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Division of Cardiovascular Medicine, Henry Ford Heart and Vascular Institute, Detroit, Michigan 48202-2689
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ABSTRACT |
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The aim of this study was to investigate modulation of voltage-dependent steady-state activation and availability from inactivation of the cardiac Na+ channel by the cytoskeleton. As an experimental approach, we used long-lasting monitoring [63 ± 5 (SE) min] of the half-point potentials of the steady-state availability curve (V1/2A) and normalized conductance curve (V1/2G) in 116 rat ventricular cardiomyocytes by whole cell patch clamp at 22-24°C. Both half-point potentials shifted in the negative direction with time as an exponentially saturating change, with the shift of V1/2G being smaller and faster. An F-actin disrupter, cytochalasin D (Cyto-D, 20 µM), accelerated the rate of the V1/2A shift but decreased the range of the V1/2G shift. An F-actin stabilizer, phalloidin (100 µM), temporarily (for 28.2 ± 2.2 min, n = 15) prevented the V1/2A shift but did not influence the V1/2G shift. The best fit for the V1/2G-V1/2A relationship in untreated cells (1,021 data points measured in 51 cells) was a second-degree (2.06) power function. Cytoskeleton-directed agents modified the relationship. In Cyto-D-treated cells, the V1/2G-V1/2A relationship was shifted (by 2.5 mV) toward positive V1/2G. On the contrary, a microtubule stabilizer, taxol (100 µM), shifted the relationship toward negative V1/2G (by 12.2 mV). We conclude that coupling between availability and activation is modulated by F-actin-based and microtubular cytoskeleton.
sodium current; patch clamp; cytochalasin D; phalloidin; colchicine; taxol
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INTRODUCTION |
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SODIUM CHANNELS ARE responsible for the initial rapid
increase in membrane permeability for
Na+, which is essential for the
generation and propagation of the action potential. Channel gating is
determined by two fundamental channel properties: activation and
inactivation. Coupling between activation and inactivation is an
important characteristic of the
Na+ channel, since it determines
the functional response of the channels to membrane depolarization.
Activation and inactivation mechanisms are the major targets in ongoing
molecular studies of Na+ channel
function (for review see Ref. 9). Activation is thought to involve
movement of the highly charged fourth membrane-spanning segment S4 (32,
42). A hydrophobic triplet of amino acid residues in the cytoplasmic
III-IV linker was suggested to form a lid that binds to a cytoplasmic
region of the channel and occludes the pore, producing fast
inactivation of the channel (25, 32, 41). Recently, it has been shown
that mutations other than in the III-IV linker can affect inactivation
as well. Complex alterations of the channel gating can be produced by
mutations in the pore region (34) and in various cytoplasmic or
transmembrane domains, e.g., mutations related to inherited heart
diseases (4) or skeletal myopathies (28). These data suggest the
importance of integrity of all channel molecule parts in the gating
process. Furthermore, channel gating is determined also by the state of channel phosphorylation (33, 41), coexpression and association of the
- and
-subunits (17, 24), and factors that affect the channel
environment, including membrane phospholipid composition and the
cytoskeleton. Our previous studies showed that membrane partition of an
ischemic metabolite, lysophosphatidylcholine, induced bursting activity
of the cardiac Na+ channel and
shifted activation toward negative membrane potentials (36). We also
found that cytochalasin D (Cyto-D), a disrupter of the F-actin-based
cytoskeleton, and antibodies to integrated proteins of the
cytoskeleton, such as F-actin,
-spectrin, and ankyrin, altered
gating kinetics by increasing open time, inducing a second open state,
and causing prolonged bursts of openings (23, 35, 37). These findings
indicated that the environment of the channel protein, in addition to
the channel protein structure itself, determines the microscopic
activation-inactivation coupling.
In the present study we addressed whether the cytoskeleton regulates coupling of Na+ channel activation and inactivation in terms of the relationship between steady-state activation and availability from inactivation. We took advantage of the spontaneous shift of availability and conductance curves that occurs for the cardiac Na+ channel during whole cell recording (14, 16) to characterize the relationship in a wide range of the half-point potentials of the curves. Cytoskeleton modifiers changed the relationship, indicating a modulating role for the cytoskeleton in activation-inactivation coupling.
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MATERIALS AND METHODS |
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Isolation of Cardiomyocytes
Ventricular cardiomyocytes were enzymatically isolated from Sprague-Dawley rat hearts into Ca2+-free Eagle's minimal essential medium with 10 mM N-2-hydroxyethylpiperazine-N'-2-ethanesulfonic acid (HEPES; pH adjusted to 7.3 with KOH), as previously described (37). After isolation, cells were kept for up to 12 h at 22°C in the same solution to which 0.3 mM CaCl2 was added. Only relatively small quiescent rod-shaped, cross-striated cells were used in the experiments.Whole Cell Current Recordings
Whole cell recordings of Na+ current (INa) were made at 22-24°C by the patch-clamp technique (15). The patch pipettes were pulled from borosilicate glass capillaries (K150F, WPI, Sarasota, FL). After they were heat polished, the pipettes had a tip resistance of 600-800 k
in standard solutions. Ion currents
were recorded by a patch-clamp amplifier (Axopatch 200A, Axon
Instruments, Foster City, CA). The current was zeroed when the pipette
was placed in the bath solution to correct for liquid junction
potentials between the bath solution and the pipette solution. Series
resistance compensation and capacitive transient cancellation were
adjusted for each cell before recording to provide optimum voltage
control and minimize the capacitive transient. Currents were digitized and recorded at 50 kHz onto a hard disk of a 486 computer for off-line
analysis. Before digitization, currents were filtered at 10 kHz
(
3 dB) using a four-pole low-pass Bessel filter. Voltage protocols and signal digitizing were performed by DigiData 1200 interface and pCLAMP 6.0 software (Axon Instruments).
INa was measured
in 116 cells obtained from 34 rats. The characteristics of the current
were monitored for as long as a stable seal could be maintained, as
judged by a total current (I)
measured at the holding potential
(Vh =
150
mV) so that I > Vh/100
M
=
1.5 nA. The duration of the whole cell experiment
averaged 63 ± 5 min (maximum duration was 345 min). To attain
stable recordings for long periods, we lifted cells from the surface of
the recording chamber after recording configuration was established.
The absence of vibrations was also an important requirement. To
minimize vibrations, our experimental setup was mounted on an
air-suspended table (model 63531, TMC, Peabody, MA).
Control and Test Solutions
Solutions for whole cell experiments were selected to suppress all currents other than INa. The external bath solution was composed of (in mM) 10 NaCl, 125 CsCl, 1 CaCl2, 1.2 MgCl2, 11 glucose, and 20 HEPES (pH adjusted to 7.4 with CsOH). The internal pipette solution was composed of (in mM) 10 NaCl, 115 CsF, 20 CsCl, 2.5 MgATP, 5.0 ethylene glycol-bis(
-aminoethyl
ether)-N,N,N',N'-tetraacetic acid, and 5.0 HEPES (pH adjusted to 7.3 with CsOH).
We used Cyto-D as disrupter and phalloidin as stabilizer of an F-actin-based cytoskeleton. Colchicine was used as microtubule disrupter and taxol as microtubule stabilizer. The final concentration of substances in the incubation medium and pipette solution was 20 µM for Cyto-D and 100 µM for phalloidin, colchicine, and taxol. Fresh test solutions were made each day and sonicated before each experiment. The cells were incubated with the cytoskeleton modifiers at least 4 h before INa recording. Experiments with Cyto-D were performed in relative darkness to avoid photodestruction of the Cyto-D molecule. All substances were purchased from Sigma Chemical (St. Louis, MO).
Quality of Voltage Clamp
In every experiment we assessed the quality of the voltage clamp using the following criteria. The deviation from voltage (Vdev) command associated with series resistance (Rs) was estimated to be Vdev = IRs. First, we determined the noncompensated Rs as
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(1) |
120 to
100 mV. In all experiments
the noncompensated
Rs was <2 M
.
Electronic series resistance compensation
(Ks) was
imposed to a point just before oscillations occurred. The final setting
of the Ks value (on an Axopatch 200A amplifier) varied from 75 to 95%. The
current-voltage (I-V) relationship
for peak INa was
measured to determine a maximum peak of the current
(Imax). In our
experimental conditions,
Imax varied from
5 to 30 nA. With
Rs compensation,
Vdev was
estimated as
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(2) |
Voltage-Clamp Protocols
Steady-state voltage-dependent availability from inactivation, A(V), was determined by using a series of 1-s-long conditioning steps to various membrane potentials (V) followed by a test depolarization of 18-ms duration to
30 mV to assess the pool of
Na+ channels left noninactivated
by the conditioning step. A 982-ms interval at a
Vh of
170
mV separated the individual pulse protocols and allowed for full
recovery of INa.
Further prolongation of the interpulse interval up to 5 s
and/or membrane hyperpolarization up to
190 mV did not
change the amplitude of
INa. Peak current (Ipeak)-voltage
relationships (I-V curves) were
obtained by applying a series of test depolarizations to various
potentials from a Vh set to
150 mV to ensure full
INa availability
and recovery from preceding pulses during a 2-s interpulse interval.
The depolarization increase followed a 3- or 5-mV step protocol.
Data Analysis
Peak INa values were calculated with off-line leak correction using ClampFit software (Axon Instruments). For determination of availability curves, the peak currents were normalized to the maximum peak current value and plotted against the conditioning potential (V). Parameters of A(V) curves were determined by fitting the data to a Boltzmann function
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(3) |
Normalized voltage-dependent Na+ conductance [G(V)] was determined from transformations of I-V curves. The maximum Na+ conductance (gmax) and reversal potential (Vrev) were estimated from a linear fit [as a slope and a cross point with test potential (Vt) axis, respectively] of an almost linear ascending portion of the I-V curve. The Na+ conductance (g) at each Vt was calculated as
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(4) |
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(5) |
K · ln(
1). We used the third-degree Boltzmann function for the data analysis, since it always fit data points better than a single Boltzmann function. However, these two fitting functions yielded almost
the same V1/2G values for the same data set:
difference <0.1 mV.
To analyze the time course of changes in voltage-dependent availability and conductance, V1/2A and V1/2G were plotted as a function of experimental time. The initial slope of the negative shift (a shift rate) for V1/2A and V1/2G was determined from a linear fit to data points taken for the initial period (first 8 min) of an experiment. The time-dependent shifts of V1/2A and V1/2G were fitted with an exponential function (see Eqs. A1 and A2).
To determine the
V1/2G-V1/2A
relationship, we measured these parameters consecutively in the same
cell. Because of a minimum delay of ~2 min related to our
experimental protocol, it was impossible to measure both parameters
simultaneously. Therefore, for every V1/2A(ti)
measured at time
ti (1 < i < N, where
N is total number of measurements made
in the cell), we calculated the coupled
V1/2G(ti) from the previously measured value,
V1/2G(
), and the next value,
V1/2G(ti + 1), assuming a linear time-dependent shift of V1/2G
between
and
ti + 1.
Origin software (version 4.1, Microcal Software, Northampton, MA) was used to fit histograms by a Gaussian function
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(6) |
Statistical significance when comparing mean values was determined by Student's t-test for unpaired data. If not otherwise stated, the two pools of data were considered to be significantly different at P < 0.01. Results are presented as means ± SE for n cells.
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RESULTS |
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Characterization of the Relationship Between Availability and Activation in Control Cells
Time-dependent shifts of steady-state availability and conductance
curves were exponential.
We monitored the time-dependent shift of V1/2G
and V1/2A in 51 control cells with a mean recording time of 70.6 ± 5.2 min. The
range for the shift in V1/2G (from
29 to
76 mV) was significantly smaller than for
V1/2A (from
68 to
128 mV). The time-dependent changes of both
parameters exhibited an exponential saturation (Fig.
1A).
The time course of the shifts was obviously not parallel, because the
change in V1/2G was smaller and saturated
faster. Time constants and saturation values for the exponentials
fitted to the shifts are given in Table 1.
Generally, the V1/2G shift was saturated within
~20 min, whereas
V1/2A shifted
over 40-60 min. Although the overall shifts were different, the
initial shift rate recorded within the first 8 min of the experiment
was not significantly different for these parameters (Table
2). Thus we found an almost parallel shift
of availability and conductance at the beginning of the recording. In
some cells we observed independent changes in
V1/2G and
V1/2A during
whole cell recording. This occurred in cells that initially
(spontaneously) had a saturation value of V1/2G
or V1/2A. Once
the parameter was found at the saturated level, it did not change,
whereas another parameter shifted exponentially (Fig. 1,
C and
D).
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V1/2G-V1/2A Relationship Is Described by a Power Function
A theoretical prediction.
Because we have found that V1/2G and
V1/2A have an exponential time
course, their relationship after the time factor is excluded can be
easily shown to be a power function with a degree equal to the ratio of
the time constants (
=
A/
G;
see APPENDIX A). The relationship
was obviously nonlinear, since the time constants
A and
G were significantly different (
2; Table 1). The suitability of the theoretical prediction to the
data points of the
V1/2G-V1/2A
relationship is illustrated in Fig.
1B, which shows the power function
determined in one cell from the exponential fits to the
V1/2G and
V1/2A time course.
Experimental evidence. We plotted data points (n = 1,021) measured during whole cell recordings in 51 control cells (Fig. 2). The best fit of the plot was the power function with a degree close to 2 (solid line in Fig. 2). A detailed comparison of the fits obtained by using different models is given in Tables 3 and 4. The data points were spread along the V1/2G axis, indicating no strict dependence between the parameters. We calculated the histogram of departures of data points from the power function fit. The histogram was fitted to a Gaussian function (Fig. 2, inset). The power function fit and parameters of the Gaussian function were used as a reference to describe effects of cytoskeleton modifiers on the V1/2G-V1/2A relationship (see below).
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Effects of Cytoskeleton Modifiers on the Relationship Between Availability and Activation
Effects of cytoskeleton modifiers on the time course of V1/2G and V1/2A. The effects of cytoskeleton modifiers were characterized by parameters of exponential fits to the time course of V1/2G and V1/2A shifts (Table 1) and by changes in initial rates of the shifts (Table 2). The V1/2A shift rate was accelerated by an F-actin disrupter, Cyto-D (>2 times) but was slowed by an F-actin stabilizer, phalloidin. Whereas Cyto-D or phalloidin changed the V1/2G shift rate insignificantly, the V1/2G shift rate was accelerated by taxol, a microtubule stabilizer (Table 2). Although in the presence of phalloidin the effect of taxol was attenuated, the V1/2G shift rate remained significantly faster than in control cells. Cyto-D changed the time course of V1/2A to an almost linear (monotonic) shift (not shown). At the same time, the V1/2G time course remained exponential, with a time constant similar to that of control cells (Table 1). The net V1/2G change was less in Cyto-D-treated than in control cells by ~7.5 mV, which resulted from the difference between saturation potentials (V1/2G; Table 1).
Phalloidin produced an apparent uncoupling of availability and activation observed as asynchronous shifts in the time course of V1/2G and V1/2A (Fig. 3). In the majority of myocytes (15 of 22 cells, 68.2%), phalloidin temporarily (for 28.2 ± 2.2 min) prevented the time-dependent shift in V1/2A (arrows in Fig. 3). After the delay, however, the exponential shift in V1/2A had the same time constant in phalloidin-treated and control cells (Table 1). The exponential change in V1/2G always occurred immediately after disruption of the membrane patch. Taxol did not potentiate the phalloidin effect. In myocytes treated with taxol + phalloidin, the delay (35.3 ± 11.2 min) of the onset of the exponential V1/2A shift was similar to the delay observed in myocytes treated with phalloidin alone. The percentage of cells (8 of 13, 61.5%) showing the delay of the V1/2A shift also remained unchanged.
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Effects of cytoskeleton modifiers on the V1/2G-V1/2A relationship. To examine the cytoskeleton modulation of the V1/2G-V1/2A relationship, we compared the relationships obtained when myocytes were treated with cytoskeleton disrupters (Fig. 4) and with stabilizers (Fig. 5). The reference line of the power function fit established in control cells (Fig. 2) is shown in the plots to visualize the modulation effect. The position of data points was clearly shifted above the reference line in Cyto-D-treated cells (Fig. 4A). To quantify the modulation effects of cytoskeleton modifiers on the V1/2G-V1/2A relationship, we calculated the histograms (insets in Figs. 2, 4, and 5) of departure of data points from the reference line along the V1/2G axis. The parameters of a Gaussian function fitted to the histograms [center (Xc) and width (W); Fig. 4A, inset] in cells treated with cytoskeleton modifiers were compared with those of control cells (Fig. 2, inset). Whereas the center of distribution in control cells was at zero, Xc values were significantly shifted (by 2.5 mV) toward more positive values in Cyto-D-treated cells. A microtubule disrupter, colchicine, however, did not potentiate the Cyto-D effect (Fig. 4B).
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Slope factors of G(V) and A(V) curve were not influenced by cytoskeleton modifiers. The slope factor for the G(V) curve increased during whole cell recording from K(t = 0) = 5.65 ± 0.28 mV (measured in 51 cells) to a steady-state level of 7.18 ± 0.14 mV after 40 min of recording. The time course of the change was well described by an exponential function, with a time constant of the best fit to all data points of 15.8 min (not shown). The slope factor for the A(V) curve did not change during the experiment: 5.59 ± 0.09 mV at the beginning of the experiment and 5.61 ± 0.09 mV after 60 min of whole cell recording. Cytoskeleton modifiers did not influence the slope factors for conductance or availability (not shown).
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DISCUSSION |
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An important role for the cytoskeleton in the modulation of gating for Na+ channels of different types has been previously described (8, 23, 29, 35, 37). In the present study, using the spontaneous shift of voltage dependence of activation and inactivation gating (16) as a model, we established that 1) the half-points of steady-state activation and availability curves for cardiac Na+ channels are coupled by a second-degree power function and 2) the relationship is modulated by F-actin- and tubulin-based cytoskeleton.
Time-Dependent Shift of Availability and Activation Are Modulated by the Cytoskeleton
We showed for the first time that the time-dependent shifts of voltage dependence for availability and activation of cardiac Na+ channels were not monotonic, as reported previously (16) but, rather, a slow (
= 10-60 min)
exponentially saturating change that was smaller and quicker for the
activation curve. This appears to be an important property of the
cardiac Na+ channel. Less shift in
the activation process than in availability was also observed for
canine cardiac Na+ channels in
cell-free and cell-attached patches, as judged by the relatively normal
threshold for channel activation (6). The smaller and faster shift for
the activation curve has been recently found by Wang et al. (38) for a
cardiac isoform of the Na+ channel
but not for the isoform of skeletal muscle. The attainment of
saturation implies that a new equilibrium of the important factors
determining Na+ channel voltage
gating is established during whole cell dialysis. In the present study
we showed that F-actin- and tubulin-based cytoskeleton is an important
factor determining the position of the steady-state activation and
availability curves of cardiac Na+
channels. In particular, the stabilization of the position for the
availability curve by phalloidin represents the first report of the
time-dependent shift prevention during cell dialysis. On the contrary,
F-actin disruption by Cyto-D accelerated the shift rate. This is in
agreement with the observation that the voltage dependence of
Na+ channel gating does not change
in nystatin-perforated cardiomyocytes, where the cytoskeleton remains
intact (40). Conversely, a pronounced V1/2A shift was found in the
cell-attached patch configuration (6), where cytoplasm remained intact,
but the cytoskeleton integrity might be damaged by plasma membrane
aspiration into the patch pipette.
V1/2G-V1/2A Relationship Is Modulated by Cytoskeleton
The main finding of the study was that the relationship of the steady-state activation and availability is strongly modulated by cytoskeleton modifiers. An important result was that F-actin modifiers influenced availability and activation but tubulin modulates only activation shift. Another interesting observation was that phalloidin alone did not change the activation, but it almost completely abolished the activation shift induced by taxol (~12.5 mV), indicating an important interplay of different cytoskeleton types in Na+ channel modulation. The finding of modulation of Na+ channel gating by microtubules is in line with previous reports showing the presence of tubulin along the plasma membrane in rat papillary muscle (39) and a modulating role of microtubules in the function of plasma membrane proteins such as insulin receptors (12), G proteins (26), and Ca2+ channels (18).Our finding that stabilization of F-actin by phalloidin influenced availability but not activation is consistent with single channel data. We previously reported that Cyto-D and antibodies to F-actin modulate channel gating by increasing open time and causing frequent reopenings of the Na+ channel observed as prolonged bursts of channel openings (23, 35, 37). The changes mainly related to inactivation state but not to activation. Thus the data of single channel studies together with the present data show a degree of independent changes modulated by the F-actin cytoskeleton on the level of microscopic and macroscopic parameters in inactivation.
Possible Mechanisms of Cytoskeleton Influence on Na+ Channel Steady-State Activation and Availability
The shift of voltage dependence of Na+ current gating could not be explained by a simple membrane voltage shift, as a surface charge effect, or by alterations in Donnan potentials, because the shifts for availability and activation curve were not parallel. We have found that, in addition to the effect on steady-state activation and availability, Cyto-D significantly slowed INa inactivation (23). Furthermore, when only one mechanism is considered, it is difficult to explain asynchronies in availability and activation shifts. We found that availability shift was prevented by phalloidin but accelerated by Cyto-D. At the same time, V1/2G undergoes a time-dependent shift immediately after establishment of the recording configuration. This resulted in a coupled shift of V1/2A and V1/2G in the case of the Cyto-D effect, but phalloidin decoupled these parameters. These data can be explained assuming a complex cytoskeleton modulation of activation and inactivation by mechanisms of a different nature. On the basis of the results of Na+ channel mutations, it has been shown that a critical structure for Na+ channel inactivation is a cluster of hydrophobic residues in the intracellular III-IV linker localized at the cytoplasmic site of the plasma membrane (25, 32, 41). Being close to the cytoplasmic site of the plasma membrane (7), the inactivation gate can be influenced by integrity of the plasma membrane-attached cytoskeleton network, where F-actin is a main structural component (5). Most models of the Na+ channels propose that the S4 segment of the Na+ channel protein participates in sensing the membrane potential during the gating process (32, 42). The influence of the cytoskeleton on this voltage sensor could be via direct cytoskeleton attachment to Na+ channel protein (1, 30) or, indirectly, by plasma membrane phospholipids (36), which, in turn, are linked to the cytoskeleton (2).Physiological Significance
Our detailed analysis of the V1/2G-V1/2A relationship indicates that cytoskeleton disruption by Cyto-D modified the coupling of steady-state activation and availability by shifting the relationship toward positive V1/2G values (Fig. 4A). This result suggests a reduction of cell excitability in conditions affecting cytoskeleton integrity. Particularly, ischemia leads to cytoskeleton disruption (31, 43), and energy depletion induces disintegration of cytoskeleton structure of F-actin filaments (19). On the other hand, a large shift of the V1/2G-V1/2A relationship toward negative V1/2G in cells with modified microtubules (Fig. 5B) may decrease the threshold of INa activation and produce premature excitations. Moreover, the shift in the relationship can result in a sustained inward INa ["window" current (3)] because of a larger overlap of the steady-state activation and availability curves. It has been recently shown that the sustained inward INa leads to excitation abnormalities of the myocardium, such as prolongation of action potential, long Q-T syndrome, and arrhythmias (4, 13). From this point of view, pharmacological interventions targeting the cytoskeleton can potentially lead to cardiac arrhythmias. Different cytoskeleton-directed antitumor agents, including taxol, produce a variety of cardiac disturbances, including ventricular tachycardia (27). Our data indicate that the cardiotoxic effect of the drugs can be related to alterations of the Na+ channel gating.In conclusion, we have shown that coupling between Na+ channel voltage-dependent availability and activation is modulated by F-actin-based and microtubular cytoskeleton. The cytoskeleton modulation of cardiac Na+ channel gating could be important in maintaining normal myocyte excitability.
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APPENDIX A |
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The exponentially saturating shifts of V1/2A [V1/2A(t)] and V1/2G [V1/2G(t)] can be represented by
|
(A1) |
|
(A2) |
A and
G are time
constants, V1/2As and
V1/2Gs are saturation levels, and
V1/2A0 and
V1/2G0 are initial values (at
t = 0). At any given time (eliminating t from Eqs.
A1 and A2 by simple
transformations), the
V1/2G-V1/2A relationship can be written as a power function
|
(A3) |
|
, a degree of the power function, equals the ratio of the respective
time constants
(
A/
G).
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APPENDIX B |
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The choice of the best model describing the V1/2G-V1/2A relationship was judged by a smaller variance and by parameters of goodness-of-fit statistics, including coefficient of determination (COD) and the model selection criterion (MSC). The COD gives the fraction of the total variance accounted for by the tested model and is defined by
|
(B1) |
i
n) and
Yi represents
calculated values corresponding to
yi values.
Because different models have a different number of parameters, the MSC
was used to represent the information content of a given set of
parameter estimations by normalizing the COD to the parameter number.
The MSC is defined by
|
(B2) |
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ACKNOWLEDGEMENTS |
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We thank Beth Malleis and Nidas Undrovinas for assistance in cell preparation and Dr. J. C. Makielski and Dr. H. N. Sabbah for helpful discussions and critical reading of the manuscript.
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FOOTNOTES |
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Financial support was provided by National Heart, Lung, and Blood Institute Grant HL-53819 (A. I. Undrovinas).
Preliminary data for this study were reported in abstracts (20-22).
Address for reprint requests: A. I. Undrovinas, Div. of Cardiovascular Medicine, Henry Ford Heart and Vascular Institute, Cardiovascular Research, Education, and Research Bldg., Rm. 4015, 2799 West Grand Blvd., Detroit, MI 48202-2689.
Received 25 November 1996; accepted in final form 9 June 1996.
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