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Reactive Oxygen Species Precede Protein Kinase C Anesthesiology 2004; 100:506–14 © 2004 American Society of Anesthesiologists, Inc. Lippincott Williams & Wilkins, Inc. Reactive Oxygen Species Precede Protein Kinase C-␦ Activation Independent of Adenosine Triphosphate–sensitive Mitochondrial Channel Opening in Sevoflurane-induced Cardioprotection R. Arthur Bouwman, M.D.,* René J. P. Musters, Ph.D.,† Brechje J. van Beek-Harmsen, B.S.,‡ Jaap J. de Lange, M.D., Ph.D.,§ Christa Boer, Ph.D.ʈ Background: In the current study, the authors investigated others have shown that protein kinase C (PKC), adeno- the distinct role and relative order of protein kinase C (PKC)-␦, sine triphosphate–sensitive mitochondrial Kϩ (mito ؉ Downloaded from http://pubs.asahq.org/anesthesiology/article-pdf/100/3/506/354512/0000542-200403000-00008.pdf by guest on 01 October 2021 adenosine triphosphate–sensitive mitochondrial K (mito ϩ ؉ K ATP) channels, and reactive oxygen species (ROS) are K ATP) channels, and reactive oxygen species (ROS) in the sig- nal transduction of sevoflurane-induced cardioprotection and necessary in the signal transduction of volatile anesthe- 3,6,7 specifically addressed their mechanistic link. tic–induced cardioprotection. Volatile anesthetics di- Methods: Isolated rat trabeculae were preconditioned with rectly activate PKC8 and induce intracellular ROS pro- 3.8% sevoflurane and subsequently subjected to an ischemic 7 ϩ duction, either through modulation of mito K ATP protocol by superfusion of trabeculae with hypoxic, glucose- function9 or through modulation of the electron trans- free buffer (40 min) followed by 60 min of reperfusion. In 10 addition, the acute affect of sevoflurane on PKC-␦ and PKC-⑀ port chain. ROS modulates PKC function directly via translocation and nitrotyrosine formation was established with oxidative modification or indirectly via tyrosine phos- 11,12 ϩ use of immunofluorescent analysis. The inhibitors cheleryth- phorylation. In addition, mito K ATP channels can rine (6 ␮M), rottlerin (1 ␮M), 5-hydroxydecanoic acid sodium be directly activated by ROS.13 Consequently, a complex (100 ␮M), and n-(2-mercaptopropionyl)-glycine (300 ␮M) were ؉ mechanistic link exists between these three signaling ␦ used to study the particular role of PKC, PKC- , mito K ATP, and ROS in sevoflurane-related intracellular signaling. molecules, and so far, their relative order in anesthetic- Results: Preconditioning of trabeculae with sevoflurane pre- induced cardioprotection has not been established. served contractile function after ischemia. This contractile pres- Cardiomyocytes express a variety of PKC isoforms ؉ ␦ ervation was dependent on PKC- activation, mito K ATP chan- modifying the function of a wide range of (end-effector) nel opening, and ROS production. In addition, on acute target substrates by phosphorylation. The involved PKC stimulation by sevoflurane, PKC-␦ but not PKC-⑀ translocated to the sarcolemmal membrane. This translocation was inhibited isoforms that contribute to preconditioning differ among 14,15 by PKC inhibitors and ROS scavenging but not by inhibition of species and by the type of preconditioning stimulus. ؉ mito K ATP channels. Furthermore, sevoflurane directly in- In particular, the class of novel PKCs, i.e., PKC-␦ and duced nitrosylation of sarcolemmal proteins, suggesting the PKC-⑀, are involved in several preconditioning stimu- formation of peroxynitrite. li.16–20 Recently, an essential role for PKC-␦ activation Conclusions: In sevoflurane-induced cardioprotection, ROS -release but not mito K؉ channel opening precedes PKC-␦ was acknowledged in the signal transduction of isoflu ATP 21 activation. Sevoflurane induces sarcolemmal nitrotyrosine for- rane-induced cardioprotection in isolated rat hearts. mation, which might be involved in the recruitment of PKC-␦ to Furthermore, it has been shown that PKC-⑀ activation is the cell membrane. necessary as a signaling molecule in sevoflurane-induced cardioprotection in guinea pig hearts.22 In addition, dif- THE volatile anesthetic sevoflurane makes the heart ferent translocation patterns in response to volatile an- more resistant to ischemia and reperfusion damage in esthetics have been shown for these PKC isoforms. In experimental models1–3 as well as in humans.4,5 We and response to isoflurane, PKC-␦ translocates to mitochon- dria, whereas PKC-⑀ translocates to the intercalated discs in rat myocardium.21 However, in human atrial tissue, * M.D.–Clinical Research Trainee, ʈ Research Associate, Department of Anes- sevoflurane induced PKC-␦ translocation toward the sar- thesiology and Laboratory for Physiology, † Research Associate, ‡ Laboratory ⑀ Technician, Laboratory for Physiology, § Professor and Chairman, Department of colemma in addition to translocation of PKC- to nuclei, Anesthesiology. intercalated discs, and mitochondriae.23 Received from the Department of Anesthesiology and the Laboratory for In the current study, we studied the contribution of Physiology, Vrije Universiteit Medical Center–Institute for Cardiovascular Re- search Vrije Universiteit, Amsterdam, The Netherlands. Submitted for publication the PKC-␦ and PKC-⑀ isoforms in isolated rat trabeculae September 4, 2003. Accepted for publication November 17, 2003. Dr. Bouwman in the signal transduction of sevoflurane-induced cardio- is supported by ZonMw, The Netherlands Organization for Scientific Research, The Hague, The Netherlands. Presented in part at the Experimental Biology, protection. Second, we investigated whether PKC iso- American Physiological Society Annual Meeting, San Diego, California, April 12, form translocation and/or activation seems to be up- 2003, and the Annual Meeting of the American Society of Anesthesiologists, San Francisco, California, October 14, 2003. stream or downstream of ROS formation and opening of ϩ Address reprint requests to Dr. Boer: Laboratory for Physiology, Vrije Universiteit mito K ATP channels. Our study provides more insight in Medical Center, van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands. the sequence of intracellular signaling involved in Address electronic mail to: [email protected]. Individual article reprints may be pur- chased through the Journal Web site, www.anesthesiology.org. sevoflurane-induced cardioprotection. Anesthesiology, V 100, No 3, Mar 2004 506 MEDIATORS OF SEVOFLURANE-INDUCED CARDIOPROTECTION 507 Fig. 1. Overview of the applied experimen- tal protocols for 17 experimental groups of randomized isolated trabeculae. The proto- cols for functional contractile experiments are indicated as protocols A–E and proto- cols for immunofluorescent staining are -hydroxyde-5 ؍ depicted in F–H. 5-HD ;chelerythrine ؍ canoic acid sodium; CHEL ;n-(2-mercaptopropionyl)-glycine ؍ MPG ؍ sevoflurane; SI ؍ rottlerin; SEVO ؍ ROT simulated ischemia. Downloaded from http://pubs.asahq.org/anesthesiology/article-pdf/100/3/506/354512/0000542-200403000-00008.pdf by guest on 01 October 2021 Materials and Methods and maximal force (Fmax,start), as determined by a post- extrasystolic potentiation protocol, were recorded. Post- Animals extrasystolic potentiation determines the contractile re- The study was performed in accordance with the serve of trabeculae by maximally filling the sarcoplasmic guidelines of the Institutional Animal Care and Use Com- ϩ reticulum with Ca2 .26 Trabeculae that did not stabilize, mittee of the VU University Medical Center (Amsterdam, spontaneously contracted, or had a saturation (ϭ F / The Netherlands). Male Wistar rats (weight, 250–400 g; dev F ) less than 25% or greater than 75% were excluded. Harlan Netherland, Horst, The Netherlands) were anes- max The contractile forces measured by the force trans- thetized with sodium pentobarbital (80 mg/kg intraperi- ducer were digitized and recorded with a sampling toneally; Ceva Sante Animale BV, Maassluis, The Nether- rate of 500 Hz. lands). After 1,000 U heparin (Leo Pharma, Breda, The Netherlands) was intravenously injected, the heart was quickly removed and subsequently retrogradely per- Measurements of Contractile Force fused through the aorta with Tyrode buffer (95% O2 and Trabeculae were randomly assigned to distinct exper- 5% CO2, pH 7.4) at room temperature. Standard solution imental groups as represented in figure 1. Trabeculae contained 120 mM NaCl, 1.22 mM MgSO4.7H2O, 1.99 mM (except for time controls) were subjected to simulated NaH2PO4, 27.0 mM NaHCO3, 5.0 mM KCl, 1 mM CaCl2, ischemia (SI) by switching to superfusion with hypoxic and 10 mM glucose. During dissection, 30 mM 2,3-butane- glucose-free Tyrode (95% N2 and 5% CO2, partial pres- Յ dione monoxime and 15 mM KCl was added to the sure of oxygen [PO2] 4 mmHg) and by increasing the 24 solution to protect the myocardium. Subsequently, a stimulation frequency to 1 Hz. Ischemia decreased Fdev suitable right ventricular trabecula (length, 2–5 mm; to zero followed by an increase in passive force after diameter, Ͻ 0.2 mm),25 running from the free ventricle starting SI. When the passive force increased to 50% of ϭ wall to the tricuspid valve, was carefully dissected. Fmax,start ( start of rigor), trabeculae were subjected to SI for another 40 min and were subsequently reperfused Experimental Setup for Isolated Trabeculae for 60 min with normal oxygenated buffer solution. After Muscles were mounted between a force transducer reperfusion, recovery of Fdev (Fdev,rec) and Fmax (Fmax,rec) (AE801; SensoNor, Horten, Norway) and a micromanip- were determined and expressed as percentages of ulator in an airtight organ bath. After mounting, super- Fdev,start and Fmax,start, respectively. Except
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