Malignant Hyperthermia: An Inherited Disorder of Skeletal Muscle Ca2+ Regulation

2001 ◽  
Vol 21 (2) ◽  
pp. 155-168 ◽  
Author(s):  
Charles F. Louis ◽  
Edward M. Balog ◽  
Bradley R. Fruen
Keyword(s):  
Skeletal Muscle ◽  
Malignant Hyperthermia ◽  
Muscle Relaxants ◽  
Release Channel ◽  
Major Locus ◽  
Channel Proteins ◽  
Ec Coupling ◽  
Physiologic Mechanism ◽  
Intact Muscle ◽  
Life Threatening

Malignant hyperthermia (MH) is a pharmacogenetic disorder of skeletal muscle characterized by muscle contracture and life-threatening hypermetabolic crisis following exposure to halogenated anesthetics and depolarizing muscle relaxants during surgery. Susceptibility to MH results from mutations in Ca2+ channel proteins that mediate excitation–contraction (EC) coupling, with the ryanodine receptor Ca2+ release channel (RyR1) representing the major locus. Here we review recent studies characterizing the effects of MH mutations on the sensitivity of the RyR1 to drugs and endogenous channel effectors including Ca2+ and calmodulin. In addition, we present a working model that incorporates these effects of MH mutations on the isolated RyR1 with their effects on the physiologic mechanism that activates Ca2+ release during EC coupling in intact muscle.

Heat Production During Anesthetic-Induced Malignant Hyperthermia

2001 ◽  
Vol 21 (2) ◽  
pp. 169-179 ◽  
Author(s):  
Thomas E. Nelson
Keyword(s):  
Skeletal Muscle ◽  
Malignant Hyperthermia ◽  
Heat Production ◽  
Calcium Release ◽  
Calcium Release Channel ◽  
Release Channel ◽  
Inhaled Anesthetics ◽  
Continuous Release ◽  
Gene Coding ◽  
Life Threatening

Malignant hyperthermia (MH) is a pharmacogenetic disease which predisposes to the trigger of a life-threatening, hypermetabolic syndrome by potent inhaled anesthetics and by depolarizing skeletal muscle relaxants. Heat production in the anesthetized MH can be profound with 5-fold increases in oxygen consumption. The trigger anesthetics cause an abnormal, sustained rise in myoplasmic calcium levels. Possible mechanisms by which continuous release of calcium from skeletal muscle sarcoplasmic reticulum stores can produce the profound hyperthermia are discussed. Mutations in the gene coding the ryanodine receptor calcium release channel have been found in MH families and these mutant channels may be the functionsl basis for MH.

Functional analysis of the R1086H malignant hyperthermia mutation in the DHPR reveals an unexpected influence of the III-IV loop on skeletal muscle EC coupling

2004 ◽  
Vol 287 (4) ◽  
pp. C1094-C1102 ◽  
Author(s):  
Regina G. Weiss ◽  
Kristen M. S. O’Connell ◽  
Bernhard E. Flucher ◽  
Paul D. Allen ◽  
Manfred Grabner ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Malignant Hyperthermia ◽  
Voltage Dependence ◽  
Charge Movement ◽  
Caffeine Concentration ◽  
Maximal Conductance ◽  
Release Channel ◽  
Ec Coupling ◽  
Negative Allosteric Modulator ◽  
Similar Decrease

Malignant hyperthermia (MH) is an inherited pharmacogenetic disorder caused by mutations in the skeletal muscle ryanodine receptor (RyR1) and the dihydropyridine receptor (DHPR) α1S-subunit. We characterized the effects of an MH mutation in the DHPR cytoplasmic III-IV loop of α1S (R1086H) on DHPR-RyR1 coupling after reconstitution in dysgenic (α1S null) myotubes. Compared with wild-type α1S, caffeine-activated Ca2+ release occurred at approximately fivefold lower concentrations in nonexpressing and R1086H-expressing myotubes. Although maximal voltage-gated Ca2+ release was similar in α1S- and R1086H-expressing myotubes, the voltage dependence of Ca2+ release was shifted ∼5 mV to more negative potentials in R1086H-expressing myotubes. Our results demonstrate that α1S functions as a negative allosteric modulator of release channel activation by caffeine/voltage and that the R1086H MH mutation in the intracellular III-IV linker disrupts this negative regulatory influence. Moreover, a low caffeine concentration (2 mM) caused a similar shift in voltage dependence of Ca2+ release in α1S- and R1086H-expressing myotubes. Compared with α1S-expressing myotubes, maximal L channel conductance ( Gmax) was reduced in R1086H-expressing myotubes (α1S 130 ± 10.2, R1086H 88 ± 6.8 nS/nF; P < 0.05). The decrease in Gmax did not result from a change in retrograde coupling with RyR1 as maximal conductance-charge movement ratio ( Gmax/Qmax) was similar in α1S- and R1086H-expressing myotubes and a similar decrease in Gmax was observed for an analogous mutation engineered into the cardiac L channel (R1217H). In addition, both R1086H and R1217H DHPRs targeted normally and colocalized with RyR1 in sarcoplasmic reticulum (SR)-sarcolemmal junctions. These results indicate that the R1086H MH mutation in α1S enhances RyR1 sensitivity to activation by both endogenous (voltage sensor) and exogenous (caffeine) activators.

Altered E-C coupling in triads isolated from malignant hyperthermia-susceptible porcine muscle

1995 ◽  
Vol 268 (6) ◽  
pp. C1381-C1386 ◽  
Author(s):  
R. el-Hayek ◽  
M. Yano ◽  
B. Antoniu ◽  
J. R. Mickelson ◽  
C. F. Louis ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Malignant Hyperthermia ◽  
Dihydropyridine Receptor ◽  
Normal Muscle ◽  
Direct Stimulation ◽  
Release Channel ◽  
Malignant Hyperthermia Susceptible ◽  
T Tubules ◽  
Junctional Foot Protein ◽  
Stimulation Of

Triad vesicles were isolated from normal (N) and homozygous malignant hyperthermia-susceptible (MHS) porcine skeletal muscle, and two types of sarcoplasmic reticulum Ca2+ release were investigated: 1) polylysine-induced Ca2+ release (direct stimulation of the junctional foot protein), and 2) depolarization-induced Ca2+ release (stimulation of the junctional foot protein via the dihydropyridine receptor). At submaximal concentrations of polylysine, the rates of induced Ca2+ release from the MHS triads were greater than from normal triads. The T tubules of polarized triads were depolarized by the K(+)-to-Na+ ionic replacement protocol. Higher grades of T-tubule depolarization resulted in higher rates of Ca2+ release from both MHS and normal triads but, when compared at a given grade of T-tubule depolarization, the release rate was always greater from the MHS than from normal triads. Thus the activity of the SR Ca2+ release channel is always higher in MHS than in normal muscle at a given submaximal dose of release trigger. This difference is observed when the channel is stimulated directly by polylysine or indirectly via a depolarization-induced activation of the T-tubule dihydropyridine receptor.

scholarly journals Increased basal metabolic rate in mice susceptible to malignant hyperthermia and heat stroke

2021 ◽  
Vol 154 (9) ◽  
Author(s):  
Matteo Serano ◽  
Laura Pietrangelo ◽  
Cecilia Paolini ◽  
Flavia A. Guarnier ◽  
Feliciano Protasi
Keyword(s):  
Malignant Hyperthermia ◽  
Heat Stroke ◽  
Gene Encoding ◽  
Release Channel ◽  
Western Blots ◽  
Ec Coupling ◽  
Mitochondrial Volume ◽  
Total Body ◽  
Old Mice

Ryanodine receptor type-1 (RYR1) and Calsequestrin-1 (CASQ1) proteins, located in the sarcoplasmic reticulum (SR), are two of the main players in skeletal excitation–contraction (EC) coupling. Mutations in the human RYR1 gene (encoding for the SR Ca2+ release channel) and ablation in mice of CASQ1 (a SR Ca2+ binding protein) cause hypersensitivity to halogenated anesthetics (malignant hyperthermia [MH] susceptibility) and to heat (heat stroke; HS). As both MH and HS are characterized by excessive cytosolic Ca2+ levels and hypermetabolic responses, we studied the metabolism of 4-mo-old mice from two different lines that are MH/HS susceptible: knock-in mice carrying a human MH mutation (RYR1YS) and CASQ1-knockout (ko) mice. RYR1YS and, to a lesser degree, CASQ1-null mice show an increased volume of oxygen consumption (VO2) and a lower respiratory quotient (RQ) compared with WT mice (indicative of a metabolism that relies more on lipids). This finding is accompanied by a reduction in total body fat mass in both Y522S and CASQ1-null mice (again, compared with WT). In addition, we found that RYR1YS and CASQ1-null mice have an increased food consumption (+26.04% and +25.58% grams/day, respectively) and higher basal core temperature (+0.57°C and +0.54°C, respectively) compared with WT mice. Finally, Western blots and electron microscopy indicated that, in hyperthermic mice, (1) SERCA (used to remove myoplasmic Ca2+) and UCP3 (responsible for a thermogenic process that dissipates mitochondrial H+ gradient) are overexpressed, and (2) mitochondrial volume and percentage of damaged mitochondria are both increased. In conclusion, the MH/HS phenotype in RYR1YS and CASQ1-null mice is associated with an intrinsically increased basal metabolism.

scholarly journals Measurement of force and calcium release using mechanically skinned fibers from mammalian skeletal muscle

2018 ◽  
Vol 125 (4) ◽  
pp. 1105-1127 ◽  
Author(s):  
Graham D. Lamb ◽  
D. George Stephenson
Keyword(s):  
Skeletal Muscle ◽  
Muscle Fiber ◽  
Calcium Release ◽  
Muscle Fibers ◽  
Mammalian Skeletal Muscle ◽  
Ec Coupling ◽  
Skeletal Muscle Fibers ◽  
Intact Muscle ◽  
Key Variables ◽  
Coupling Sequence

The mechanically skinned (or “peeled”) skeletal muscle fiber technique is a highly versatile procedure that allows controlled examination of each of the steps in the excitation-contraction (EC)-coupling sequence in skeletal muscle fibers, starting with excitation/depolarization of the transverse tubular (T)-system through to Ca2+ release from sarcoplasmic reticulum (SR) and finally force development by the contractile apparatus. It can also show the overall response of the whole EC-coupling sequence together, such as in twitch and tetanic force responses. A major advantage over intact muscle fiber preparations is that it is possible to set and rapidly manipulate the “intracellular” conditions, allowing examination of the effects of key variables (e.g., intracellular pH, ATP levels, redox state, etc.) on each individual step in EC coupling. This Cores of Reproducibility in Physiology (CORP) article describes the rationale, procedures, and experimental details of the various ways in which the mechanically skinned fiber technique is used in our laboratory to examine the physiological mechanisms controlling Ca2+ release and contraction in skeletal muscle fibers and the aberrations and dysfunction occurring with exercise and disease.

scholarly journals PKA phosphorylation activates the calcium release channel (ryanodine receptor) in skeletal muscle

2003 ◽  
Vol 160 (6) ◽  
pp. 919-928 ◽  
Author(s):  
Steven Reiken ◽  
Alain Lacampagne ◽  
Hua Zhou ◽  
Aftab Kherani ◽  
Stephan E. Lehnart ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Ryanodine Receptor ◽  
Calcium Release ◽  
Calcium Release Channel ◽  
Skeletal Muscle Function ◽  
Release Channel ◽  
Fk506 Binding Protein ◽  
Ec Coupling ◽  
Increased Activity

The type 1 ryanodine receptor (RyR1) on the sarcoplasmic reticulum (SR) is the major calcium (Ca2+) release channel required for skeletal muscle excitation–contraction (EC) coupling. RyR1 function is modulated by proteins that bind to its large cytoplasmic scaffold domain, including the FK506 binding protein (FKBP12) and PKA. PKA is activated during sympathetic nervous system (SNS) stimulation. We show that PKA phosphorylation of RyR1 at Ser2843 activates the channel by releasing FKBP12. When FKB12 is bound to RyR1, it inhibits the channel by stabilizing its closed state. RyR1 in skeletal muscle from animals with heart failure (HF), a chronic hyperadrenergic state, were PKA hyperphosphorylated, depleted of FKBP12, and exhibited increased activity, suggesting that the channels are “leaky.” RyR1 PKA hyperphosphorylation correlated with impaired SR Ca2+ release and early fatigue in HF skeletal muscle. These findings identify a novel mechanism that regulates RyR1 function via PKA phosphorylation in response to SNS stimulation. PKA hyperphosphorylation of RyR1 may contribute to impaired skeletal muscle function in HF, suggesting that a generalized EC coupling myopathy may play a role in HF.

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