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Am J Physiol Cell Physiol 290: C1221-C1229, 2006. First published November 23, 2005; doi:10.1152/ajpcell.00526.2005
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MEMBRANE TRANSPORTERS, ION CHANNELS, AND PUMPS

Intermittent hypoxia protects cardiomyocytes against ischemia-reperfusion injury-induced alterations in Ca2+ homeostasis and contraction via the sarcoplasmic reticulum and Na+/Ca2+ exchange mechanisms

Le Chen,1 Xi-Yuan Lu,2 Jun Li,2 Ji-Dong Fu,1 Zhao-Nian Zhou,3 and Huang-Tian Yang1,2

1Laboratory of Molecular Cardiology, Institute of Health Sciences, Shanghai Institutes for Biological Sciences (SIBS), Chinese Academy of Sciences (CAS) and Shanghai Jiao Tong University School of Medicine (SJTUSM), Graduate School of the CAS, Shanghai; 2Laboratory of Molecular Cardiology, Institute of Health Sciences, SJTUSM and SIBS, CAS, Shanghai; and 3Physiological Laboratory of Hypoxia, SIBS, CAS, Shanghai, China

Submitted 19 October 2005 ; accepted in final form 17 November 2005


    ABSTRACT
 TOP
 ABSTRACT
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 GRANTS
 REFERENCES
 
We have previously demonstrated that intermittent high-altitude (IHA) hypoxia significantly attenuates ischemia-reperfusion (I/R) injury-induced excessive increase in resting intracellular Ca2+ concentrations ([Ca2+]i). Because the sarcoplasmic reticulum (SR) and Na+/Ca2+ exchanger (NCX) play crucial roles in regulating [Ca2+]i and both are dysfunctional during I/R, we tested the hypothesis that IHA hypoxia may prevent I/R-induced Ca2+ overload by maintaining Ca2+ homeostasis via SR and NCX mechanisms. We thus determined the dynamics of Ca2+ transients and cell shortening during preischemia and I/R injury in ventricular cardiomyocytes from normoxic and IHA hypoxic rats. IHA hypoxia did not affect the preischemic dynamics of Ca2+ transients and cell shortening, but it significantly suppressed the I/R-induced increase in resting [Ca2+]i levels and attenuated the depression of the Ca2+ transients and cell shortening during reperfusion. Moreover, IHA hypoxia significantly attenuated I/R-induced depression of the protein contents of SR Ca2+ release channels and/or ryanodine receptors (RyRs) and SR Ca2+ pump ATPase (SERCA2) and SR Ca2+ release and uptake. In addition, a delayed decay rate time constant of Ca2+ transients and cell shortening of Ca2+ transients observed during ischemia was accompanied by markedly inhibited NCX currents, which were prevented by IHA hypoxia. These findings indicate that IHA hypoxia may preserve Ca2+ homeostasis and contraction by preserving RyRs and SERCA2 proteins as well as NCX activity during I/R.

intracellular Ca2+ concentration; Ca2+ transients; Ca2+ transporters; myofilament Ca2+ sensitivity


BRIEF EPISODES of myocardial ischemia-reperfusion (I/R) protect the heart against subsequent ischemic injury, a phenomenon termed ischemic preconditioning (21). Ischemic tolerance of the heart can also be induced by long-term adaptation to intermittent high-altitude (IHA) hypoxia (1, 22, 37, 41). This form of cardiac protection persists longer than ischemic preconditioning (6, 39) and is associated with less adverse effects, such as right ventricular hypertrophy, than those associated with chronic hypoxia (1, 25, 36, 39). Therefore, the elucidation of the subcellular mechanisms through which IHA hypoxia exerts its beneficial effect may be of basic clinical importance. In contrast to the mechanisms of ischemic preconditioning, however, those underlying IHA hypoxia have scarcely been clarified.

Cytosolic free Ca2+ concentration ([Ca2+]i) plays a crucial role in determining cardiac contraction and relaxation in both physiological and pathophysiological conditions. Intracellular Ca2+ overload due to abnormal Ca2+ homeostasis in cardiomyocytes is one of the main factors involved in I/R injury (7, 27). Because the sarcoplasmic reticulum (SR) is the major source and sink of cytosolic Ca2+ and plays a critical role in regulating [Ca2+]i and subsequent contraction, the dysfunction of SR due to I/R (34, 35), particularly the impaired SR Ca2+ release channels/ryanodine receptors (RyRs) and SR Ca2+-pump ATPase (SERCA2), may contribute to Ca2+ overload and thereby affect contractility after ischemia (34, 35, 37). In cardiomyocytes, the Na+/Ca2+ exchanger (NCX) works with SERCA2 to exclude cytosolic Ca2+ during diastole by mediating most of the trans-sarcolemmal efflux, triggering SR (17), and directly activating the contractile elements (23). It also plays an important role in Ca2+ overload during I/R, leading to cellular injury and cell death (19, 20). Recently, we demonstrated that IHA hypoxia can protect the heart against lethal Ca2+ overload injury induced by Ca2+ paradox (36) and prevent the increase in resting [Ca2+]i due to I/R (41). More recently, we observed (37) that IHA hypoxia mitigates I/R-induced depression in SERCA2 activity by upregulating dual-site phospholamban (PLB) phosphorylation and that these effects are associated with improved recovery of contractile relaxation. We therefore hypothesized that IHA hypoxia may maintain Ca2+ homeostasis and result in better recovery of contractility during I/R via its protection of the SR and sarcolemmal Ca2+-handling proteins. To elucidate this issue in the present study, we have compared the time-dependent changes in Ca2+ transients and cell contraction at baseline and during I/R in cardiomyocytes in normoxic rats with those from IHA hypoxic rats and investigated the influence of IHA hypoxia on the changes in the protein contents and activities of SR RyRs, SERCA2, and sarcolemmal NCX during these processes.


    MATERIALS AND METHODS
 TOP
 ABSTRACT
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 GRANTS
 REFERENCES
 
Animals used in this study were maintained in accordance with the Guide for the Care and Use of Laboratory Animals (Publication 85-23, revised 1996; National Institutes of Health, Bethesda, MD), and all procedures were approved by the Institutional Review Board of the Institute of Health Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences and Shanghai Jiao Tong University School of Medicine (Shanghai, China).

IHA hypoxic animals. Male Sprague-Dawley rats were exposed to IHA hypoxia in a hypobaric chamber (equivalent to an altitude of 5,000 m; barometric pressure PB = 404 mmHg, PO2 = 84 mmHg) for one 6-h period each day for 42 days as previously described (36, 37). Their body weight during this period rose from 100–130 g to 310–340 g. Age-matched normoxic animals were maintained in the normoxic environment for a corresponding period. Their body weights and weight gains were identical to those of rats exposed to IHA hypoxia. All animals had free access to water and to a standard laboratory diet.

Isolation of ventricular myocytes. Left ventricular myocytes were isolated from the heart using a standard enzymatic method described previously (3), and >90% of isolated, rod-shaped myocytes were Ca2+ tolerant.

I/R protocol in isolated cardiomyocytes. To determine directly the effects of IHA hypoxia on alterations of Ca2+ transients and contractions due to I/R, a cellular model of simulated I/R in isolated ventricular myocytes was used as previously described (9, 41). Briefly, myocytes were equilibrated in modified Krebs-Henseleit (K-H) solution at 35°C, pH 7.4. Subsequently, the solution was switched to ischemic solution containing (in mM) 123.0 NaCl, 8.0 KCl, 6.0 NaHCO3, 0.9 NaH2PO4, 0.5 MgSO4, 20.0 Na+-lactate, and 1.8 CaCl2, and was then gassed with 95% N2-5% CO2 (pH 6.8) for 20 min, followed by 30-min reperfusion with modified K-H solution. Left ventricular myocytes from the same heart were harvested for protein extraction at preischemia, after 20 min of ischemia (I20), and after 3 min (R3) and 30 min of reperfusion (R30), respectively.

Simultaneous measurement of Ca2+ transients and cell shortening. Ca2+ transients and cell shortening were detected simultaneously as previously described (3). Cells were incubated with a Ca2+ indicator, indo-1 AM (5 µM; Molecular Probes, Carlsbad, CA), at 25°C for 10 min. Loaded cells were electrically stimulated at 0.5 Hz, except during ischemia. The ratio of emitted fluorescence at 405 and 485 nm was recorded as an indicator of [Ca2+]i (3). Simultaneously, the cells were illuminated with a red light (650–750 nm) through the bright-field path of the microscope, and cell shortening was detected using an optical edge detector, collected using a charge-coupled device camera, and analyzed using IonWizard 4.4 software in length mode (IonOptix; Milton, MA).

To estimate the SR Ca2+ content and the involvement of NCX, caffeine-induced Ca2+ transients was measured as previously described (3) at preischemia, I20, and R30, but not at R3, because the cells died soon afterward as a result of severe hypercontracture. Because Na+-lactate was used to simulate acidosis due to ischemia and therefore could not be eliminated in the present study, Ni2+ (5 mM) was applied to block NCX just before and during the addition of caffeine (10 mM) (28). The time constants ({tau}) representing a decay rate of Ca2+ transients and cell shortening were determined as previously described (3).

Measurement of electrogenic NCX currents. The Ni2+-sensitive currents were recorded as electrogenic NCX currents (INa/Ca) using the standard whole cell patch-clamp technique as previously described (32). Briefly, membrane currents were assessed using an Axopatch multiclamp model 700B amplifier and a 1/100 CV-3 head stage (Axon Instruments, Sunnyvale, CA). The electrode resistance ranged from 2 to 5 M{Omega}. When INa/Ca was measured, K+ in the external solution was replaced by Cs+ (to abolish inwardly rectifying K+ current), and 10 µM nifedipine and 20 µM ouabain (to inhibit L-type Ca2+ currents and the Na+ pump, respectively) were added. Glibenclamide (2 µM) and hexamethyleneamiloride (2 µM) were also added to the ischemic solution to block the ATP-sensitive K+ (KATP) channel and Na+/H+ exchange, respectively. Ni2+ (5 mM) was added to define the fraction of currents derived from INa/Ca (total current remaining after subtraction of post-Ni2+ trace). A Cs+-based internal dialysis solution was used for all recordings, which contained (in mM) 65 CsCl, 20 NaCl, 5 MgATP, 6 CaCl2, 4 MgCl2, 10 HEPES, 20 tetraethyl ammonium chloride (TEA), and 21 EGTA (pH 7.2 adjusted with CsOH) (32). INa/Ca was elicited using ramp voltage-clamp pulses from holding potential –40 mV to +80 and then to –120 mV (100 mV/s) at 0.1 Hz. Membrane capacitance was read directly from the membrane test function of pCLAMP 9.0 software (Axon Instruments) before compensating series resistance and membrane capacitance.

Preparation of SR vesicles and cell sarcolemmal membrane samples. Harvested cells were homogenated in a lysis buffer containing (in mM) 15 Tris·HCl, 10 NaHCO3, 5 NaN3, 250 sucrose, and 1 EDTA (2°C, pH 7.0) using a homogenizer (Polytron PT 3100; Kinematica, Littau-Lucerne, Switzerland). The homogenate was centrifuged for 5 min at 3,000 g to remove cellular debris. For cell membrane preparation (25), the supernatant was centrifuged at 100,000 g for 60 min and then discarded. The pellet representing the sarcolemma-enriched fraction was resuspended in the solution with (in mM) 100 NaCl, 50 LiCl, 6 KCl, and 20 HEPES-Tris, pH 7.4, for Western blot analysis of NCX. For SR vesicle isolation (25, 35), the 3,000 g supernatant was further centrifuged at 48,000 g for 75 min and then discarded. The pellet was suspended in a mixture of 0.6 mM KCl and 20 mM Tris·HCl (pH 7.0) and centrifuged at 48,000 g for 60 min. The final pellet was rehomogenized in 250 mM sucrose and 40 mM imidazole-HCl and stored at –70°C. All solutions contained three protease inhibitors: soybean trypsin inhibitor (40 µg/ml), 0.1% PMSF, and leupeptin (0.5 µg/ml). The concentration of the proteins was determined using the method of Bradford.

Measurement of 45Ca2+ uptake of SR. Ca2+ uptake activity of SR was determined using 45Ca2+ (Amersham, Piscataway, NJ) and the Millipore (Billerica, MA) filtration technique as described previously (25, 35). The uptake conditions for SR protein (50 µg) were as follows: 22°C for 10 min in 40 imidazole-HCl (pH 7.0), 100 KCl, 20 NaCl, 5 MgCl2, 4 ATP-Na2, 1.3 µCi 45CaCl2, 5 µM Ru-360, and 5 µM calmidazolium (to inhibit Ca2+ uptake of mitochondria and SERCA2, respectively). The 45Ca2+ uptake by SERCA2 was defined as the difference between the rate of 45Ca2+ uptake in a 5 mM K+-oxalate-containing solution in the presence and absence of 5 µM cyclopiazonic acid, a specific inhibitor of SERCA2. The difference in uptake in the presence and absence of 20 µM ryanodine, a special blocker of RyRs, was defined as Ca2+ release via the RyRs (25).

Western blot analysis of RyRs, SERCA2, and NCX. The protein contents of RyRs and SERCA2 in the SR (25) and NCX in the sarcolemmal membrane (18) were determined using Western blot analysis. SR samples (50 µg) and membrane samples (30 µg) were subjected to 10% and 7.5% SDS-PAGE, respectively. Proteins were electrophoretically transferred to polyvinylidene difluoride membranes and probed with anti-RyR antibody (1:500 dilution; ABR, Golden, CO), anti-SERCA2 antibody (1:1,000 dilution; Santa Cruz Biotechnology, Santa Cruz, CA), and anti-NCX1 (1:400 dilution; Abcam, Cambridge, UK), respectively. The membranes were then incubated with horseradish peroxidase-conjugated goat anti-mouse IgG (1:2,500 dilution; Sigma, St. Louis, MO). The immunoreactions were visualized using an ECL detection kit (Amersham), exposed to X-ray film, and quantified using a video documentation system (Gel Doc 2000; Bio-Rad Laboratories, Hercules, CA).

Data presentation and statistical analysis. Data are presented as means ± SE. Significant differences were evaluated using ANOVA or paired and unpaired t-tests as appropriate. P < 0.05 was regarded as statistically significant.


    RESULTS
 TOP
 ABSTRACT
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 GRANTS
 REFERENCES
 
Characteristics of Ca2+ transients and cell shortening in ventricular myocytes from normoxic and IHA hypoxic rats during I/R. During the preischemic phase, no significant difference in resting [Ca2+]i was detected between normoxic and hypoxic groups (0.62 ± 0.04 vs. 0.64 ± 0.04 F405/F485 ratio, n = 16–18; P > 0.05). I/R induced a significant increase in resting [Ca2+]i levels in cardiomyocytes from normoxic rats, but this increase was markedly attenuated in myocytes from IHA hypoxic rats (Fig. 1, A and C). Consistently, Ca2+ transients and cell shortening during preischemia were not altered by IHA hypoxia (Figs. 1, B and C, and 2). After 20 min of ischemia, the amplitude of the Ca2+ transients and cell shortening increased to a similar extent at 3 min of reperfusion (R3) in both groups, accompanied by hypercontracture, and then decreased significantly at 30 min of reperfusion (R30) (Figs. 1, B and C, and 2, A and B). However, the decreases at R30 were significantly smaller in myocytes from the IHA hypoxia group (Fig. 2, A and B). Moreover, a bigger decrease in cell shortening at R30 (decreased by 70.2 ± 7.2%) than that in the Ca2+ transients (36.3 ± 6.1%; P < 0.001) observed in the normoxia group was not detected in the IHA hypoxia group (Fig. 2, A and B). The maximum upstroke velocity (Vmax) of Ca2+ transients and cell shortening increased at R3 but decreased at R30 in both groups, whereas the decrease observed at R30 was significantly attenuated by IHA hypoxia (Fig. 2, C and D). The {tau} values of Ca2+ transients and cell shortening, which represent the decay from the peak and are reverse indicators of the speed of Ca2+ removal from the cytosol or of relaxation in contractility, were significantly prolonged at R3 and R30 in the normoxic group, whereas in hypoxic group, the prolonged {tau} of the Ca2+ transients at R3 was significantly improved and returned completely to preischemia level at R30, accompanied by resumed {tau} of cell shortening during reperfusion (Fig. 2, E and F). These results demonstrate that the IHA hypoxia-induced prevention of Ca2+ overload due to I/R is associated with improved postischemic Ca2+ transients and contractile function.


Figure 1
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Fig. 1. Resting intracellular Ca2+ concentration ([Ca2+]i) level (A) and representative traces showing cell shortening (B and C, bottom) and Ca2+ transients (C, top) recorded from left ventricular myocytes of normoxic and intermittent high-altitude (IHA) hypoxic rats during preischemia (Pre) and ischemia-reperfusion (I/R) injury. Electrical field stimulation was stopped during ischemia. R3 and R30, 3 and 30 min of reperfusion, respectively. Number of myocytes from 8 rats in each group is indicated in parentheses. ##P < 0.01 vs. corresponding values from normoxic group.

 

Figure 2
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Fig. 2. Dynamics of Ca2+ transients and cell shortening in left ventricular myocytes from normoxia and IHA hypoxia groups during preischemia and I/R injury. Analysis of the amplitude (A and B), maximum upstroke velocity (Vmax; C and D) and decay rate time constants ({tau}; E and F) of Ca2+ transients (left) and cell shortening (right). Number of myocytes from 8 rats in each group is indicated in parentheses. *P < 0.05, **P < 0.01, and ***P < 0.001 vs. corresponding preischemic values. #P < 0.05, ##P < 0.01, and ###P < 0.001 vs. corresponding values in normoxia group.

 
Contents and activities of RyRs and SERCA2 in ventricular myocytes from normoxic and IHA hypoxic rats during I/R. To determine the mechanisms underlying IHA hypoxia-improved rise and decay rates of Ca2+ transients during reperfusion, we next examined the time course of the contents and function of SR Ca2+ release channel RyRs and SERCA2 with or without I/R. In the normoxia group, the protein contents of RyRs and SERCA2 decreased markedly at I20, R3, and R30 (Figs. 3A and 4A). IHA hypoxia did not affect the protein contents of RyRs and SERCA2 in the preischemia phase, but it significantly attenuated the I/R-induced decreases at I20, R3, and R30 (Figs. 3A and 4A). The ryanodine-sensitive 45Ca2+ uptake, an indication of Ca2+ release via SR RyRs, was markedly reduced at I20 and R30 in the normoxia group, whereas IHA hypoxia significantly attenuated the depression, although it did not affect baseline level, in Ca2+ release of RyRs (Fig. 3B). SR Ca2+ uptake also was reduced significantly in the normoxic group but was improved by IHA hypoxia (Fig. 4B). Therefore, IHA hypoxia attenuated the I/R-induced inhibition of the contents of SR RyRs and SERCA2 proteins as well as SR Ca2+ release activity via RyRs and Ca2+ uptake via Ca2+ pump ATPase.


Figure 3
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Fig. 3. Protein contents and activities of sarcoplasmic reticulum (SR) ryanodine receptors (RyRs) in left ventricular myocytes from normoxia and IHA hypoxia groups during preischemia and I/R. A: representative immunoblots showing RyR protein content (top) and average densitometric results of immunoblot analysis (bottom) at Pre, 20 min of ischemia (I20), 3 min (R3), and 30 min (R30) of reperfusion. B: changes in ryanodine-sensitive Ca2+ uptake rate of SR at Pre, I20, R3, and R30. Number of rats is indicated in parentheses. *P < 0.05, **P < 0.01, and ***P < 0.001 vs. corresponding preischemic values. #P < 0.05, ##P < 0.01, and ###P < 0.001 vs. corresponding values in normoxia group.

 

Figure 4
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Fig. 4. Protein contents and activities of SR Ca2+ pump ATPase (SERCA2) in left ventricular myocytes from normoxia and IHA hypoxia groups during preischemia and I/R injury. A: representative immunoblots of SERCA2 protein content (top) and average densitometric results of immunoblot analysis (bottom) at Pre, I20, R3, and R30 reperfusion. B: changes in SERCA2 activities at Pre, I20, R3, and R30. Number of rats is indicated in parentheses. **P < 0.01, ***P < 0.001 vs. corresponding preischemic values. #P < 0.05, ##P < 0.01 vs. corresponding values of normoxia group.

 
Changes in caffeine-induced Ca2+ transients in ventricular myocytes from normoxic and IHA hypoxic rats during I/R. To determine whether IHA hypoxia-improved SR function during I/R would affect SR Ca2+ load and Ca2+ transients, we next compared 10 mM caffeine-induced SR Ca2+ release between two groups with or without I/R. Caffeine caused similar large Ca2+ transients at preischemia and comparable increases in the amplitude at I20 and R30 between two groups (Fig. 5, A and B), indicating that IHA hypoxia did not alter I/R-increased SR load. Subsequently, we examined possible involvement of NCX in the IHA hypoxia-improved Ca2+ homeostasis in caffeine-induced SR Ca2+ release using Ni2+ to inhibit NCX (28). Upon addition of 5 mM Ni2+, the amplitude of caffeine-induced Ca2+ transients was increased by 9.2–18.8% in both normoxia and IHA hypoxia groups at preischemia, I20, and R30 compared with these transients without Ni2+ (P < 0.05), but no significant difference was detected between the normoxia and IHA hypoxia groups.


Figure 5
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Fig. 5. Time course of changes in 10 mM caffeine-induced Ca2+ transients in left ventricular myocytes from normoxia and IHA hypoxia groups during preischemia and I/R. A: representative traces at Pre, I20, and R30. B: analysis of amplitude, Vmax, and {tau} of caffeine-induced Ca2+ transients at Pre, I20, and R30. C: representative traces in absence and presence of Ni2+ (5 mM) at R30. D: %increases in {tau} in presence of Ni2+ at Pre, I20, and R30. Number of myocytes from 5 rats in each group is indicated in parentheses. *P < 0.05, **P < 0.01 vs. corresponding preischemia values. #P < 0.05, ##P < 0.01 vs. corresponding values of normoxia group.

 
The upstroke Vmax of the caffeine-induced Ca2+ transients, which reflects RyR activity, was significantly inhibited by I/R (Fig. 5B), whereas IHA hypoxia totally reversed this inhibition at I20 and R30 without affecting the preischemic rise (Fig. 5, A and B). The decay rate of caffeine-induced Ca2+ transients, which mainly reflects NCX activity (3), increased significantly at R20 and R30 in myocytes from the normoxia group; however, IHA hypoxia totally preserved these changes without affecting {tau} during the preischemia phase (Fig. 5, A and B). Addition of 5 mM Ni2+ before caffeine led to similar increases in {tau} at preischemia in both groups, but {tau} increased significantly at I20 and R30 in the IHA hypoxia group compared with the normoxia group (Fig. 5, C and D). These data indicate that NCX is involved in Ca2+ efflux during I/R and in the cardioprotection induced by IHA hypoxia upon Ca2+ exclusion.

Protein content and activity of NCX in ventricular myocytes from normoxic and IHA hypoxic rats during ischemia. To gain further insight into the changes in NCX during ischemia and the effect of IHA hypoxia on it, we examined INa/Ca. Figure 6A shows a set of typical recordings of INa/Ca at preischemia and I20 in myocytes from normoxia and IHA hypoxia groups. There was no difference in the cell capacitance between the normoxia group (126.54 ± 17.53 pF, n = 12) and the IHA hypoxia group (127.37 ± 18.86 pF, n = 10; P > 0.05). During the preischemia phase, no difference between the two groups was observed regarding INa/Ca (Fig. 6B). Ischemia at 20 min in normoxic myocytes significantly decreased both the inward and outward directed INa/Ca and shifted the apparent reversal potential to a positive direction (from –45.96 ± 3.56 mV to –34.63 ± 4.50 mV; P < 0.05) (Fig. 6, C and E). IHA hypoxia totally reserved these changes, with the similar apparent reversal potential of –46.17 ± 4.69 mV at preischemia and –46.26 ± 3.48 mV at I20 (P > 0.05) (Fig. 6, D and E). NCX protein content was not altered by I/R in both groups (Fig. 6F). These data indicate that IHA hypoxia relieves the ischemia-induced depression of NCX activity.


Figure 6
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Fig. 6. Protein contents of Na+/Ca2+ exchange (NCX) and electrogenic NCX currents (INa/Ca) in left ventricular myocytes from normoxic (Nor) and IHA hypoxia (IHA) groups. A: representative traces of Ni2+-sensitive INa/Ca recorded at preischemia and I20 (bottom) by applying descending ramp pulses from +80 mV to –120 mV at a rate of 0.1 Hz (top). BD: current-voltage (I-V) relationships obtained from normoxia and IHA hypoxia groups at preischemia (B), from normoxia group at preischemia and I20 (C), and from IHA hypoxia group at preischemia and I20 (D). E: analysis of inward (at –80 mV) and outward (at +80 mV) INa/Ca at Pre and I20 in cells from normoxia and hypoxia groups. F: immunoblots of NCX at Pre, I20, and R3 and R30. Number of rats is indicated in parentheses. ***P < 0.001 vs. corresponding values.

 

    DISCUSSION
 TOP
 ABSTRACT
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 GRANTS
 REFERENCES
 
In this study, we have provided evidence for the effect of IHA hypoxia on Ca2+ transients and cell contraction and for the protection of IHA hypoxia against I/R injury-induced alterations in Ca2+ handling by preventing changes in the SR and the NCX. Our findings provide novel insights into the cellular and molecular mechanisms underlying the regulation of Ca2+ homeostasis by IHA hypoxia against I/R-induced injury, which may help in the development of a preventive therapeutic regimen against ischemic injury.

Influence of IHA hypoxia on Ca2+ transients and cell shortening during I/R. We have shown that Ca2+ overload that occurred during I/R was accompanied by increases in the amplitude of Ca2+ transients and cellular contracture at the early phase of reperfusion and by decreases in Ca2+ transients and cell shortening at the late phase of reperfusion. These observations are basically similar to previous findings in acidosis (12), anoxia/reoxygenation (29), and I/R (27).

Several mechanisms have been proposed for the cardioprotective effects of IHA hypoxia against I/R injury, such as increases in the oxygen uptake and antioxidative ability (39), activation of PKC isoforms (10), and opening of a mitochondrial ATP-sensitive K+ channel (mitoKATP) (1, 41), but knowledge of target proteins that regulate Ca2+ homeostasis during IHA hypoxia is limited. Our current finding that IHA hypoxia preventing I/R-induced increase in resting [Ca2+]i levels is consistent with findings reported in a previous study (41). The novel findings in this study are that at the late phase of reperfusion, IHA hypoxia attenuates I/R-induced depression of Ca2+ transients and cell shortening without affecting baseline levels of these parameters. This direct evidence indicates that maintaining relatively normal Ca2+ homeostasis plays a crucial role in the cardioprotective effects of IHA hypoxia. This view is supported by our previous data indicating that IHA hypoxia protects the heart against lethal Ca2+ overload injury (36). It has been shown that continuous, chronic hypoxia lasting 2–3 wk decreases the amplitude of Ca2+ transients in association with the prolongation of time to peak and {tau} (25). Interestingly, longer IHA hypoxia lasting 6 wk did not alter baseline parameters, indicating that intermittent hypoxia may have better tolerance to counteract ischemic insults because it provides cells sufficient time to recover from acute damage while deriving the endogenous protective mechanisms.

IHA hypoxia maintains Ca2+ homeostasis during I/R by preventing alterations in major SR Ca2+-handling proteins RyR and SERCA2. The activator Ca2+ is released mainly by RyRs and is taken up by SERCA2 (5). We confirmed the previous observations of the activities and/or protein contents of RyRs and SERCA2 being decreased during I/R (24, 3335). IHA hypoxia attenuated the above changes without affecting the baseline levels of these parameters. The depressed SR Ca2+ uptake due to I/R can be interpreted as the result of decreased protein content of SERCA2 and activity of the pump. Previous studies conducted by us (37) and by others (30) demonstrated that the decreased phosphorylation of PLB, an intrinsic protein of the cardiac SR that reversibly inhibits SERCA2 activity (14) is correlated to the depression of SERCA2 activity and relaxation recovery. Improved SR Ca2+ uptake stimulated by IHA hypoxia is ascribed at least in part to the preserved protein content and upregulated dual-site PLB phosphorylation induced by PKA and CaMKII (37). We previously observed that in rat myocardium, the abbreviation of action potential duration induced by I/R could be improved by IHA hypoxia (38). Because the action potential duration modulates the extent of SR Ca2+ loading (4), the electrophysiological alteration may also contribute to the improvement of SR Ca2+ uptake due to IHA hypoxia during I/R. Consistent with the decreased SR Ca2+ uptake during I/R, SR Ca2+ release from RyRs also decreased at the end of reperfusion. Although the latter may alleviate Ca2+ overload (24, 27), the reduced activity of RyRs would be detrimental to the contractility due to the depression of Ca2+ release from the SR. This notion is supported by our observation that IHA hypoxia-protected activity of RyRs correlates with the improved amplitude and rise of Ca2+ transients and cell shortening. It is also noteworthy that I/R-increased SR load remains unchanged in the IHA hypoxia group. Altogether, these findings indicate that 1) depression in SR Ca2+ handling due to I/R accounts for the decreased amplitude and delayed rise and decay of Ca2+ transients and cell contraction during reperfusion, and 2) IHA hypoxia may suppress I/R-induced cytosolic Ca2+ overload by reserving the protein content and function of RyRs and SERCA2, which could enhance the SR's capability of dealing with transiently overloaded cytosolic Ca2+ during I/R and maintaining a better balance of Ca2+ homeostasis, leading to improvement in contractility.

IHA hypoxia prevents alteration of NCX currents due to ischemia. On the basis mainly of pharmacological studies, it is generally thought that NCX causes Ca2+ overload during I/R (18, 31). The decreased inward and outward INa/Ca, with a shift of apparent reversal potential to a positive direction observed at the late phase of ischemia, may contribute to delayed cytosolic Ca2+ efflux (Fig. 5D) and, as others suggested (32), may lead to Ca2+ overload. Suppression of INa/Ca may be mediated by ischemia-induced intracellular acidosis (32) and decreases in cytosolic ATP levels (8) but not by alterations of protein content (18).

IHA hypoxia totally reversed ischemia-induced inhibition of the inward and outward INa/Ca as well as the shift of apparent reversal potential. This effect may be helpful for cells to alleviate the Ca2+ overload during ischemia by extruding cytosolic Ca2+ more quickly (Fig. 5B), consequently contributing to better relaxation observed in the IHA hypoxia group. The protected function of NCX, together with the improved contents and activities of RyRs and SERCA2 by IHA hypoxia during I/R, indicates that IHA hypoxia increases the capacity of cells to cope with Ca2+ overload by accelerating the removal of cytosolic Ca2+ into the SR and out of cells.

IHA hypoxia can maintain the mitochondrial integrity of both structure and function during Ca2+ overload or I/R by activating mitoKATP (1, 36, 41) and inhibiting the opening of mitochondrial permeability transition pores (40). Thus it significantly improves energy supply to reoxygenated myocardium after acute anoxia (15) and suppresses mitochondrial Ca2+ overload caused by I/R (40). Because the metabolism of mitochondria may affect the function of SR Ca2+-handling proteins (42) and the protection of IHA hypoxia against lethal Ca2+ overload injury can be abolished by inhibiting mitoKATP (36), the beneficial effects of IHA hypoxia on mitochondria may play an important role in its protection of the SR and sarcolemmal Ca2+-handling proteins and also in better recovery of postischemic contractility during I/R.

Beneficial effect of IHA hypoxia on the depressed Ca2+ sensitivity of myofilaments during reperfusion. We also observed that the decreased Ca2+ sensitivity of myofilaments due to I/R is largely suppressed by IHA hypoxia. Because Ca2+ overload directly decreases the Ca2+ sensitivity of myofilaments and depresses contractility during reperfusion (11, 16), improved contraction may be directly related to IHA hypoxia-induced suppression of Ca2+ overload. In addition, mitochondrial reactivation, such as production of energy, also influences the function of myofibrillar enzymes (26). IHA hypoxia protects the mitochondria and ATP production in anoxic reoxygenated myocardium (15) and in I/R myocytes (40); therefore, this mechanism also may be involved in the beneficial effect of IHA hypoxia on the resumed myofilament sensitivity and contractility during reperfusion. Moreover, ischemia preconditioning (2) could reduce acidosis-induced depression of myofilament Ca2+ sensitivity and maximum force (13). Thus the contribution of this mechanism to the beneficial effect of IHA hypoxia requires further future study.

In conclusion, our findings demonstrate that 1) IHA hypoxia does not alter baseline Ca2+ transients, cell shortening, and the contents and function of major Ca2+ handling proteins; 2) IHA hypoxia-attenuated cytosolic Ca2+ overload during I/R is associated with improved dynamics of Ca2+ transients and cell shortening; and 3) these beneficial effects of IHA hypoxia may be ascribed to the maintained contents and activities of RyRs and SERCA2 and the activity of NCX, which contribute to improved cellular contraction and relaxation during reperfusion.


    GRANTS
 TOP
 ABSTRACT
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 GRANTS
 REFERENCES
 
This study was supported by grants from Major and General Programs of the National Natural Sciences Foundation of China (30393133 and 30370536), the Major State Basic Research Development Program of the People's Republic of China (G2000056905), and the Science & Technology Committee of Shanghai Municipality (02JC14038).


    FOOTNOTES
 

Address for reprint requests and other correspondence: H.-T. Yang, Laboratory of Molecular Cardiology, Institute of Health Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, and Shanghai Jiao Tong Univ. School of Medicine, 225 Chong Qing Nan Rd., #1 Bldg., Shanghai 200025, China (e-mail: htyang{at}sibs.ac.cn)

The costs of publication of this article were defrayed in part by the payment of page charges. The article must therefore be hereby marked "advertisement" in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.


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 DISCUSSION
 GRANTS
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