An analysis of the actions of low concentrations of ouabain on membrane currents in Purkinje fibres

Sensational site: the sodium pump ouabain-binding site and its ligands

Cardiotonic steroids (CTS), used by certain insects, toads, and rats for protection from predators, became, thanks to Withering's trailblazing 1785 monograph, the mainstay of heart failure (HF) therapy. In the 1950s and 1960s, we learned that the CTS receptor was part of the sodium pump (NKA) and that the Na+/Ca2+ exchanger was critical for the acute cardiotonic effect of digoxin- and ouabain-related CTS. This "settled" view was upended by seven revolutionary observations. First, subnanomolar ouabain sometimes stimulates NKA while higher concentrations are invariably inhibitory. Second, endogenous ouabain (EO) was discovered in the human circulation. Third, in the DIG clinical trial, digoxin only marginally improved outcomes in patients with HF. Fourth, cloning of NKA in 1985 revealed multiple NKA α and β subunit isoforms that, in the rodent, differ in their sensitivities to CTS. Fifth, the NKA is a cation pump and a hormone receptor/signal transducer. EO binding to NKA activates, in a ligand- and cell-specific manner, several protein kinase and Ca2+-dependent signaling cascades that have widespread physiological effects and can contribute to hypertension and HF pathogenesis. Sixth, all CTS are not equivalent, e.g., ouabain induces hypertension in rodents while digoxin is antihypertensinogenic ("biased signaling"). Seventh, most common rodent hypertension models require a highly ouabain-sensitive α2 NKA and the elevated blood pressure is alleviated by EO immunoneutralization. These numerous phenomena are enabled by NKA's intricate structure. We have just begun to understand the endocrine role of the endogenous ligands and the broad impact of the ouabain-binding site on physiology and pathophysiology.

High Potassium Concentration during Culturing of Early Mammalian Embryos: Normal or Extreme Situation?

Analysis of the element composition of oviduct and uterine fluid in mammals showed high potassium concentrations in the early embryo microenvironment in vivo. The results of early embryogenesis of mammals in vitro in the presence of high potassium concentrations are discussed. The data are summarized in accordance with the conditions of experimentally modeled pre-implantation development. Comparative assessment of the quality of embryo development until the blastocyst stage in vitro proved the embryos more successfully developed at potassium concentrations close to those registered in the oviductal fluid.

Advances in understanding the role of cardiac glycosides in control of sodium transport in renal tubules

Cardiotonic steroids have been used for the past 200 years in the treatment of congestive heart failure. As specific inhibitors of membrane-bound Na(+)/K(+) ATPase, they enhance cardiac contractility through increasing myocardial cell calcium concentration in response to the resulting increase in intracellular Na concentration. The half-minimal concentrations of cardiotonic steroids required to inhibit Na(+)/K(+) ATPase range from nanomolar to micromolar concentrations. In contrast, the circulating levels of cardiotonic steroids under physiological conditions are in the low picomolar concentration range in healthy subjects, increasing to high picomolar levels under pathophysiological conditions including chronic kidney disease and heart failure. Little is known about the physiological function of low picomolar concentrations of cardiotonic steroids. Recent studies have indicated that physiological concentrations of cardiotonic steroids acutely stimulate the activity of Na(+)/K(+) ATPase and activate an intracellular signaling pathway that regulates a variety of intracellular functions including cell growth and hypertrophy. The effects of circulating cardiotonic steroids on renal salt handling and total body sodium homeostasis are unknown. This review will focus on the role of low picomolar concentrations of cardiotonic steroids in renal Na(+)/K(+) ATPase activity, cell signaling, and blood pressure regulation.

Characterization of the stimulation of neuronal Na(+), K(+)-ATPase activity by low concentrations of ouabain

Low concentrations (< 10(?7) M) of ouabain stimulate the activity of Na(+), K(+)-ATPase in whole homogenates of rat brain. The magnitude of this stimulation varies from 5 to 70%. The concentrations of ouabain which induces maximal stimulation is also highly variable and ranges between 10(?9) to 10(?7) M. The ouabain stimulation disappears following 1:50 dilution and 2 h preincubation or freezing and thawing of the membranes or their treatment with deoxycholate. "Aging" of a preparation of ATPase also results in loss of its ability to be stimulated by ouabain but ouabain inhibition is preserved. No stimulation of enzyme activity by ouabain is observed in rat brain microsomal fraction. The ?-adrenergic blocker propranolol does not inhibit the ouabain induced stimulation of ATPase activity. It is suggested that the stimulation of Na(+), K(+)-ATPase activity by low concentrations of cardiac glycosides if a result of either the displacement of an endogenous ouabain-like compound from the enzyme or an indirect effect by changing membrane surrounding environment of the Na(+), K(+)-ATPase.

Low-dose cardiotonic steroids increase sodium-potassium ATPase activity that protects hippocampal slice cultures from experimental ischemia

The sodium-potassium ATPase (Na/K ATPase) is a major ionic transporter in the brain and is responsible for the maintenance of the Na(+) and K(+) gradients across the cell membrane. Cardiotonic steroids such as ouabain, digoxin and marinobufagenin are well-characterized inhibitors of the Na/K ATPase. Recently, cardiotonic steroids have been shown to have additional effects at concentrations below their IC(50) for pumping. The cardiotonic steroids ouabain, digoxin, and marinobufagenin all show an inverted U-shaped dose-response curve with inhibition of pumping at concentrations near their IC(50), while increasing Na/K ATPase activity at doses below their IC(50). This stimulatory effect of cardiotonic steroids was observed in vitro in hippocampal slice cultures as well as in the hippocampus in vivo. Increased Na/K ATPase activity has been shown to protect slice culture neurons from hypoxia-hypoglycemia. Ouabain protected slice culture neurons from experimental ischemia at concentrations that increased Na/K ATPase. This protective effect was observed when ouabain was dosed 30min before, or 2h following experimental ischemia. Ouabain no longer protected against experimental ischemia if the increase of Na/K ATPase was blocked. These data suggest that the protective effect of ouabain was due to increased Na/K ATPase activity. The demonstration of a neuroprotective effect of cardiotonic steroids could potentially assist in the treatment of stroke since digoxin, one of the cardiotonic steroids examined in this study, has approval by the Food and Drug Administration and can be safely administered at the concentrations that increase Na/K ATPase activity.

Electrogenic Na+/Ca2+-exchange of nerve and muscle cells

The plasma membrane Na(+)/Ca(2+)-exchanger is a bi-directional electrogenic (3Na(+):1Ca(2+)) and voltage-sensitive ion transport mechanism, which is mainly responsible for Ca(2+)-extrusion. The Na(+)-gradient, required for normal mode operation, is created by the Na(+)-pump, which is also electrogenic (3Na(+):2K(+)) and voltage-sensitive. The Na(+)/Ca(2+)-exchanger operational modes are very similar to those of the Na(+)-pump, except that the uncoupled flux (Na(+)-influx or -efflux?) is missing. The reversal potential of the exchanger is around -40 mV; therefore, during the upstroke of the AP it is probably transiently activated, leading to Ca(2+)-influx. The Na(+)/Ca(2+)-exchange is regulated by transported and non-transported external and internal cations, and shows ATP(i)-, pH- and temperature-dependence. The main problem in determining the role of Na(+)/Ca(2+)-exchange in excitation-secretion/contraction coupling is the lack of specific (mode-selective) blockers. During recent years, evidence has been accumulated for co-localisation of the Na(+)-pump, and the Na(+)/Ca(2+)-exchanger and their possible functional interaction in the "restricted" or "fuzzy space." In cardiac failure, the Na(+)-pump is down-regulated, while the exchanger is up-regulated. If the exchanger is working in normal mode (Ca(2+)-extrusion) during most of the cardiac cycle, upregulation of the exchanger may result in SR Ca(2+)-store depletion and further impairment in contractility. If so, a normal mode selective Na(+)/Ca(2+)-exchange inhibitor would be useful therapy for decompensation, and unlike CGs would not increase internal Na(+). In peripheral sympathetic nerves, pre-synaptic alpha(2)-receptors may regulate not only the VSCCs but possibly the reverse Na(+)/Ca(2+)-exchange as well.

K+ currents generated by NMDA receptor activation in rat hippocampal pyramidal neurons

Long lasting outward currents mediated by Ca2+-activated K+ channels can be induced by Ca2+ influx through N-methyl-D-aspartate (NMDA)-receptor channels in voltage-clamped hippocampal pyramidal neurons. Using specific inhibitors, we have attempted to identify the channels that underlie these outward currents. At a holding potential of -50 mV, applications of 1 mM NMDA to the soma of cultured hippocampal pyramidal neurons induced the expected inward currents. In 44% of cells tested, these were followed by outward currents (average amplitude 60 +/- 7 pA) that peaked 2.5 s after the initiation of the inward NMDA currents and decayed with a time constant of 1.4 s. In 43% of those cells exhibiting an outward current, SK channel inhibitors, UCL 1848 (100 nM) and apamin (100 nM) abolished the outward current. In the remainder of the cells, the outward currents were either insensitive or only partly inhibited (44 +/- 4%) by 100 nM UCL 1848. In these cells, the outward currents were reduced by the slow afterhyperpolarization (sAHP) inhibitors, muscarine (3 microM; 43 +/- 9%), UCL 1880 (3 microM; 34 +/- 10%), and UCL 2027 (3 microM; 57 +/- 6%). Neither the BK channel inhibitor, charybdotoxin (100 nM), nor the Na+/K+ ATPase inhibitor, ouabain (100 microM), reduced these outward currents. Irrespective of the pharmacology, the time course of the outward current did not differ. Interestingly, no correlation was observed between the presence of a slow apamin-insensitive afterhyperpolarization and an outward current insensitive to SK channel blockers following NMDA-receptor activation. It is concluded that an NMDA-mediated rise in [Ca2+]i can result in the activation of apamin-sensitive SK channels and of the channels that underlie the sAHP. The activation of these channels may, however, depend on their location relative to NMDA receptors as well as on the spatial Ca2+ buffering within individual neurons.

Isoform-specific stimulation of cardiac Na/K pumps by nanomolar concentrations of glycosides

It is well-known that micromolar to millimolar concentrations of cardiac glycosides inhibit Na/K pump activity, however, some early reports suggested nanomolar concentrations of these glycosides stimulate activity. These early reports were based on indirect measurements in multicellular preparations, hence, there was some uncertainty whether ion accumulation/depletion rather than pump stimulation caused the observations. Here, we utilize the whole-cell patch-clamp technique on isolated cardiac myocytes to directly measure Na/K pump current (I(P)) in conditions that minimize the possibility of ion accumulation/depletion causing the observed effects. In guinea pig ventricular myocytes, nanomolar concentrations of dihydro-ouabain (DHO) caused an outward current that appeared to be due to stimulation of I(P) because of the following: (1) it was absent in 0 mM [K(+)](o), as was I(P); (2) it was absent in 0 mM [Na(+)](i), as was I(P); (3) at reduced [Na(+)](i), the outward current was reduced in proportion to the reduction in I(P); (4) it was eliminated by intracellular vanadate, as was I(P). Our previous work suggested guinea pig ventricular myocytes coexpress the alpha(1)- and alpha(2)-isoforms of the Na/K pumps. The stimulation of I(P) appears to be through stimulation of the high glycoside affinity alpha(2)-isoform and not the alpha(1)-isoform because of the following: (1) regulatory signals that specifically increased activity of the alpha(2)-isoform increased the amplitude of the stimulation; (2) regulatory signals that specifically altered the activity of the alpha(1)-isoform did not affect the stimulation; (3) changes in [K(+)](o) that affected activity of the alpha(1)-isoform, but not the alpha(2)-isoform, did not affect the stimulation; (4) myocytes from one group of guinea pigs expressed the alpha(1)-isoform but not the alpha(2)-isoform, and these myocytes did not show the stimulation. At 10 nM DHO, total I(P) increased by 35 +/- 10% (mean +/- SD, n = 18). If one accepts the hypothesis that this increase is due to stimulation of just the alpha(2)-isoform, then activity of the alpha(2)-isoform increased by 107 +/- 30%. In the guinea pig myocytes, nanomolar ouabain as well as DHO stimulated the alpha(2)-isoform, but both the stimulatory and inhibitory concentrations of ouabain were approximately 10-fold lower than those for DHO. Stimulation of I(P) by nanomolar DHO was observed in canine atrial and ventricular myocytes, which express the alpha(1)- and alpha(3)-isoforms of the Na/K pumps, suggesting the other high glycoside affinity isoform (the alpha(3)-isoform) also was stimulated by nanomolar concentrations of DHO. Human atrial and ventricular myocytes express all three isoforms, but isoform affinity for glycosides is too similar to separate their activity. Nevertheless, nanomolar DHO caused a stimulation of I(P) that was very similar to that seen in other species. Thus, in all species studied, nanomolar DHO caused stimulation of I(P), and where the contributions of the high glycoside affinity alpha(2)- and alpha(3)-isoforms could be separated from that of the alpha(1)-isoform, it was only the high glycoside affinity isoform that was stimulated. These observations support early reports that nanomolar concentrations of glycosides stimulate Na/K pump activity, and suggest a novel mechanism of isoform-specific regulation of I(P) in heart by nanomolar concentrations of endogenous ouabain-like molecules.

Mechanisms underlying the shortening of the action potential at high and low stimulus rates in sheep Purkinje fibres

The shortening of the action potential of sheep Purkinje fibres at high and low rates of stimulation has been investigated. The shortening of the action potential at high rates can be entirely accounted for by incomplete recovery of the plateau conductances between beats. When sufficient time is allowed for membrane recovery, a prolongation of the action potential, rather than a shortening, occurs at high frequencies. The effect on electrical activity of increasing the stimulus frequency is similar to decreasing the bathing K concentration. The possibility of a reduction in the cleft K concentration at high frequencies is discussed. The shortening of the action potential at low rates is unaffected by 4-amino pyridine (a blocker of the transient outward current, i to ) is abolished by D600 (a blocker of the second inward current, i st ) and by a rise in the bathing Ca concentration. It is concluded that i si rather than i to is involved in action potential shortening at low rates. Action potential shortening at low rates is closely associated with declines in the maximum diastolic potential and the pacemaker potential; all of these changes are abolished by ouabain (a blocker of the Na-K pump). It is concluded that the shortening of the action potential at low rates may be the result of a decline in i si , which in turn is dependent on a decline in [Na] i . It is suggested that the rate-dependent changes in the maximum diastolic potential, pacemaker potential and tension are also related to [Na] i .

Digoxin activates sarcoplasmic reticulum Ca(2+)-release channels: a possible role in cardiac inotropy

1. The effect of digoxin on rapid 45Ca2+ efflux from cardiac and skeletal sarcoplasmic reticulum (SR) vesicles was investigated. Additionally the interaction of digoxin with single cardiac and skeletal muscle SR Ca(2+)-release channels incorporated into planar phospholipid bilayers and held under voltage clamp was determined. 2. Digoxin (1 nM) increased the initial rate and amount of Ca(2+)-induced release of 45Ca2+ from cardiac SR vesicles, passively loaded with 45CaCl2, at an extravesicular [Ca2+] of 0.1 microM. The efflux in the presence and absence of digoxin was inhibited at pM extravesicular Ca2+ and blocked by 5 mM Mg2+. 3. To elucidate the mechanism of action of digoxin, single-channel recording was used. Digoxin (1-20 nM) increased single-channel open probability (Po) when added to the cytosolic but not the luminal face of the cardiac channel in the presence of sub-maximally activating Ca2+ (0.1 microM-10 microM) with an EC50 of 0.91 nM at 10 microM Ca2+. The mechanisms underlying the action of digoxin appear to be concentration-dependent. The activation observed at 1 nM digoxin appears to be consistent with the sensitization of the channel to the effects of Ca2+. At higher concentrations the drug appears to interact synergistically with Ca2+ to produce values of Po considerably greater than those seen with Ca2+ as the sole activating ligand. 4. Digoxin had no effect on single-channel conductance or the Ca2+/Tris permeability ratio. In channels activated by digoxin the Po was decreased by Mg2+. Single-channels were characteristically modified to along lasting open, but reduced, conductance state when 100 nM ryanodine was added to the cytosolic side of the channel.5. Activation of the cardiac SR Ca2+-release channel was observed with similar concentrations of digitoxin, however, higher concentrations of ouabain were required to increase PO. In contrast, a steroid which is not positively inotropic, chlormadinone acetate, had no effect on either cardiac or skeletal SR Ca2+-release channel activity.6. At concentrations up to 1 microM, digoxin had no effect on Ca2+-induced 45Ca2+ efflux from skeletal muscle SR vesicles nor did it affect skeletal SR Ca2+-release channel Po, reflecting a difference between the cardiac and skeletal isoforms of the Ca2+-release channel.7. Since activation of the cardiac SR Ca2+-release channel occurs within the range of concentrations of digoxin encountered therapeutically, it is possible that activation of this channel contributes to the positive inotropic effect observed with this drug. Further, activation of the channel by higher concentrations of digoxin may contribute to the toxic effects seen clinically.

Membrane fractions display different lipid and enzyme content in three cell types in 16-cell stage embryos of sea urchins

Three cell types were isolated from dissociated 16-cell sea urchin embryos. Four membrane density fractions from discontinuous gradients have different proportions of lipids, surfacer markers and enzymes for the three cell types. Assays of lipid content, CH/PLIPID and SPH/PC ratios, acyl chain length, level of unsaturation by proton NMR and assays of enzyme activity revealed variation at the same density between the three cell types and among different densities from one cell type. There were also differences between whole embryos and dissociated embryo cells. There was no typical membrane domain at a particular density common to the cell types. Cell surface characteristics and polarity of adult cells rely on which lipid domains and enzymes are present, their association with cytoskeleton and how they are localized. At the 16-cell stage these characteristics are still very dynamic as revealed by cytochemical localization of Na+/K(+)-ATPase which varied with cell type and suggests endocytosis at set times in the division cycle. Polarity has not been permanently set for Na+/K(+)-ATPase yet. Membrane enzyme and lipid distributions unique to the three cell types seen in this study suggest parcelling out or insertion of new membrane domains occurs during early sea urchin cleavage. Perturbation of membrane density distribution and lipid content occurs after treatment of embryos with animalizing and vegetalizing teratogens which alter development.

Effects of phlorizin and ouabain on the polarity of mouse 4-cell/16-cell stage blastomere heterokaryons

Cell polarity is thought to be required for the efficient production of nascent blastocoele fluid, which begins at the 16-cell stage of mouse preimplantation development. In this study the 4-cell/16-cell blastomere heterokaryon was used to test the hypothesis that solute transport across the apical membrane domain induces the apical-basal axis of organelle distribution across polar 16-cell-stage blastomeres. Fusion of 4-cell/16-cell blastomere pairs resulted in a population of heterokaryons of which 65% were polar (contain an apical plasma membrane domain from a polar 16-cell-stage plasma membrane insert) and 30% were apolar (contain an apolar 16-cell-stage plasma membrane insert). Polar heterokaryons were distinguished from apolar ones by labeling their apical domains with fluorescent succinylated concanavalin A. In polar heterokaryons, both nuclei (labeled with Hoeschst 33242) were immediately subjacent to the apical plasma membrane domain, while in apolar heterokaryons both nuclei were located centrally. Two inhibitors of apical transmembrane solute transport--phlorizin, which inhibits brush border (apical) Na+/glucose symporters, and ouabain, which inhibits Na+/K+-ATPase, thereby modifying the transmembrane Na+ gradient--were examined for their effect on nuclear position in polar and apolar heterokaryons after a 4-hr incubation in either inhibitor. Both ouabain (L.M. Wiley, 1984, Dev. Biol. 105, 330-342) and phlorizin (this study) had a biphasic effect on the rate of nascent blastocoele fluid accumulation such that at lower concentrations (ouabain, 10(-5) M; phlorizin, 10(-6) M) fluid accumulation was accelerated and at higher concentrations (both inhibitors, 10(-4) M) fluid accumulation was delayed. In polar heterokaryons, both concentrations of each inhibitor caused the nuclei to become displaced basally from their normal location against the apical plasma membrane domain. Both nuclei, however, remained on the axis of polarity passing through the apical domain. The magnitude of displacement was greater at higher concentrations of either inhibitor. Neither inhibitor affected nuclear position in apolar heterokaryons. These observations agree with the hypothesis that apical plasma membrane solute transport maintains the asymmetric organelle distribution across the apical-basal axis of polar 16-cell-stage blastomeres.

Blastocoel expansion in the preimplantation mouse embryo: role of extracellular sodium and chloride and possible apical routes of their entry

The trophectoderm of the mouse blastocyst is a fluid transporting epithelium that is responsible for generating a fluid-filled cavity called the blastocoel. Vectorial transport of ions from the medium into the blastocoel generates an osmotic gradient that drives fluid across this epithelium. We report here that substitution of Na+ or Cl-, but not K+, in the medium halves the rate of blastocoel expansion in the mouse blastocyst. Entrance of Na+ into the trophectoderm may involve several routes, since both blastocoel expansion and 22Na+ uptake are decreased in the presence of the highly specific Na+/H+ exchanger inhibitor, 5-(N-ethyl-N-isopropyl)amiloride, and to a lesser extent with the amiloride-sensitive Na+-channel blocker, benzamil. Uptake of 22Na+ manifests saturation kinetics as a function of extracellular Na+ concentration, whereas uptake of 36Cl- is linear. Furthermore, neither 4,4-diisothiocyanostilbene-2,2-disulfonic acid, which is an inhibitor of the Cl-/HCO3- exchanger, nor 2-(3,4-dichlorobenzyl)-5-nitrobenzoic acid, which is a Cl- -channel blocker, affect either blastocoel expansion or 36Cl- uptake. These results suggest that Na+ entry into the mouse blastocyst is carrier-mediated and probably involves several routes that include the Na+/H+ exchanger and possibly the Na+-channel. Chloride entry, however, may not be carrier-mediated and may occur through a paracellular route, i.e., between the trophectodermal cells.

Relation between Na+-K+ pump, Na+ activity and force in strophanthidin inotropy in sheep cardiac Purkinje fibres

1. The effects of different concentrations of strophanthidin on intracellular sodium activity (aiNa), membrane potential and contractile force have been studied in cardiac sheep Purkinje fibres under conditions (overdrive) that stimulate Na+-K+ pump activity. 2. In fibres driven at 1 Hz, a 5 min overdrive at 2 Hz in the steady state increased force by +74.2%, aiNa by +10.9% and the maximum diastolic potential (Emax) by 3.32 +/- 0.52 mV. 3. During the recovery from overdrive (the fibres being driven again at 1 Hz), both contractile force and aiNa transiently undershot the control value by -10.5 and -3.7%, respectively. When the fibres were quiescent during the recovery from overdrive, no aiNa undershoot was present. 4. During overdrive, force and aiNa were closely correlated when plotted either on linear (correlation coefficient, R = 0.98) or logarithmic (R = 0.98) co-ordinates. 5. A low concentration of strophanthidin (0.01 microM) decreased force (-31.7%) and aiNa (-7.2%): overdrive increased force and Emax more and aiNa less than in the absence of strophanthidin. During the recovery, the undershoot in force (-12.9%) and aiNa (-5.4%) was larger and longer than in the absence of strophanthidin. 6. An intermediate concentration of strophanthidin (0.05 microM) increased force (+43.5%) and aiNa (+6.4%): overdrive increased force and aiNa as usual, but during the recovery the force remained above the value prior to overdrive and there was no aiNa undershoot. 7. A high concentration of strophanthidin (0.1 microM) increased force (+91.4%) and aiNa (+11.7%): overdrive further increased force and aiNa more than in control but there was no increase in Emax. During the recovery, both force and aiNa remained well above the values prior to overdrive. 8. Force and aiNa were closely correlated whether aiNa decreased in 0.01 microM-strophanthidin (R = 0.99 both on linear and logarithmic co-ordinates) or increased in 0.05-microM- (R = 1.00 on both co-ordinates) and in 0.1 microM- (R = 0.98 and 0.99, respectively) strophanthidin. The two parameters were well correlated also during overdrive in the three strophanthidin solutions. However, the slope of the relation was less steep in the low- than in the higher-strophanthidin solutions. 9. For a 1 mM change in aiNa, force decreased less in the low- than it increased in the intermediate-strophanthidin solution. Also, in low-strophanthidin solution, at the end of overdrive the aNao/aNai ratio was similar to that in Tyrode solution but force was well above control (+73.2%).(ABSTRACT TRUNCATED AT 400 WORDS)

Dissociation between force and intracellular sodium activity with strophanthidin in isolated sheep Purkinje fibres

1. We have recorded membrane potential, intracellular Na activity (aiNa) and force of contraction in sheep Purkinje fibres. Force and aiNa were recorded continuously and simultaneously during exposure to strophanthidin and its subsequent washing off. 2. Exposure to strophanthidin in concentrations of 1.5 X 10(-7), 5 X 10(-7) and 10(-5) M caused an increase in force of contraction which was temporally dissociated from the increase of aiNa. 3. There was hysteresis in the relationship between force and aiNa when the period of increasing force was compared to the period of decreasing force. When force increased on exposure to strophanthidin, the same aiNa was always associated with a higher force than when force was decreasing while washing off the drug. 4. For the same rise of aiNa higher doses of strophanthidin produced larger rises of force than lower doses. 5. When diphenylhydantoin was present in the bathing solution at concentrations of 10(-5) and 10(-4) M, the relation between force and aiNa with 10(-5) M-strophanthidin had a less steep slope, but still displayed hysteresis. 6. The relationship between force and aiNa during changes of the bathing K concentration also displayed a hysteresis, which was in the same direction as that found with strophanthidin. 7. These results are discussed in relation to proposed mechanisms of action of strophanthidin and more generally in relation to the factors linking force of contraction and aiNa. We conclude that in sheep Purkinje fibres the increase of force caused by strophanthidin is not solely due to an increase of aiNa, and that other interventions can also result in hysteresis between force and aiNa.

200 years of digitalis: the emerging central role of the sodium ion in the control of cardiac force

Digitalis has been used therapeutically for two centuries, but the mechanism by which it enhances the ability of cardiac muscle to produce force (the positive inotropic effect) has not been fully elucidated. The major controversy concerns the question of whether the inhibition of the Na+-K+ pump by digitalis, particularly at low (therapeutic) concentrations, increases the intracellular Na+ concentration and thus is causally related to the positive inotropic effect. Na+-selective microelectrodes, introduced recently, have made it possible to measure small changes in intracellular Na+ activity (aiNa) in beating preparations of cardiac muscle and, in particular, to follow the exact time course of change in both aiNa and contractile force during the positive inotropic effect of digitalis. It has been demonstrated that digitalis at low and high concentrations produces a parallel increase in aiNa and in contractile force during the onset of its effect; washout of the drug results in a parallel and complete recovery of aiNa and contractile force. Additional strong evidence for a correlation between the pump inhibition and digitalis inotropy is the fact that the magnitude of increase in aiNa and contractile force produced by digitalis depends on the level of aiNa and therefore on the rate of Na+ extrusion by the Na+-K+ pump. The study on the quantitative relationship between aiNa and contractile force reveals that the force of contraction is a power function of aiNa, such that a small rise in aiNa produces a significant increase in contractile force. Direct measurements of aiNa and intracellular free Ca2+ during digitalis inotropy strongly support the hypothesis that an increase in aiNa raises intracellular Ca2+ via Na+-Ca2+ exchange, thus producing the positive inotropic effect. In conclusion, the recent data available from the simultaneous and continuous measurements of aiNa and contractile force strongly indicate that the inhibition of the Na+-K+ pump is causally related to the positive inotropic effect of digitalis on cardiac muscle.

Cellular mechanisms of digitalis action

Although the therapeutic actions of digitalis glycosides have been known for over 200 years, their direct inotropic actions on the heart were not established until the last 50 years. Digitalis has undergone intense research, particularly with respect to its mechanisms of action. Many authors have claimed to have found the true mechanism of action, compounding the complexity of literature. Recent subcellular studies have pointed to specific areas of action of the digitalis glycosides. Each discovery has been dependent on the greater understanding of the electrophysiologic characteristics of cardiac muscle and excitation-contraction coupling. The current hypothesis suggests that digitalis specifically inhibits Na-K ATPase. This produces an elevation in intracellular sodium level that in turn produces an increase in the intracellular calcium level. The increased quantities of calcium available to the contractile elements of cardiac muscle provide the observed increased inotropy.

Erythrosin B inhibits high affinity ouabain binding in guinea-pig heart Na+-K+-ATPase without influence on cardiac glycoside induced contractility

Binding of [3H]-ouabain to guinea-pig heart membranes enriched in Na+-K+-ATPase revealed two different cardiac glycoside binding sites. High affinity binding was obtained at a KD = 2.2 X 10(-7) mol 1(-1) (Bmax = 16.8 pmol ouabain mg-1 protein) whereas low affinity ouabain binding occurred at a KD much greater than 10(-6) mol 1(-1). To discover whether the two ouabain binding sites are functional in guinea-pig heart muscle, erythrosin B, an inhibitor of the high affinity ouabain binding in rat brain tissue, was tested in guinea-pig isolated heart muscle preparations. Erythrosin B proved to be a potent inhibitor of the Mg2+ (Na+)-dependent-, as well as Na+-K+-activated ATPase (ID50 = 9 X 10(-6) mol 1(-1). Contractility of guinea-pig isolated papillary muscles, however, was not influenced by erythrosin B in concentrations up to 1 X 10(-5) mol 1(-1). Only very high concentrations (4 X 10(-4) mol 1(-1) resulted in a slightly negative inotropic effect (about 20%). Erythrosin B dose-dependently inhibited [3H]-ouabain binding to the Na+-K+-ATPase (KD = - 3.6 X 10(-6) mol 1(-1). In a concentration of 1 X 10(-5) mol 1(-1) the dye abolish high affinity [3H]-ouabain binding without affecting the low affinity binding sites. In contrast, in guinea-pig isolated atria, no functional antagonism between erythrosin B (5 X 10(-5) mol 1(-1) and ouabain was observed. 5 As there is a coincidence between the high affinity binding (KD = 2.2 x 10-7moll ') and the concentration for half maximum inotropic effects of ouabain (EDIo = 1.6 x 10-7 mol I), the lack of effect oferythrosin B on ouabain-induced inotropy may be caused by an inaccessibility of the dye to the (internal) ATP-site of the Na+-K+-ATPase.

Cavitation in the mouse preimplantation embryo: Na/K-ATPase and the origin of nascent blastocoele fluid

This study tested the proposition that Na/K-ATPase activity could be involved in the morphogenetic aspects of mouse blastocyst formation by facilitating the localization of certain organelles to apposed borders, the production of nascent blastocoele fluid, and cavitation. It was assumed that such Na/K-ATPase activity would be sensitive to varying concentrations of external K (Ko)--which would alter plasma membrane potentials--and to ouabain--which would directly alter Na/K-ATPase function. Morulae were cultured for 40 hr in varying concentrations of Ko and/or ouabain and were observed for their ability to form blastocoeles (cavitate) and to localize mitochondria to apposed cell borders. Cavitation was accelerated when Ko was decreased from the control value of 6.0 to 0.6 mM and was delayed when Ko was increased to 25 mM. With Ko at 6.0 mM, 10(-5) M ouabain accelerated cavitation while 10(-4) M ouabain delayed cavitation and reduced the total number of embryos that cavitated by the end of the 40-hr culture period. With Ko at 0.6 mM, 10(-5) M ouabain now delayed cavitation while 10(-4) M ouabain almost completely inhibited it. When Ko was increased to 25 mM, 10(-5) M ouabain again accelerated cavitation while 10(-4) M ouabain delayed-rather than inhibited--cavitation. Morphometric analyses at the electron microscopic level showed changes in the distances of mitochondria from apposed cell borders with conditions that accelerated or delayed cavitation and these changes differed for inside and outside cells of the morula. These observations are consistent with the proposition that Na/K-ATPase activity could be involved in the localization of organelles to apposed cell borders, the production of nascent blastocoele fluid, and in cavitation during mouse blastocyst development.

Changes in the electrical activity of dog cardiac Purkinje fibres at high heart rates

Rate-dependent changes in the electrical activity of dog Purkinje fibres have been studied. At high rates of stimulation the rate of repolarization is greater, the action potential is shorter, the maximum diastolic potential is increased, the pace-maker potential is reduced in amplitude, and on cessation of rapid stimulation there can be a suppression of spontaneous activity. After an increase of the stimulus frequency there is an abrupt shortening of the action potential, which can be attributed to incomplete recovery of the plateau currents; this is followed by a progressive decline in action potential duration over the next several hundred seconds. The factor responsible for the slow changes in duration could also be responsible for the accompanying increase in maximum diastolic potential because this develops along a similar time course. These slow changes in electrical activity have been investigated with the phase-plane technique. They are the result of an increase in the net outward current over a wide range of potentials (approximately -10 to approximately -90 mV) during the repolarization phase of the action potential. In voltage-clamp experiments background current has been observed to be strongly rate dependent: the background current during a test voltage-clamp pulse after a train of action potentials is more outward at higher stimulus frequencies. When the frequency is increased, background current slowly becomes more outward over several hundred seconds, and this change therefore occurs along the appropriate time course to explain the slow alteration in electrical activity under these conditions. The extra outward background current at high rates is relatively independent of membrane potential in the range from -110 to -40 mV (more circumstantial evidence indicates that this range may extend to at least +10 mV); this potential dependence is similar to that of the Na-K-pump current (Eisner & Lederer, 1980). Strophanthidin and ouabain, agents known to block the Na-K pump, alter both the changes in background current and the slow rate-dependent changes in electrical activity. Although after an increase in rate there is a gradual change in background current that can be explained by an increase in electrogenic Na-K-pump activity, the initial effect of switching rate is to produce a change in current that is consistent with an increase of the extracellular K concentration. A transient increase in the K concentration of restricted extracellular clefts has been recorded under these conditions in dog Purkinje strands by Kline & Kupersmith (1982) using K-sensitive microelectrodes. The effect on electrical activity of these changes is discussed.(ABSTRACT TRUNCATED AT 400 WORDS)

Excitation-contraction coupling in cardiac Purkinje fibers. Effects of cardiotonic steroids on the intracellular [Ca2+] transient, membrane potential, and contraction

The [Ca2+]-activated photoprotein aequorin was used to measure [Ca2+] in canine cardiac Purkinje fibers during the positive inotropic and toxic effects of ouabain, strophanthidin, and acetylstrophanthidin. The positive inotropic effect of these substances was associated with increases in the two components of the aequorin signal, L1 and L2. On the average, strophanthidin at 10(-7) M produced steady, reversible increases in L1, L2, and peak twitch tension of 20, 91, and 240%, respectively. This corresponds to increases in the upper-limit spatial average [Ca2+] from 1.9 X 10(-6) M to 2.1 X 10(-6) M at L1 and from 1.4 X 10(-6) M to 1.8 X 10(-6) M at L2. Elevation of diastolic luminescence above the control level was not detected. At higher concentrations (5 X 10(-7) M), strophanthidin produced aftercontractions, diastolic depolarization, and transient depolarizations, all of which were associated with temporally similar changes in [Ca2+]. During these events, diastolic [Ca2+] rose from the normal level of approximately 3 X 10(-7) M up to 1-2 X 10(-6) M. The negative inotropic effect of 5 X 10(-7) M strophanthidin was not associated with a corresponding decrease in the [Ca2+] transient but was associated with a change in the relationship between [Ca2+] and tension. Assuming the Na+-lag mechanism of cardiotonic steroid action, we conclude the following: at low concentrations of drug, increased Ca2+ uptake by the sarcoplasmic reticulum prevents a detectable rise in cytoplasmic [Ca2+] during diastole, but this increased Ca2+ uptake results in increased release of Ca2+ during the action potential. At higher drug concentrations, observable [Ca2+] changes during diastole activate tension and membrane conductance changes.

Biphasic positive inotropic actions of ouabain on rat, guinea-pig and cat heart: a mathematical description

The inotropic action of ouabain on isolated perfused hearts of rat, guinea-pig, and cat was studied over a wide concentration range (10(-12)-5 X 10(-3) M). In all three species used, the positive inotropic effect (PIE) of ouabain appeared to be biphasic in character. However, there was a remarkable difference in the course of the logdose-response curves of ouabain on guinea-pig and cat heart as compared with than on rat heart. The first two species showed, at very low concentrations of ouabain (guinea-pig heart: 10(-9) M and cat heart: 10(-10) M), a typical bell-shaped increase in cardiac contractile activity, while at higher concentrations (10(-8)-10(-6) M and 10(-9)-10(-7) M, respectively) the normally observed S-shaped increase in contractile activity occurred. On the contrary, rat hearts showed a flat S-curve between 10(-8) and 10(-6) M and a steep one between 10(-6) and 10(-4) M of ouabain. In order to explain the biphasic action of ouabain a hypothetical model for the mechanism(s) of action of ouabain is discussed. Mathematical description of this model is based on the existence of two different receptor-types for ouabain. It is suggested that sarcolemma-bound calcium may play an important role in both mechanisms of inotropic action of ouabain.

Simulation of potassium accumulation in clefts of Purkinje fibers: effect on membrane electrical activity

Purkinje fiber action potentials and concomitant intercellular cleft [K] variations were reconstructed by using modified McAllister, Noble & Tsien (1975) equations including the pump current, ip, and the pacemaker current, if. Three different mean cleft widths were chosen: 40, 200 and 1000 nm. Assuming a cylindrical arrangement of the cells in the bundle, the cleft [K] gradient across the bundle was calculated by using the radial cylindrical diffusion equation. The effects of varying several parameters (cleft width, tortuosity, ip and if) were studied in conditions corresponding to two different values of [K] in the bulk solution, namely 2.7 and 5.4 mM. The shortening influence on the action potential of the systolic increase in cleft [K] was detectable only in the case of the smallest cleft width. Reduction in electrogenic pump activity led to alterations of the electrical activity which depended on the cleft width. The evolution of the intercellular [K] during each action potential and the following diastolic period was normally biphasic; a small reaccumulation during the late part of the diastole was induced by the K component of the if current. Experimentally determined intercellular [K] variations described in the literature exhibit a monophasic evolution. Such a monophasic evolution could be reproduced after reduction of both if and the transient outward K current and suppression of the negative slope of the ik1-Em relationship. In this case the amplitude of the cyclic change in intercellular [K] was approximately equal to 0.2 mM (for a 200 nm cleft width), a value much lower than that experimentally recorded. Possible reasons for this discrepancy are discussed. A simplified three compartment model for K diffusion was also used. Results obtained with the two models demonstrated that the simplified model can be used as a reasonable approximation of the more complex radial diffusion model, with a reduction in computation time reaching 80% or more.

Inhibition of the sodium pump in guinea-pig ventricular muscle by dihydro-ouabain: effects of external potassium and sodium

The inhibition of the electrogenic pump current in quiescent guinea-pig ventricular muscle by dihydro-ouabain (DHO) was studied with the three-micro-electrode voltage-clamp technique described previously (Daut, 1982c). From dose-response curves of the drug-induced current change (ID) the equilibrium dissociation constant of the binding of DHO to the Na-K pump (KD) and the electrogenic pump current flowing in the steady state (Ip) were inferred (Daut & Rüdel, 1982b). The external K concentration ([K]o) was varied between 2 and 4.5 mM (substituted by Na). KD was found to increase with increasing [K]o. A plot of log KD versus log [K]o gave a straight line with a slope of about 1.5. The time constants of the onset (tau on) and decay (tau off) of ID are supposed to represent the chemical kinetics of binding and unbinding of the drug (Daut & Rüdel, 1981, 1982b). Tau on was found to be inversely related to [K]o whereas tau off was found to be independent of [K]o. Ip was found to be independent of [K]o. This was interpreted to indicate that in the steady state Ip is mainly determined by the passive influx of Na into the cell, which may be relatively insensitive to small changes in [K]o. The effects of [K]o on the drug-induced current change are consistent with competitive inhibition of the binding of DHO to the Na-K pump. It is suggested that K ions and cardiac glycosides compete for extracellular binding sites on the same conformation of the Na-K pump. The external Na concentration ([Na]o) was varied between 147 and 49 mM (substituted by choline or Tris). Reduction of [Na]o produced a proportional decrease of Ip. This may be a consequence of the accompanying reduction of passive Na influx and the resulting decrease in intracellular Na activity (alpha iNa). Reduction of [Na]o markedly increased KD. This effect may be mediated by competition between Na and K at the K-loading sites of the pump and/or by separate modulatory Na-binding sites. It is concluded that the well known effects of external Na and K on the positive inotropic action of cardiac glycosides can be fully accounted for by the marked changes in the apparent binding affinity of the drug reported here.

Relation between intracellular sodium and twitch tension in sheep cardiac Purkinje strands exposed to cardiac glycosides

Changes in intracellular sodium ion activity (aiNa) produced by several cardiac glycosides were correlated with twitch tension in sheep cardiac Purkinje strands. Simultaneous measurements of aiNa and twitch tension were obtained through the use of Na-sensitive intracellular microelectrodes (ETH 227) in Purkinje preparations stimulated at a frequency of 1 Hz. All concentrations of ouabain, acetylstrophanthidin, and actodigin that were tested caused an increase in aiNa immediately before, or coincident with, a positive inotropic effect. No fall in aiNa was observed at any positive inotropic concentration of digitalis in these beating fibers. In all cases, the onset and washout of the positive inotropic effect were paralleled by the rise and fall in aiNa, respectively. No dissociation between changes in aiNa and twitch tension occurred at any concentration of any of the agents used. The relation between changes in aiNa and twitch tension was linear with 1 mM increase in aiNa producing about a 100% increase in the twitch magnitude. Propranolol did not significantly alter this relationship. The increase in aiNa with digitalis was also associated with a reduction in the maximum depolarization rate of the action potential, presumably as a consequence of a reduction in the transmembrane Na electrochemical gradient. These results indicate that the positive inotropic action of digitalis in sheep Purkinje strands is always associated with a rise in aiNa secondary to inhibition of the Na pump. This increase in aiNa could increase calcium available for contraction via the Na-Ca equilibrium exchange process. In addition, the increase in aiNa reduces Vmax, as a consequence of decreasing the electrochemical gradient for Na.

Active transport and inotropic state in guinea pig left atrium

Although the positive inotropic effect of cardiac glycosides correlates well with inhibition of Na+ pump activity in many preparations, digitalis at low concentrations (10(-9) to 10(-8) M) may produce an apparent stimulation of monovalent cation transport in isolated intact myocardium or produce an inotropic effect that does not correlate with pump inhibition. Digitalis is known to modify tissue metabolism of endogenous neurotransmitters that may affect inotropic state, Na,K-ATPase activity, and K+ permeability. We examined the interactions of low concentrations of ouabain with adrenergic and cholinergic influences in isolated guinea pig left atria stimulated at 3.3 Hz in which inotropic state and monovalent cation transport (measured as 86Rb+ uptake) were assessed simultaneously. Ouabain (10(-9) M) stimulated Rb+ transport (+25%) without an inotropic response; the stimulatory effect on transport was abolished by propranolol or atropine pretreatment. In atria pretreated with atropine, 10(-8) M ouabain produced a small positive inotropic effect (+10%) without measurable associated Na+-K+ pump inhibition. This inotropic response was abolished in catecholamine-depleted atria. Ouabain (10(-7) M) always produced a positive inotropic response (about +25%) independent of catecholamine depletion, beta-adrenergic blockade, or muscarinic blockade, but Rb+ uptake inhibition was observed only in beta-adrenergically-blocked atria. In all preparations, ouabain concentrations greater than 10(-7) M caused an inotropic response associated with pump inhibition. At concentrations 3 X 10(-7) M and higher, mechanical toxicity was observed in all preparations except those pretreated with propranolol. Incubation with low concentrations of ouabain did not modify the inotropic response to isoproterenol. At concentrations of isoproterenol sufficient to stimulate Rb+ transport by 25%, there was a large (+80%) inotropic response. We conclude first, that, in guinea pig atria exposed to ouabain, the mechanism as well as the extent of inotropic response and of monovalent cation transport modification is concentration dependent, second, that at low concentrations (1-10 X 10(-9) M), in vitro inotropic and monovalent cation transport responses are in part mediated by an effect of ouabain on endogenous neurotransmitters; and third, that in this preparation at concentrations between 10(-9) and 10(-7) M ouabain, monovalent cation transport as measured by tissue 86Rb+ uptake does not correlate with inotropic response.

Heterogeneous pathways of Ca2+ metabolism in the triggering of the proliferative process in rat thymocytes

Concanavalin A induces in rat thymocytes a calcium uptake at 1 h exposure and proliferative response after 24 h exposure. Phosphodiesterase activity parallels the proliferative response (thymidine uptake). Valinomycin, monensin and a small dose of ouabain also induce calcium uptake, but do not lead to thymidine uptake later. The latter treatments reduce, in some instances drastically, the concanavalin A response with respect to thymidine uptake. Trifluoperazine reduces the unstimulated thymidine uptake and the concanavalin A induced thymidine uptake. These results suggest that calcium has a decisive role in inducing proliferation but that some ways of increasing cellular Ca2+ concentration interfere in other steps with the DNA synthesis.

Voltage-clamp studies on the canine Purkinje strand

Purkinje strands were excised from the left and right ventricles of adult mongrel dogs and cut to lengths of less than 2.0 mm in order to apply the two-microelectrodes voltage-clamp technique. A sizeable fraction of these preparations fully recover following dissection, with resting potentials more negative than--80 mV and upstroke velocities faster than 290 V s-1. Analysis of the voltage response to small current pulses shows that the short Purkinje strands can be treated as simple finite one-dimensional cables with ends of infinite resistance. The average length constant is 2.5 mm. In keeping with the relatively long length constant, insertion of a third microelectrode along the strand demonstrates a high degree of longitudinal homogeneity of the voltage clamp. Analysis of the capacity transient gives an estimate of the total capacity, normalized to cylindrical surface area, of 11.5 muF cm-2. The final decay of the capacity transient is a single exponential with an average time constant of 1 ms. A second slower component to the final decay of the capacity transient is absent in solutions of normal conductivity as well as in solutions of reduced (13%) conductivity. This suggests that the extracellular series resistance may be relatively small. The magnitude of the K+ depletion current was estimated by measuring the ratio of depletion current to instantaneous current. This ratio averaged 10%. These two results are consistent with the morphometric data described in the accompanying paper, which show that the canine preparation has wider extracellular clefts than the ungulate preparation. The existence of the full complement of inward and outward currents, including the pacemaker current, is demonstrated. The presence of wide clefts does not affect the potential at which the pacemaker current reverses (about--107 mV in 4 mM [K+] Tyrode solution), since the pacemaker current reverses at approximately the same potential in the canine Purkinje preparation as it does in the ungulate.

The effects of low concentrations of cardiotonic steroids on membrane currents and tension in sheep Purkinje fibres

1. Simultaneous measurements of voltage-clamp currents and tension were made in shortened sheep Purkinje fibres exposed to various concentrations of strophanthidin, ouabain and digoxin.2. In 5.4 mM-K moderate doses (mean 2.4 x 10(-7)M) of the drugs produced an inward shift of the current-voltage relationship at very negative potentials, consistent with an increase in cleft K concentration (Cohen, Daut & Noble, 1976b), which was always accompanied by an increase in tension. This change, which has been attributed to Na-K pump inhibition, was often better correlated with an increase in voltage-dependent tonic tension than in twitch tension.3. Exposure to dihydro-ouabain gave a monotonic increase in tension but a delayed increase in inward current. This suggests (cf. Lee, Kang, Sokol & Lee, 1980) that minor changes in pump activity may not always change the current-voltage relationship.4. Low concentrations of strophanthidin (5 x 10(-9) to 5 x 10(-7) M) produced an outward current shift at very negative potentials, this change becoming smaller with a more rapid onset and reversing on increasing the dose. This change is attributed to pump stimulation.5. The outward current shift was often associated with a negative inotropic effect, which always reversed either spontaneously or on removal of the drug.6. The alternative response at a narrower dose range (1 x 10(-8) to 2 x 10(-7) M) was an increase in twitch (not tonic) tension, termed the low-dose positive inotropic effect.7. After a low concentration of cardiotonic steroid had given an early negative inotropic effect the bulk Ca concentration was reduced and the drug re-applied. The low-dose positive inotropic mechanism was then observed.8. Outward current shifts and negative inotropy were also obtained with low concentrations of the clinically used glycosides digoxin and ouabain.9. Low concentrations of strophanthidin applied to externally stimulated sheep ventricular trabeculae produced negative inotropy with lengthening of the action potential duration. Positive inotropy and action potential shortening occurred with higher doses.10. A computer model of ionic currents and distributions in Purkinje fibres satisfactorily reproduced the changes in membrane currents and ionic gradients observed with cardiotonic steroids. The only perturbations capable of explaining our results were Na pump stimulation and inhibition.11. It is concluded that cardiotonic steroids possess two inotropic mechanisms. The first is a low-dose positive inotropic mechanism causally unrelated to changes in sodium pump activity and possibly a direct release of a membrane-associated calcium fraction. Should this mechanism be unavailable then net pump stimulation at low doses will produce negative inotropy. The second mechanism is the well known Na-lag process.

The passive electrical properties of guinea-pig ventricular muscle as examined with a voltage-clamp technique

1. A voltage-clamp technique was developed for stable recording of small currents in guinea-pig ventricular muscle. Small cylindrical preparations were impaled with three micro-electrodes, one for measuring the feed-back potential and two for injecting current. 2. The longitudinal potential profile resulting from current injection at one point was measured. It agreed well with the theoretical predictions for a linear cable which is sealed at both ends ('healing over'), with a length constant (lambda) of 580 +/- 145 micron. 3. When the clamp current was injected symmetrically into each half of the preparation via two electronic current pumps a spatially homogeneous clamp could be achieved in preparations with a diameter of less than or equal to 250 micron and a length of less than or equal to 2 lambda. 4. The membrane capacity and the membrane resistance of the preparations at the resting potential were measured with small voltage-clamp pulses. Assuming a specific membrane capacity (Cm) of 1 microF/cm2 a specific membrane resistance (Rm) of 6.7 +/- 1.8 k omega cm2 was obtained in Tyrode solution containing 3 mM-K. 5. The total surface area was calculated from the measured capacity of the preparation assuming a Cm of 1 microF/cm2. The total cellular volume was estimated from optical measurement of the external dimensions of the preparation assuming an extracellular space of 25%. From these data the average surface/volume ratio of individual cells was calculated to be 7200 cm2/cm3. 6. From the measured electrical constants the specific resistance of the intracellular space (Ri) was calculated to be 200-250 omega cm. With small constant current pulses a membrane time constant of 6.6 +/- 1.3 ms was measured. 7. The influence of the extracellular potassium concentration ([K]o) on Rm was studied in the range 1.5-6 mM-[K]o. Rm was found to depend on [K]o less than predicted by the constant field theory.

The effects of sodium pump activity on the slow inward current in sheep cardiac Purkinje fibres

The effects of Na pump activity on the slow inward current, Isi, magnitude and twitch tension were investigated in sheep cardiac Purkinje fibres. A two-microelectrode voltage-clamp method was used, tension being measured simultaneously. Na pump activity was lowered either by reducing the extracellular K concentration, [K]O, or by applying the cardiotonic steroid strophanthidin. Reduction of [K]O from 4 to 0 mM leads to time-dependent increases in Isi magnitude and twitch tension. The increases of Isi and tension could be reversed by adding Tl, Rb, Cs or NH4 ions to the K-free superfusate. The actions of these ions are attributed to the known ability of these cations to activate the external site of the Na pump. This conclusion is supported by the observation that such activator cations do not reverse the increases in Isi and tension produced by strophanthidin. We conclude that the effects of low [K]O on Isi are mediated by Na pump inhibition. Similarly the Na pump inhibition produced by strophanthidin increases Isi and tension, although, in this case, other mechanisms may also contribute. Measurements of the activity of the electrogenic Na pump show that elevated intracellular Na ion concentration secondary to Na pump inhibition and not the instantaneous Na pump turnover rate mediates the increase in Isi magnitude.

Stimulation of monovalent cation active transport by low concentrations of cardiac glycosides. Role of catecholamines

The stimulatory effect of low concentrations of ouabain on the Na-K pump in isolated guinea pig left atria was studied in vitro by assessing active transport of the K(+) analog Rb(+). Active transport of Rb(+) was stimulated 20+/-8% (SEM, P < 0.05) above control values by 3 nM ouabain, but was inhibited by concentrations >10 nM. Preincubation with the beta-adrenergic antagonist propranolol (1 muM) completely blocked stimulation of active transport of Rb(+) by 3 nM ouabain. Norepinephrine, 10 nM, increased Rb(+) active transport 29+/-10% (P < 0.02) above control values. The beta-adrenergic agonist l-isoproterenol, 10 nM, increased active transport of Rb(+) by 33+/-10% (P < 0.01) above control levels. This stimulatory effect was abolished if tissues were first exposed to propranolol. Tyramine (0.1 muM), a stimulator of endogenous catecholamine release, increased active transport of Rb(+) 26+/-12% (P < 0.05) above control values. Rb(+) active transport was not significantly changed when left atrial tissues were incubated with alpha-adrenergic agonists or antagonists. Ouabain stimulation of Rb(+) active transport was prevented by in vivo depletion of myocardial endogenous catecholamines by either reserpine or 6-hydroxydopamine. These findings indicated that in myocardial tissue, Na-K pump stimulation by low concentrations of ouabain is mediated at least in part through beta-adrenergic effects of endogenous catecholamines.

Ouabain effects on intracellular potassium activity and contractile force in cat papillary muscle

The relationship between the positive inotropic and toxic effects of cardiac glycosides and their effects on intracellular ionic composition is incompletely defined. We measured intracellular potassium activity (alpha ik), extracellular potassium activity (alpha ek), resting potential, action potential duration, and contractile force at 32 degrees C in paired papillary muscles from feline right ventricles exposed to ouabain. Muscles used for electrophysiological measurements were quiescent except for isolated stimulation to confirm impalement and record action potential duration. Muscles used for contractile force measurements were quiescent except for 4-min periods when force was measured at a cycle length of 1,400 ms. Muscle length was adjusted to achieve 50% of maximal tension at this cycle length before each experiment. In four experiments, alpha ik and contractile force were measured in the same muscle. Alpha iK was measured with single and double-barrel K-sensitive electrodes. At 10 nM ouabain, action potential duration is prolonged. Among the concentrations tested, the threshold for a clear positive inotropic effect is 0.1 microM ouabain. The threshold for decrease in alpha iK, increase in alpha eK, and decrease in membrane potential is 1 microM, at which concentration toxic signs develop, including arrhythmias, aftercontractions, and alteration in the staircase response of contractile force to repetitive stimulation. Ouabain need not change alpha iK to effect positive inotropy in ventricular muscle, a relationship different from that reported between [K]i (intracellular potassium concentration) and positive inotropy. Higher ouabain concentrations, which others have shown to clearly inhibit active Na and K transport, are shown to upset intracellular potassium activity homeostasis and to consistently produce toxicity.

Is Na + ATPase a myelin-associated enzyme?

The Na + K ATPase activity associated with purified myelin has been investigated. On the basis of marker enzyme studies, the Na + K ATPase activity of myelin was higher than could be accounted for by microsomal contamination. Fractions prepared from white matter-enriched areas of rat brain showed a threefold enrichment in Na + K ATPase activity in myelin as compared with the white matter homogenate. The ATPase activity in myelin was stimulated fourfold by treatment with sodium deoxycholate, but the activity in the whole brain homogenate and the microsomal fraction was only doubled. This discontinuity temperature for Na + K ATPase activity was significantly higher for the myelin fraction (29 degrees C) than for the microsomal fraction (21 degrees C), but the energies of activation, both above and below the discontinuity temperature, were the same for both fractions, Myelin Na + K ATPase had a lower affinity for strophanthidin than the microsomal enzyme, but both fractions were inhibited to the same extent by 10-3 M-strophanthidin. The evidence thus indicated that much of the ATPase activity of myelin is not the result of microsomal contamination. Although the possibility of axolemmal contamination cannot be ruled out conclusively, indirect evidence suggest that this is not a significant factor and that Na + K ATPase may be a myelin-associated enzyme.

Relationship between the positive inotropic effect of ouabain and its inhibitory effects on Na+, K+ -ATPase and active transport of Rb+ in the dog heart

Two previous reports have indicated that in the dog if sustained positive inotropy without arrhythmias is induced by ouabain infusion, inhibition of myocardial Na+, K+-activated adenosine triphosphatase is not observed. Another previous study has shown that in similar experiments induction of sustained inotropy is accompanied by inhibition of the active uptake of Rb+. To resolve the apparent inconsistencies between these findings, we repeated the experiments and measured the inhibition of the enzyme and the inhibition of Rb+ uptake after the induction of sustained inotropy with ouabain. Utilizing three different ouabain dosage regimens in open-chested dogs, we obtained three different quasi-steady state plasma levels of ouabain. At the highest level, ouabain toxicity accompanied by enzyme inhibition and inhibition to RB+ uptake was observed. With the intermediate levels, positive inotropy without significant toxicity was also accompanied by enzyme inhibition and the inhibition of Rb+ uptake. At the lowest ouabain plasma levels, sustained positive inotropy without significant inhibition of either enzyme activity or +b+ uptake was obtained. The data indicate that in this preparation either a small degree of enzyme inhibition, which is difficult to detect is sufficient to produce pronounced positive inotropy, or that the inhibition of the enzyme is not required for the induction of positive inotropy.

The effects of heart rate on the action potential of guinea-pig and human ventricular muscle

1. On increasing the stimulation frequency of isolated pieces of guinea-pig ventricular muscle, the resting potential depolarizes, and the action potential duration and amplitude are reduced. On termination of the high frequency train of action potentials, these changes are reversed. 2. The resting potential changes are roughly exponential, with a time constant of the order of 10 sec, and are attributable to K+ accumulation in the extracellular space. They are not explicable in terms of known gating variables. 3. The action potential duration and amplitude recover much more slowly than the resting potential, after a high frequency train (half-time approximately 5 min). The time course of these recoveries is not exponential, and is slower after trains which produce more shortening of the action potential. The slow time course suggests that K+ accumulation is not the main cause of the changes in action potential shape. Furthermore, when a certain depolarization of the resting potential is produced by a high frequency train, there is a greater reduction of the action potential duration than that which occurs when the bathing [K+] is raised to produce the same depolarization (Reiter & Stickel, 1968). This is so even when a gradient of extracellular [K+] is induced in the preparation, to mimic non-uniform K+ accumulation. 4. Similarly, the shortening of the action potential produced by toxic doses or cardiotonic steroids is probably not the result of K+ accumulation. 5. The slow changes of the action potential shape produced by a high frequency train are not attributable to the effects of gating variables, nor (solely) to a rise in the intracellular Na concentration stimulating the electrogenic Na/K pump. The dye 3,3'-diethylthiadicarbocyanine, which blocks the Ca2+-activated K conductance in the erythrocyte, has no significant effect on the shape changes. 6. After a sudden change in heart rate, the QT interval of the human electrocardiogram (e.c.g.) changes slowly to a new equilibrium value. The time course of this change is similar to that of the action potential duration in guinea-pig ventricle following a change in stimulation frequency. These changes of the e.c.g. are probably not due to slow alterations of neural or hormonal factors extrinsic to the heart. In the whole heart, the effects on the ventricular action potential duration of changes in sympathetic or vagal tone, or of circulating catecholamines, can be largely accounted for by the changes of atrial driving frequency they produce.

Two receptor forms for ouabain in sarcolemma-enriched preparations from canine ventricle

Some evidence indicates that the inotropic effect of cardiac glycosides occurs at concentrations too low to affect Na+,K+-ATPase activity. This suggests that some receptor other than Na+,K+-ATPase mediates the inotropic effect. We studied ouabain binding to sarcolemma-enriched preparations from canine ventricle under conditions known to promote binding to Na+,K+-ATPase. Profiles for binding and dissociation were characterized by two kinetic components: (1) fast association and slow dissociation; (2) slow association and fast dissociation. Profiles in the absence of supporting ligands were consistent with a single species of receptors with slow association, fast dissociation and minimal effect on Na+,K+-ATPase activity. Binding supported by magnesium plus inorganic phosphate inhibited Na+,K+-ATPase activity by 86%. The two binding components were affected differentially by heating at 55 degrees C. It was concluded that the preparation possesses two receptors for ouabain: the Na+,K+-ATPase and a "new" receptor. The latter may be different chemically from the Na+,K+-ATPase. The more likely possibility is that the "new" receptor is the Na+,K+-ATPase in a state characterized by low catalytic activity, low affinity for ouabain, and no requirement of specific ligands for ouabain binding. Further, the data suggest an interdependence between the two forms. This leads to a mechanism which allows an inotropic effect to precede loss of Na+,K+-ATPase activity even though both result from glycoside binding to Na+,K+-ATPase. The mechanism involves an equilibrium between inactive and active forms of the Na+,K+-ATPase such that the inactive form buffers loss of the active form upon exposure to a cardiac glycoside.

Activity-dependent extracellular K+ fluctuations in canine Purkinje fibres

Cardiac Purkinje fibres are important in cardiac electrophysiology and pathology due to their specialized role in the ventricular conducting system, and their properties as a second cardiac pacemaker. Changes in extracellular K+ activity (Ko) affect the conduction velocity and the natural automatic rate of the Purkinje fibre. Both anatomical and electrophysiological studies of the Purkinje fibres have demonstrated the possibility of Ko fluctuations in the narrow intercellular clefts. We investigated using K+ selective electrodes, the effect of the Ko fluctuations observed during activity in canine Purkinje fibres. Summation of Ko fluctuations during single action potentials leads to elevation of baseline Ko during rapid trains. However, unlike in ventricular muscle where depolarization is seen, membrane potential is non-automatic Purkinje fibres hyperpolarizes in response to rapid beating. Prolonged depletions of extracellular K+ following long periods of overdrive are associated with slowly changing membrane currents, which markedly influence automaticity, action potential duration, and membrane potential.

Characterization of the electrogenic sodium pump in cardiac Purkinje fibres

1. The Na pump is examined in sheep cardiac Purkinje fibres using a two micro-electrode voltage clamp technique.2. After reducing the external K concentration, [K](o), to zero for 2 min or more, subsequent addition of an ;activator cation' (known to activate the Na pump in other preparations) produces a transient increase of outward current. This outward current transient is abolished by 10(-5)M-strophanthidin (cf. Gadsby & Cranefield, 1979a).3. It is concluded that this transient increase of outward current is a result of a transient stimulation of the sodium pump by the raised [Na](i) following exposure to 0-K(o). Although this current transient may reflect the activity of an electrogenic Na pump, it is difficult to use K as the activator cation to establish this point. This is due to the extracellular K depletion that occurs during Na pump reactivation and the subsequent change that this K depletion produces in the current-voltage relationship of the Purkinje fibre.4. Rb(o) or Cs(o) have been used instead of K(o) to reactivate the Na pump when examining the transient increase of outward current. On adding either of these cations after exposing a preparation to a solution without such ;activator cations', the outward current transient is relatively voltage independent over a wide range of potentials (-90 to +10 mV). It is concluded that, following the addition of Rb(o) or Cs(o), the transient increase of outward current is a direct measure of the transient increase of the electrogenic Na pump current.5. Increasing [Rb](o) or [Cs](o) over the range of 0-40 mM increases the rate of decay of the electrogenic Na pump current transient. Using a simple model (cf. Rang & Ritchie, 1968), it is shown that the decay rate constant of the electrogenic Na pump current transient is a good measure of the degree of activation of the external site of the Na pump. At a given concentration of activator cation, Rb(o) produces a greater activation of the Na pump than does Cs(o). The K(0.5) for Rb(o) is 6.3 mM and for Cs(o) is 14.2 mM. Li(o) activates the Na pump more weakly than Rb(o) and Cs(o).6. The coupling ratio of the Na pump is shown to be independent of Rb(o) or Cs(o) over the range 2-40 mM. Furthermore, consistent with the results of Gadsby & Cranefield (1979a), the coupling ratio is independent of Na(i) over the range considered.7. The Q(10) for the electrogenic Na pump current transient varies between 1.6 and 2.3 over the range of temperature 26-46 degrees C.8. A maximum Na pump current of about 0.78 muA cm(-2) is obtained. Assuming a coupling ratio of 3Na/2K, the rate of Na ion transport into the cell is estimated to be about 23 p-mole cm(-2) sec(-1). Assuming a Na pump turnover of 150 sec(-1), we estimate that there are about 1000 Na pump sites per mum(2) of cell surface.9. We conclude that the electrogenic Na pump current transient provides a good measure of the activity of the Na pump when Rb or Cs are used as ;activator cations'. This measure can be used in the intact preparation to investigate the relationship between Na pump rate and other cellular events such as the regulation of tension (Eisner & Lederer, 1980).

The relationship between sodium pump activity and twitch tension in cardiac Purkinje fibres

1. Sheep cardiac Purkinje fibres were studied under voltage clamp conditions to examine the relationship between the Na pump rate and twitch tension.2. The Na pump activity was measured following a period of decreased Na pump rate and increased internal Na activity, Na(i), by examining the electrogenic Na pump current transient produced by reactivating the Na pump (see Eisner & Lederer, 1980).3. Various concentrations of Cs or Rb were used to reactivate the Na pump in the absence of extracellular K, K(o). Results from such experiments showed that these ;activator cations' produced a monotonic increase in Na pump rate with increasing concentration while producing monotonic decreases in steady-state twitch tension. A given concentration of Rb was more potent than the same concentration of Cs in its effects on both Na pump rate and tension. Nevertheless, varying [Rb](o) or [Cs](o) produced the same relationship between Na pump activity and tension.4. After the preparation was exposed to low K(o) (below 4 mM), the Na pump was reactivated with 10 mM-Rb(o) (0-K(o)). The area under the resulting electrogenic Na pump current transient gives a measure of the increase of [Na](i) that occurred when the preparation was exposed to the test solution compared to the steady-state Na(i) in 10 mM-Rb(o). Increasing the duration of exposure to low K(o), further augments the twitch tension achieved at the end of the test period and the area under the electrogenic Na pump current transient. Similarly, for equal periods of exposure, the lower the [K](o) in the test solution, the greater the increase of twitch tension at the end of the test period and the greater the area under the electrogenic Na pump current transient.5. The relationship between tension and the area under the electrogenic Na pump current transient is the same for a variable duration exposure to 0-K(o) or for a constant exposure to various low K(o). It is concluded that a rise in [Na](i) is the rate limiting step linking Na pump activity and twitch tension.6. In an experiment similar to the one described in (4), the fibre was exposed to a test solution containing a variable concentration of one of the activator cations of the Na pump for a fixed period. The effects of different cations were compared with the effects of a test solution containing no activator cation. Increasing the concentration of a particular activator cation from zero reduced the twitch tension augmentation in the test solution and also reduced the area under the electrogenic Na pump current transient on subsequently reactivating the Na pump with 10 mM-Rb(o). It is concluded that the ability of a test solution to reduce the area of the electrogenic Na pump current transient reflects the ability of the test solution to activate the Na pump. Equivalent concentrations of the activator cations that are required to activate the Na pump are: 2 mM-K(o) = 2 mM-Rb(o) = 6 mM-Cs(o) = 6 mM-NH(4o) = 22 mM-Li(o). Tl(o) was more effective than K(o). The order of these cations to reduce twitch tension is found to be the same as that to reduce the area under the electrogenic Na pump current transient.7. We conclude that the effects of the activator cations on twitch tension are determined by their effects on the Na pump and thereby on [Na](i).