calcium store size was not increased in bepridil-treated cells. Taken together findings suggest inhibition of sodium-calcium exchange increases the magnitude of the receptor-initiated store-release phase of the ET-1 calcium signaling response as the result of impaired calcium clearance from the cytoplasm.

Characteristics of Ca2+ oscillations in ileal longitudinal muscle cells of guinea pig

We studied the mechanisms and characteristics of the spontaneously evoked intracellular Ca2+ changes (Ca2+ oscillations) in ileal longitudinal smooth muscle from guinea pig. Two-dimensional images of Ca2+ oscillations were obtained at 33-ms intervals with a Ca2+-sensitive fluorescence probe, fluo-3 using the intensified CCD camera. Nicardipine (10-7 M) significantly decreased the maximum level of fluorescence intensity of the Ca2+ oscillations, inhibited the frequency of the oscillations and tended to decrease the basal level of fluorescence intensity. However, tetrodotoxin (3 x 10-7 M) did not affect these oscillations. Phorbol 12,13-dibutyrate (10-7 M) significantly increased the maximum level of fluorescence intensity and the frequency of Ca2+ oscillations, and it changed them to steady and chronometric Ca2+ oscillations. Cyclopiazonic acid (3 x 10-5 M) also significantly increased the frequency of Ca2+ oscillations. Acetylcholine (10-8 M) increased the basal and maximum level of fluorescence intensity and the frequency of Ca2+ oscillations, and accelerated their onset. The increase of basal level of fluorescence intensity was then decreased by cyclopiazonic acid treatment. These results suggest that the augmentation of Ca2+ oscillations is mainly due to the activation of L-type Ca2+ channels, which is modulated by protein kinase C, and that the emptying of intracellular Ca2+ stores may activate the Ca2+ oscillations mediated through the increase of Ca2+ influx in ileal smooth muscle of guinea pig.

Studies on the endothelin-1-induced contraction of rat granulation tissue pouch mediated by myofibroblasts

A granulation tissue pouch, mostly composed of myofibroblasts, was prepared by injecting rats subcutaneously with croton oil. The contraction of the granulation tissue pouch caused by endothelin-1 (ET-1) and the effects of the ET receptor antagonists, BQ123 and BQ788 on it were thus examined. ET-1 produced contractions in a dose-dependent manner. Pretreatment with BQ123, an ETA receptor selective antagonist, shifted the dose-response curve to the right, whereas pretreatment with BQ788, an ETB receptor selective antagonist, showed little effect. IRL1620, an ETB receptor selective agonist, did not cause any contraction in the granulation tissue pouch. The existence of both ETA and ETB receptors in the granulation tissue pouch and in cultured myofibroblasts was demonstrated by RT-PCR. Intracellular Ca2+ mobilization in Fura-2/acetyl-methoxy ester loaded cultured myofibroblasts isolated from the granulation tissue was also examined. ET-1 produced a transient increase in [Ca2+]i followed by a sustained elevation of [Ca2+]i, whereas IRL1620 caused only a transient peak. These results suggest that the ET-1 induced contraction of granulation tissue is mainly mediated through the mobilization of Ca2+ from the extracellular space caused by stimulation with ETA receptor.

Radioligand binding characteristics of the endothelin receptor in the rabbit iris

We previously suggested the presence of functionally atypical endothelin (ET) A receptors in the rabbit iris sphincter. Here, we further characterized the ET receptor by a radioligand-receptor binding study utilizing a membrane fraction of the rabbit iris. In addition, we functionally confirm the presence of an atypical ET(A) receptor in the iris dilator similar to that in the iris sphincter. In binding experiments, [125I]ET-1 was completely displaced by ET-3 in a biphasic fashion, but only partially by BQ-123 and ET(B) ligands. In the presence of RES-701, ET-3 and sarafotoxin (SRTX)-b completely displaced [125I]ET-1 in a monophasic fashion, but with shallow slopes. Moreover, ET-1, ET-3 and SRTX-b completely displaced [3H]BQ-123 with IC50 values of 0.8, 81 and 4.4 nM, respectively, but with slopes of ET-3 and SRTX-b being again shallow. In iris dilator muscles, ET-3 showed lower and SRTX-b showed higher contractile activities than ET-1. SRTX-c was inactive. BQ-123 more preferentially antagonized ET-3 and SRTX-b than ET-1, with the Schild plot slope of SRTX-b being shallow. Thus, functional experiments suggested the presence of atypical ET(A) receptors in the iris dilator similar to the iris sphincter. However, the binding experiments suggested the presence of rather typical ET(A)- and ET(B)-like receptors. Therefore, we apparently failed to show ET binding sites corresponding to functionally atypical ET(A) receptors.

Inhibitory effect of phorbol 12,13-dibutyrate on norepinephrine-induced contraction in rabbit iris dilator muscle

The hypothesis that the increase in Ca2+ sensitivity on norepinephrine-induced contraction of smooth muscles and also the decrease of the norepinephrine-induced sustained level of intracellular Ca2+ concentration are produced by the activation of protein kinase C was tested. Phorbol 12,13-dibutyrate (PDB; 10(-6) M) relaxed the norepinephrine-induced sustained contraction in a concentration-dependent manner. On pretreatment with PDB a transient contraction was produced by the application of norepinephrine, but the sustained contraction was significantly reduced. The sustained elevations of intracellular Ca2+ concentration ([Ca2+]i) and the contraction induced by norepinephrine in fura-2-loaded preparations were decreased by the application of PDB. These inhibitory effects were antagonized by potent protein kinase inhibitors, 2-(1-(3-dimethylaminopropyl)-indol-3-yl)-3-(-indol-3-yl)-maleimide (GF 109203X) (10 (-6) M) and 1-(5-isoquinolinesulfonyl)-2-methylpiperazine dihydrochloride (H-7) (10 (-6) M), but were not affected by a protein kinase A/G inhibitor, N-(2-cinnamylaminoethyl)-5-isoquinolinesulfonamide (H-88) (10(-6) M). The slope of the regression line for norepinephrine for [Ca2+]i and tension was significantly steeper than those obtained with high K+. Also, on pretreatment with PDB the Ca2+ sensitivity of the K(+)-induced contraction was decreased, but the Ca2+ sensitivity of norepinephrine-induced contraction tended to be increased. These observations indicate that PDB induces a decrease of [Ca2+]i on Ca2+ mobility and an increase of Ca2+ sensitivity on contraction of smooth muscle through the activation of protein kinase C.