扎考必利对心肌细胞钾通道电流的影响

<正>心肌细胞的钾通道电流按整流现象分为外向整流钾电流,例如瞬时外向钾电流(I_(to))和延迟整流钾电流(I_K),以及内向整流钾电流(I_(K1))。已有研究认为药物的致心律失常作用与其阻断延迟整流钾通道I_K有关。促胃肠动力药西沙必利就是如此。扎考必利是另一种促胃肠动力药,与西沙必利同属于5-羟色胺(5-HT)4受体激动剂,兼有5-HT3(5-HT3)受体拮抗剂的作用。我们曾观察比较了它     

常咯啉对豚鼠和家兔单个心肌细胞钾电流的影响(英文)

目的:研究常咯啉是否对心肌细胞的钾电流有影响作用。方法:采用高阻抗密封膜片箝全细胞技术,记录分离的豚鼠和家兔心肌单个细胞的钾电流。结果:在临床用量常咯啉50μmol·L~(-1)抑制家兔心房肌细胞的瞬间外向钾电流(I_(TO))17.7％±2.4％(n=8)。但并不影响电压依赖性通道。同一剂量的常咯啉对单个家兔心室肌细胞的内向整流钾电流(I_(Kl))和单个豚鼠心室肌细胞的延迟整流钾电流(I_K)并不产生任何作用。结论:提示常咯啉具有阻制(I_(TO))的作用,而对(I_K)和(I_(Kl))无任何作用。     

1—（2，6—二甲基苯氧基）—2—（3，4—二甲氧基苯乙氨基）丙烷盐酸盐抑制豚鼠心室肌细胞内向整流和延迟整流钾电流

目的:研究1-(2,6-二甲基苯氧基)-2-(3,4-二甲氧基苯乙氨基)丙烷盐酸盐(DDPH)对心室肌细胞动作电位(AP)、内向整流钾通道电流(I_(K1))及延迟整流钾通道电流(I_K)的影响。方法:全细胞膜片箝技术。结果:DDPH 10,100μmol·L~(-1)使豚鼠心室肌细胞AP时程APD_(50)明显缩短;但DDPH(>1μmol·L~(-1))延长APD_(90)。DDPH浓度依赖性地抑制I_K尾电流(I_(K·tail)),EC_(50)为13.3(11.6.6-16.7)μmol·L~(-1)。DDPH(>1.0μmol·L~(-1))明显抑制I_(Kl);同时,DDPH使I_(Kl)翻转电位向正电位方向移动。结论:DDPH对豚鼠心室肌细胞I_(Kl)和I_K具有明显的抑制作用。     

雌二醇抑制豚鼠心室肌细胞内向整流和延迟整流钾通道电流

目的:研究雌二醇(Estradiol,Est)对心室肌细胞动作电位(AP)、内向整流钾通道电流(I_(K1))及延迟整流钾通道电流(I_K)的影响。方法:全细胞膜片箝技术。结果:EST 10μmol·L~(-1)使豚鼠心室肌细胞AP时程明显缩短,APD_(50)由给药前(474±71)ms缩短至(330±75)ms(P<0.05),Est 100μmol·L~(-1)使APD_(50)缩短至(229±67)ms(P<0.01),使APD_(90)由(587±60)ms缩短至(418±79)ms(P<0.05)。Est浓度依赖性地抑制I_K尾电流(I_K·tail),10μmol·L~(-1)浓度下,I_K·tail减少53％(P<0.05),100μmol·L~(-1)浓度下,I_K·tail减少80％(P<0.05)。10μmol·L~(-1)以上浓度Est明显抑制I_(K1),在-100mV刺激电压下,内向电流最大抑制为49％(P<0.01);在-40mV刺激电压下,外向电流最大抑制为72％(P<0.01)。同时,Est使I_(K1)翻转电位向负电位方向移位(由-70mV变为-76mV)。结论:Est对豚鼠心室肌细胞I_(K1)和I_K通道具有明显的抑制作用。     

蝙蝠葛碱对豚鼠心室肌细胞钾电流的阻断作用(英文)

目的:研究蝙蝠葛碱对豚鼠心室肌细胞快激活(I_(Kr))和慢激活(I_(Ks))延迟整流钾电流及内向整流钾电流(I_(K1))的作用。方法:酶解法制备单个心室肌细胞。电压箝制方式下全细胞记录豚鼠单个心室肌细胞钾通道电流。结果:蝙蝠葛碱1-100μmol·L~(-1)浓度依赖性阻断I_(Ks),I_(Ks-tail)[IC_(50)=33(95 ％可信限:24-46)μmol·L~(-1)]及I_(Kr),I_(Kr-tail)[IC_(50))=16 (95％可信限:13-22)μmol·L~(-1)]。对I_(Ks-tail),I_(Kr-tail)的去激活过程无明显影响,给药前的时间常数分别为(92±18)ms和(140±38)ms,给药后分别为(84±16)ms和(130±26)ms(P>0.05)。蝙蝠葛碱对I_(Ks)的抑制作用具有电压依赖性。 蝙蝠葛碱20μmol·L~(-1)对I_(K1)的内向部分具有阻断作用。结论:蝙蝠葛碱对I_(Kr)和I_(Ks)具有阻断作用,但不影响此两种成分的去激活过程. 蝙蝠葛碱同时具有阻断I_(K1)的作用。     

苄基四氢巴马汀对豚鼠和大鼠心室肌细胞钾电流的作用

目的:研究苄基四氢巴马汀(BTHP)对心室肌细胞快激活(I_(Kr))和慢激活(I_(Ks))延迟整流钾电流、内向整流钾电流(I_(Kl))和瞬时外向钾电流(I_(to))的作用.方法:采用全细胞膜片箝技术记录豚鼠及大鼠心室肌细胞钾电流.结果:BTHP在 1-100 μmol/L的范围内以浓度依赖性方式阻滞I_(Kr)和I_(Ks),其中对I_(Kr)的IC_(50)为 13.5 μmol/L(95％可信限:11.2-15.8 μmol/L)而对 I_(Ks)的 IC_(50)则为 9.3 μmol/L(95％可信限:7.8-11.8 μmol/L).BTHP 30μmol/L时可使 I_(Kr)及I_(Kr,tail)分别降低31％±4％和36％±5％(n=6,P<0.01);使I_(Ks)及I_(Ks,tail)分别降低40％±6％和45％±15％(n=7,P<0.01);BTHP 5μmol/L可抑制大鼠心室肌细胞I_(to)电流,使电流幅值降低63％±6％(n=6,P<0.01),BTHP1-100μmol/L以浓度依赖性方式阻滞入I_(to),其 IC_(50)为 3.6 μmol/L(95％可信限:2.9-4.3μmol/L).但BTHP 200 μpmol/L对I_(Kl)基本无影响.结论:BTHP对I_(Kr)、I_(Ks)、I_(to)均有抑制作用,且其阻滞作用呈现出浓度依赖性特征.     

Cyclopiazonic acid增加SHR和WKY血管平滑肌细胞Ca~(2+)-依赖性外向K~+-电流

采用全细胞及细胞贴附式斑片钳技术记录自发性高血压大鼠(SHR)和Wistar-Kyoto对照鼠(WKY)培养主动脉平滑肌细胞的Ca~(2+)-依赖性外向K~+电流[I_(k(Ca))],测定肌浆网Ca~(2+)泵抑制剂CPA对其影响.CPA能增加I_K(Ca))单通道开放时间,缩短关闭时间,增加全细胞I_(K(Ca))幅度,这些作用与Ca~(2+)相关并可被K~+通道阻断药glybenclamide阻断。CPA作用在SHR和WKY之间无明显差异。结果提示高血压状态下血管平滑肌的功能改变可能与I_(K(Ca))无关。     

小檗碱对心肌细胞I_(K1)、I_K及HERG通道的抑制作用(英文)

目的:研究小檗碱(Ber)对豚鼠心室肌细胞钾通道和动作电位作用,以及在蛙卵中表达的人的HERG通道的作用。方法:酶解方法分离单个心肌细胞,采用全细胞膜片箝方法记录钾离子电流及动作电位,基因箝技术研究HERG通道电流。结果:Ber可显著延长动作电位时程,并呈剂量依赖性。Ber 100μmol/L使APD_(90)由对照的(450±48)ms延长至(888±90)ms(n=6,P<0.01)。Ber对I_(Kl)及I_K呈剂量依赖性抑制作用。Ber 100μmol/L对I_(Kl)的抑制率达65％±7％(n=6,P<0.01)。Ber 50μmol/L对I_K的抑制率达57％±6％;对I_(Ktail)的抑制率达53％±6％。Ber对I_K作用呈现电压依赖性。Ber对在蛙卵中表达的HERG通道具有很强的阻断作用,IC_(50)为75μmol/L,此阻断作用也呈电压依赖性。结论:Ber可使动作电位时程明显延长,对I_(Kl)及I_K具有阻断作用。Ber可显著抑制HERG通道。Ber抗心律失常的机制与其抑制I_(Kl)、I_K及HERG通道密切相关。     

DDPH对豚鼠心室肌细胞延迟整流钾电流两种成分的抑制作用

目的:研究1-(2,6-二甲基苯氧基)-2-(3,4-二甲氧基苯乙氨基)丙烷盐酸盐(DDPH)对豚鼠心室肌细胞快激活(I_(Kr))和慢激活(I_(Ks))延迟整流钾电流的作用.方法:全细胞膜片箝技术.结果:DDPH 0.1-100μmol/L浓度依赖性抑制I_(Kr),I_Kr-tail[IC_(50)(μmol/L)为6.1,95％可信限为(2.8—13.5)].DDPH同时浓度依赖性抑制 I_(Ks),I_(Ks-tail[IC_(50)(μmol/L)为12.5,95％可信限为(4.8-32.2)].DDPH(10 μmol/L)不影响I_(Kr)和I_(Ks)的电压依赖性激活过程,给药前I_(Kr)的半激活电压(V_(1/2),mV)和斜率因子(k,mV)分别为(-21.7±0.8)和(5.9±0.8),给药后分别为(-23.5±2.4)和(8.1±2.2),无统计学意义(P>0.05).用药前后I_(Ks)的半激活电压和斜率因子的差异亦无统计学意义(P>0.05),用药前分别为(27.0±0.8)和(14.9± 0.9),用药后分别为(27.1±0.7)和(16.6±0.8).DDPH(<10μmol/L)可抑制 I_(Kr)和 I_(Ks)的去激活过程,并且加快I_(Kr)的失活.结论:DDPH抑制I_(Kr)和I_(Ks)无选择性.且主要作用于其去激活过程,而非激活过程.DDPH进一步通过加速其失活过程抑制I_(Kr).     

RP58866对哺乳动物心室肌细胞跨膜钾电流的作用(英文)

目的:研究RP58866对于豚鼠或犬分离心室肌细胞I_K,I_(to),和I_(Kl)的影响。方法:采用全细胞膜片箝技术。结果:在-100 mV时,RP58866以浓度依赖方式明显减少了豚鼠心室肌细胞I_(kl),其IC_(50)为(3.4±0.8)μmol·L~(-1)(n=6)。在犬心室肌细胞,RP58866可明显抑制I_(to),其IC_(50)为(2.3±0.5)μmol·L~(-1)。RP58866 100μmol·L~(-1)阻断豚鼠的心室肌细胞I_K,在 40mv时使I_(Kstep)减少(58±13)％,其IC_(50)为(7.5±0.8)μmol·L~(-1),I_(Ktail)减少(86±17)％,其IC_(50)为(3.5±0.9)μmol·L~(-1)。尾电流分析表明,RP58866对I_(Kr)和I_(Ks)均有阻断作用。结论:RP58866对心肌细胞的I_(Kl)和I_(to),I_K均有抑制作用,而不是一种特殊的I_(Kl)抑制剂。     

Molecular cardiopharmacology of selective inhibitors of cyclic nucleotide phosphodiesterase isozymes]

The existence of multiple isozymes of cyclic nucleotide phosphodiesterase (PDE) in many tissues including the heart has been demonstrated. Five isozyme families, each composed of several subtypes and having different tissue and subcellular distributions, have been characterized. Selective inhibitors of PDE III (cGMP-inhibited PDE) elevates the cAMP level which mediates positive inotropic actions with compartmentation of cAMP related to cardiac cell particulate structures. Both cardiac cytosolic and particulate PDE III were potently and selectively inhibited by the new cardiotonic agents competitively with respect to cAMP, except for vesnarinone. There might be at least two subtypes of PDE III, and vesnarinone may be a selective subtype inhibitor of PDE III in human heart. It was also reported that vesnarinone was beneficial in treating patients with congestive heart failure. Moreover, selective inhibitors of PDE III with ancillary properties such as calcium sensitization may prove to be more useful drugs for the treatment of heart failure.     

Osmosensitive properties of rapid and slow delayed rectifier K+ currents in guinea-pig heart cells

1. Changes in cell volume affect a variety of sarcolemmal transport processes in the heart. To study whether osmotically induced cell volume shrinkage has functional consequences for K+ channel activity, guinea-pig cardiac preparations were superfused with hyperosmotic Tyrode's solution (1.2-2-fold normal osmolality). Membrane currents and cell surface dimensions were measured from whole-cell patch-clamped ventricular myocytes and membrane potentials were recorded from isolated ventricular muscles and non-patched myocytes. 2. Hyperosmotic treatment of myocytes quickly (< 3 min to steady state) shrank cell volume (approximately 20% reduction in 1.5-fold hyperosmotic solution) and depressed the delayed rectifier K+ current (IK). Analysis using different activation protocols and a selective inhibitor (5 micro mol/L E4031) indicated that the IK inhibition was due to osmolality and cell volume-dependent changes in the two subtypes of the classical cardiac IK (rapidly activating IKr and slowly activating IKs); 1.5-fold hyperosmotic treatment depressed the amplitudes of IKr and IKs by approximately 30 and 50%, respectively. 3. Superfusion of muscles and myocytes with 1.5-fold hyperosmotic solution lengthened the action potentials by 14-17%. Hyperosmotic treatment also caused 6-7 mV hyperpolarization that is most likely due to a concentrating of intracellular K+. 4. The inhibition of IK helps explain the lengthening of action potentials observed in osmotically stressed heart cells. These results, together with the reported IK stimulation by hyposmotic cell swelling, provide further support for cell volume-sensitive properties of cardiac electrical activity.     

Effect of vesnarinone in combination with anti-cancer drugs on lung cancer cell lines

Vesnarinone, a quinolinone derivative which is used as an oral inotropic agent in the clinic, has recently also been shown to have anti-cancer activity. We have studied the anti-cancer effect of vesnarinone in combination with cisplatin, VP-16 (etoposide) and gemcitabine, against human lung cancer cell lines (PC-9 and Lu 134A) using the MTT assay and isobologram analysis. Simultaneously, by establishing two cisplatin-resistant sublines, i.e. PC-9/CDDP and Lu 134A/CDDP, we analyzed the cross-resistance between vesnarinone and cisplatin and the resistance-reversing effect of vesnarinone. Nuclear fragmentation, as the presumed mechanism of tumor cell growth inhibition, was further studied quantitatively using flow cytometric analysis. Combination of vesnarinone with the studied anti-cancer drugs had a synergic or additive inhibitory effect on both PC-9 and Lu 134A tumor cell growth. Neither decrease of the sensitivity to vesnarinone nor cross-resistance between vesnarinone and anti-cancer drugs was observed. On the contrary, vesnarinone showed a resistance-reversing effect. Both vesnarinone and the studied anti-cancer drugs could induce tumor cell apoptosis, but a definite correlation between nuclear fragmentation and the growth inhibitory effect was not established.     

Antiarrhythmic agents act differently on the activation phase of the ACh-response in guinea-pig atrial myocytes.

1. Anti-acetylcholine effects of pilsicainide, flecainide, disopyramide and propafenone on the acetylcholine (ACh)-induced K+ current (IK.ACh) were examined in dissociated guinea-pig atrial myocytes under whole-cell voltage clamp by the use of the 'concentration-clamp' technique. 2. The IK.ACh was activated with a latency of about 100 ms after 1 microM ACh application and desensitized to a steady-state level. The latent period and the time to peak response were shortened with increasing ACh concentration. 3. The values of half-maximal inhibition (IC50) on the peak and steady state responses were 25 and 25 microM for pilsicainide, 1.7 and 2.0 microM for disopyramide, 19 and 2.0 microM for flecainide and 0.7 and 0.2 microM for propafenone, respectively. 4. Pilsicainide and disopyramide increased the latent period and the time to peak of IK.ACh in a concentration-dependent manner. Flecainide and propafenone did not change the latent period, but shortened the time to peak and hastened the decay of IK.ACh in a voltage-independent manner. 5. The results suggest that the mechanisms underlying the anti-acetylcholine effect of antiarrhythmic drugs are different among these drugs: i.e., pilsicainide and disopyramide mainly block the muscarinic ACh receptors while flecainide and propafenone inhibit the K+ channel itself as open channel blockers.     

Induction of a glibenclamide-sensitive K-current by modification of a delayed rectifier channel in rat portal vein in insulinoma cells.

In insulinoma cells (RINm5F), the glibenclamide-sensitive K-current (IK(ATP)) which developed spontaneously or after exposure to levcromakalim or to butanedione monoxime was always accompanied by a reduction in the delayed rectifier current (IK(V)). At potentials over which IK(V) was fully activated, the total outward current remained constant. In rat portal vein, the delayed rectifier channel inhibitor, margatoxin, reduced the combined induction of IK(ATP) and inhibition of IK(V) by levcromakalim. These data suggest that the ATP-sensitive K-channel, K(ATP), is a voltage-insensitive state of the delayed rectifier, KV.     

IK independent class III actions of MS-551 compared with sematilide and dofetilide during reperfusion in anaesthetized rats.

1. The antiarrhythmic and haemodynamic effects of three class III antiarrhythmic drugs, MS-551, sematilide and dofetilide, were examined in the coronary artery, ligation-reperfusion model of pentobarbitone-anaesthetized rats, a species deficient in functional cardiac IK. MS-551 is a non-selective potassium channel blocker, while both sematilide and dofetilide are selective delayed rectifier potassium (K) channel (IK) blockers. 2. Before coronary ligation, 3 and 10 mg kg-1 MS-551 decreased the heart rate by 6% (P < 0.01) and 12% (P < 0.01), and increased mean arterial pressure (MAP) by 14% (P < 0.05) and 33% (P < 0.01), respectively. Sematilide at 10 and 30 mg kg-1 also decreased the heart rate by 4% (P < 0.01) and 9% (P < 0.01), respectively, and the higher dose of 30 mg kg-1 decreased MAP by 29% (P < 0.01). Dofetilide, 1 mg kg-1, decreased the heart rate (P < 0.01), but had no significant effect on MAP. 3. The QT interval was increased by 10% (P < 0.01) and 31% (P < 0.01), when 3 and 10 mg kg-1 MS-551 were given. Sematilide and dofetilide had no effect on the QT interval. 4. Immediately after reperfusion, lethal ventricular fibrillation (VF) was induced in 80% of the saline group. MS-551 at 3 and 10 mg kg-1, reduced the incidence of lethal VF to 50% and 20% (P < 0.05). Neither dofetilide 1 mg kg-1 nor sematilide (10 and 30 mg kg-1) decreased the incidence of lethal VF (70%, 80% and 50%, respectively). None of the three drugs had any effect on the occurrence of reperfusion-induced VT or the total incidence of VF. However, 10 mg kg-1 MS-551 delayed the onset of reperfusion-induced VF (27 +/- 5 s compared with 12 +/- 2 s of the control group, P < 0.05). 5. In conclusion, in rats which are deficient in cardiac IK MS-551 prolonged the QT interval and reduced the incidence of sustained VF after reperfusion. Blockade of channels other than IK might participate in the defibrillatory effect of MS-551. Sematilide and dofetilide, which are selective IK blockers, did not increase the QT interval nor did they show antiarrhythmic effects Mechanisms other than K channel block may be involved in the different effects of the three drugs on blood pressure.     

Identification and characterization of multiple subtypes of muscarinic acetylcholine receptors and their physiological functions in canine hearts

M2 receptors have long been believed to be the only functional subtype of muscarinic acetylcholine receptor (mAChR) in the heart, although recent studies have provided evidence for the presence of other subtypes. We performed a detailed study to clarify this issue. In the presence of tetramethylammonium (1 microM to 10 mM), a novel K+ current with both delayed rectifying and inward rectifying properties (IKTMA) was activated in single canine atrial myocytes. 4-Aminopyridine (0.05-2 mM) also induced a K+ current (IK4AP) with characteristics similar to but distinct from those of IKTMA. Both IKTMA and IK4AP were abolished by 1 microM atropine. IK4AP, but not IKTMA, was minimized by treatment with pertussis toxin. IKTMA was markedly decreased by 4-diphenylacetoxy-N-methylpiperidine methiodide (a selective antagonist for M3 subtype) but was not altered by pirenzepine (for M1), methoctramine (for M2), and tropicamide (for M4). Tropicamide substantially reduced IK4AP, but the antagonists for other mAChR subtypes had no effects on IK4AP. By comparison, IKACh (ACh-induced K+ current) was significantly depressed by methoctramine but was unaltered by other antagonists. Results from displacement binding of [methyl-3H]N-scopolamine methyl chloride with pirenzepine, methoctramine, 4-diphenylacetoxy-N-methylpiperidine methiodide, or tropicamide revealed the coexistence of multiple mAChR subtypes in canine atrium. Cloning of cDNA fragments and detection of mRNAs coding for M2, M3, and M4 provided further supporting evidence. Our results suggest that 1) multiple subtypes of mAChRs (M2/M3/M4) coexist in the dog heart and 2) different subtypes of mAChRs are coupled to different K+ channels. Our findings represent the first functional evidence for the physiological role of cardiac M3 and M4 receptors.     

比较比索洛尔与卡维地洛治疗慢性充血性心力衰竭的疗效及安全性

目的:比较比索洛尔与卡维地洛治疗慢性充血性心力衰竭的疗效及安全性。方法:选择已接受常规抗心力衰竭治疗的慢性充血性心力衰竭(心脏彩超仪测定左心室射血分数<40%)患者40例,随机分为2组,分别接受比索洛尔或卡维地洛治疗,渐增至最大剂量后,维持6mo。结果:治疗后,心功能、血压、心率2组均较治疗前明显改善(P<0.01),比索洛尔组左心室射血分数、心率较卡维地洛组改善更明显(P<0.05);卡维地洛组左心室舒张末期容量、左心室收缩末期容量、收缩压及舒张压较比索洛尔组改善更明显(P<0.01)。不良反应发生率比索洛尔组为35%,卡维地洛组为60%,有统计学差异(P<0.01);无因不良反应退出试验者。结论:比索洛尔与卡维地洛均可改善慢性充血性心力衰竭患者的心功能,但不同的β受体阻滞药改善的程度有差异。     

Effects of R56865 on membrane currents in isolated ventricular cardiomyocytes of the guinea-pig.

In isolated heart muscle, the compound R56865 (N-[1-[4-(4-fluorophenoxy)butyl]-4-piperidinyl]-N-methyl-2- benzothiazolamine) has been shown to protect against intoxication by cardiac glycosides. We studied the influence of R56865 on various membrane currents in single isolated ventricular cardiomyocytes of the guinea-pig. The sodium current, INa, was investigated at reduced extracellular Na+ (30 mM) in the presence of Cd2+ to block the calcium current, ICa, and with Cs+ substituted for K+ to reduce the K+ currents, IK. Under these conditions, R56865 concentration dependently decreased the peak INa with a half-maximum effect at about 1 microM. The steady state inactivation and normalized conductance of INa were not significantly different from the control. In 'normal' Tyrode solution, R56865 (10 microM) did not markedly reduce ICa, and did not affect the quasi steady state IK, which was taken as an index of K+ conductance. We conclude that R56865 possesses Na+ channel-blocking properties, whereas ICa and membrane K+ conductance were not influenced.     

A comparison of the covalent binding of clozapine, procainamide, and vesnarinone to human neutrophils in vitro and rat tissues in vitro and in vivo

Covalent binding of drug reactive metabolites to neutrophils or their precursors is thought to play a role in the development of drug-induced agranulocytosis. In this study, we used immunochemical techniques to compare the covalent binding of clozapine, vesnarinone, and procainamide (three drugs associated with agranulocytosis) to phorbol-12,13-myristate acetate (PMA)-activated human neutrophils in vitro and rat tissues in vivo. In PMA-activated human neutrophils in vitro, clozapine and procainamide modified neutrophil proteins with molecular masses ranging from 30 to 200 kDa, while vesnarinone predominately formed adducts with molecular masses greater than 70 kDa. All three drugs formed adducts at 126, 98, and 58 kDa, and they all covalently bound to human myeloperoxidase when incubated with this enzyme and H2O2 in vitro. Covalent binding to PMA-activated neutrophils was inhibited by nucleophiles, such as glutathione and N-acetylcysteine, but not by N-acetyllysine. In the presence of the PMA, all three drugs covalently bound to activated rat bone marrow cells in vitro, while in its absence only clozapine did. Covalently modified liver proteins were observed in rats treated for 6 weeks with clozapine (25 or 50 mg/kg/day), vesnarinone (300 mg/kg/day), or procainamide (50 mg/kg/day). Clozapine extensively modified proteins in all subcellular fractions; procainamide formed a 99 kDa adduct in a membrane-containing fraction and 57, 47, and 36 kDa adducts in a cytosolic fraction, while vesnarinone formed liver-protein adducts with molecular masses of 82, 62, 49, and 40 kDa in membrane, cytosolic, and S9 fractions. In addition, clozapine and procainamide, but not vesnarinone, formed a 49 kDa drug-protein adduct in the bone marrow of treated rats. Furthermore, procainamide covalently bound to a 58 kDa protein in neutrophils of a patient treated with the drug. We suspect that covalent modification of common targets in the neutrophils by these three drugs plays a role in the development of drug-induced agranulocytosis.