Muscarinic receptor stimulation and cyclic AMP-dependent effects in guinea-pig ventricular myocardium

Muscarinic regulation of cardiac ion channels

The parasympathetic component of the autonomic nervous system plays an important role in the physiological regulation of cardiac function by exerting significant influence over the initiation as well as propagation of electrical impulses, in addition to being able to regulate contractile force. These effects are mediated in whole or in part through changes in ion channel activity that occur in response to activation of M(2) muscarinic cholinergic receptors following release of the neurotransmitter acetylcholine. The coupling of M(2) receptor activation to most changes in cardiac ion channel function can be explained by one of two general paradigms. The first involves direct G protein-dependent regulation of ion channel activity. The second involves indirect regulation of ion channel activity through modulation of cAMP-dependent responses. This review focuses on recent advances in our understanding of the mechanisms by which M(2) muscarinic receptor activation both inhibits and facilitates cAMP-dependent ion channel responses in the heart.

Reduction of infarct size by selective stimulation of prostaglandin EP(3)receptors in the reperfused ischemic pig heart

We have previously identified prostaglandin EP(3)receptors in left ventricular myocardium. To assess the potential contribution of this receptor subtype to the anti-ischemic properties of E-type prostaglandins (i.e. PGE(1)), two groups of anesthetized open-chest minipigs were subjected to LAD occlusion (1 h) and reperfusion (3 h). In one group, the selective EP(3)receptor agonist M&B 28.767 (2 pmol/kgxmin) was infused into the LAD from 20 min before ischemia until the end of reperfusion. The other group received vehicle. M&B 28.767 did not alter the systemic hemodynamics, but significantly reduced infarct size (tetrazolium staining) and creatine kinase release by 53% and 48%, respectively. Ischemia-induced ventricular arrhythmias were mostly reduced. Further experiments analysed the effects of EP(3)receptor stimulation on normoxic myocardium. PGE(1), an unselective agonist to all EP receptor subtypes, as well as M&B 28.767 (2 pmol/kgxmin of each into the LAD) reduced the action potential duration (epicardial monophasic electrodes) and almost prevented the inotropic response to intravenous isoprenaline. This dual response is consistent with the EP(3)receptor coupling to an inhibitory G protein. This was confirmed in separate experiments with stable Chinese hamster ovary cell transfectants expressing the porcine EP(3)receptor, where M&B 28.767 inhibited the forskolin-induced increase in cAMP in a concentration-dependent manner. It is concluded that the protection of reperfused ischemic myocardium by E-type prostaglandins is mediated by EP(3)receptors, which seems to involve a combined activation of repolarizing membrane currents and an inhibition of deleterious effects caused by ischemia-induced catecholamine release.

Muscarinic-cholinoceptor mediated attenuation of phospholamban phosphorylation induced by inhibition of phosphodiesterase in ventricular cardiomyocytes: evidence against a cAMP-dependent effect

In intact guinea pig ventricles, acetylcholine (ACH) has been shown to attenuate the positive inotropic effects of isobutylmethylxanthine (IBMX), a phosphodiesterase inhibitor, by reducing protein phosphorylation without altering cAMP levels. In the present study, we tested the hypothesis that the cAMP-independent inhibitory action of ACH is also evident in isolated cardiomyocytes. cAMP-dependent protein kinase (PKA) activity ratio (-cAMP/+cAMP) and phosphorylation of phospholamban (PLB) were determined in unlabeled and 32P-labeled guinea pig ventricular cardiomyocytes, respectively. IBMX increased PKA activity ratio and phosphorylation of PLB in a dose-dependent manner. When cardiomyocytes were incubated simultaneously with IBMX (0-1 mM) and ACH (2 microM), ACH attenuated PLB phosphorylation stimulated by low concentration (1O-100 microM) but not by high concentrations (> 200 microM) of IBMX. EC50 value for IBMX-induced phosphorylation of PLB was 32 +/- 6 microM and increased nearly 3-fold after addition of ACH while PKA activity ratio remained unchanged. The rank order of cyclic nucleotide derivatives to phosphorylate PLB was 8 bromo-cAMP > dibutyryl cAMP > 8 bromo-cGMP > dibutyryl cGMP. ACH reduced phosphorylation of PLB stimulated by 8 bromo-cAMP. We conclude that in isolated cardiomyocytes (1) ACH inhibits phosphorylation of PLB stimulated by either IBMX or 8 bromo-cAMP and (2) ACH does not lower IBMX-stimulated PKA activity ratio. These effects of ACH on PLB phosphorylation cannot be explained by a reduction in IBMX-stimulated cAMP levels but may involve the activation of protein phosphatases.

Deferoxamine blocks interactions of fluoride and carbachol in isolated mammalian cardiac preparations

In papillary muscles, carbachol reduced the positive inotropic effects of isoprenaline (10 nmol/l). The negative inotropic effects of carbachol in isoprenaline-stimulated guinea pig papillary muscles were attenuated by additionally applied sodium fluoride (3 mmol/l). These effects of sodium fluoride were blocked by deferoxamine (200 micromol/l). In guinea pig left atria, sodium fluoride alone greatly reduced force of contraction. These effects in atria were blocked by 200 micromol/l deferoxamine, and positive inotropic effects of sodium fluoride were observed. It is suggested that the cardiac effects of muscarinic M2 receptor agonists in the ventricle involve, at least in part, the activation of phosphatases which are blocked by fluoride and reactivated by deferoxamine.

Cyclic GMP-dependent protein kinase activation in the absence of negative inotropic effects in the rat ventricle

1. It has been suggested that activation of cyclic GMP-dependent protein kinase (PKG) is a necessary step in the chain of events leading to the production of negative inotropy by muscarinic receptor agonists in mammalian ventricles, and that some cyclic GMP-elevating agents, such as sodium nitroprusside (SNP), fail to exert a negative inotropic effect because they elevate cyclic GMP levels in a pool that does not activate the kinase. This hypothesis was tested in the present study by monitoring the effects of carbachol, SNP and atrial natriuretic peptide (ANP) on contractility, cyclic GMP content and PKG activity in rat intact ventricular preparations and freshly isolated ventricular cardiomyocytes. 2. The presence of PKG in both the intact vehicle and in isolated ventricular cardiomyocytes was confirmed by MonoQ anion exchange chromatography and Western blotting. The elution profile indicated that the conditions of the PKG assay were selective for measuring PKG activity. 3. Carbachol induced a marked negative inotropic effect in intact, perfused hearts and ventricular strips in the presence of isoproterenol. The negative inotropic effect of carbachol was not associated with significant changes in cyclic GMP content or PKG activity in intact ventricular tissue, or in PKG activity in isolated cardiomyocytes. 4. SNP and ANP significantly increased cyclic GMP levels and activated PKG in intact ventricular preparations. Both drugs also activated PKG in isolated cardiomyocytes. However, neither drug had any negative inotropic effect in isoprenaline-stimulated perfused hearts and ANP did not change the contractility of isoprenaline-stimulated isolated cardiomyocytes. 5. The results of this study demonstrate that the negative inotropic effects of muscarinic receptor agonists can occur in the absence of significant activation of PKG. Conversely, marked increases in ventricular cyclic GMP content and PKG activity caused by SNP or ANP were not accompanied by a negative inotropic effect. 6. These results suggest that increases in cyclic GMP levels and activation of PKG do not play important roles in the regulation of rat ventricular contractility by muscarinic receptor agonists.

Sodium fluoride attenuates the negative inotropic effects of muscarinic M2 and adenosine receptor agonists

Sodium fluoride increased the force of contraction in isolated guinea-pig papillary muscles concentration dependently, starting at 3 mmol/1. Sodium fluoride inhibited phosphorylase phosphatase activity in homogenates from guinea pig hearts, starting at 1 mmol/1. The positive inotropic effect of 3 mmol/1 sodium fluoride was not accompanied by an increase in cAMP content in guinea-pig papillary muscles. In papillary muscles, carbachol or (-)-N(6)-phenylisopropyladenosine reduced the positive inotropic effect of isoprenaline (10 nmol/1) or the phosphodiesterase inhibitor 3-isobutyl-1-methylxanthine (60 mu mol/1). These negative inotropic effects of carbachol and (-)-N(6)-phenylisopropyladenosine were attenuated by additional sodium fluoride (3 mmol/l). It is concluded that sodium fluoride can impair the signal transduction of muscarinic M2 (carbachol) and adenosine receptor (-)-N(6)-phenylisopropyladenosine) agonists. This effect of sodium fluoride could support the hypothesis that the cardiac effects of muscarinic M2 and adenosine receptor agonists involve, at least in part, the activation of phosphatases.

Effects of doxorubicin on excitation-contraction coupling in guinea pig ventricular myocardium

Doxorubicin, an anticancer drug, was recently shown to release Ca2+ from cardiac sarcoplasmic reticulum (SR) by increasing the open probability of Ca2+ release channels. In the present study, we investigated the effects of doxorubicin on excitation-contraction coupling of guinea pig heart preparations. In papillary muscles contracting at 0.5 Hz, 100 mumol/L doxorubicin produced within 3 hours the following effects: it increased the force of contraction by 269.3 +/- 19.8% (n = 6) and prolonged the time to peak force by 75.1 +/- 8.7% (n = 6), relaxation time by 54.7 +/- 8.7% (n = 6), and action potential duration (APD) at 90% repolarization (APD90) by 38.6 +/- 2.9% (n = 3). Despite its positive inotropic effect, doxorubicin depressed the early contraction component by increasing the latency between stimulus and the onset of force development. In single myocytes, 100 mumol/L doxorubicin prolonged APD90 by 62.1% (n = 18) and blocked time-dependent delayed rectifier K+ current (IK) by 44% (n = 9). Ca2+ inward current and inward rectifier K+ current were not affected by doxorubicin. Ca2+ transients elicited in myocytes loaded with the fluorescent Ca2+ indicator fura 2 were strongly suppressed by doxorubicin in their initial rising phase. There-after, doxorubicin produced a delayed rise in intracellular Ca2+, which reached a late peak exceeding that of the control peak by 52 +/- 8% (n = 5). The results suggest that doxorubicin decreases Ca(2+)-induced Ca2+ release from cardiac SR, probably by increasing the SR Ca2+ leak. On the other hand, prolongation of APD due to inhibition of IK allows more Ca2+ to enter the cell. After being only temporarily buffered by the SR, Ca2+ may accumulate in the cytosol as long as depolarization is maintained and lead to a more complete activation of contractile proteins.

Role of nitric oxide in parasympathetic modulation of beta-adrenergic myocardial contractility in normal dogs

In vitro studies indicate that muscarinic cholinergic inhibition of beta-adrenergic cardiac responses may be modulated in part by nitric oxide (NO). To evaluate the role of NO in parasympathetic inhibition of the beta-adrenergic contractile response in vivo, we assessed the inotropic response to dobutamine before and during bilateral vagus nerve stimulation in closed-chest dogs. Dobutamine administration and vagal stimulation were repeated during intracoronary infusion of the NO synthase inhibitor NG-monomethyl-L-arginine (L-NMMA, 10 mumol/min) and again following infusion of L-arginine (100 mg/kg). In eight dogs, intracoronary dobutamine infusion at rates of 25 and 50 micrograms/min increased peak +dP/dt by 131 +/- 24 and 168 +/- 22%, respectively (P < 0.0001). Vagal stimulation (2.5 Hz) attenuated the responses to dobutamine (25 and 50 micrograms/min) by 23 +/- 4 and 21 +/- 4%, respectively (P < 0.001). L-NMMA reduced (by 44-62%; P < 0.001) and L-arginine restored vagal inhibition of the dobutamine-stimulated inotropic response. In a second group of nine dogs, dobutamine was administered systemically to assure a constant concentration in the coronary circulation. Vagal stimulation (2.5 Hz) attenuated the dobutamine-stimulated inotropic response (2.5 and 5.0 micrograms/kg per min) by 40 +/- 12% and 57 +/- 8%, respectively (P < 0.004). As with intracoronary dobutamine, L-NMMA diminished and L-arginine restored vagal inhibition of the inotropic response to dobutamine. Intracoronary infusion of atropine (12 micrograms/min) abolished the vagal inhibitory effect, and intracoronary infusion of 8-bromo-cyclic GMP (1 and 10 mM) caused a dose-dependent attenuation of the dobutamine-stimulated increase in +dP/dt. These data suggest that NO mediates, at least in part, vagal inhibition of the inotropic response to beta-adrenergic stimulation by dobutamine, and thus may play a role in normal physiologic regulation of myocardial autonomic responses.

Muscarinic receptors--characterization, coupling and function

At least five muscarinic receptor genes have been cloned and expressed. Muscarinic receptors act via activation of G proteins: m1, m3 and m5 muscarinic receptors couple to stimulate phospholipase C, while m2 and m4 muscarinic receptors inhibit adenylyl cyclase. This review describes the localization, pharmacology and function of the five muscarinic receptor subtypes. The actions of muscarinic receptors on the heart, smooth muscle, glands and on neurons (both presynaptic and postsynaptic) in the autonomic nervous system and the central nervous system are analyzed in terms of subtypes, biochemical mechanisms and effects on ion channels, including K+ channels and Ca2+ channels.