Mg2+ Dependence of Halothane-induced Ca2+ Release from the Sarcoplasmic Reticulum in Skeletal Muscle from Humans Susceptible to Malignant Hyperthermia

Background: Recent work suggests that impaired Mg2+ regulation of the ryanodine receptor is a common feature of both pig and human malignant hyperthermia. Therefore, the influence of [Mg2+] on halothane-induced Ca2+ release from the sarcoplasmic reticulum was studied in malignant hyperthermia-susceptible (MHS) or -nonsusceptible (MHN) muscle.

Methods: Vastus medialis fibers were mechanically skinned and perfused with solutions containing physiologic (1 mm) or reduced concentrations of free [Mg2+]. Sarcoplasmic reticulum Ca2+ release was detected using fura-2 or fluo-3.

Results: In MHN fibers, 1 mm halothane consistently did not induce sarcoplasmic reticulum Ca2+ release in the presence of 1 mm Mg2+. It was necessary to increase the halothane concentration to 20 mm or greater before Ca2+ release occurred. However, when [Mg2+] was reduced below 1 mm, halothane became an increasingly effective stimulus for Ca2+ release; e.g., at 0.4 mm Mg2+, 58% of MHN fibers responded to halothane. In MHS fibers, 1 mm halothane induced Ca2+ release in 57% of MHS fibers at 1 mm Mg2+. Reducing [Mg2+] increased the proportion of MHS fibers that responded to 1 mm halothane. Further experiments revealed differences in the characteristics of halothane-induced Ca2+ release in MHS and MHN fibers: In MHN fibers, at 1 mm Mg2+, halothane induced a diffuse increase in [Ca2+], which began at the periphery of the fiber and spread slowly inward. In MHS fibers, halothane induced a localized Ca2+ release, which then propagated along the fiber. However, propagated Ca2+ release was observed in MHN fibers when halothane was applied at an Mg2+ concentration of 0.4 mm or less.