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Schneider A, Hage A, Stein ICAP, Kriedemann N, Zweigerdt R, Leffler A. A Possible Role of Tetrodotoxin-Sensitive Na + Channels for Oxidation-Induced Late Na + Currents in Cardiomyocytes. Int J Mol Sci 2024; 25:6596. [PMID: 38928302 PMCID: PMC11203718 DOI: 10.3390/ijms25126596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 06/10/2024] [Accepted: 06/13/2024] [Indexed: 06/28/2024] Open
Abstract
An accumulation of reactive oxygen species (ROS) in cardiomyocytes can induce pro-arrhythmogenic late Na+ currents by removing the inactivation of voltage-gated Na+ channels including the tetrodotoxin (TTX)-resistant cardiac α-subunit Nav1.5 as well as TTX-sensitive α-subunits like Nav1.2 and Nav1.3. Here, we explored oxidant-induced late Na+ currents in mouse cardiomyocytes and human-induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) as well as in HEK 293 cells expressing Nav1.2, Nav1.3, or Nav1.5. Na+ currents in mouse cardiomyocytes and hiPSC-CMs treated with the oxidant chloramine T (ChT) developed a moderate reduction in peak current amplitudes accompanied by large late Na+ currents. While ChT induced a strong reduction in peak current amplitudes but only small persistent currents on Nav1.5, both Nav1.2 and Nav1.3 produced increased peak current amplitudes and large persistent currents following oxidation. TTX (300 nM) blocked ChT-induced late Na+ currents significantly stronger as compared to peak Na+ currents in both mouse cardiomyocytes and hiPSC-CMs. Similar differences between Nav1.2, Nav1.3, and Nav1.5 regarding ROS sensitivity were also evident when oxidation was induced with UVA-light (380 nm) or the cysteine-selective oxidant nitroxyl (HNO). To conclude, our data on TTX-sensitive Na+ channels expressed in cardiomyocytes may be relevant for the generation of late Na+ currents following oxidative stress.
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Affiliation(s)
- Anja Schneider
- Department of Anesthesiology and Intensive Care Medicine, Hannover Medical School, 30625 Hannover, Germany (A.H.); (I.C.A.P.S.)
| | - Axel Hage
- Department of Anesthesiology and Intensive Care Medicine, Hannover Medical School, 30625 Hannover, Germany (A.H.); (I.C.A.P.S.)
| | | | - Nils Kriedemann
- Leibniz Research Laboratories for Biotechnology and Artificial Organs (LEBAO), Department of Cardiothoracic, Transplantation and Vascular Surgery (HTTG), REBIRTH—Research Center for Translational Regenerative Medicine, Hannover Medical School, 30625 Hannover, Germany
| | - Robert Zweigerdt
- Leibniz Research Laboratories for Biotechnology and Artificial Organs (LEBAO), Department of Cardiothoracic, Transplantation and Vascular Surgery (HTTG), REBIRTH—Research Center for Translational Regenerative Medicine, Hannover Medical School, 30625 Hannover, Germany
| | - Andreas Leffler
- Department of Anesthesiology and Intensive Care Medicine, Hannover Medical School, 30625 Hannover, Germany (A.H.); (I.C.A.P.S.)
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2
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Deisl C, Chung JH, Hilgemann DW. Longitudinal diffusion barriers imposed by myofilaments and mitochondria in murine cardiac myocytes. J Gen Physiol 2023; 155:e202213329. [PMID: 37555782 PMCID: PMC10412754 DOI: 10.1085/jgp.202213329] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 05/08/2023] [Accepted: 07/14/2023] [Indexed: 08/10/2023] Open
Abstract
Using optical and electrical methods, we document that diffusion in the cytoplasm of BL6 murine cardiomyocytes becomes restricted >20-fold as molecular weight increases from 30 to 2,000, roughly as expected for pores with porin channel dimensions. Bodipy-FL ATP diffuses >40-fold slower than in free water at 25°C. From several fluorophores analyzed, bound fluorophore fractions range from 0.1 for a 2 kD FITC-labeled polyethylene glycol to 0.93 for sulforhodamine. Unbound fluorophores diffuse at 0.5-8 × 10-7 cm2/s (5-80 μm2/s). Analysis of Na/K pump and veratridine-modified Na channel currents suggests that Na diffusion is nearly unrestricted at 35°C (time constant for equilibration with the pipette tip, ∼20 s). Using multiple strategies, we estimate that at 35°C, ATP diffuses four to eight times slower than in free water. To address whether restrictions are caused more by protein or membrane networks, we verified first that a protein gel, 10 g% gelatin, restricts diffusion with strong dependence on molecular weight. Solute diffusion in membrane-extracted cardiac myofilaments, confined laterally by suction into large-diameter pipette tips, is less restricted than in intact myocytes. Notably, myofilaments extracted similarly from skeletal (diaphragm) myocytes are less restrictive. Solute diffusion in myocytes with sarcolemma permeabilized by β-escin (80 µM) is similar to diffusion in intact myocytes. Restrictions are strain-dependent, being twofold greater in BL6 myocytes than in CD1/J6/129svJ myocytes. Furthermore, longitudinal diffusion is 2.5-fold more restricted in CD1/J6/129svJ myocytes lacking the mitochondrial porin, VDAC1, than in WT CD1/J6/129svJ myocytes. Thus, mitochondria networks restrict long-range diffusion while presumably optimizing nucleotide transfer between myofilaments and mitochondria. We project that diffusion restrictions imposed by both myofilaments and the outer mitochondrial membrane are important determinants of total free cytoplasmic AMP and ADP (∼10 μM). However, the capacity of diffusion to deliver ATP to myofilaments remains ∼100-fold greater than ATP consumption.
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Affiliation(s)
- Christine Deisl
- Department of Physiology, Southwestern Medical Center, Dallas, TX, USA
| | - Jay H. Chung
- Laboratory of Obesity and Aging Research, Cardiovascular Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
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3
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Deisl C, Chung JA, Hilgemann DW. Pore-like diffusion barriers in murine cardiac myocytes. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.01.02.522313. [PMID: 36712045 PMCID: PMC9881867 DOI: 10.1101/2023.01.02.522313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Using both optical and electrical methods, we document that solute diffusion in the cytoplasm of BL6 murine cardiac myocytes becomes restricted >30-fold as molecular weight increases from 30 to 2000, roughly as expected for pores with dimensions of cardiac porin channels. The Bodipy-FL ATP analogue diffuses ∼50-fold slower in BL6 cardiac cytoplasm than in free water. From several fluorophores analyzed, our estimates of bound fluorophore fractions range from 0.1 for a 2 kD FITC-labeled polyethylene glycol to 0.93 for sulforhodamine. We estimate that diffusion coefficients of unbound fluorophores range from 0.5 to 8 x 10 -7 cm 2 /s. Analysis of Na/K pump and veratridine-modified Na channel currents confirms that Na diffusion is nearly unrestricted (time constant for equilibration with the pipette tip, ∼20 s). Using three different approaches, we estimate that ATP diffuses 8 to 10-times slower in the cytoplasm of BL6 myocytes than in free water. To address whether restrictions are caused more by cytoplasmic protein or membrane networks, we verified first that a protein gel, 10 gram% gelatin, restricts solute diffusion with strong dependence on molecular weight. Solute diffusion in membrane-extracted cardiac myofilaments, confined laterally by suction into large-diameter pipette tips, is however less restricted than in intact myocytes. Notably, myofilaments from equivalently extracted skeletal (diaphragm) myocytes restrict diffusion less than cardiac myofilaments. Solute diffusion in myocytes with sarcolemma permeabilized by β-escin (80 µM) is similarly restricted as in intact myocytes. Diffusion restriction in cardiac myocytes is strain-dependent, being about two-fold greater in BL6 myocytes than in myocytes with a CD1/J6/129svJ background. Furthermore, diffusion is 2.5-fold more restricted in CD1/J6/129svJ myocytes lacking the mitochondrial porin, Vdac1, than in WT CD1/J6/129svJ myocytes. We conclude that both myofilaments and mitochondria networks restrict diffusion in cardiac myocytes. As a result, long-range solute diffusion may preferentially occur via passage through porin channels and intramembrane mitochondrial spaces, where diffusion is less restricted than in myofilament spaces.
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Affiliation(s)
- Christine Deisl
- Department of Physiology, Southwestern Medical Center, Dallas, TX 75235-9040 USA
| | - Jay A Chung
- Laboratory of Obesity and Aging Research, Cardiovascular Branch, NHLBI, NIH, Bethesda, MD 20892, USA
| | - Donald W Hilgemann
- Department of Physiology, Southwestern Medical Center, Dallas, TX 75235-9040 USA
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4
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Skogestad J, Aronsen JM. Regulation of Cardiac Contractility by the Alpha 2 Subunit of the Na+/K+-ATPase. Front Physiol 2022; 13:827334. [PMID: 35812308 PMCID: PMC9258780 DOI: 10.3389/fphys.2022.827334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 05/16/2022] [Indexed: 11/14/2022] Open
Abstract
Cytosolic Na + concentrations regulate cardiac excitation-contraction coupling and contractility. Inhibition of the Na+/K+-ATPase (NKA) activity increases cardiac contractility by increasing cytosolic Ca2+ levels, as increased cytosolic Na+ levels are coupled to less Ca2+ extrusion and/or increased Ca2+ influx from the Na+/Ca2+-exchanger. NKA consists of one α subunit and one β subunit, with α1 and α2 being the main α isoforms in cardiomyocytes. Substantial evidence suggests that NKAα2 is the primary regulator of cardiac contractility despite being outnumbered by NKAα1 in cardiomyocytes. This review will mainly focus on differential regulation and subcellular localization of the NKAα1 and NKAα2 isoforms, and their relation to the proposed concept of subcellular gradients of Na+ in cardiomyocytes. We will also discuss the potential roles of NKAα2 in mediating cardiac hypertrophy and ventricular arrhythmias.
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Affiliation(s)
- Jonas Skogestad
- Department of Molecular Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Pharmacology, Oslo University Hospital, Oslo, Norway
| | - Jan Magnus Aronsen
- Department of Molecular Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Pharmacology, Oslo University Hospital, Oslo, Norway
- *Correspondence: Jan Magnus Aronsen,
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Takeuchi A, Matsuoka S. Physiological and Pathophysiological Roles of Mitochondrial Na +-Ca 2+ Exchanger, NCLX, in Hearts. Biomolecules 2021; 11:biom11121876. [PMID: 34944520 PMCID: PMC8699148 DOI: 10.3390/biom11121876] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/10/2021] [Accepted: 12/10/2021] [Indexed: 12/21/2022] Open
Abstract
It has been over 10 years since SLC24A6/SLC8B1, coding the Na+/Ca2+/Li+ exchanger (NCLX), was identified as the gene responsible for mitochondrial Na+-Ca2+ exchange, a major Ca2+ efflux system in cardiac mitochondria. This molecular identification enabled us to determine structure–function relationships, as well as physiological/pathophysiological contributions, and our understandings have dramatically increased. In this review, we provide an overview of the recent achievements in relation to NCLX, focusing especially on its heart-specific characteristics, biophysical properties, and spatial distribution in cardiomyocytes, as well as in cardiac mitochondria. In addition, we discuss the roles of NCLX in cardiac functions under physiological and pathophysiological conditions—the generation of rhythmicity, the energy metabolism, the production of reactive oxygen species, and the opening of mitochondrial permeability transition pores.
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Affiliation(s)
- Ayako Takeuchi
- Department of Integrative and Systems Physiology, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan;
- Life Science Innovation Center, University of Fukui, Fukui 910-1193, Japan
- Correspondence: ; Tel.: +81-776-61-8311
| | - Satoshi Matsuoka
- Department of Integrative and Systems Physiology, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan;
- Life Science Innovation Center, University of Fukui, Fukui 910-1193, Japan
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6
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Assali EA, Sekler I. Sprinkling salt on mitochondria: The metabolic and pathophysiological roles of mitochondrial Na + signaling mediated by NCLX. Cell Calcium 2021; 97:102416. [PMID: 34062329 DOI: 10.1016/j.ceca.2021.102416] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/25/2021] [Accepted: 04/26/2021] [Indexed: 11/25/2022]
Abstract
NCLX, the mitochondrial Na+/Ca2+ transporter is a key player in Ca2+ signaling. However, its role in Na+ signaling is poorly understood. In this review we focus on Na+ signaling by NCLX, and discuss recent physiological and pathophysiological roles attributed to the Na+ influx into mitochondria.
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Affiliation(s)
- Essam A Assali
- Department of Physiology and Cell Biology, Faculty of Health Sciences, Ben-Gurion University, Beer-Sheva, 84105, Israel
| | - Israel Sekler
- Department of Physiology and Cell Biology, Faculty of Health Sciences, Ben-Gurion University, Beer-Sheva, 84105, Israel.
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Pérez-Hernández M, Leo-Macias A, Keegan S, Jouni M, Kim JC, Agullo-Pascual E, Vermij S, Zhang M, Liang FX, Burridge P, Fenyö D, Rothenberg E, Delmar M. Structural and Functional Characterization of a Na v1.5-Mitochondrial Couplon. Circ Res 2021; 128:419-432. [PMID: 33342222 PMCID: PMC7864872 DOI: 10.1161/circresaha.120.318239] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
RATIONALE The cardiac sodium channel NaV1.5 has a fundamental role in excitability and conduction. Previous studies have shown that sodium channels cluster together in specific cellular subdomains. Their association with intracellular organelles in defined regions of the myocytes, and the functional consequences of that association, remain to be defined. OBJECTIVE To characterize a subcellular domain formed by sodium channel clusters in the crest region of the myocytes and the subjacent subsarcolemmal mitochondria. METHODS AND RESULTS Through a combination of imaging approaches including super-resolution microscopy and electron microscopy we identified, in adult cardiac myocytes, a NaV1.5 subpopulation in close proximity to subjacent subsarcolemmal mitochondria; we further found that subjacent subsarcolemmal mitochondria preferentially host the mitochondrial NCLX (Na+/Ca2+ exchanger). This anatomic proximity led us to investigate functional changes in mitochondria resulting from sodium channel activity. Upon TTX (tetrodotoxin) exposure, mitochondria near NaV1.5 channels accumulated more Ca2+ and showed increased reactive oxygen species production when compared with interfibrillar mitochondria. Finally, crosstalk between NaV1.5 channels and mitochondria was analyzed at a transcriptional level. We found that SCN5A (encoding NaV1.5) and SLC8B1 (which encode NaV1.5 and NCLX, respectively) are negatively correlated both in a human transcriptome data set (Genotype-Tissue Expression) and in human-induced pluripotent stem cell-derived cardiac myocytes deficient in SCN5A. CONCLUSIONS We describe an anatomic hub (a couplon) formed by sodium channel clusters and subjacent subsarcolemmal mitochondria. Preferential localization of NCLX to this domain allows for functional coupling where the extrusion of Ca2+ from the mitochondria is powered, at least in part, by the entry of sodium through NaV1.5 channels. These results provide a novel entry-point into a mechanistic understanding of the intersection between electrical and structural functions of the heart.
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Affiliation(s)
| | - Alejandra Leo-Macias
- Leon H Charney Division of Cardiology NYU Grossman School of Medicine. New York, NY
| | - Sarah Keegan
- Institute for Systems Genetics and Department of Biochemistry and Molecular Pharmacology. NYU Grossman School of Medicine. New York, NY
| | - Mariam Jouni
- Department of Pharmacology, Northwestern University Feinberg School of Medicine. Chicago, IL
| | - Joon-Chul Kim
- Leon H Charney Division of Cardiology NYU Grossman School of Medicine. New York, NY
| | | | - Sarah Vermij
- Leon H Charney Division of Cardiology NYU Grossman School of Medicine. New York, NY
| | - Mingliang Zhang
- Leon H Charney Division of Cardiology NYU Grossman School of Medicine. New York, NY
| | - Feng-Xia Liang
- Microscopy laboratory, Division of Advanced Research Technologies. NYU Grossman School of Medicine. New York, NY
| | - Paul Burridge
- Department of Pharmacology, Northwestern University Feinberg School of Medicine. Chicago, IL
| | - David Fenyö
- Institute for Systems Genetics and Department of Biochemistry and Molecular Pharmacology. NYU Grossman School of Medicine. New York, NY
| | - Eli Rothenberg
- Institute for Systems Genetics and Department of Biochemistry and Molecular Pharmacology. NYU Grossman School of Medicine. New York, NY
| | - Mario Delmar
- Leon H Charney Division of Cardiology NYU Grossman School of Medicine. New York, NY
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8
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Skogestad J, Aronsen JM, Tovsrud N, Wanichawan P, Hougen K, Stokke MK, Carlson CR, Sjaastad I, Sejersted OM, Swift F. Coupling of the Na+/K+-ATPase to Ankyrin B controls Na+/Ca2+ exchanger activity in cardiomyocytes. Cardiovasc Res 2020; 116:78-90. [PMID: 30949686 DOI: 10.1093/cvr/cvz087] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 02/22/2019] [Accepted: 04/03/2019] [Indexed: 01/28/2023] Open
Abstract
AIMS Ankyrin B (AnkB) is an adaptor protein that assembles Na+/K+-ATPase (NKA) and Na+/Ca2+ exchanger (NCX) in the AnkB macromolecular complex. Loss-of-function mutations in AnkB cause the AnkB syndrome in humans, characterized by ventricular arrhythmias and sudden cardiac death. It is unclear to what extent NKA binding to AnkB allows regulation of local Na+ and Ca2+ domains and hence NCX activity. METHODS AND RESULTS To investigate the role of NKA binding to AnkB in cardiomyocytes, we synthesized a disruptor peptide (MAB peptide) and its AnkB binding ability was verified by pulldown experiments. As opposed to control, the correlation between NKA and NCX currents was abolished in adult rat ventricular myocytes dialyzed with MAB peptide, as well as in cardiomyocytes from AnkB+/- mice. Disruption of NKA from AnkB (with MAB peptide) increased NCX-sensed cytosolic Na+ concentration, reduced Ca2+ extrusion through NCX, and increased frequency of Ca2+ sparks and Ca2+ waves without concomitant increase in Ca2+ transient amplitude or SR Ca2+ load, suggesting an effect in local Ca2+ domains. Selective inhibition of the NKAα2 isoform abolished both the correlation between NKA and NCX currents and the increased rate of Ca2+ sparks and waves following NKA/AnkB disruption, suggesting that an AnkB/NKAα2/NCX domain controls Ca2+ fluxes in cardiomyocytes. CONCLUSION NKA binding to AnkB allows ion regulation in a local domain, and acute disruption of the NKA/AnkB interaction using disruptor peptides lead to increased rate of Ca2+ sparks and waves. The functional effects were mediated through the NKAα2 isoform. Disruption of the AnkB/NKA/NCX domain could be an important pathophysiological mechanism in the AnkB syndrome.
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Affiliation(s)
- Jonas Skogestad
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Ullevål, N-0407 Oslo, Norway.,KG Jebsen Cardiac Research Centre and Center for Heart Failure Research, University of Oslo, Oslo, Norway
| | - Jan Magnus Aronsen
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Ullevål, N-0407 Oslo, Norway.,Bjørknes College, Oslo, Norway
| | - Nils Tovsrud
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Ullevål, N-0407 Oslo, Norway.,KG Jebsen Cardiac Research Centre and Center for Heart Failure Research, University of Oslo, Oslo, Norway
| | - Pimthanya Wanichawan
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Ullevål, N-0407 Oslo, Norway.,KG Jebsen Cardiac Research Centre and Center for Heart Failure Research, University of Oslo, Oslo, Norway
| | - Karina Hougen
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Ullevål, N-0407 Oslo, Norway.,KG Jebsen Cardiac Research Centre and Center for Heart Failure Research, University of Oslo, Oslo, Norway
| | - Mathis Korseberg Stokke
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Ullevål, N-0407 Oslo, Norway.,KG Jebsen Cardiac Research Centre and Center for Heart Failure Research, University of Oslo, Oslo, Norway.,Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Cathrine Rein Carlson
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Ullevål, N-0407 Oslo, Norway.,KG Jebsen Cardiac Research Centre and Center for Heart Failure Research, University of Oslo, Oslo, Norway
| | - Ivar Sjaastad
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Ullevål, N-0407 Oslo, Norway.,KG Jebsen Cardiac Research Centre and Center for Heart Failure Research, University of Oslo, Oslo, Norway
| | - Ole Mathias Sejersted
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Ullevål, N-0407 Oslo, Norway.,KG Jebsen Cardiac Research Centre and Center for Heart Failure Research, University of Oslo, Oslo, Norway
| | - Fredrik Swift
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Ullevål, N-0407 Oslo, Norway.,KG Jebsen Cardiac Research Centre and Center for Heart Failure Research, University of Oslo, Oslo, Norway.,Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
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9
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Tazmini K, Frisk M, Lewalle A, Laasmaa M, Morotti S, Lipsett DB, Manfra O, Skogestad J, Aronsen JM, Sejersted OM, Sjaastad I, Edwards AG, Grandi E, Niederer SA, Øie E, Louch WE. Hypokalemia Promotes Arrhythmia by Distinct Mechanisms in Atrial and Ventricular Myocytes. Circ Res 2020; 126:889-906. [PMID: 32070187 PMCID: PMC7098435 DOI: 10.1161/circresaha.119.315641] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
RATIONALE Hypokalemia occurs in up to 20% of hospitalized patients and is associated with increased incidence of ventricular and atrial fibrillation. It is unclear whether these differing types of arrhythmia result from direct and perhaps distinct effects of hypokalemia on cardiomyocytes. OBJECTIVE To investigate proarrhythmic mechanisms of hypokalemia in ventricular and atrial myocytes. METHODS AND RESULTS Experiments were performed in isolated rat myocytes exposed to simulated hypokalemia conditions (reduction of extracellular [K+] from 5.0 to 2.7 mmol/L) and supported by mathematical modeling studies. Ventricular cells subjected to hypokalemia exhibited Ca2+ overload and increased generation of both spontaneous Ca2+ waves and delayed afterdepolarizations. However, similar Ca2+-dependent spontaneous activity during hypokalemia was only observed in a minority of atrial cells that were observed to contain t-tubules. This effect was attributed to close functional pairing of the Na+-K+ ATPase and Na+-Ca2+ exchanger proteins within these structures, as reduction in Na+ pump activity locally inhibited Ca2+ extrusion. Ventricular myocytes and tubulated atrial myocytes additionally exhibited early afterdepolarizations during hypokalemia, associated with Ca2+ overload. However, early afterdepolarizations also occurred in untubulated atrial cells, despite Ca2+ quiescence. These phase-3 early afterdepolarizations were rather linked to reactivation of nonequilibrium Na+ current, as they were rapidly blocked by tetrodotoxin. Na+ current-driven early afterdepolarizations in untubulated atrial cells were enabled by membrane hyperpolarization during hypokalemia and short action potential configurations. Brief action potentials were in turn maintained by ultra-rapid K+ current (IKur); a current which was found to be absent in tubulated atrial myocytes and ventricular myocytes. CONCLUSIONS Distinct mechanisms underlie hypokalemia-induced arrhythmia in the ventricle and atrium but also vary between atrial myocytes depending on subcellular structure and electrophysiology.
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Affiliation(s)
- Kiarash Tazmini
- From the Institute for Experimental Medical Research, Oslo University Hospital (K.T., M.F., M.L., D.B.L., O.M., J.S., J.M.A., O.M.S., I.S., W.E.L.), University of Oslo, Norway
- Department of Internal Medicine, Diakonhjemmet Hospital, Oslo, Norway (K.T., E.Ø.)
| | - Michael Frisk
- From the Institute for Experimental Medical Research, Oslo University Hospital (K.T., M.F., M.L., D.B.L., O.M., J.S., J.M.A., O.M.S., I.S., W.E.L.), University of Oslo, Norway
- KG Jebsen Center for Cardiac Research (M.F., M.L., O.M., I.S., W.E.L.), University of Oslo, Norway
| | - Alexandre Lewalle
- Division of Imaging Sciences and Biomedical Engineering, King’s College London, United Kingdom (A.L., S.A.N.)
| | - Martin Laasmaa
- From the Institute for Experimental Medical Research, Oslo University Hospital (K.T., M.F., M.L., D.B.L., O.M., J.S., J.M.A., O.M.S., I.S., W.E.L.), University of Oslo, Norway
- KG Jebsen Center for Cardiac Research (M.F., M.L., O.M., I.S., W.E.L.), University of Oslo, Norway
| | - Stefano Morotti
- Department of Pharmacology, School of Medicine, University of California Davis (S.M., A.G.E., E.G.)
| | - David B. Lipsett
- From the Institute for Experimental Medical Research, Oslo University Hospital (K.T., M.F., M.L., D.B.L., O.M., J.S., J.M.A., O.M.S., I.S., W.E.L.), University of Oslo, Norway
| | - Ornella Manfra
- From the Institute for Experimental Medical Research, Oslo University Hospital (K.T., M.F., M.L., D.B.L., O.M., J.S., J.M.A., O.M.S., I.S., W.E.L.), University of Oslo, Norway
- KG Jebsen Center for Cardiac Research (M.F., M.L., O.M., I.S., W.E.L.), University of Oslo, Norway
| | - Jonas Skogestad
- From the Institute for Experimental Medical Research, Oslo University Hospital (K.T., M.F., M.L., D.B.L., O.M., J.S., J.M.A., O.M.S., I.S., W.E.L.), University of Oslo, Norway
| | - Jan M. Aronsen
- From the Institute for Experimental Medical Research, Oslo University Hospital (K.T., M.F., M.L., D.B.L., O.M., J.S., J.M.A., O.M.S., I.S., W.E.L.), University of Oslo, Norway
- Bjørknes College, Oslo, Norway (J.M.A.)
| | - Ole M. Sejersted
- From the Institute for Experimental Medical Research, Oslo University Hospital (K.T., M.F., M.L., D.B.L., O.M., J.S., J.M.A., O.M.S., I.S., W.E.L.), University of Oslo, Norway
| | - Ivar Sjaastad
- From the Institute for Experimental Medical Research, Oslo University Hospital (K.T., M.F., M.L., D.B.L., O.M., J.S., J.M.A., O.M.S., I.S., W.E.L.), University of Oslo, Norway
- KG Jebsen Center for Cardiac Research (M.F., M.L., O.M., I.S., W.E.L.), University of Oslo, Norway
| | - Andrew G. Edwards
- Department of Pharmacology, School of Medicine, University of California Davis (S.M., A.G.E., E.G.)
| | - Eleonora Grandi
- Department of Pharmacology, School of Medicine, University of California Davis (S.M., A.G.E., E.G.)
| | - Steven A. Niederer
- Division of Imaging Sciences and Biomedical Engineering, King’s College London, United Kingdom (A.L., S.A.N.)
| | - Erik Øie
- Department of Internal Medicine, Diakonhjemmet Hospital, Oslo, Norway (K.T., E.Ø.)
| | - William E. Louch
- From the Institute for Experimental Medical Research, Oslo University Hospital (K.T., M.F., M.L., D.B.L., O.M., J.S., J.M.A., O.M.S., I.S., W.E.L.), University of Oslo, Norway
- KG Jebsen Center for Cardiac Research (M.F., M.L., O.M., I.S., W.E.L.), University of Oslo, Norway
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Blaustein MP, Hamlyn JM. Ouabain, endogenous ouabain and ouabain-like factors: The Na + pump/ouabain receptor, its linkage to NCX, and its myriad functions. Cell Calcium 2020; 86:102159. [PMID: 31986323 DOI: 10.1016/j.ceca.2020.102159] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 01/01/2020] [Accepted: 01/03/2020] [Indexed: 12/12/2022]
Abstract
In this brief review we discuss some aspects of the Na+ pump and its roles in mediating the effects of ouabain and endogenous ouabain (EO): i) in regulating the cytosolic Ca2+ concentration ([Ca2+]CYT) via Na/Ca exchange (NCX), and ii) in activating a number of protein kinase (PK) signaling cascades that control a myriad of cell functions. Importantly, [Ca2+]CYT and the other signaling pathways intersect at numerous points because of the influence of Ca2+ and calmodulin in modulating some steps in those other pathways. While both mechanisms operate in virtually all cells and tissues, this article focuses primarily on their functions in the cardiovascular system, the central nervous system (CNS) and the kidneys.
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Affiliation(s)
- Mordecai P Blaustein
- Department of Physiology, University of Maryland School of Medicine, Baltimore, MD 21201, USA; Department of Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
| | - John M Hamlyn
- Department of Physiology, University of Maryland School of Medicine, Baltimore, MD 21201, USA
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Hilgemann DW. Control of cardiac contraction by sodium: Promises, reckonings, and new beginnings. Cell Calcium 2019; 85:102129. [PMID: 31835176 DOI: 10.1016/j.ceca.2019.102129] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 11/20/2019] [Accepted: 11/20/2019] [Indexed: 12/12/2022]
Abstract
Several generations of cardiac physiologists have verified that basal cardiac contractility depends strongly on the transsarcolemmal Na gradient, and the underlying molecular mechanisms that link cardiac excitation-contraction coupling (ECC) to the Na gradient have been elucidated in good detail for more than 30 years. In brief, small increases of cytoplasmic Na push cardiac (NCX1) Na/Ca exchangers to increase contractility by increasing the myocyte Ca load. Accordingly, basal cardiac contractility is expected to be physiologically regulated by pathways that modify the cardiac Na gradient and the function of Na transporters. Assuming that this expectation is correct, it remains to be elucidated how in detail signaling pathways affecting the cardiac Na gradient are controlled in response to changing cardiac output requirements. Some puzzle pieces that may facilitate progress are outlined in this short review. Key open issues include (1) whether the concept of local Na gradients is viable, (2) how in detail Na channels, Na transporters and Na/K pumps are regulated by lipids and metabolic processes, (3) the physiological roles of Na/K pump inactivation, and (4) the possibility that key diffusible signaling molecules remain to be discovered.
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Affiliation(s)
- Donald W Hilgemann
- Department of Physiology, University of Texas Southwestern Medical Center, Dallas, TX, 75235, USA.
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