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MEMBRANE TRANSPORTERS, ION CHANNELS, AND PUMPS
1Department of Anesthesiology and Critical Care Medicine, Philipps-University Marburg, Germany and 2Institut für Physiologie II, Universitätsklinikum Münster; 3Institute of Physiology, Philipps-University Marburg; 4Klinik und Poliklinik für Anästhesiologie, Universitätsklinikum Würzburg; and 5Department of Anesthesiology and Critical Care, University of Pennsylvania Health System, Philadelphia, Pennsylvania
Submitted 13 May 2007 ; accepted in final form 7 August 2007
| ABSTRACT |
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volatile anesthetics; etomidate; propofol; ion channels
General anesthesia is usually initiated by injection of intravenous anesthetics such as propofol (2,6-diisopropylphenol) or, where better hemodynamic stability is called upon, etomidate [2-ethyl-1-(1-phenylethyl)-1H-imidazole-5-carboxylate]. Unlike the case for volatile anesthetics, little attention has been given to the possible effects of these drugs on K2P channel activity. In this study, we aimed to determine whether activation of TASK channels was common to volatile and intravenous anesthetics. We compared the effects of volatile and intravenous anesthetics on acid-sensitive K+ currents in isolated rat ventricular myocytes and oocytes expressing selected K2P channels. Putzke et al. (31) recently reported, in accord with others (26), that the rat heart expresses TASK-1, TASK-3, and TREK-1, but real-time PCR analyses indicated that purified ventricular myocytes predominantly express TASK-1. Moreover, Putzke et al. (31) found that the novel TASK-1 blocker A293 increased the duration of the action potential in rat ventricular myocytes by about 30%. Thus TASK-1 is probably an important modulator of excitability in both the central nervous system and the heart.
| METHODS AND MATERIALS |
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Isolation of ventricular myocytes. Ventricular myocytes were isolated from collagenase-perfused rat hearts as essentially described elsewhere (9). Myocytes were seeded onto 3-mm diameter cell culture dishes (Nunc, Denmark). After a dish was mounted on the stage of an inverted microscope (Olympus, Japan) equipped with a CCD camera, a U-shaped perfusion chamber was seated on the floor of the dish, and cells were superfused with solution containing (in mM) 140 NaCl, 5.4 KCl, 1 CaCl2, 1 MgCl2, 0.33 NaH2PO4, 10 glucose, and 5 HEPES (pH 7.4 with NaOH).
Patch-clamp experiments with myocytes.
Electrophysiological recordings were performed using the whole cell patch-clamp recording configuration under voltage-clamp conditions. Patch pipettes were pulled from borosilicate glass capillaries (Science Products, Hofheim, Germany) with a two-stage puller (DMZ Universal Puller, Zeitz-Instrumente, Munich, Germany), and the resistance was 4–8 M
. Membrane currents were measured using an Axopatch 200B amplifier (Axon Instruments, Burlingame, CA), and data were analyzed using custom software (LabView, National Instruments, Austin, TX). Slow voltage ramps (6 mV/s) were applied between –60 and +30 mV. The pipette solution contained (in mM) 60 KCl, 65 potassium-glutamate, 5 EGTA, 2 MgCl2, 3 K2ATP, 0.2 Na2GTP, and 5 HEPES (pH 7.2 with KOH). To avoid the confounding effect of specific ion channels, the bath solutions were modified by addition of 1 µM propranolol (nonselective
-receptor blocker), 3 µM nisoldipine (L-type Ca2+ channel blocker), and 2 µM glibenclamide (ATP-sensitive K+ channel blocker). In preliminary experiments, we found that outward current at +30 mV was reduced by 19 ± 7% (n = 4) in the presence of these combined blockers. Na+ currents were minimized by applying a slow voltage-step protocol.
Channel expression in Xenopus oocytes. Oocytes were harvested from Xenopus laevis as previously described (22, 25) and injected with cRNA for human TASK-1 (hTASK-1, 1.5 ng), hTASK-3 (0.05 ng), or gpKir2.1 (2.5 ng). After 48 h incubation, oocytes were placed in a Perspex recording chamber and superfused with solution containing (in mM) 96 NaCl, 2 KCl, 1.8 CaCl2, 1 MgCl2, 2.5 Na-pyruvate, and 5 HEPES (pH 7.4 with NaOH). Whole cell K+ currents were measured by two-electrode voltage clamp. Pipette solutions contained 3 M KCl. All myocyte and oocyte experiments were performed at room temperature. In contrast to the myocyte experiments, all oocyte experiments were performed in the absence of ion channel blockers.
Drugs. Methanandamide was obtained from Calbiochem (Germany), and etomidate and propofol were acquired from Braun (Melsungen, Germany). Sevoflurane and racemic isoflurane were obtained from Abbott (Wiesbaden, Germany), and pure enantiomers of isoflurane were prepared by chiral chromatography. All other chemicals were purchased from Sigma (Germany) or Fluka (Germany). Methanandamide was added directly to solutions, whereas stock solutions of etomidate and propofol were prepared in dimethylsulfoxide. The volatile anesthetics used in this study [halothane, racemic isoflurane, R-(–)-isoflurane, S-(+)-isoflurane, and sevoflurane] were dissolved directly into the solution, which was held in a specially designed syringe (AnaConDa, Hudson RCI, Upplands Väsby, Sweden) impermeable to these agents. Using HPLC and gas chromatography, we confirmed that there was no loss of anesthetic content between the syringe and the recording chamber. We tested volatile anesthetics at a concentration of 1 mM, which approximately corresponds to three times the MAC value for each agent (10), where 1 MAC is defined as the minimal alveolar concentration required to prevent movement in response to a painful stimulus in 50% of animals. Thus volatile anesthetics were tested at the upper end of clinically relevant concentrations.
Statistical analyses. All values are reported as means ± SE with P < 0.05 as a criterion for significance. Data were evaluated using SigmaPlot (Aspire Software International, Leesburg, VA) and an ANOVA was used to test for significant differences were necessary.
| RESULTS |
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50%.
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Effects of sevoflurane and isoflurane R-(–)- and S-(+)-enantiomers on human TASK-1. Given the potential importance of TASK-1 in the mechanism of volatile anesthetic action (30), we investigated whether the halogenated ether sevoflurane activated hTASK-1. Moreover, S-(+)-isoflurane has been reported to increase human TRESK (TWIK-related spinal cord K+ channel) current significantly more than the R-(–)-enantiomer (15), and therefore we also tested hTASK-1 for stereoselectivity. As shown in Fig. 2A, sevoflurane (1 mM) reversibly increased the current in oocytes expressing hTASK-1, whereas acidification almost completely abolished the current. On average, sevoflurane increased hTASK-1 current by a factor of 1.45 ± 0.01 (Fig. 2B; n = 4). Racemic isoflurane (1 mM) similarly increased the hTASK-1 current (Fig. 3A). The pure enantiomers of isoflurane each increased hTASK-1 current, as shown in the example in Fig. 3B, but, unlike the case reported for TRESK (15), we found that there was no significant difference in the stimulatory effect of racemic (n = 8), R-(–)-isoflurane (n = 5), or S-(+)-isoflurane (n = 5) on hTASK-1 current, as summarized in Fig. 3C. Thus sevoflurane and isoflurane, independent of optical configuration, are hTASK-1 openers.
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20% (Fig. 5B). To assess the contribution TASK-1 normally makes to the outward current in myocytes, we employed the TASK-1-selective blocker methanandamide, an analogue of the endogenous cannabinoid anandamide (20). When 10 µM methanandamide was introduced to myocytes, the outward current was decreased from 252 ± 19 to 194 ± 20 pA (n = 18), a 25% reduction (Fig. 5, C and D). In complementary experiments, we varied extracellular pH because TASK-1 and TASK-3 are strongly inhibited by extracellular acidosis (6, 16, 17, 21). As shown in Fig. 5, E and F, a decrease of the extracellular pH from 7.4 to 6.0 inhibited the outward current in ventricular myocytes. On average, acidification of the bath solution decreased current from 252 ± 22 to 189 ± 15 pA (n = 25) at +30 mV, a decrease of
25%. In contrast, alkalinization increased the current from 300 ± 46 to 332 ± 43 pA (n = 10), an 11% increase. Etomidate (1 mM) did not inhibit residual outward current measured at pH 5.0 (Fig. 5F). These data suggest that etomidate inhibits the TASK components TASK-1 > TASK-3 (31) of the outward current in ventricular myocytes.
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| DISCUSSION |
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In the rodent heart, TASK-1 is expressed in ventricular myocytes (13, 31) and richly present in the conduction system (8). We found that about 20% of the outward current in rat ventricular myocytes was acid sensitive at positive potentials, and the strong inhibitory effect of the blocker methanandamide suggested that TASK-1 is the dominant subtype expressed in rat myocytes (19, 31). Recently, Besana and colleagues (1) nicely demonstrated that TASK-1 current could be inhibited in isolated mouse ventricular myocytes by platelet-activating factor, culminating in action potential repolarization abnormalities. In further work, Putzke et al. (31) demonstrated that inhibition of TASK-1 with the novel blocker A293 prolonged the action potential of rat myocytes, indicating that TASK-1 current contributes to normal repolarization. Interestingly, it has been known for a long time that volatile anesthetics shorten the cardiac action potential (10). This effect could be explained, at least in part, by TASK-1 activation.
TASK-1 and IK1 is inhibited by the intravenous anesthetic etomidate but insensitive to propofol.
Our data suggest that "activation" of TASK-1 or TASK-3 is not essential for the mechanism of anesthesia induced by etomidate and propofol. Etomidate, in fact, inhibited hTASK-1 and hTASK-3 expressed in oocytes. Furthermore, consistent with TASK-1 (and possibly TASK-3) inhibition, etomidate inhibited pH-sensitive currents at positive potentials in ventricular myocytes. In addition, we observed that etomidate inhibited IK1 in myocytes. Homomeric Kir2.1 and Kir2.2 have been deduced to be the major channels underlying IK1 in mammalian hearts (36, 37) and, consistent with our myocyte data, we found that etomidate inhibited gpKir2.1 expressed in oocytes. In accord with our observations, Buljubasic et al. (2) reported that 60 µM etomidate weakly inhibited IK1 measured in isolated canine ventricular myocytes. However, etomidate reaches peak concentrations of about 10 µM after intravenous injection (5, 7) and, thus, significant inhibition of TASK-1 or TASK-3 would not be expected following administration of clinically relevant doses. Moreover, hTASK-1 and hTASK-1 were essentially unresponsive to the structurally distinct intravenous anesthetic propofol, even at concentrations exceeding predicted peak plasma concentrations (
40 µM) achieved in a clinical setting (11).
In conclusion, the major novel findings of this study are that volatile and intravenous anesthetics do not share the ability to activate human TASK-1. High concentrations of etomidate, but not propofol, inhibit TASK-1 (and TASK-3), which makes a modest contribution to outward current at positive potentials in the heart. Etomidate additionally inhibits Kir2.x channels. In contrast to the intravenous anesthetics, we found that, in addition to halothane, sevoflurane, and the purified R-(–)- and S-(+)-enantiomers of isoflurane stimulate hTASK-1 activity at clinically relevant concentrations. We speculate that stimulation of TASK-1 current by volatile anesthetics contributes to the cerebral depressive and cardiac action potential shortening actions of these drugs.
| ACKNOWLEDGMENTS |
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| FOOTNOTES |
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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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