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Am J Physiol Cell Physiol 294: C1206-C1214, 2008. First published March 19, 2008; doi:10.1152/ajpcell.90634.2007
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MEMBRANE TRANSPORTERS, ION CHANNELS, AND PUMPS

The vitamin D receptor agonist elocalcitol upregulates L-type calcium channel activity in human and rat bladder

Annamaria Morelli,1 Roberta Squecco,2 Paola Failli,3 Sandra Filippi,3 Linda Vignozzi,1 Aravinda K. Chavalmane,1 Benedetta Fibbi,1 Rosa Mancina,1 Giorgia Luciani,2 Mauro Gacci,4 Enrico Colli,5 Fabio Francini,2 Luciano Adorini,5 and Mario Maggi1,6

Department of 1Clinical Physiopathology, 2Physiological Sciences, 3Pharmacology, 4Urology, University of Florence, Florence; 5Bioxell, Milan; and 6National Institute of Biostructures and Biosystems, Rome, Italy


    ABSTRACT
 TOP
 ABSTRACT
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 REFERENCES
 
Human bladder contraction mainly depends on Ca2+ influx via L-type voltage-gated Ca2+ channels and on RhoA/Rho kinase contractile signaling, which is upregulated in overactive bladder (OAB). Elocalcitol is a vitamin D receptor agonist inhibiting RhoA/Rho kinase signaling in rat and human bladder. Since in the normal bladder from Sprague-Dawley rats elocalcitol treatment delayed the carbachol-induced contraction without changing maximal responsiveness and increased sensitivity to the L-type Ca2+ channel antagonist isradipine, we investigated whether elocalcitol upregulated L-type Ca2+ channels in human bladder smooth muscle cells (hBCs). In hBCs, elocalcitol induced a rapid increase in intracellular [Ca2+], which was abrogated by the L-type Ca2+ channel antagonist verapamil. Moreover, hBCs exhibited L-type voltage-activated Ca2+ currents (ICa), which were selectively blocked by isradipine and verapamil and enhanced by the selective L-type agonist BAY K 8644. Addition of elocalcitol (10–7 M) increased L-type ICa size and specific conductance by inducing faster activation and inactivation kinetics than control and BAY K 8644, while determining a significant negative shift of the activation and inactivation curves, comparable to BAY K 8644. These effects were strengthened in long-term treated hBCs with elocalcitol (10–8 M, 48 h), which also showed increased mRNA and protein expression of pore-forming L-type {alpha}1C-subunit. In the bladder from Sprague-Dawley rats, BAY K 8644 induced a dose-dependent increase in tension, which was significantly enhanced by elocalcitol treatment (30 µg·kg–1·day–1, 2 wk). In conclusion, elocalcitol upregulated Ca2+ entry through L-type Ca2+ channels in hBCs, thus balancing its inhibitory effect on RhoA/Rho kinase signaling and suggesting its possible efficacy for the modulation of bladder contractile mechanisms.

vitamin D analogue; human bladder smooth muscle cells; voltage-gated calcium channel; overactive bladder


IN ALL SMOOTH MUSCLE CELLS, an increase in intracellular calcium concentrations is the key signal to activate the contractile apparatus via calcium/calmodulin-dependent phosphorylation of myosin light chain (MLC). In bladder smooth muscle, intracellular calcium rise and contraction are mainly triggered by muscarinic M3 receptor ligation through an inositol trisphosphate-mediated Ca2+ release from intracellular stores and a concomitant Ca2+ influx across membrane voltage-gated channels (2). The L-type voltage-gated Ca2+ channel is the primary calcium channel present in bladder smooth muscle (2). Accordingly, in the urinary bladder of different species, including humans, M3-mediated contraction requires Ca2+ influx via L-type Ca2+ channel (17). In the human and rat bladder, M3 ligation is also coupled to activation of the calcium-sensitizing RhoA/Rho kinase (ROCK) pathway, enabling a sustained contractile response and tone, independently of intracellular calcium levels (16, 25, 28, 33). Interestingly, involuntary bladder contractions are often attributed to an increased signaling of RhoA/ROCK pathway (17, 5, 23, 28). This is supported by the observation that selective ROCK inhibitors (Y27632, HA-1077) reduce contractions evoked by carbachol without affecting the contractile response to KCl (33). Moreover, Rho kinase inhibition limits bladder hyperactivity and reduces carbachol-induced contractions in bladder strips from spontaneously hypertensive rats (SHR) overexpressing RhoA/ROCK signaling and genetically prone to develop bladder overactivity (21, 22).

Elocalcitol (also known as BXL-628) is a vitamin D receptor (VDR) agonist able to inhibit RhoA/ROCK signaling in both SHR bladder strips and human bladder cells (21), thus, suggesting the use of this molecule in controlling bladder contractile activity. Interestingly, in the normal bladder from Sprague-Dawley (SD) rats, elocalcitol treatment delays the contractile effect of carbachol without changing maximal responsiveness (21). This observation suggests that elocalcitol-induced inhibition of RhoA/ROCK signaling could be balanced by an upregulation of other intracellular contractile pathways to maintain the overall contractile function of the bladder. The key role played by Ca2+ influx via L-type Ca2+ channel for bladder contraction (1) has been clearly demonstrated in mice deficient for the L-type Ca2+ channel pore-forming subunit Cav1.2 (32). In these mice, K+- and carbachol-induced bladder contractions were significantly reduced compared with wild-type mice and partially compensated by ROCK hyperactivity, as demonstrated by an increased sensitivity to Y27632. The reverse could occur under elocalcitol dosing, which reduces ROCK signaling. Since bladder strips from elocalcitol-treated rats exhibited a higher sensitivity to the selective L-type Ca2+ channel antagonist isradipine (21), we hypothesized an upregulation of L-type Ca2+ channel activity. To confirm this hypothesis, we investigated the effects of elocalcitol on bladder smooth muscle L-type calcium channels. Here we report results from electrophysiological, molecular, and intracellular calcium transient studies performed on primary cell cultures of human bladder smooth muscle cells (hBCs), which has been previously characterized (11, 21). Functional studies of in vitro contractility in urinary bladder strips from rats chronically treated with elocalcitol are also described.


    MATERIALS AND METHODS
 TOP
 ABSTRACT
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 REFERENCES
 
Cell cultures. Primary hBCs were obtained and cultured as previously described (11, 21). Three different hBC preparations have been used in the study. All the experiments were performed using the same primary cell cultures after 3 to 6 passages seeded onto 10-mm diameter culture dishes. After 24 h starvation in serum-free medium, cells were incubated in phenol red and serum-free medium containing 0.1% BSA with or without the vitamin D analogue 1-{alpha}-fluoro-25-hydroxy-16,23E-diene-26,27-bishomo-20-epi-cholecalciferol (referred to as elocalcitol) at a fixed concentration (10 nM) for 6, 24, and 48 h (gene expression experiments) or for 48 h (protein expression experiments). Elocalcitol was provided by Dr. Milan Uskokovic (BioXell, Nutley, NJ). For cytosolic free calcium concentration measurements ([Ca2+]i) and electrophysiological studies, hBCs were seeded in their growth medium onto sterile glass coverslips and cultured until 70–80% confluence. Experiments were performed as described below.

[Ca2+]i measurements in hBCs. [Ca2+]i was measured in hBCs using fura-2 applied to microfluorescent digital video imaging, as previously described (14). Subconfluent cells, grown on round glass coverslips, were starved for 24 h in serum-free medium and then were loaded with 4 µmol/l of fura 2-AM and 15% Pluronic F-127 (Molecular Probes, Eugene, OR) for 40 min at 22°C. [Ca2+]i was measured in fura 2-loaded cells in HEPES-NaHCO3 buffer containing (in mmol/l) 140 NaCl, 4.8 KCl, 0.5 NaH2PO4, 12 NaHCO3, 1.2 MgCl2, 1.5 CaCl2, 10 HEPES, and 10 glucose (pH 7.4). Verapamil (Sigma-Aldrich, St. Louis, MO) treatment (10–6 M) was performed for 48 h before [Ca2+]i measurements. Experiments performed in the absence of extracellular calcium were performed in a buffer of a similar composition as above, where in nominally calcium-free buffer EDTA 0.5 mM was added. Thapsigargin (3 x 10–8 M, Sigma-Aldrich) and different concentrations of elocalcitol (10–12-10–7 M) were directly added into the perfusion chamber (time 0 in the time-course graphics) after recording of the [Ca2+]i basal value. Ratio images (340–380 nm excitation, 510 nm emission) were collected every 3 s; calibration curves were obtained as previously described (14). At least eight cells found in the same optical field (using x40 magnification objective) were analyzed for each different treatment, and the value obtained from each single cell was pooled within the same experiment. Each treatment was repeated using three different cell preparations; the number of different experiments is indicated as n.

Electrophysiological recordings. The electrophysiological records were obtained by the whole cell patch-clamp technique in voltage-clamp conditions. Coverslips with adherent cells (hBCs) were superfused at a rate of 1.8 ml/min with an external TEA-Ca2+ bath solution that blocked any ionic current but Ca2+ current and with the following composition (in mM): 10 CaCl2, 145 TEA-Br, and 10 HEPES. The patch pipettes were filled with an internal solution (in mM): 150 CsBr, 5 MgCl2, 10 EGTA, and 10 HEPES. pH was 7.4 and 7.2 for the bath and pipette solution, respectively. When filled, the resistance of the pipettes measured 3–7 M{Omega}. The details of the technique, set up, and electronics are described in Benvenuti et al. (3). Briefly, the patch pipette was connected to a micromanipulator and an Axopatch 200B amplifier (Axon Instruments, Union City, CA). Voltage-clamp protocol generation and data acquisition were controlled by using an output and an input of the A/D-D/A interfaces (Digidata 1200; Axon Instruments) and Pclamp 9 software (Axon Instruments). Currents were low-pass filtered with a Bessel filter at 2 kHz. For the activation pulse protocol the cell was held at –90 mV, and 4-s long step pulses from –80 to 50 mV were applied in 10-mV increments; the protocol used an interval of 20 s between stimulating episodes for recovery. The steady-state inactivation for Ca2+ current (ICa) was studied by two-pulse protocol with a 1-s prepulse to different voltages, 1-s test pulse fixed to 10 mV, and interpulse of 200 ms. We used prepulses and test pulse of 1 s duration since L-type ICa did not completely inactivate: its decay reached a steady-state value after about 0.8 s in control and 0.6 or less after BAY K 8644 or elocalcitol treatments. The interpulse interval to the holding potential of 200 ms was chosen to both prevent substantial recovery from inactivation between activating pulses and allow the activation kinetics of Ca2+ permeability to return to its resting state. Again, in the two-pulse protocol, we used an interval of 20 s between stimulating episodes for recovery. Every activation and inactivation protocols were repeated twice. The steady-state ionic current of activation was evaluated by Ia(V) = Gmax(VVrev)/{1 + exp[(VaV)/ka]} and steady-state inactivation by Ih(V) = I/{1 + exp[–(Vh V)/kh]}, where Gmax is the maximal conductance for the Ia; Vrev is the apparent reversal potential; Va and Vh are the potentials that elicit, respectively, the half-maximal activation and inactivation values; and ka and kh are the steepness factors. The amount of Ca2+ entry was evaluated by the time integral of ICa time course elicited by voltage step at 0 mV. To compare the contribution of the early rising phase respect to that of the falling phase, we calculated the time integral of the first 20 ms and of the following 4 s of the current trace. The membrane capacitance (Cm) was used as an index of cell-surface area assuming that membrane-specific capacitance is constant at 1 µF/cm2. To allow comparison of test current recorded from different cells, the current amplitude and membrane conductance (Gm) were normalized to Cm. Experiments were performed at 22°C.

Real-time quantitative RT-PCR. Isolation of RNA from hBCs was performed using RNAeasy kit (Quiagen, Valencia, CA). cDNA synthesis were performed as previously described (11). The mRNA quantitative analysis (qRT-PCR) was performed according to the fluorescent TaqMan methodology (19). PCR primers and probes specific for mRNA sequence of target genes (CACNA1C/{alpha}1C, CACNA1D/{alpha}1D, and CACNA1S/{alpha}1S) were purchased from Applied Biosystems (Foster City, CA). GAPDH was chosen as reference gene and selected among the endogenous control provided by Applied Biosystems. Amplification and detection were performed with the ABI Prism 7700 Sequence Detection System, as previously reported (21). Each measurement was carried out in duplicate. Data analysis was based on the comparative Ct method according to the manufacturer's instructions (Applied Biosystems).

SDS-PAGE/Western blot analysis. After treatment, cells were washed in phosphate-buffered saline and scraped in 1x MLB lysis buffer (5x lysis buffer: 125 mM HEPES, pH 7.5, 750 mM NaCl, 5% Igepal CA-630, 50 mM MgCl2, 5 mM EDTA, and 10% glycerol) Aliquots containing 80 µg of proteins measured by Bradford's method using Coomassie reagent (Bio-Rad Labs, Hercules, CA) were diluted in reducing sample buffer (62.5 mM Tris, pH 6.8, 10% glycerol, 20% SDS, 2.5% pyronin, and 100 mM dithiothreitol) and loaded onto 7% SDS-PAGE. After separation by SDS-PAGE, proteins were transferred to polyvinyldifluoride membrane (Immobilon-P, Millipore, Bedford, MA). Membranes were blocked overnight at 4°C in 3% BSA in 1x PBS (Sigma-Aldrich)-0.01% Tween and incubated for 5 h with primary antibodies anti-human Cav1.2 (1:500 dilution, Alomone Labs, Jerusalem, Israel) and anti-actin (1:1,000 dilution, Santa Cruz Biotechnology) in 0.2% BSA in 1x PBST followed by peroxidase-conjugated secondary IgG (1:10,000, Santa Cruz Biotechnology). Finally, bands were visualized by home-made chemiluminescence reagent (10) and autoradiographed using hyperfilm (GE Healthcare, Buckinghamshire, UK). Densitometric analysis of band intensity was performed using Photoshop 5.5 software (Adobe Systems, Agrate Brianza, Milan, Italy).

Contractility studies. Male SD rats (275–300 g; Harlan Italy, San Pietro al Natisone, Udine, Italy) were divided into two groups: 1) untreated and 2) treated with elocalcitol, 30 µg/kg by daily oral gavage, for a total of 9 administrations in 2 wk, as previously described (10). Blood for serum calcium measurements was obtained at the end of experimental protocol. Animals were euthanized by cervical dislocation, and the urinary bladders were removed for in vitro contractility studies. Bladder strips, longitudinally dissected, were mounted in 10-ml vertical tissue baths as previously reported (21). High potassium salt solution (KCl), made by equimolar substitution of sodium by potassium, increased the tonic tension of bladder strips, with the maximum effect obtained at 80 mM. The increase in basal tension elicited by a fixed dose of carbachol (10 µM) was referred to that evoked by 80 mM KCl, taken as 100%. The maximal tonic tension elicited by 10 µM carbachol (Sigma-Aldrich) was then taken as 100%, and the contractile effect induced by different concentrations of S-(–)-1,4-dihydro-2,6-dimethyl-5-nitro-4-[2-(trifluoromethyl)phenyl]-3-pyridinecarboxylic acid methyl ester (BAY K 8644, Sigma-Aldrich) was referred to this value. Stock solutions of BAY K 8644 were made in ethanol; carbachol was freshly dissolved in double-distilled water and further dilutions of all substances were made in Krebs solution. Control experiments with BAY K 8644 showed that the final concentrations of ethanol did not modify the vasoconstrictor response to BAY K 8644.

Experiments were performed in accordance to the Italian Ministerial Law no. 116/92 and approved by the Institutional Animal Care and Use Committee of the University of Florence, Florence, Italy.

Serum calcium measurements. Serum calcium levels were measured using a commercially available colorimetric assay (Sigma-Aldrich), according to the manufacturer's instructions, as previously reported (10).

Statistical analysis. Results are expressed as means ± SE. Statistical analysis was performed with one-way ANOVA test followed by Tukey-Kramer post hoc analysis, or, for electrophysiological data, by two-way ANOVA with Bonferroni's correction for multiple comparisons. P < 0.05 was taken as significant. Half-maximal response effective concentration (EC50) was calculated using the computer program ALLFIT (12).


    RESULTS
 TOP
 ABSTRACT
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 REFERENCES
 
Elocalcitol increases [Ca2+]i in hBCs. Exposure of hBCs to elocalcitol (10–12 to 10–7 M) induced a dose-dependent increase in [Ca2+]i (Fig. 1A, –pIC50 = 8.53 ± 0.46). Maximal effect (8-fold increase in [Ca2+]i) was obtained at 10–7 M elocalcitol (Fig. 1A, n = 3–6). Results from a typical experiment are shown in Fig. 1B. Elocalcitol (10–7 M) stimulated a rapid increase in [Ca2+]i, which was abrogated by pretreatment with the L-type calcium channel antagonist verapamil (10–6 M, 48 h). This suggests that elocalcitol-induced [Ca2+]i rise in hBCs is dependent from an influx through L-type Voltage-gated calcium channels. This was confirmed by analyzing the elocalcitol effect in the absence of extracellular calcium, with 0.5 mM EDTA pretreatment. As shown in Fig. 1C, elocalcitol-mediated [Ca2+]i increase in hBCs was undetectable in the absence of extracellular calcium, but restoration of extracellular calcium to physiological levels rescued the efficacy of the VDR agonist (Fig. 1C). A small intracellular calcium increase also occurred in control cells (buffer addition without elocalcitol), but this increase was very small compared with elocalcitol-treated cells (Fig. 1C). This results pointed out to the effect of elocalcitol on calcium influx.


Figure 1
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Fig. 1. Effect of elocalcitol (Elo) on the intracellular cytosolic calcium concentration ([Ca2+]i) in human bladder smooth muscle cells (hBCs). A: dose-response curve of increasing concentrations of Elo in hBCs. Ordinate, ratio of the fura 2 emission spectra at 340- and 380-nm excitation, {Delta}Ratio ({Delta}Ratio = maximal – basal value). Abscissa, different concentrations of Elo (10–12 to 10–6 M). Each value is the mean ± SE of the fluorescence increase in response to elocalcitol stimulation obtained from 3 to 6 different set of experiments performed using three different cell preparations, where at least 8–12 cells were analyzed simultaneously. B, C, and D: representative transient increase in [Ca2+]i in response to a fixed dose of Elo (10–7 M) in hBCs under different experimental conditions. Ordinate left, [Ca2+]i (in nM). Ordinate right, ratio of the fura-2 emission at 340- and 380-nm excitation. Abscissa, time of observation (seconds, s). Addition of Elo to hBCs is indicated by a black diamond ({blacklozenge}). B: effect of Elo in hBCs pretreated (dashed line) or untreated (solid line) with verapamil (10–6 M, 48 h). C: effect of Elo (solid line) or buffer alone (dotted line), administered at the first black diamond ({blacklozenge}), in the absence of extracellular calcium ([Ca2+]out = 0 mM). Extracellular calcium concentration was restored to the physiological value ([Ca2+]out = 1.5 mM) at the second black diamond ({blacklozenge}). D: effect of Elo following depletion of sarcoendoplasmatic reticulum induced by thapsigargin (3 x 10–8 M) in the presence of different concentrations of extracellular calcium (0 and 1.5 mM). Addition of thapsigargin (3 x 10–8 M) and Elo (10–7 M) in hBCs are indicated by an asterisk (*) and a black diamond ({blacklozenge}), respectively.

 
The central role of calcium influx in elocalcitol-induced [Ca2+]i increase was further strengthened by adding elocalcitol after thapsigargin, an agent-depleting calcium from the sarcoendoplasmatic reticulum. Figure 1D shows a typical experiment in hBCs pretreated with thapsigargin (3 x 10–8 M), 12 min before elocalcitol addition. In the presence of extracellular calcium, the effect of 10–7 M elocalcitol was unaffected by thapsigargin but no detectable signal was measured in its absence.

Voltage-gated Ca2+ currents in hBCs. hBCs exhibited voltage-activated ICa. ICa traces representative of three different cell preparations are shown in Fig. 2A (holding potential, HP = –90 mV). The inward transient current recorded from –50 mV indicates the occurrence of T-type ICa (Fig. 2, AF). This current at –40 mV showed a time to peak (tp) at 55 ms and decayed with a time constant ({tau}i) of about 50 ms. The slower decay observed starting from –30 mV, with {tau}i = 130 ms at 0 mV, indicates the activation of L-type Ca2+ channels. The inactivating current was evaluated by fitting the ICa decay by an exponential function plus a constant such as ICa(t) = ICa,decay exp(–t/{tau}i) + ICa,ss, where ICa,ss is a constant. The value of ICa,ss was equal to zero for T-type but different to zero for L-type ICa. This inactivating current value is indicated in Table 1. The peak current of ICa versus V plot (ICa-V) agrees with the occurrence of T- and L-type ICa due to a change in steepness between –30 and –20 mV (Fig. 2G). Accordingly, the selective L-type Ca2+ channel antagonists isradipine (10–7 M, Fig. 2, B and G) or verapamil (10–7 M, data not shown), only blocked the slow L-type ICa. Hence, the decaying phase was faster ({tau}i about 50 ms). The residual ICa, corresponding to T-type ICa, could be reduced in size, using the two-pulse protocol, by prepulsing the test voltage step to 10 mV and was completely blocked by prepulses above –30 mV (Fig. 2B).


Figure 2
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Fig. 2. Effects of Elo on inward Ca2+ currents (in ICa) hBCs. A: representative ICa traces obtained in untreated hBCs. T and L-type ICa are indicated as T and L, respectively. B: representative ICa elicited by voltage step to 10 mV from a holding potential (HP) of –90 mV, before (Con, –90 mV) and after addition of isradipine 10–7 M (Isr, –90 mV) to the bath solution, to block L-type ICa and record only the T-type ICa. The latter is strongly reduced by a prepulse to –30 mV (Isr, –30 mV). C: ICa traces recorded with BAY K 8644 (Bay K, 10–5 M), which was added to the bath solution. D, E, and F: typical ICa recordings in the presence of Elo (D: 10–7 M), after 48 h treatment with Elo (E: 10–8 M, 48 h) in normal solution, or in the presence of BAY K 8644 (F: Elo 48 h + Bay K). HP = –90 mV. G: peak currents versus voltage (ICa-V) plots determined in all the experimental conditions. The maximal amplitude of T-type ICa was 1.9 ± 0.4 pA/pF; the values for L-type ICa are reported in Table 1. In all the panels, ICa is normalized respect to membrane capacitance (Cm). In some panels T- and L-type ICa are indicated as T and L.

 

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Table 1. Effects of elocalcitol and BAY K 8644 on L-type ICa in hBCs

 
ICa-V plot (Fig. 2G) for T-type ICa showed a maximum at about –20 mV (1.9 ± 0.3 pA/pF). To further strengthen these observations, we analyzed steady-state activation and inactivation curves. Figure 3A shows the T-type ICa-V relationships obtained in the presence of isradipine. The related Boltzmann parameters were the following: Gmax = 25.1 ± 3.1 nS/pF; Va = –37.1 ± 3.4 mV; ka = 6.9 ± 2.1 mV; Vrev = 65 mV; Vh = –65.1 ± 5.2 mV; kh = 10.8 mV. Similar results were observed by using verapamil (data not shown). The L-type ICa-V curves, obtained from a HP of –30 mV, are reported in Fig. 3B, and the related Boltzmann parameters are reported in Table 1 (see control). The presence of L-type ICa in hBCs was also confirmed by using a selective L-type Ca2+ channels agonist BAY K 8644 added to the bath solution at a fixed concentration of 10–5 M. As expected, this agonist enhanced L-type ICa size (Fig. 2, C and G), current density, ICa/Cm, and its specific conductance Gm/Cm (Fig. 3C; P < 0.01), whereas it did not affect T-type ICa (Fig. 2, C and G, and 3A). Moreover, BAY K 8644 accelerated the kinetics of L-type ICa by reducing the tp from 72 to 46 ms (Table 1; P < 0.01 vs. control) and by determining a faster decay ({tau}i from 130 to 104 ms; see Table 1, P < 0.05 vs. control). Moreover, it increased the steady-state Ca2+ current (ICa,ss) value. Notably, with respect to control, the Boltzmann parameters of activation and inactivation curves were shifted of 5 (Va, P < 0.01) and 10 mV (Vh, P < 0.001) toward more negative potentials, respectively (Table 1). Because the ka and Vrev values are not substantially different with respect to control, the stronger increase of ICa/Cm with respect to Gm/Cm agrees with the shift of Va (Fig. 3C).


Figure 3
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Fig. 3. Effects of Elo on ICa. A and B: normalized activation and inactivation plots of T- (A) and L-type ICa (B) in control (cont), 5 min after addition of Elo in bath solution and in 48-h Elo-treated cells. The related Boltzmann parameters (see text for definitions) for T-type ICa in control are the following: Gmax/Cm= 25.1 ± 2.1 nS/pF; Va = –37.1 ± 3.2 mV; ka = 6.9 ± 2.2 mV; Vrev 65 ± 8.1 mV; Vh = –65.1 ± 4.1 mV; kh = 10.8 ± 3.1 mV; no significant variation was observed in any treatment or experimental condition. Boltzmann parameters for L-type ICa related to any experimental condition are reported in Table 1. C: maximal L-type ICa density (ICa/Cm) evaluated at the peak and maximal specific ICa conductance (Gm/Cm) in all experimental conditions normalized to control values. D: time course integral of L-type ICa related to the early 20 ms and up to 4 s normalized to control values. Significant differences are indicated by the following: *P < 0.05, ***P <0.01, and ***P < 0.001, respectively, for ICa/Cm and #P < 0.05 and ##P <0.01, respectively, for Gm/Cm versus related controls. §P < 0.05 between the indicated bars.

 
Short-term effects of elocalcitol on Ca2+ currents. ICa were recorded 5 min after addition of elocalcitol to the bath solution. Elocalcitol dosing (10–9 to 10–7 M) affected ICa size and kinetics in a dose-dependent manner (data not shown), with a more evident effect observed at 10–7 M. Therefore, 10–7 M elocalcitol was used in all subsequent experiments. As shown in Figs. 2D and 3A, elocalcitol did not affect T-type but only L-type ICa. The corresponding peak current of ICa-V plot is shown in Fig. 2G, whereas activation and inactivation curves for T-type and L-type ICa are reported in Fig. 3, A and B, respectively. The effect of elocalcitol on L-type ICa was similar to that of BAY K 8644 (compare Fig. 2, C and D), but at variance, elocalcitol induced faster activation and inactivation kinetics of L-type ICa (Table 1) not only versus control (P < 0.001) but also versus BAY K 8644 (P < 0.01). Time to peak (tp) at 0 mV was 72, 46, and 20 ms in control, BAY K 8644, and elocalcitol, respectively (Table 1). The rate of the current decay evaluated by the {tau}i of the exponential decay at 0 mV was 130, 104, and 60 ms in control, BAY K 8644, and elocalcitol, respectively (Table 1). Elocalcitol increased L-type ICa size and the specific conductance (Gm/Cm), but less than BAY K 8644 (Fig. 3C and Table 1). Finally, elocalcitol determined a significant negative shift of the activation and inactivation curves (see Va and Vh value, respectively, in Table 1), as observed with BAY K 8644. Interestingly, elocalcitol differed from BAY K 8644 also in a time-dependent Ca2+ entry, as evaluated by the time integral of ICa: Ca2+ entry induced by elocalcitol, which was higher in the first 10 ms but lower at later time points (4 s, see Fig. 3D and ICa,ss/Cm value in Table 1). T- and L-type ICa did not change significantly during the different protocols denoting that the effect of elocalcitol persisted at least more than 40 min (that is the experiment duration in a single cell) .

Long-term effects of elocalcitol on Ca2+ currents. The long-term effect of elocalcitol on Ca2+ currents was evaluated in hBCs treated for 48 h with the VDR agonist (10–8 M). Again, as shown in Figs. 2, E and G, and 3A, elocalcitol did not affect T-type but only L-type ICa. In L-type ICa, a further significant shift of Va and Vh toward more negative potentials was observed in long-term stimulated cells compared with acute treatments (Table 1). Moreover, both Gm/Cm and ICa/Cm were significantly increased (P < 0.05) in long-term versus acute treatments (Figs. 2, E and G and 3C; elocalcitol 48 h). Interestingly, treating hBCs with 10–8 M elocalcitol for 48 h did not prevent further activation of the Ca2+ channels by 10–5 M BAY K 8644. In fact, this agonist did not modify Va, Vh, and {tau}i values (Table 1) but caused a significant (P < 0.05) further increase of Gm/Cm, ICa/Cm, and time integral at the early 20 ms (Figs. 2, F and G, and 3, C and D; Table 1). These results suggest that BAY K 8644 and elocalcitol operate through different mechanisms on L-type Ca2+ channels. When experiments were performed in hBCs pretreated with verapamil (10–7 M, 48h), elocalcitol did not induce any effect (Fig. 3C).

L-type calcium channel expression in hBCs. To test whether elocalcitol effects on Ca2+ currents in hBCs were associated to changes in the expression of L-type Ca2+ channel, we analyzed gene and protein expression of the corresponding pore-forming {alpha}1 subunit. By qRT-PCR we analyzed in hBCs the mRNA levels of different isoforms of the L-type {alpha}1 subunits, {alpha}1C, {alpha}1D, and {alpha}1S. In good agreement with the known tissue distribution of the L-type {alpha}1 isoforms in smooth muscle cells (13), we found that the mRNA level for {alpha}1C (also referred to as Cav1.2) was the most abundant in hBCs, being 1,000-fold more expressed than the {alpha}1D isoform, whereas mRNA for the {alpha}1S (skeletal muscle isoform) was not detectable, as expected (Fig. 4A). Time-course experiments (6, 24, and 48 h) in hBCs showed that treatment with 10–8 M elocalcitol significantly induced mRNA expression for {alpha}1C only at 48 h (Fig. 4B; P < 0.01, n = 5) and did not affect {alpha}1D expression levels (data not shown). Protein expression results obtained by Western blot analysis were consistent with those from qRT-PCR, confirming the elocalcitol-induced increase in Cav1.2 expression. As shown in Fig. 4C, a band corresponding to the expected molecular mass for Cav1.2 protein, just over 200 kDa, was detected in hBCs. This immunopositivity was significantly increased (P < 0.01, n = 4) in protein extracts from elocalcitol-treated (10–8 M, 48 h) compared those with untreated hBCs (Fig. 4D).


Figure 4
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Fig. 4. Effects of Elo on the expression of L-type calcium channels in hBCs. A: qRT-PCR for the mRNA level of different isoforms of L-type {alpha}1 pore-forming subunit ({alpha}1S, {alpha}1D, and {alpha}1C). Target mRNA level has been normalized on GAPDH mRNA expression. B: qRT-PCR for the mRNA level of {alpha}1C isoform in hBCs treated (solid bar) or not (open bar) with Elo (10–8 M) for 6, 24, and 48 h. {alpha}1C mRNA level, normalized on GAPDH, is reported as percentage over that of untreated cells at the relative time point. C: Western blot analysis of {alpha}1C/Cav1.2 (molecular mass ~200 kDa; top) and actin (molecular mass 44 kDa, bottom) protein expression in hBCs treated or not with Elo (10–8 M for 48 h). Images are representative 7% SDS-PAGE run for protein extracts of two distinct cell preparations (untreated- and Elo-1; untreated- and Elo-2). D: densitometric computer-assisted analysis for Cav1.2 band intensity normalized over actin in hBCs treated or not with Elo (10–8 M for 48 h). Results are expressed as percentage with respect to untreated cells and are reported as means ± SE of 4 experiments.

 
Effects of elocalcitol on L-type calcium channel-mediated bladder contractility in the rat. The ability of elocalcitol to potentiate L-type calcium channel activity in the bladder was finally evaluated in SD rats chronically treated for 2 wk with the VDR agonist. Elocalcitol did not increase calcemia above the normal range (10.37 ± 0.35 mg/dl in elocalcitol-treated vs. 9.51 ± 0.24 mg/dl in untreated rats). Figure 5 shows the effect of increasing concentrations of the selective L-type calcium channel agonist BAY K 8644 (10–11–3 x 10–5 M) on bladder strips from untreated and elocalcitol-treated rats, reported as sigmoid relationships. In both groups, BAY K 8644 induced a dose-dependent increase in tension with a shared EC50 = 0.48 ± 0.14 µM. Interestingly, elocalcitol treatment significantly increased the maximal contractile effect of BAY K 8644, with Emax values of 40.6 ± 1.9 and 117 ± 6.4, for untreated and treated rats, respectively (P < 0.01). At variance, maximal responsiveness to a fixed dose of carbachol (10 µM) was unchanged in bladder strips from elocalcitol-treated rats compared with untreated (Fig. 5, inset).


Figure 5
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Fig. 5. Effect of Elo on L-type calcium channel-mediated bladder contractility in the Sprague-Dawley (SD) rat. Effects of increasing concentrations of the selective L-type Ca2+ channel agonist (BAY K 8644, 0.01 nM–30 µM) on the basal tone of bladder strip preparations from untreated and Elo-treated (30 µg/kg for 2 wk) rats are reported. Ordinate, contractile activity, expressed as a percentage of the maximal response obtained with carbachol (10 µM). Abscissa, concentration of BAY K 8644. Inset: response to 10 µM carbachol of bladder strips from untreated and Elo-treated rats, expressed as percentage of the maximal response obtained with KCl (80 mM). Data are expressed as means ± SE from at least 9 rats per group. The relative EC50 and Emax values are reported in the text.

 

    DISCUSSION
 TOP
 ABSTRACT
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 REFERENCES
 
Smooth muscle cells of the bladder are electrically excitable (1). It is well known that initiation of the action potential results from the activity of L-type Ca2+ channels, the primary molecular gateway regulating extracellular calcium influx into the cytosol (1). In the bladder, this Ca2+ current is not only involved in refilling intracellular stores but also triggers Ca2+ release via ryanodine receptors, Ca-calmodulin-dependent MLC phosphorylation, and finally contraction (24). In this study, we demonstrate for the first time that in hBCs calcium influx through L-type Ca2+ channels is regulated by the VDR agonist elocalcitol. Our previous studies have demonstrated that the bladder is a target of VDR agonists, and elocalcitol was able not only to reduce in vitro growth and change contractile phenotype (11) but also to inhibit RhoA/ROCK calcium-sensitizing pathway both in rat bladder and in hBCs (21). Here, we report the ability of elocalcitol to increase [Ca2+]i in hBCs by inducing a calcium influx from extracellular source, mainly involving the opening of L-type Ca2+ channels. In addition, electrophysiological measurements show that elocalcitol increases total L-type Ca2+ current, current density (ICa/Cm), specific conductance (Gm,Cm), and the amount of Ca2+ influx, as evaluated by the time-course integral. Overall, these observations suggest a plausible role for elocalcitol in regulating Ca2+ effects in bladder smooth muscle contractions.

L-type Ca2+ channels are heteromeric macromolecules composed of a pore-forming {alpha}1 (or CaV1) subunit that can generate Ca2+ currents, plus ancillary {alpha}2/{delta}, β, and, in skeletal muscle, {gamma} subunits (see Ref. 9 for review). According to the proposed nomenclature of voltage-gated Ca2+ channels, the CaV1 family (CaV1.1 through CaV1.4) includes channels containing {alpha}1S, {alpha}1C, {alpha}1D, and {alpha}1F, which specifically mediate L-type Ca2+ currents, with the {alpha}1C (also referred to as CaV1.2) being the most expressed in smooth muscle cells (13). Accordingly, hBCs showed a predominant {alpha}1C mRNA expression.

L-type Ca2+ channels belong to the "high-threshold" activation type of calcium channels, because they open under large depolarization of the plasma membrane. In hBCs, we found that both BAY K 8644 and elocalcitol activate calcium currents, a novel observation compatible with L-type Ca2+ channel activation. Moreover, the steady-state activation and inactivation curves relative to the L-type Ca2+ channel opening were clearly shifted more toward negative potential by acute exposure to elocalcitol and, to a greater extent, after long-term treatment. These findings suggest an improved and earlier excitability of hBCs in the presence of elocalcitol. Thus elocalcitol may induce influx of Ca2+ into hBCs at potentials close to the resting value. In addition, the faster inactivation kinetics observed in elocalcitol-treated versus untreated hBCs may be responsible for a time-limited faster change of intracellular calcium that could promote phasic contractions and conversely could inhibit a sustained contraction. About twofold increase of specific channel conductance and about 2.5-fold faster time course of L-type Ca2+ currents were observed under elocalcitol stimulus. In good agreement with our findings, 1,25-dihydroxyvitamin D3, 1,25(OH)2D3, the natural vitamin D3 hormone, facilitates the opening of L-type Ca2+ channels in osteoblastic-like osteosarcoma ROS 17/2.8 cells at membrane potentials close to the resting value (8). Indeed, effects of 1,25(OH)2D3 on cell excitability via modulation of calcium influx through L-type Ca2+ channels have been described in a variety of cell systems, including neuronal (6, 7) and bone (8, 18, 29, 34) cells, as well as diverse muscle cell types, such as skeletal (31), cardiac (27), and vascular smooth muscle (4). In osteoblasts, along with genomic effects on gene transcription, 1,25(OH)2D3 also promotes nongenomic rapid responses by acting on L-type Ca2+ channel activities (8, 18, 29, 34). In hippocampal neurons, 1,25(OH)2D3 reduces age-related changes associated with Ca2+ dysregulation (6) and, in particular, confers neuroprotection by downregulating L-type Ca2+ channel expression (7). Finally, in isolated cardiac muscle cells the L-type Ca2+ channel blockers nifedipine and verapamil abolished the increase in Ca2+ uptake produced by 1,25(OH)2D3 (27).

In the present studies, in addition to rapid, nongenomic actions on Ca2+ fluxes, we found that both gene and protein expression levels of pore-forming {alpha}1C subunit were significantly upregulated in hBCs after 48 h treatment with elocalcitol, suggesting also long-term genomic effects of the VDR agonist on L-type Ca2+ channel expression. In contrast to our results, studies performed in osteoblastic (20) and neuronal (7) cells showed that chronic treatment with 1,25(OH)2D3 downregulates {alpha}1C mRNA expression. This apparent discrepancy may reflect the cell-type selectivity of elocalcitol-mediated actions, which depend on coactivators and corepressors selectively expressed in different cell types (15). Alternatively, this discrepancy may reflect a different functional role played by calcium entry through L-type channels in different cell types.

In any case, the molecular evidence for increased Cav1.2/{alpha}1C expression by elocalcitol treatment of hBCs is further strengthened by our electrophysiological data, obtained in hBCs chronically treated with the VDR agonist. Indeed, a significant shift of the activation and inactivation membrane potentials toward more negative values was observed in long-term stimulated cells compared with acute treatments, along with an increase of L-type ICa amplitude and specific channel conductance (Gm/Cm). In addition, the functional enhancement in sensitivity to L-type calcium agonist (BAY K 8644, present study) and antagonist (isradipine; Ref. 21) in the bladder of SD rats chronically treated for 2 wk with elocalcitol, further support a positive effect of elocalcitol on L-type Ca2+ channel.

This novel property of elocalcitol regulating opening and functional activity of L-type Ca2+ channel in hBCs could open new opportunities for VDR ligation in bladder pharmacology. Precisely coordinated contractions of different smooth muscle components are required to ensure a normal bladder function, which involves not only the ability to fill and store urine at low pressure, but also to generate sufficient force for complete bladder emptying. The contractile force of bladder smooth muscle cells is dependent on several mechanisms that regulate the phosphorylated status of MLC, through a balance between the activity of MLC kinase (calcium dependent) and MLC phosphatase. The activity of the latter is negatively regulated by calcium-independent mechanisms, mainly RhoA/ROCK-mediated. Elocalcitol inhibits the RhoA/ROCK signaling, thus reducing calcium sensitizing-mediated contractions (21), but also activates L-type calcium channels, as shown in the present study, thus promoting calcium-dependent contractile mechanisms. These apparently antithetic activities of elocalcitol could explain its overall lack of effect on carbachol-stimulated bladder contractility, as observed after chronic dosing in different rat models (21, 26, and present study). Therefore, elocalcitol does not simply suppress bladder contractions, but modulates bladder contractility, by decreasing calcium sensitization and increasing L-type-mediated calcium entry.

In conclusion, the present studies identify a novel action of the VDR agonist elocalcitol, by showing its capacity to regulate calcium entry through L-type Ca2+ channels in the hBCs. This suggests a possible efficacy of elocalcitol for the modulation of bladder contractile mechanisms. Promising preclinical studies performed in a rat model of bladder outlet obstruction (BOO) have demonstrated the efficacy of elocalcitol in reducing the negative functional changes of the bladder smooth muscle associated with BOO, thus preserving the emptying ability of the bladder (26). Moreover, a proof of concept clinical study has recently demonstrated the ability of elocalcitol to ameliorate overactive bladder symptoms compared with placebo (30).


    FOOTNOTES
 

Address for reprint requests and other correspondence: M. Maggi, Andrology Unit, Dept. of Clinical Physiopathology, Univ. of Florence, V.le G. Pieraccini, 6 50139 Florence, Italy (e-mail: m.maggi{at}dfc.unifi.it)

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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