Robust anti-arrhythmic efficacy of verapamil and flunarizine against dofetilide-induced TdP arrhythmias is based upon a shared and a different mode of action

BACKGROUND AND PURPOSE

The high predisposition to Torsade de Pointes (TdP) in dogs with chronic AV-block (CAVB) is well documented. The anti-arrhythmic efficacy and mode of action of Ca(2+) channel antagonists, flunarizine and verapamil against TdP were investigated.

EXPERIMENTAL APPROACH

Mongrel dogs with CAVB were selected based on the inducibility of TdP with dofetilide. The effects of flunarizine and verapamil were assessed after TdP and in different experiments to prevent dofetilide-induced TdP. Electrocardiogram and ventricular monophasic action potentials were recorded. Electrophysiological parameters and short-term variability of repolarization (STV) were determined. In vitro, flunarizine and verapamil were added to determine their effect on (i) dofetilide-induced early after depolarizations (EADs) in canine ventricular myocytes (VM); (ii) diastolic Ca(2+) sparks in RyR2(R4496+/+) mouse myocytes; and (iii) peak and late I(Na) in SCN5A-HEK 293 cells.

KEY RESULTS

Dofetilide increased STV prior to TdP and in VM prior to EADs. Both flunarizine and verapamil completely suppressed TdP and reversed STV to baseline values. Complete prevention of TdP was achieved with both drugs, accompanied by the prevention of an increase in STV. Suppression of EADs was confirmed after flunarizine. Only flunarizine blocked late I(Na). Ca(2+) sparks were reduced with verapamil.

CONCLUSIONS AND IMPLICATIONS

Robust anti-arrhythmic efficacy was seen with both Ca(2+) channel antagonists. Their divergent electrophysiological actions may be related to different additional effects of the two drugs.

Co-localization of vesicles and P/Q Ca2+-channels explains the preferential distribution of exocytotic active zones in neurites emitted by bovine chromaffin cells

We have taken advantage of the differences between the preferential localization of secretion in the terminals of neurite-emitting bovine chromaffin cells in contrast with the random distribution secretion in spherical cells to study the possible molecular factors determining such localization by using immunofluorescence and confocal microscopy techniques. By analyzing the distribution of dopamine beta-hydroxylase present in the membrane of chromaffin granules, we found that vesicles migrate and accumulate in dense packages in the terminals of neurite processes. Neither members of the fusion core complex such as SNAP-25, nor nicotinic receptors are preferentially located in the terminals as would be expected from elements defining sites of release, thereby suggesting the presence of additional factors. Interestingly, we observed a preferential distribution of the P/Q subtype of Ca2+ channels in these neurite terminals and co-localization with vesicles present in these structures, in sharp contrast with the overall distribution of the L subtype channels. Using the same immunofluorescence techniques we were unable to detect N-type calcium channels. In addition, omega-agatoxin IVA was able to block 70% of the exocytotic release occurring into the neurites, whereas L-type blockers had a weak effect. Taken together our results strongly indicate that the co-localization of vesicles and clusters of P/Q Ca2+ channels may explain the precise localization of exocytotic sites in the terminals of neurite-emitting chromaffin cells, whereas the distribution of secretory sites in round cells may arise from the random presence of these factors as indicated by their partial co-localization.

Pancreatitis induces HSP72 in the lung: role of neutrophils and xanthine oxidase

The aim of this work was to evaluate the systemic Hsp72 expression in rat lung and liver in vivo in a model of acute pancreatitis and investigate the possible involvement of xanthine oxidase and neutrophils in this process. Pancreatitis was induced by intraductal administration of 5% sodium taurocholate and samples of lung and liver were obtained 1 and 3 h later. In some groups of rats circulating xanthine oxidase was inhibited with oxypurinol, and neutrophil recruitment was blocked with a monoclonal antibody against P-selectin. Hsp72 expression was assessed by means of Western blot and immunohistochemistry. Results showed Hsp72 induction in lung, but not in liver, shortly after pancreatitis. Hsp72-induced expression was located in bronchial epithelium, alveolar macrophages, infiltrating neutrophils, and blood vessels. Oxypurinol and the antibody against P-selectin prevented pancreatitis-induced lung Hsp72 overexpression suggesting that Hsp72 induction is mediated by neutrophil infiltration into the lungs.