心肌兴奋收缩耦联过程中的钙调控

联系以膜电位变化为特征的细胞兴奋和以肌丝滑行为基础的肌肉收缩的中介过程通常称为兴奋收缩耦联。在所有参与调控心肌收缩功能的离子中,钙离子被认为是最重要的介导因子,因此验明钙离子参与介导心肌兴奋收缩耦联的方式和途径等特征无疑有益于更好地理解心脏的生理功能。     

心肌细胞兴奋收缩耦联的分子机制

肌细胞兴奋时,动作电位通过电压门控钙通道激活肌质网钙释放,由此引发的细胞内钙离子的瞬时升高驱动细胞收缩,这个过程叫做兴奋收缩耦联．21世纪以来,随着钙成像技术和分子细胞生物学技术的联合应用,心肌兴奋收缩耦联的分子机制逐步阐明．本文结合本实验室的相关研究,系统总结该领域的前沿进展,包括钙释放通道的分子性质、电压门控钙通道激活肌质网钙释放通道的动力学过程、生理调控以及病理变化．     

CaMKII在细胞钙稳态维持及心肌保护中作用的研究进展

钙/钙调素依赖性蛋白激酶II(CaMKII)是主要表达于心脏的一种多功能苏氨酸/丝氨酸蛋白激酶,通过磷酸化与Ca2+调节相关的蛋白影响心肌的兴奋收缩耦联及细胞钙稳态.在心肌缺血缺氧等病理条件下,心肌细胞钙离子循环出现异常,CaMKII通过代偿性活性改变起到维持Ca2+稳态及心肌保护效应.深入了解CaMKII对钙循环的调节、在间歇性高海拔缺氧介导的心脏保护及心肌细胞内酸中毒后心肌收缩力恢复过程中的作用机制,具有重要的基础研究及临床应用前景.     

青蛙心肌细胞膜在调节肌浆钙离子浓度中所起作用的定量考虑

在骨胳肌兴奋-收缩耦联过程中,肌浆钙离子浓度主要由肌浆网系调节。青蛙心肌细胞的肌浆网系不发达,没有横管,且细胞直径很小,因此肌浆钙离子浓度很可能由发生在肌膜上的过程调节。本文从定量角度验证这一设想的可能性。假定青蛙心肌细胞兴奋时钙离子顺浓度差从细胞外跨膜扩散入细胞使肌浆钙浓度升高,又经肌膜上类似载体作用的主动过程将钙离子排出细胞,由此计算静息蛙心肌在某一频率的重复刺激下肌浆钙离子浓度随刺激次数的变化以及对不同刺激频率当收缩张力达稳态时肌浆内钙浓度值。利用肌肉稳态收缩张力和细胞内钙离子浓度之间已知的单值关系可以看到,计算结果同实验记录的蛙心肌稳态张力与刺激频率间的“阶梯”关系符合得很好,说明青蛙心肌细胞膜在调节肌浆钙离子浓度中起决定作用这一想法从定量角度考虑也完全是可能的.     

β-肾上腺素受体调控心肌细胞兴奋收缩耦联的分子过程研究

兴奋收缩耦联是肌细胞兴奋期间由动作电位触发肌质网释放钙离子,从而导致收缩的过程。心肌细胞的兴奋收缩耦联是通过“钙致钙释放（Ca^2＋-induced Ca^2＋ release）的机制完成的。兴奋期间,细胞膜电位的去极化导致电压依赖性的L．型钙通道（LCC）开放,细胞外钙离子通过LCC流入细胞,激活了肌质网膜上称为ryanodine受体（RyR）的钙释放通道,后者从肌质网钙库中释放钙离子,使细胞质游离钙浓度迅速上升。细胞质钙浓度的升高一方面启动细胞收缩,另一方面激活了肌质网钙泵和细胞膜钠钙交换,二者分别将钙离子运回肌质网或细胞外,使细胞质钙浓度很快回落,从而完成了一次“钙瞬变（Ca^2＋ transient）”。钙瞬变在每个心动周期发生一次,是直接控制细胞收缩的细胞内信号。     

CACNA1C基因突变致L-型钙通道异常与心律失常研究的进展

L-型CaV1.2钙通道广泛表达在心肌细胞中,是钙离子流入心肌细胞的主要通道,其介导的内向电流是心肌兴奋收缩耦联的始动条件,也是心肌细胞动作电位平台期的重要贡献因素。L-型钙通道由功能亚单位α1亚单位(心肌型为CaV1.2)和其他附属亚单位构成。研究发现编码CaV1.2的CACNA1C基因功能获得型与丧失型突变常与包括长QT综合征、Brugada综合征、短QT综合征在内的遗传性心律失常综合征有关。本文将对近年来出现的CACNA1C突变及其导致的各种心律失常进行综述。     

膜耦联的关键分子junctophilin

junctophilin是目前公认的可兴奋细胞的胞膜与内(肌)质网耦联的分子基础.其可能的作用机制是以C端锚定在内(肌)质网上, 通过N端的MORN结构域(MORN motif)与细胞膜相互作用.目前已知该分子在哺乳动物中存在四种亚型,在骨骼肌和心肌分别以Jp-1和Jp-2为主. junctophilin的低表达会导致细胞膜与内(肌)质网脱耦联,从而使心肌和骨骼肌兴奋收缩耦联效率降低, 进而影响收缩能力.目前已发现junctophilin基因突变与心衰等疾病有关,因而junctophilin可能成为针对这些疾病的药物开发新靶点.     

肌浆网钙漏流与心力衰竭

钙离子在心脏兴奋-收缩偶联中发挥关键作用,全细胞钙浓度升高通过激活相关信号通路参与基因表达的调控已受到广泛的关注.肌浆网是心肌细胞重要的钙库,在维持细胞内钙稳态起非常重要的作用,是心肌兴奋-收缩偶联的关键因素.舒张期心肌细胞肌浆网RyR2通道活性增强,异常开放增加或关闭不全,钙离子异常释放,引起肌浆网钙漏流.心力衰竭时肌浆网功能障碍,越来越多的研究表明,心力衰竭尤其是在终末期,肌浆网钙漏流所介导的心肌细胞局部钙信号增强,从而引起心脏发生结构、功能的重构.本文就肌浆网钙漏流的发生机制及其在心力衰竭发生发展中的作用和研究进展进行简要综述,并提出展望,以期为临床心力衰竭的预防和治疗及有效药物的开发应用提供理论依据.     

淋巴管的收缩性及其调节

淋巴管收缩性对维持淋巴循环、体液稳态具有重要作用,其收缩性是通过电兴奋-收缩耦联和化学兴奋-收缩耦联引发淋巴管平滑肌细胞的动作电位、启动不同的收缩蛋白而实现的,受淋巴管张力、神经及体液因素的调节,并受细胞间及细胞内信号转导通路的调控。     

心肌肥厚中L-型钙通道与ryanodine受体分子间信号耦联的衰退

心脏压力负荷导致心肌肥厚的过程是心衰发生的关键环节。已有研究表明,控制心脏收缩的细胞钙致钙释放过程在心肌肥厚及心衰状态下发生缺损,但分子机制尚未阐明。我们以主动脉结扎手术建立压力负荷的大鼠心肌肥厚模型：实验组分为假手术组、代偿性肥厚组（CHT）和失代偿性肥厚组（DHT）,以松钳一共聚焦成像技术研究单个L-型钙通道（LCC）与ryanodine受体（RyR）间的钙信号耦联。我们发现DHT中LCC—RyR分子耦联潜伏期延长49％,耦联成功率降低47％,失败概率提高72％,证明DHT进入了一种“分子间衰退”状态。出人意料的是,心功能正常的CHT也发生分子间衰退,并与锚定肌质网与细胞膜的junctophilin蛋白表达下降有关,表明分子间耦联衰退在细胞功能变化显现之前已经潜性地发生。与此一致,细胞兴奋期钙释放同步性降低,但钙释放总量和细胞钙瞬变在CHT并无变化。这些结果提示,在一个我们称为“稳定余量”（stability margin）的范围内,分子间耦联衰退不会影响细胞兴奋收缩耦联能力,只有分子间耦联衰退超出稳定余量,心衰才会发生。潜性的分子间耦联衰退的发现对早期防治心衰有重要意义。     

Myocardial calcium signalling and arrhythmia pathogenesis

Myocardial calcium signalling is a vital component of the normal physiological function of the heart. Key amongst the many roles calcium plays is its use as the primary signalling component of excitation-contraction coupling, the intracellular process that links cardiomyocyte depolarisation to contraction. Defective cellular calcium handling, due to abnormalities of the various components which mediate and control excitation-contraction coupling, is widely recognised as a significant patho-physiological event in the contractile dysfunction of the failing heart. In addition, similar defects also appear to be increasingly recognised as mediators of certain forms of cardiac arrhythmias. Such defects include single gene defects in excitation-contraction coupling components that lead to inherited sudden death arrhythmia syndromes. Alternatively, arrhythmogenesis occurring within the context of acquired cardiac disease, in particular heart failure, also appears to be highly dependent on abnormal calcium homeostasis. In this article we review the defects in cardiomyocyte calcium homeostasis that lead to particular pro-arrhythmogenic phenomena and discuss recent insights gained into a variety of inherited and acquired arrhythmia syndromes that appear to involve defective calcium signalling as a central component of their patho-physiology. Potential opportunities for new anti arrhythmic therapeutic strategies based on these recent insights are also discussed.     

Models of cardiac excitation-contraction coupling in ventricular myocytes

Mathematical and computational modeling of cardiac excitation-contraction coupling has produced considerable insights into how the heart muscle contracts. With the increase in biophysical and physiological data available, the modeling has become more sophisticated with investigations spanning in scale from molecular components to whole cells. These modeling efforts have provided insight into cardiac excitation-contraction coupling that advanced and complemented experimental studies. One goal is to extend these detailed cellular models to model the whole heart. While this has been done with mechanical and electophysiological models, the complexity and fast time course of calcium dynamics have made inclusion of detailed calcium dynamics in whole heart models impractical. Novel methods such as the probability density approach and moment closure technique which increase computational efficiency might make this tractable.     

Inositol phosphate production following alpha 1-adrenergic, muscarinic or electrical stimulation in isolated rat heart

A possible participation of polyphosphoinositide metabolism in the excitation-contraction coupling in heart was investigated. Isolated rat ventricles prelabelled with myo-[2-3H]inositol were stimulated by conditions that increase mechanical activity. Both noradrenaline and carbachol increased the basal level of IP3, IP2 and IP by the activation of alpha 1-adrenergic and muscarinic receptors, respectively. Electrical stimulation accelerated inositol lipid degradation by phospholipase C thus enhancing the IP3 level as compared to quiescent ventricles. It is proposed that IP3 may be involved in excitation-contraction coupling in cardiac tissue.     

Increased susceptibility to isoproterenol-induced cardiac hypertrophy and impaired weight gain in mice lacking the histidine-rich calcium-binding protein

The sarcoplasmic reticulum (SR) plays a critical role in excitation-contraction coupling by regulating the cytoplasmic calcium concentration of striated muscle. The histidine-rich calcium-binding protein (HRCBP) is expressed in the junctional SR, the site of calcium release from the SR. HRCBP is expressed exclusively in muscle tissues and binds calcium with low affinity and high capacity. In addition, HRCBP interacts with triadin, a protein associated with the ryanodine receptor and thought to be involved in calcium release. Its calcium binding properties, localization to the SR, and interaction with triadin suggest that HRCBP is involved in calcium handling by the SR. To determine the function of HRCBP in vivo, we inactivated HRC, the gene encoding HRCBP, in mice. HRC knockout mice exhibited impaired weight gain beginning at 11 months of age, which was marked by reduced skeletal muscle and fat mass, and triadin protein expression was upregulated in the heart of HRC knockout mice. In addition, HRC null mice displayed a significantly exaggerated response to the induction of cardiac hypertrophy by isoproterenol compared to their wild-type littermates. The exaggerated response of HRC knockout mice to the induction of cardiac hypertrophy is consistent with a regulatory role for HRCBP in calcium handling in vivo and suggests that mutations in HRC, in combination with other genetic or environmental factors, might contribute to pathological hypertrophy and heart failure.     

Calmodulin kinase II inhibition protects against structural heart disease

Beta-adrenergic receptor (betaAR) stimulation increases cytosolic Ca(2+) to physiologically augment cardiac contraction, whereas excessive betaAR activation causes adverse cardiac remodeling, including myocardial hypertrophy, dilation and dysfunction, in individuals with myocardial infarction. The Ca(2+)-calmodulin-dependent protein kinase II (CaMKII) is a recently identified downstream element of the betaAR-initiated signaling cascade that is linked to pathological myocardial remodeling and to regulation of key proteins involved in cardiac excitation-contraction coupling. We developed a genetic mouse model of cardiac CaMKII inhibition to test the role of CaMKII in betaAR signaling in vivo. Here we show CaMKII inhibition substantially prevented maladaptive remodeling from excessive betaAR stimulation and myocardial infarction, and induced balanced changes in excitation-contraction coupling that preserved baseline and betaAR-stimulated physiological increases in cardiac function. These findings mark CaMKII as a determinant of clinically important heart disease phenotypes, and suggest CaMKII inhibition can be a highly selective approach for targeting adverse myocardial remodeling linked to betaAR signaling.     

Calcium handling in myocardium from amphibian,avian, and mammalian species: the search for two components

Summary Steps involved in excitation-contraction coupling in mammalian myocardium have been derived using a relatively limited number of animal species. However, the use of animal models for investigations into excitation-contraction coupling in normal and disease states has encompassed a wide range of animal species. We addressed the question as to whether excitation-contraction coupling as currently understood applies to intracellular calcium handling in myocardium from multiple mammalian species, amphibian, and avian myocardium. The bioluminescent calcium indicator aequorin was used to record intracellular calcium transients in both ventricular and atrial tissue. We report that in all mammalian and avian species studied the calcium transient recorded in both ventricular and atrial myocardium is monophasic and reflects calcium release and re-uptake by the sarcoplasmic reticulum. In contrast, the Ca²⁺ transient recorded from salamander myocardium is prolonged relative to mammalian and avian myocardium, and appears to reflect in part trans-sarcolemmal calcium entry. Only in diseased myocardium derived from human and swine myocardium was a second component detected in the calcium transient. These data indicate that sarcoplasmic reticulum calcium handling is pivotal in excitation-contraction coupling for multiple species with differing physiologies. Also, in disease states, intracellular calcium handling is often affected with resultant alterations in the time-course and/or configuration of the calcium transient.     

Impaired S-Nitrosylation of the Ryanodine Receptor Caused by Xanthine Oxidase Activity Contributes to Calcium Leak in Heart Failure

S-Nitrosylation is a ubiquitous post-translational modification that regulates diverse biologic processes. In skeletal muscle, hypernitrosylation of the ryanodine receptor (RyR) causes sarcoplasmic reticulum (SR) calcium leak, but whether abnormalities of cardiac RyR nitrosylation contribute to dysfunction of cardiac excitation-contraction coupling remains controversial. In this study, we tested the hypothesis that cardiac RyR2 is hyponitrosylated in heart failure, because of nitroso-redox imbalance. We evaluated excitation-contraction coupling and nitroso-redox balance in spontaneously hypertensive heart failure rats with dilated cardiomyopathy and age-matched Wistar-Kyoto rats. Spontaneously hypertensive heart failure myocytes were characterized by depressed contractility, increased diastolic Ca²⁺ leak, hyponitrosylation of RyR2, and enhanced xanthine oxidase derived superoxide. Global S-nitrosylation was decreased in failing hearts compared with nonfailing. Xanthine oxidase inhibition restored global and RyR2 nitrosylation and reversed the diastolic SR Ca²⁺ leak, improving Ca²⁺ handling and contractility. Together these findings demonstrate that nitroso-redox imbalance causes RyR2 oxidation, hyponitrosylation, and SR Ca²⁺ leak, a hallmark of cardiac dysfunction. The reversal of this phenotype by inhibition of xanthine oxidase has important pathophysiologic and therapeutic implications.     

Calcium binding to cardiac myocytes protected from proteolytic enzyme activity

Excitation-contraction coupling in cardiac muscle is dependent on extracellular calcium and calcium bound to the surface of the myocardial cell. In this study, we examined the physical characteristics of calcium binding to adult guinea pig ventricular myocytes disaggregated mechanically in oxygenated tissue culture medium containing a proteinase inhibitor (aprotinin), and separated from cellular debris by Cytodex beads. Cells prepared in this manner excluded Trypan blue and showed no evidence of spontaneous contraction or contracture. Scatchard plots of calcium binding determined by continuous flow equilibrium dialysis revealed a high-affinity, low-capacity pool, Ka = 65 X 10(3) M-1 and Bt = 1.3 nmol X mg-1 and a low-affinity, high-capacity pool, Ka = 141 M-1 and Bt = 138 nmol X mg-1. The low-affinity pool was not detectable after lanthanum, trypsin or collagenase treatment or in cells prepared without aprotinin in the isolation medium. Both neuraminidase and phospholipase C reduced Bt of the low-affinity pool by one half, but only neuraminidase affected the affinity constant of this pool. Ka was increased to 516.7 M-1, similar to the apparent affinity constant for calcium binding estimated from dP/dtmax measured at several extracellular calcium concentrations (470 M-1). The results suggest that calcium bound to sarcolemmal phospholipids represents the superficial calcium involved in excitation-contraction coupling in the heart.