Effect of halothane on human skeletal muscle sarcoplasmic reticulum calcium-release channel.
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Calcium↗
Biomedical subjects
T E Nelson
Publications and source records attributed to T E Nelson.
Abnormal human sarcoplasmic reticulum Ca2+ release channels in malignant hyperthermic skeletal muscle.
Single sarcoplasmic reticulum (SR) Ca2+ release channels were reconstituted from normal and malignant hyperthermic (MH) human skeletal muscle biopsies (2-5 g samples). Conduction, gating properties, and myoplasmic Ca2+ dependence of human SR Ca2+ release channels were similar to those in other species (rabbit, pig). The MH diagnostic procedure distinguishes three phenotypes (normal, MH-equivocal, and MH-susceptible) on the basis of muscle contracture sensitivity to caffeine and/or halothane. Single channel studies reveal that human MH muscles (both MH phenotypes) contain SR Ca2+ release channels with abnormally greater caffeine sensitivity. Muscles from MH-equivocal and MH-susceptible patients appear to contain channels with the same abnormality. Further, our data (n = 115, 21 channels, 11 patients) reveals that human MH muscles (both phenotypes) may contain two populations of SR Ca2+ release channels, possibly corresponding to normal and abnormal isoforms. Thus, whole cell phenotypic variation (MH-equivocal vs. MH-susceptible) arises in muscles containing channels with similar caffeine sensitivity suggesting that human MH does not arise from a single defect. These results have important ramifications concerning (a) correlation of functional and genetic MH studies, (b) identification of other, yet to be determined, factors which may influence MH expression, and (c) characterization of normal SR Ca2+ release channel function by exploring genetic channel defects.
Animals↗
Evidence for intraluminal Ca++ regulatory site defect in sarcoplasmic reticulum from malignant hyperthermia pig muscle.
Malignant hyperthermia (MH) is a pharmacogenetic disease of humans and various animal species that predisposes to a life-threatening, anesthetic agent-induced syndrome. MH is thought to be a consequence of abnormal, sustained increases in myoplasmic Ca++ and sarcoplasmic reticulum (SR) membranes from MH muscle have been shown to have a Ca++ release channel defect. In the present study we have tested a hypothesis that the abnormal Ca++ release mechanism in MH can be expressed when Ca++ is loaded in the presence of pyrophosphate. SR membrane vesicles isolated from normal and MH pig muscle were loaded with Ca++ in the presence and absence of pyrophosphate until Ca(++)-induced Ca++ release occurred. Under both circumstances the threshold amount of Ca++ loaded until Ca++ release occurred was lower in the SR from MH pig skeletal muscle. This difference in amount of Ca++ preload is not explained by results obtained comparing rates of Ca++ uptake, number of ryanodine binding sites or the amounts of calsequestrin among SR vesicles from MH and normal muscle. We conclude from this study that use of pyrophosphate for Ca++ loading does not ablate the abnormal Ca++ release in SR from MH muscle, suggesting the study can be done on small amounts of SR from biopsied human muscle. The data also suggest that abnormality in an intraluminal, low affinity Ca++ binding site regulating Ca++ release occurs in the SR membrane of MH pig muscle.
Animals↗
Intra- and extraluminal sarcoplasmic reticulum membrane regulatory sites for Ca2(+)-induced Ca2+ release.
A heavy skeletal muscle sarcoplasmic reticulum (SR) fraction was actively loaded stepwise with calcium until Ca2(+)-induced Ca2+ release occurred. The total Ca2+ load, T1, at which release occurred is postulated to be regulated by an intraluminal, low-affinity receptor. After obtaining T1, the critical concentration of Ca2+ required extraluminally (T2) was determined. T1 averaged 58.6 +/- S.D., 6.9 nmol Ca2+/mg SR and T2 averaged 2.14 +/- S.D., 0.24 microM. Both T1 and T2 were increased by Mg2+ and decreased by caffeine. Ruthenium red increased T2 more than T1 while ryanodine had no effect on T1 but markedly increased T2. The results suggest that two Ca2+ regulatory sites may be functional for Ca2(+)-induced Ca2+ release from SR.
Analysis of Variance↗
Porcine malignant hyperthermia: critical temperatures for in vivo and in vitro responses.
Malignant hyperthermia (MH) can be triggered in swine either by stress or by certain anesthetic agents. In humans, MH commonly occurs in patients previously exposed uneventfully to triggering anesthetics. This variability in expressivity of the MH syndrome is a combination of unknown genetic and environmental factors. A hypothesis was tested that a fall in rectal temperature following general anesthesia can prevent the MH syndrome in susceptible patients. Nine littermate Pietrain pigs with MH were exposed to halothane after their rectal temperatures were stabilized at 35 degrees, 36 degrees, and 37 degrees C during thiopental/nitrous oxide anesthesia. The in vivo MH metabolic, cardiopulmonary, and contracture responses were attenuated at the lower rectal temperatures. The effect of varying temperatures on biopsies of skeletal muscle from these animals showed a marked decrease in contracture response to halothane when the muscle was cooled to 25 degrees C. Studies on the Ca2+ uptake process and on Ca2+ channel-Ca2+ release properties of isolated sarcoplasmic reticulum (SR) membranes showed that increasing incubation temperatures from 25 degrees to 38 degrees C increased the Ca2+ uptake rate by the SR Ca2+ pump and also increased the probability of Ca2(+)-induced Ca2+ opening of a Ca2+ channel and the release of stored Ca2+. This study indicates that temperature can have a marked effect on the expressivity of the MH defect at the whole animal, isolated tissue, and fragmented membrane levels of organization. Since many surgical patients' temperatures decrease after induction and anesthesia, this may explain one environmental factor that determines the incidence, rate, and magnitude of the MH syndrome.
Animals↗
Diagnosing malignant hyperthermia.
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Biopsy↗
SR function in malignant hyperthermia.
Malignant hyperthermia (MH) is a genetic disease in man and other animal species that predisposes to a catastrophic hypermetabolic syndrome that is triggered by certain anesthetic agents. A working hypothesis is that a defect in regulation of muscle cell calcium is the primary mechanism that initiates the MH syndrome. This paper reviews the evidence for a defect in muscle cell calcium as regulated by the sarcoplasmic reticulum membrane system. Skeletal muscle biopsied from MH man, pigs and dogs has abnormal in vitro contracture response to halothane and caffeine and these responses can be altered by lowering calcium content of the bathing solution and/or the muscle. Measurements of MH muscle cell Ca2+ by Ca2+-specific microelectrodes in vivo and fura-2 in vitro have demonstrated abnormal Ca2+ levels in resting and in caffeine-stimulated states. The SR membrane system is the primary calcium regulating organelle in skeletal muscle and a likely site for the defect in MH muscle. Two Ca2+ regulating functions of the SR have been explored in SR isolated from MH muscle. An abnormality of the 100K Ca2+-ATPase protein that functions to transport Ca2+ from myoplasm to inside the SR does not appear to be responsible for MH. The most probable defective site in the SR appears to be Ca2+ release channels and a Ca2+-induced Ca2+ release pathway has been shown to be abnormal in SR from MH human and pig muscle.
Animals↗
Ca2+ uptake and Ca2+ release by skeletal muscle sarcoplasmic reticulum: differing sensitivity to inhalational anesthetics.
The effects of halothane, enflurane, and isoflurane were measured on two different mechanisms of Ca2+ regulation by isolated skeletal muscle sarcoplasmic reticulum (SR) membranes. A 100,000-dalton Ca2+-ATPase protein transports Ca2+ from outside to inside the SR membrane. At concentration ranges representing anesthetic levels of 0.06 to 2.3 times MAC, halothane, enflurane, and isoflurane each increased rate of Ca2+ uptake by SR. Each concentration of isoflurane produced a greater rate of Ca2+ uptake, whereas halothane and enflurane produced maximum stimulation of Ca2+ uptake at 1 and 1.6 times MAC, respectively. The second Ca2+ regulation mechanism studied was a Ca2+ release channel in the SR membrane. The release of Ca2+ via this mechanism requires a critical threshold Ca2+ load (nmol Ca2+/mg SR protein) for Ca2+-induced Ca2+ release to occur. Each anesthetic tested effectively lowered the critical Ca2+ load threshold for Ca2+ release, i.e., the Ca2+ channel was more readily induced to an open state in the presence of anesthetic. The concentrations of anesthetics having this effect on the putative Ca2+ channel were between 0.0026 and 0.078 MAC equivalents for each agent, and these concentrations are much lower than the anesthetic concentrations affecting Ca2+ uptake. These data show that in isolated skeletal muscle SR membranes a Ca2+ channel release function is altered at anesthetic concentrations far below those that change Ca2+ uptake function by a Ca2+-ATPase and below concentrations of the volatile agents producing clinical anesthesia. The Ca2+ channel effect may represent protein-anesthetic interaction, whereas the Ca2+-ATPase effect may occur by a generalized SR membrane perturbation by the anesthetics.
Anesthesiology↗
Calcium and magnesium content of skeletal muscle. Studies in subjects undergoing diagnostic testing for malignant hyperthermia.
Ca2+ and Mg2+ contents were measured and compared among three different malignant hyperthermia susceptible (MHS) diagnostic groups. No difference was found among mean values for Ca2+ content, whereas Mg2+ content was greater in MHS muscle. Variance of measured values was unequal and greatest among MHS muscles, suggesting a possible abnormal distribution associated with MHS. Although more muscle fibres with Ca2+ less than or equal to 12 mumol g-1 were observed in MHS muscle, this difference was not statistically significant. In contrast, non-parametric analysis showed that the population of Mg2+ values was significantly greater in the MHS muscle. This study suggests that the distribution of Ca2+ and Mg2+ values is different in MHS muscle as a result of unknown genetic factors associated with the disease.
Calcium↗
Ryanodine: antithetical calcium channel effects in skeletal muscle sarcoplasmic reticulum.
The effects of ryanodine, a neutral alkaloid, on the Ca++ uptake and Ca++ release properties of a skeletal muscle isolated sarcoplasmic reticulum (SR) preparation were evaluated. Ryanodine had no effect on the rate of oxalate-facilitated Ca++ uptake in this SR. Ruthenium red, which reportedly blocks Ca++ channels, increased Ca++ uptake by 2-fold in the SR. Although no effect of ryanodine on Ca++ transport by SR was observed, notable effects on Ca++-induced Ca++ release pathways were discovered. Ryanodine acts on the same Ca++ channels that are affected by ruthenium red. When these Ca++ channels were activated by Ca++ to an open state in the presence of ryanodine, then ryanodine maintained the channel in an activated, open state. However, once Ca++ was taken up by the SR, ryanodine tended to lock the channel in a closed state, producing a condition refractory to Ca++-induced Ca++ release. Thus, dual, opposing effects of ryanodine were demonstrated. In a fast-reaction kinetics measurement of Ca++-induced Ca++ release, both rate and amount of Ca++ release were reduced by ryanodine, and Ca++ appeared to act in a noncompetitive, antagonistic mode. These unusual, antithetical effects of ryanodine on the Ca++ efflux pathway are not mechanistically defined by this study, but they reveal the potential value of ryanodine as a probe for exploring Ca++ channel function.
Alkaloids↗
Comparison of Ca++ uptake and spontaneous Ca++ release from sarcoplasmic reticulum vesicles isolated from muscle of malignant hyperthermia diagnostic patients.
Inward Ca++ transport and spontaneous Ca++ release activities were compared among sarcoplasmic reticulum (SR) membrane fractions isolated from human skeletal muscle in patients undergoing malignant hyperthermia (MH) diagnostic contracture testing. Two different membrane fractions were isolated, a heavy (8-12,000 X g) and light (12-48,000 X g) fraction, from each diagnostic subject. The rates of inward Ca++ transport were faster in light SR compared to heavy SR, but no statistically significant difference was observed among MH diagnostic groups. Spontaneous Ca++ release occurred at optimum Ca++ preload in all SR fractions and this preload did not differ among MH diagnostic groups. Optimal Ca++ preload for rate of spontaneously released Ca++ was greater in light SR compared to heavy SR. Similarly, rate of Ca++ release was faster in light SR than in heavy SR, but no difference in rate of spontaneously released Ca++ was observed among MH diagnostic groups. Amount of Ca++ released did not differ among SR fractions and it did not differ among diagnostic groups. In contrast to previous studies showing a defect in Ca++-induced Ca++ release, the mechanisms related to spontaneous Ca++ release and to oxalate-facilitated inward Ca++ transport, as measured in this study, appear to be normal in SR from human MH skeletal muscle.
Calcium↗
Thiol/disulfide redox equilibrium between glutathione and glycogen debranching enzyme (amylo-1,6-glucosidase/4-alpha-glucanotransferase) from rabbit muscle.
Rabbit skeletal muscle glycogen debranching enzyme is inactivated in a kinetically biphasic manner by GSSG at pH 8.0. The rapid phase results in the loss of 30% activity, while the slower phase leads to total enzyme inactivation. Both the glucosidase and the transferase activities of the enzyme are inhibited by GSSG. The inactivation by disulfides is fully and rapidly reversed in a biphasic manner by reduction with excess reduced dithiothreitol or GSH. After a fast initial recovery of 70% of the initial activity, the remaining 30% of the activity is recovered more slowly. Equilibration of the enzyme with a redox buffer of GSH and GSSG shows a monophasic equilibration of the activity. The ratio of GSH/GSSG where the enzyme is 50% active (R0.5) is 0.06 +/- 0.03. The R0.5 does not vary significantly with the total concentration of glutathione species suggesting formation of protein-SSG mixed disulfides. The ratios of the observed second-order rate constants for GSSG inactivation and GSH reactivation do not lead to a correct value of the observed thiol/disulfide oxidation equilibrium constant. Although the enzyme has sulfhydryl groups, the oxidation of which leads to activity changes, the kinetic and thermodynamic resistance to oxidation suggests that the enzyme is not likely to be subject to regulation by thiol/disulfide exchange in vivo.
Animals↗
Pregnancy: increased effect of verapamil in human uterine arteries.
The effect of verapamil on the contractile response to norepinephrine in isolated, suffused uterine arteries from pregnant and nonpregnant humans was investigated. The arteries, obtained after hysterectomy, were dissected free from surrounding tissue and arterial rings were prepared and mounted in tissue chambers filled with Krebs-bicarbonate solution. Isometric tension was recorded. There was no significant difference between arteries from pregnant patients and arteries from nonpregnant patients when maximal contractile response and sensitivity to norepinephrine were compared. At concentrations of 0.3 and 3 microM, verapamil attenuated the response to norepinephrine in uterine arteries from both pregnant and nonpregnant patients. However, verapamil was significantly more potent in blocking the response to norepinephrine in arteries from pregnant patients.
Adolescent↗
Malignant hyperthermia: is etomidate safe?
The safety of etomidate for induction of anesthesia in malignant hyperthermia-susceptible (MHS) pigs was evaluated in a two-phase experiment. Two litters of Purebred Poland China pigs, one MHS (n = 4) and the other malignant hyperthermia-resistant (MHR) (n = 4) were used. Phase I compared MHS vs MHR animals in terms of cardiovascular, metabolic, and skeletal muscle rigidity responses to etomidate and fentanyl anesthesia and to a subsequent malignant hyperthermia (MH) challenge with halothane-succinylcholine. When three of the four criteria for the diagnosis of MH occurred (rigidity, tachycardia, or increases in temperature or end-tidal CO2) in an animal, phase I was terminated. In phase II, only the MHS animals were used and experimental procedures were as in phase I except thiopental replaced etomidate. In phase I, evidence was inadequate to support the diagnosis of MH based upon responses of MHS pigs to the infusion of etomidate even though the infusion of etomidate in MHS pigs was associated with statistically significant increases in body temperature and plasma lactate levels above those observed in MHR pigs. Heart rate and bicarbonate levels were lower in MHS than in MHR pigs during etomidate infusion. With discontinuation of etomidate and a subsequent challenge with halothane-succinylcholine, all four pigs developed the MH syndrome within 15-30 min. Thiopental replacement of etomidate in the phase II experiment resulted in a twofold greater time (45-75 min) for halothane-succinylcholine to trigger MH in the susceptible pigs.(ABSTRACT TRUNCATED AT 250 WORDS)
Animals↗
Dantrolene does not block calcium pulse-induced calcium release from a putative calcium channel in sarcoplasmic reticulum from malignant hyperthermia and normal pig muscle.
Calcium pulse additions to isolated SR membranes can cause a reversible efflux of calcium. The threshold level of calcium loading at which calcium efflux occurs is lower for SR membranes isolated from malignant hyperthermia susceptible (MHS) swine. Dantrolene, a unique muscle relaxant, had no effect on threshold calcium load, amounts and rates of calcium release from SR isolated from control and MHS skeletal muscle. It is concluded that the putative calcium channel through which this calcium pulse-induced calcium release mechanism occurs is not affected by dantrolene under these experimental conditions.
Animals↗
Prophylactic and therapeutic doses of dantrolene for malignant hyperthermia.
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Adult↗
Halothane-succinylcholine induced masseter spasm: indicative of malignant hyperthermia susceptibility?
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Caffeine↗