Calcium signaling and T-type calcium channels in cancer cell cycling

Regulation of intracellular calcium is an important signaling mechanism for cell proliferation in both normal and cancerous cells. In normal epithelial cells, free calcium concentration is essential for cells to enter and accomplish the S phase and the M phase of the cell cycle. In contrast, cancerous cells can pass these phases of the cell cycle with much lower cytoplasmic free calcium concentrations, indicating an alternative mechanism has developed for fulfilling the intracellular calcium requirement for an increased rate of DNA synthesis and mitosis of fast replicating cancerous cells. The detailed mechanism underlying the altered calcium loading pathway remains unclear; however, there is a growing body of evidence that suggests the T-type Ca^2＋ channel is abnormally expressed in cancerous cells and that blockade of these channels may reduce cell proliferation in addition to inducing apoptosis. Recent studies also show that the expression of T-type Ca^2＋ channels in breast cancer cells is proliferation state dependent, i.e. the channels are expressed at higher levels during the fast-replication period, and once the cells are in a non-proliferation state, expression of this channel is minimal. Therefore, selectively blocking calcium entry into cancerous cells may be a valuable approach for preventing tumor growth. Since T-type Ca^2＋ channels are not expressed in epithelial cells, selective T-type Ca^2＋ channel blockers may be useful in the treatment of certain types of cancers.     

T-type calcium channel as a portal of iron uptake into cardiomyocytes of beta-thalassemic mice

Objectives: Iron‐overload condition can be found in β‐thalassemic patients with regular blood transfusion, leading to iron deposition in various organs including the heart. Elevated cardiac iron causes iron‐overload cardiomyopathy, a condition that provokes mortality because of heart failure in patients with thalassemia. Previous studies demonstrated that myocardial iron uptake may occur via L‐type calcium channels (LTCCs). However, direct evidence regarding the claimed pathway in thalassemic cardiomyocytes has never been investigated. Methods: Hearts from genetic‐altered β‐thalassemic mice and adult wild‐type mice were used for cultured ventricular cardiomyocytes. Blockers for LTCC, T‐type calcium channel (TTCC), transferrin receptor1 (TfR1), and divalent metal transporter1 (DMT1) were used, and quantification of cellular iron uptake under various iron loading conditions was performed by Calcein‐AM fluorescence assay. Microarray analysis was performed to investigate gene expressions in the hearts of these mice. Results: This study demonstrated that iron uptake under iron‐overload conditions in the cultured ventricular myocytes of thalassemic mice was greater than that of wild‐type cells (P < 0.01). TTCC blocker, efonidipine, and an iron chelator, deferoxamine, could prevent iron uptake into cultured cardiomyocytes, whereas blockers of TfR1, DMT1, and LTCC could not. Microarray analysis from thalassemic hearts demonstrated highly up‐regulated genes of TTCC, zinc transporter, and transferrin receptor2. Conclusions: Our findings indicated that iron uptake mechanisms in cultured thalassemic cardiomyocytes are mainly mediated by TTCC, suggesting that TTCC is the important pathway for iron uptake in this cultured thalassemic cardiomyocyte model.     

脑缺血与Ca2+

急性缺血性脑血管病是严重危害人类健康的疾病之一，其发病机制复杂，但细胞内Ca^2＋超载在缺血性脑损伤中的作用已得到证实。文章从触发细胞内Ca^2＋稳态失调的途径、其介导脑损伤的机制及钙通道阻滞药的应用现状对脑缺血与Ca^＋的关系进行了综述。     

Iron overload thalassemic cardiomyopathy: Iron status assessment and mechanisms of mechanical and electrical disturbance due to iron toxicity

Patients with thalassemia major have inevitably suffered from complications of the disease, due to iron overload. Among such complications, cardiomyopathy is the leading cause of morbidity and mortality (63.6% to 71%). The major causes of death in this group of patients are congestive heart failure and fatal cardiac tachyarrhythmias leading to sudden cardiac death. The free radical-mediated pathway is the principal mechanism of iron toxicity. The consequent series of events caused by iron overload lead to catastrophic cardiac effects. The authors review the electrophysiological and molecular mechanisms, pathophysiology and correlated clinical insight of heart failure and arrhythmias in iron overload thalassemic cardiomyopathy.     

Impaired Phagocyte Antibacterial Effector Functions in β-thalassemia: A Likely Factor in the Increased Susceptibility to Bacterial Infections

Bacterial diseases are serious complications of β-thalassemia syndromes but the mechanisms underlying the increased susceptibility to these infections are not fully understood. Factors which are likely to be involved are anemia, splenectomy, iron-overload and alterations in innate/adaptive immune responses. There is substantial evidence that a defect in innate effector functions of phagocytes (neutrophils, monocytes/macrophages) plays an important role in the weakened resistance to pathogenic bacteria and is at least in part due to iron overload.

There is substantial evidence of an iron-related defect in bacterial phagocytosis by neutrophils. Moreover, reduced chemotaxis by these phagocytes has been repeatedly demonstrated. Similarly, an impairment of monocyte bacterial phagocytosis and generation of anti-bacterial compounds have recently been delineated but any relation to iron overload needs to be established.

Additional mechanisms of defective innate immune responses such as altered expression of pathogen recognising receptors and function seem possible and have to be explored.

Further insight into innate phagocyte effector functions in β-thalassemia is essential for understanding the increased susceptibility to bacterial infections and their management.     

Effect of a novel oral active iron chelator: 1-(N-acetyl-6-aminohexyl)-3-hydroxy-2-methylpyridin-4-one (CM1) in iron-overloaded and non-overloaded mice

ObjectiveTo evaluate efficacy and toxicity of a novel orally active bidentate iron chelator, 1-(N-acetyl-6-aminohexyl)-3-hydroxy-2-methylpyridin-4-one (CM1) in mice under normal and iron overload conditions.MethodsWild type C57BL/6 mice were fed with normal and 0.2% (w/w) ferrocene-supplemented (Fe) diets, respectively for 240 d and orally given the CM1 (50, 100 and 200 mg/kg) for 180 d. Blood iron profiles, hematological indices, liver enzymes and histopathology were determined.ResultsCM1 treatment lowered plasma levels of labile plasma iron and non-transferrin bound iron, but not ferritin in the Fe-fed mice. However, the treatment did not impact blood hemoglobin level, white blood cell and platelet numbers in both normal diet and Fe diet-fed mice. Interestingly, CM1 treatment did not markedly elevate plasma aspartate aminotransferase, alanine aminotransferase and alkaline phosphatase activities in the normal diet-fed mice but it tended to increase the levels of the liver enzymes slightly in the Fe-fed mice. Hematoxylin and eosin staining result showed no abnormal pathological changes in heart, liver and spleen tissues.ConclusionsIt is clear that CM1 would not be toxic to bone marrow and liver cells under normal and iron-overload conditions.     

Ghrelin对大鼠心室肌细胞L型钙电流的影响

目的：研究一种具有生长激素释放活性的脑肠肽（Ghrelin）对大鼠心室肌细胞L型钙电流的影响。方法：采用酶解消化法获得大鼠单个心室肌细胞,通过全细胞膜片钳技术研究不同浓度（10 nmol/L、100 nmol/L及1μmol/L） Ghrelin对L型钙电流的影响。结果：10 nmol/L、100 nmol/L及1μmol/L Ghrelin依次抑制大鼠心室肌细胞L型钙电流峰电位,抑制率分别为：8.95%±2.13%、31.18%±4.78%及64.63%±8.57%,（P<0.05）;I-V曲线上移,通道半数失活电压从（-1.34±1.9） mV分别降至（-8.04±1.32）mV、（9.76±1.17）mV及（-11.81±0.73）mV（P<0.05）,并延长失活后恢复时间由给药前τ值63.23±9.32,分别增至98.95±10.74、109.56±13.42和127.39±16.13,差异有统计学意义（P<0.05）。结论：Ghrelin通过加快L型钙电流的失活及延长失活后恢复时间,具有浓度依赖性地抑制L型钙电流。     

Assessment of iron overload with T2* magnetic resonance imaging

T2* is a magnetic relaxation property of any tissue and is inversely related to intracellular iron stores. Measurement is simple, quick, and robust and has high reproducibility. The ability to measure ventricular function plus T2* in the heart and liver during the same scan has revolutionized the understanding of iron storage disease and the management of the iron-loaded patient. The early findings using T2* challenged conventional teachings, and both the technique and the findings were initially viewed with scepticism. However, after a decade of work in validating, calibrating, and expanding access to this method, it is now accepted as the method of choice for tissue iron assessment. In the UK, where T2* measurement was first used in the clinical care of patients with thalassemia major, a large and significant fall in mortality has been seen in this patient group.     

氯沙坦对自发性高血压大鼠心肌细胞钙电流影响的分子机制

目的:探讨自发性高血压大鼠(SHR)心肌细胞L型钙电流(ICa-L)和L型钙通道a1C亚基(CaL.α1C)信使核糖核酸(mRNA)及蛋白的变化,并观察氯沙坦对这些变化的影响以期评估氯沙坦的抗心律失常作用及其分子机制.方法:将SHR按随机数字表法分成以下三组(每组n=10):氯沙坦组、依那普利组和安慰剂组,另选同龄Wistar大鼠作为空白对照(对照组,n=10).8周后采用膜片钳技术记录左心室心肌ICa-L,并采用逆转录-聚合酶链反应及蛋白质印迹方法测定CaL-α1C的mRNA及蛋白水平.结果:氯沙坦组左心室细胞的50%动作电位持续时间、90%动作电位持续时间比安慰剂组、依那普利组缩短(P均<0.01).氯沙坦组的ICa-L峰值及电流密度比安慰剂组及依那普利组降低(P均<0.05).氯沙坦组ICa-L的τ值比安慰剂组及依那普利组升高(P均<0.01).氯沙坦组的CaL-α1C mRNA及蛋白表达水平比安慰剂组及依那普利组降低(P均<0.05).上述比较差异均有统计学意义.结论:氯沙坦能缩短单个心肌细胞动作电位时程,延迟L型钙通道失活再激活的恢复时间,通过下调CaL-α1CmRNA及其蛋白水平而发挥作用.     

Channel-mediated calcium current in the heart

Summary Calcium ions play an important role in the regulation of heart functions. Calcium ions may enter or leave the myocardial cell through various mechanisms, including several exhange mechanisms and pumps. This review concentrates on the influx of calcium ions through channels in the sarcolemma, resulting in an electric current flow. The calcium current plays an important role in the maintenance of the action potential duration, in the generation of pacemaker activity, and in the initiation of contraction.The calcium current displays both activation and a subsequent inactivation when the membrane potential is changed in a stepwise fasion. Previously, the activation was thought to occur rather slowly, hence the name slow inward current. Recent evidence suggests that the calcium current occurs much faster and that two types of calcium currents might exist, differing in their selectivity to other ions and in their sensitivity to membrane potential and to drugs.The calcium current is modulated by several factors. Beta-adrenergic stimulation increases the calcium current by increasing the opening probability of the calcium channel. The effects of acetylcholine are less well described. There also exists a class of drugs, called calcium channel blockers (or calcium antagonists) that decrease the flow of calcium ions through calcium channels.It is not quite clear how the calcium current is changed during myocardial ischemia. Factors that may reduce the calcium current during ischemia are the increased extracellular potassium concentration, metabolic inhibition and a decreased ATP level, and acidosis. Raised levels of intracellular cAMP, however, should lead to an increased calcium current.     

Cardiac iron overload in thalassemic patients: An endomyocardial biopsy study

Secondary heart failure induced by organ siderosis is the main cause of death in patients affected by thalassemia major. At present it cannot be predicted whether heart siderosis is correlated with iron overload and little is known about the real cardiac histological pattern of post transfusional hemochromatosis in patients with thalassemia major and intermedia. The study aim was to evaluate cardiac iron overload by non invasive and invasive techniques. Fifteen thalassemic patients were investigated and endomyocardial biopsy performed in ten revealed different grades of endomyocardial iron overload with histochemical positivity. Non invasive techniques are not able to furnish an exact picture of the cardiac hemochromatosis. There was a significant correlation between serum ferritin and myocardial iron grade.Patients with elevated ferritin levels and poor compliance to chelating therapy are at high risk of severe heart hemochromatosis. It was seen that endomyocardial biopsy is a useful tool in studying myocardial iron.     

Altered Pharmacologic Responsiveness of Reduced L-Type Calcium Currents in Myocytes Surviving in the Infarcted Heart

Altered Pharmacology of I_ca,L in Myocytes From Infarcted Heart. The pharmacologic responses of macroscopic L-type calcium channel currents to the dihydropyridine agonist, Bay K 8644, and β-adrenergic receptor stimulation by isoproterenol were studied in myocytes enzymatically dissociated from the epicardial border zone of the arrhythmic 5-day infarcted canine heart (IZs). Calcium currents were recorded at 36° to 37° C using the whole cell, patch clamp method and elicited by applying step depolarizations from a holding potential of -40 mV to various test potentials for 250-msec duration at 8-second intervals. A Cs⁺ -rich and 10 mM EGTA-containing pipette solution and a Na⁺-and K⁺-free external solutions were used to isolate calcium currents from other contaminating currents. During control, peak I_ca,L, density was found to be significantly less in IZs (4.0 ± 1.1 pA/pF) than in myocytes dispersed from the epicardium of the normal noninfarcted heart (NZs; 6.5 ± 1.8 pA/pF). Bay K 8644 (I μM) significantly increased peak I_ca,L density 3.5-fold above control levels in both NZs (to 22.5 ± 6.2 pA/pF; n = 7) and IZs (to 12.8 ± 3.0 pA/pF; n = 5), yet peak I_ca,L density in the presence of drug was significantly less in IZs than NZs. The effects of Bay K 8644 on kinetics of current decay and steady-state inactivation relations of peak I_ca,L were similar in the two cell types. In contrast, the response of peak L-type current density to isoproterenol (1 μM) was significantly diminished in IZs compared to NZs regardless of whether Ba²⁺ or Ca²⁺ ions carried the current. Thus, these results indicate an altered responsiveness to β-adrenergic stimulation in cells that survive in the infarcted heart. Furthermore, application of forskolin (1 μM and 10 μM) or intracellular cAMP (200 μM), agents known to act downstream of the β-receptor, also produced a smaller increase in peak I_Ba density in IZs versus NZs, suggesting that multiple defects exist in the β-adrenergic signaling pathway of IZs. In conclusion, these studies illustrate that reduced macroscopic calcium currents of cells in the infracted heart exhibit an altered pharmacologic profile that has important implications in the development of drugs for the diseased heart.     

硝苯地平对心室肌细胞L型钙通道状态依赖性阻滞的研究

目的探讨选择性L型钙通道阻滞剂硝苯地平对L型钙流[ICa(L)]浓度、状态依赖性阻滞作用的影响。方法采用膜片钳全细胞记录技术对豚鼠单个心室肌细胞,给予35℃的各种含药物细胞外液快速灌流,记录ICa(L)。结果①保持电位-80mV,硝苯地平抑制ICa(L)的IC50为0.3μmol·L-1;保持电位为-40mV时,IC50为0.05μmol·L-1,呈浓度依赖性阻滞。硝苯地平0.3μmol·L-1作用于电压依赖的ICa(L)失活曲线,使其左移17mV,至更负的膜电位,显示硝苯地平相对选择与失活态钙通道结合。②在10s的静息间隔药物作用时间后的第1个实验刺激,硝苯地平3μmol·L-1或30μmol·L-1加速ICa(L)的失活,提示硝苯地平对ICa(L)可能存在激活态阻滞。结论在生理条件下,硝苯地平对ICa(L)的阻滞呈浓度、状态依赖性。相对选择与失活态钙通道结合,且可能存在激活态阻滞。     

Liver iron content determination by magnetic resonance imaging

Accurate evaluation of iron overload is necessary to establish the diagnosis of hemochromatosis and guide chelation treatment in transfusion-dependent anemia. The liver is the primary site for iron storage in patients with hemochromatosis or transfusion-dependent anemia, therefore, liver iron concentration (LIC) accurately reflects total body iron stores. In the past 20 years, magnetic resonance imaging (MRI) has emerged as a promising method for measuring LIC in a variety of diseases. We review the potential role of MRI in LIC determination in the most important disorders that are characterized by iron overload, that is, thalassemia major, other hemoglobinopathies, acquired anemia, and hemochromatosis. Most studies have been performed in thalassemia major and MRI is currently a widely accepted method for guiding chelation treatment in these patients. However, the lack of correlation between liver and cardiac iron stores suggests that both organs should be evaluated with MRI, since cardiac disease is the leading cause of death in this population. It is also unclear which MRI method is the most accurate since there are no large studies that have directly compared the different available techniques. The role of MRI in the era of genetic diagnosis of hemochromatosis is also debated, whereas data on the accuracy of the method in other hematological and liver diseases are rather limited. However, MRI is a fast, non-invasive and relatively accurate diagnostic tool for assessing LIC, and its use is expected to increase as the role of iron in the pathogenesis of liver disease becomes clearer.     

Effect of altered iron metabolism on markers of haem biosynthesis and intestinal iron absorption in mice

In this study, well-characterised animal models of altered iron metabolism were used to investigate link(s) between haem biosynthesis and intestinal iron absorption. Mice rendered iron deficient by feeding a low-iron diet for 3–4 weeks showed low levels of hepatic non-haem iron and hepcidin mRNA, with reduced urinary 5-aminolaevulinic acid (ALA) excretion and enhanced intestinal iron absorption. Hepatic ALA synthase activity was reduced while ALA dehydratase activity was increased. Iron-loaded mice had markedly increased liver non-haem iron and hepcidin mRNA, with increased urinary ALA excretion. Intestinal iron absorption was decreased mainly due to a reduction in transfer of absorbed iron from mucosa to the carcass. Hepatic ALA synthase activity was increased and ALA dehydratase activity moderately reduced. Mice exposed to hypoxia (0.5 atm) for 1–3 days had reduced hepatic hepcidin mRNA and urinary ALA excretion, while intestinal iron absorption was increased. Hepatic ALA synthase activity was reduced. The ALA dehydratase activity in liver and spleen was markedly enhanced. Injection of ALA to iron-deficient mice or hypoxic mice reduced their intestinal iron absorption to normal levels. This study further supports the hypothesis that alterations in haem biosynthesis influence duodenal iron absorption. ALA in particular appears to function as a modulator in controlling intestinal iron absorption.     

Ferritin in bone marrow and serum in iron deficiency and iron overload

Summary Nonheme iron and ferritin in the bone marrow and serum ferritin was investigated in patients with iron deficiency anaemia or iron overload. As controls served patients without any disturbance of the iron metabolism.There is a precise correlation between the nonheme iron and ferritin in the bone marrow of patients with and without disturbance of iron metabolism. A correlation was also found between the ferritin in the bone marrow and the serum. Nonheme iron and ferritin in the bone marrow and serum ferritin was decreased in patients with iron deficiency anaemia. Conversely, the same parameters were increased in patients with iron overload.     

Binding of rapamycin analogs to calcium channels and FKBP52 contributes to their neuroprotective activities

Rapamycin is an immunosuppressive immunophilin ligand reported as having neurotrophic activity. We show that modification of rapamycin at the mammalian target of rapamycin (mTOR) binding region yields immunophilin ligands, WYE-592 and ILS-920, with potent neurotrophic activities in cortical neuronal cultures, efficacy in a rodent model for ischemic stroke, and significantly reduced immunosuppressive activity. Surprisingly, both compounds showed higher binding selectivity for FKBP52 versus FKBP12, in contrast to previously reported immunophilin ligands. Affinity purification revealed two key binding proteins, the immunophilin FKBP52 and the beta1-subunit of L-type voltage-dependent Ca(2+) channels (CACNB1). Electrophysiological analysis indicated that both compounds can inhibit L-type Ca(2+) channels in rat hippocampal neurons and F-11 dorsal root ganglia (DRG)/neuroblastoma cells. We propose that these immunophilin ligands can protect neurons from Ca(2+)-induced cell death by modulating Ca(2+) channels and promote neurite outgrowth via FKBP52 binding.     

Calcium channel antagonism reduces exercise-induced ventricular arrhythmias in catecholaminergic polymorphic ventricular tachycardia patients with RyR2 mutations

Calcium channel antagonism in RyR2 defects. INTRODUCTION: Recently, gain-of-function mutations of cardiac ryanodine receptor RyR2 gene have been identified as a cause of familial or catecholaminergic polymorphic ventricular tachycardia. We examined the influence of the calcium channel blockers, verapamil and magnesium, on exercise-induced ventricular arrhythmias in patients with RyR2 mutations. METHODS AND RESULTS: Six molecularly defined catecholaminergic polymorphic ventricular tachycardia patients, all carrying a RyR2 mutation and on beta-adrenergic blocker therapy, underwent exercise stress test four times: at baseline, after verapamil and magnesium sulphate infusions, and finally, without interventions. The number of isolated and successive premature ventricular complexes during exercise ranged from 40 to 374 beats (mean 165 beats) at baseline, and was reduced during verapamil by 76+/-17% (P<0.05). Premature ventricular complexes appeared later and at higher heart rate during verapamil than at baseline (119+/-21 vs. 127+/-27 min-1, P<0.05). Magnesium did not inhibit the arrhythmias. Results in the fourth exercise stress test without interventions were similar to those in the first baseline study. CONCLUSIONS: This study provides the first in vivo demonstration that a calcium channel antagonist, verapamil, can suppress premature ventricular complexes and nonsustained ventricular salvoes in catecholaminergic polymorphic ventricular tachycardia caused by RyR2 mutations. Modifying the abnormal calcium handling by calcium antagonists might have therapeutic value.     

钙通道阻滞剂抗动脉粥样硬化作用的研究进展

钙通道阻滞剂具有降低血压之外的独立的抗动脉粥样硬化的作用,现就其相关临床试验证据及作用机制做一综述.     

Prevalence and Clinical Significance of Hepatitis C Virus Infection in Thai Patients with Thalassemia

Hepatitis C virus (HCV) infection is a common cause of liver disease in thalassemia major patients in Western, especially Mediterranean, countries. Its significance in thalassemic patients from Southeast Asia has not been critically evaluated. In this report, we describe our study of the prevalence of HCV infection among Thai patients with thalassemia. The relationships of the infection to blood transfusion and the infection's effects on liver function have also been determined. Of the 104 patients studied, 21 (20.2%) tested positively by enzyme immunoassay for anti-HCV antibody, whereas only 2 patients (2%) had the hepatitis B surface antigen. There was no significant relationship between the presence of anti-HCV antibodies and the number and frequency of blood transfusions. In fact, 2 patients (10%) who tested positive for anti-HCV antibodies had never received transfusions. Patients with anti-HCV antibodies had significantly abnormal liver functions, such as higher levels of serum aspartate aminotransferase (SGOT) and alanine aminotransferase (SGPT) and lower levels of serum albumin, compared with patients without anti-HCV antibodies (P = .021, .017, and .004, respectively). However, there were also significant correlations between iron status as indicated by transferrin saturation or serum ferritin levels and SGOT, SGPT, and gamma-glutamyltransferase (GGT) levels. Moreover, abnormal liver function as represented by elevated levels of SGOT, SGPT, GGT, and serum alkaline phosphatase was observed more frequently in patients with iron overload than in patients with a lower degree of iron burden. The presence of HCV did not alter the effects of iron overload on liver function. The findings suggest that both HCV and iron overload are the main causes of abnormal liver function in Thai patients with thalassemia. The treatment of both problems, if coexisting in patients with thalassemia, is required to prevent progression to chronic liver disease.