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Department of Physiology, The University of Western Ontario, London, Ontario, Canada N6A 5C1
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ABSTRACT |
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Diminished
Ca2+-sequestering activity of the
sarcoplasmic reticulum (SR) is implicated in the age-associated slowing
of cardiac muscle relaxation. In attempting to further define the
underlying mechanisms, the present study investigated the impact of
aging on the contents of major SR
Ca2+-cycling proteins and SR
protein phosphorylation by endogenous Ca2+/calmodulin-dependent protein
kinase (CaM kinase). The studies were performed using homogenates and
SR vesicles derived from the ventricular myocardium of adult (6-8
mo old) and aged (26-28 mo old) Fischer 344 rats. Western
immunoblotting analysis showed no significant age-related difference in
the relative amounts of ryanodine
receptor-Ca2+-release channel
(RyR-CRC), the Ca2+-storage
protein calsequestrin,
Ca2+-pumping ATPase
(Ca2+-ATPase), and
Ca2+-ATPase-regulatory protein
phospholamban (PLB) in SR or homogenate. On the other hand, the
relative amount of immunoreactive CaM kinase II (
-isoform) was
~50% lower in the aged heart. CaM kinase-mediated phosphorylation of
RyR-CRC, Ca2+-ATPase, and PLB was
reduced significantly (~25-40%) in the aged compared with adult
rat. ATP-dependent Ca2+-uptake
activity of SR and the stimulatory effect of calmodulin on
Ca2+ uptake were also reduced
significantly with aging. Treatment of SR vesicles with anti-PLB
antibody (PLBab) invoked relatively less stimulation of
Ca2+ uptake in the aged (
26%)
compared with the adult (
65%) rat. Ca2+-ATPase but not PLB underwent
phosphorylation by CaM kinase in PLBab-treated SR with resultant
stimulation of Ca2+ uptake. The
rates of Ca2+ uptake by
PLBab-treated SR were significantly lower (45-55%) in the aged
compared with adult rat in the absence and presence of calmodulin.
These findings imply that changes in the intrinsic functional
properties of SR Ca2+-cycling
proteins and/or their phosphorylation-dependent regulation contribute to impaired SR function in the aging heart.
ryanodine receptor; calcium adenosinetriphosphatase; calsequestrin; phospholamban; calcium/calmodulin-dependent protein kinase
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INTRODUCTION |
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IN SEVERAL MAMMALIAN SPECIES, including humans, postmaturational aging is accompanied by a prolongation of cardiac muscle contraction duration (22, 23). The prolonged contraction duration in the senescent heart is caused by an age-associated increase in time to peak tension and a slower rate of relaxation (12, 17, 22, 23). The cellular and molecular mechanisms underlying these age-associated changes have only been partially defined to date. Evidence from a number of studies using the rat model suggests that an age-associated decline in the Ca2+-sequestering activity of the sarcoplasmic reticulum (SR) Ca2+-ATPase is a major factor contributing to the slowing of cardiac muscle relaxation seen with aging (12, 30, 31, 43). An age-related decrease in the Ca2+-ATPase content of rat cardiac SR has been reported in some studies (41) but not others (17, 30, 31), and the mechanistic basis for the diminished Ca2+-sequestering activity of the SR in the aging heart remains to be resolved.
Ca2+-cycling proteins in the SR,
in addition to Ca2+-ATPase,
include the intraluminal
Ca2+-storage protein calsequestrin
(28), the ryanodine
receptor-Ca2+-release channel
(RyR-CRC) (5), and the
Ca2+-ATPase-regulatory protein
phospholamban (28, 40). Age-related changes in the content of these SR
Ca2+-cycling proteins
and/or their functional properties can, conceivably, influence
the time course of contraction and relaxation as well as contractile
force development. However, very little is known about the impact of
aging on these SR Ca2+-cycling
proteins in cardiac muscle. Studies using rat cardiac SR indicated that
the ability of phospholamban to undergo phosphorylation by exogenous
cAMP-dependent protein kinase (PKA) in vitro and the stimulatory effect
of phospholamban phosphorylation on
Ca2+ uptake are not altered by
aging (18). On the other hand, in studies using isolated perfused
beating rat hearts,
-adrenergic-mediated cAMP accumulation and
phospholamban phosphorylation were found to be significantly reduced
with aging (17). Also, age-associated decrements in the inotropic and
lusitropic responses to
-adrenergic stimulation have been observed
in studies using intact hearts and cardiac tissue preparations (8, 13,
17). Besides PKA, Ca2+/calmodulin-dependent protein
kinase (CaM kinase), associated with cardiac SR (and present in the
cytosol), is implicated in the modulation of the
Ca2+-uptake and -release functions
of the SR through phosphorylation of phospholamban (7, 20, 35, 39),
RyR-CRC (14, 42, 45), and
Ca2+-ATPase (15, 44, 47, 48). To
our knowledge, the effect of aging on CaM kinase-mediated
phosphorylation of the SR
Ca2+-cycling proteins has not been
reported. The present study was designed to investigate the influence
of aging on the contents of major SR
Ca2+-cycling proteins and their
phosphorylation by the SR-associated CaM kinase in rat myocardium.
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METHODS |
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Animals. Male virgin Fischer 344 rats, ages 6-8 mo (adult animals, 340-375 g body wt) and 26-28 mo (aged animals, 330-385 g body wt), were obtained from the aging Fischer rat colony of the National Institute of Aging (maintained by Harlan Industries). On arrival, these animals were housed individually in plastic cages in the Health Sciences Center animal care facility of this institution at 23°C on a 12:12-h light-dark cycle. The animals had free access to food (Purina Chow containing 20% protein) and water and were used for experiments within 2 wk.
Chemicals.
Reagents for electrophoresis were obtained from Bio-Rad Laboratories
(Mississauga, ON, Canada),
[
-32P]ATP was
purchased from Amersham (Oakville, ON, Canada), and 45CaCl2
was from NEN (Mississauga, ON, Canada). Monoclonal antibodies against
ryanodine receptor (1), SR
Ca2+-ATPase (19), and
calsequestrin (21) were purchased from Affinity BioReagents (Golden,
CO). Anti-phospholamban monoclonal antibody (38) was obtained from
Upstate Biotechnology (Lake Placid, NY). Anti-
-CaM kinase II
polyclonal antibody was a generous gift from Dr. H. A. Singer (Weis
Center for Research, Danville, PA). All other chemicals were from Sigma
Chemical (St. Louis, MO) or BDH Chemicals (Toronto, ON, Canada).
Isolation of SR vesicles.
SR-enriched membrane vesicles were prepared from the ventricular
myocardium of adult and aged rats as described previously (37). The wet
weight of the ventricles averaged 0.82 ± 0.06 and 0.92 ± 0.05 g, respectively, in the case of adult and aged rats. After isolation,
the SR vesicles were suspended in 10 mM Tris-maleate (pH 6.8)
containing 100 mM KCl and stored at
80°C after
quick-freezing in liquid N2.
Protein was determined by the method of Lowry et al. (27) using bovine
serum albumin as standard. The yield of SR membranes from adult and
aged hearts was similar (~2 mg protein/g wet tissue). Enzyme markers
were assessed as described previously (30). Mitochondrial contamination
was ~12% as assessed from azide-sensitive
Ca2+-Mg2+-ATPase
activity measured in the presence of 8.2 µM free
Ca2+, 5 mM
MgCl2, 5 mM ATP, and 5 mM
NaN3. Sarcolemmal contamination was ~10% as assessed from ouabain-sensitive
Na+-K+-ATPase
activity measured in a reaction medium composed of 50 mM imidazole-HCl
(pH 7.5), 100 mM NaCl, 10 mM KCl, 5 mM
MgCl2, 5 mM ATP, 1 mM ouabain, and
125 µg SDS/mg SR protein (30). The Ca2+-stimulated ATPase activity of
SR membranes (measured in the presence of 8.2 µM free
Ca2+, 5 mM
MgCl2, and 5 mM ATP) amounted to
191 ± 20 nmol
Pi · mg protein
1 · min
1.
No age-related difference was observed in these enzyme markers. Furthermore, as documented extensively in our previous studies (17, 30,
31), the polypeptide composition and relative purity of SR membranes
isolated from adult and aged rat hearts were essentially similar (also
see RESULTS).
Preparation of muscle homogenates. In addition to SR, homogenates from adult and aged hearts were used in some experiments. The homogenates were prepared by homogenizing the ventricular tissue in 10 volumes (based on tissue wt) of 10 mM Tris-maleate-100 mM KCl buffer (pH 6.8) using a Polytron PT-10 homogenizer (three 10-s bursts with 30-s interval between bursts; setting 8; Brinkman Instruments, Westbury, NY). The homogenates were filtered through four layers of cheesecloth and used for experiments.
Immunoblotting of SR Ca2+-cycling proteins. Western immunoblotting techniques were used for the detection and estimation of the relative amounts of SR Ca2+-cycling proteins in adult and aged rat hearts. For immunoassay of RyR-CRC, Ca2+-ATPase, phospholamban, calsequestrin, and CaM kinase, homogenate (25 µg protein/lane) or SR (25 µg protein/lane) samples were first subjected to SDS-PAGE in 6% (for RyR-CRC), 10% (for Ca2+-ATPase, calsequestrin and CaM kinase), or 15% (for phospholamban) gels. The protein samples separated by gel electrophoresis were then electroblotted to nitrocellulose membranes. The membranes were probed with antibodies specific for cardiac RyR-CRC [monoclonal (1), dilution 1:2,500], cardiac sarco(endo)plasmic reticulum Ca2+-ATPase (SERCA2) [monoclonal (19), dilution 1:3,000], phospholamban [monoclonal (38), 0.5 µg/ml], calsequestrin [monoclonal (21), dilution 1:1,000], or CaM kinase II (polyclonal, dilution 1:1,000). A peroxidase-linked anti-mouse (for RyR-CRC, Ca2+-ATPase, phospholamban, and calsequestrin) or anti-rabbit (for CaM kinase) IgG at a dilution of 1:5,000 was used as the secondary antibody. Protein bands reactive with antibodies were visualized using the enhanced chemiluminescence detection system from Amersham and quantified using laser-scanning densitometry of the Western immunoblots. The Western blotting detection system was determined to be linear with respect to the amount of SR/homogenate protein in the range of 10 to 40 µg using the laser-scanning densitometry method.
Phosphorylation assay.
The standard incubation medium (total volume 50 µl) for
phosphorylation by endogenous CaM kinase contained 50 mM HEPES (pH 7.4), 10 mM MgCl2, 200 µM
CaCl2, 200 µM EGTA, 1 µM
calmodulin, 0.8 mM
[
-32P]ATP (specific
activity 250-350
counts · min
1 · pmol
1),
and SR (30 µg protein). Identical amounts of SR protein from adult
and aged hearts were used in each individual experiment. The initial
free Ca2+ concentration,
determined using the computer program of Fabiato (11), was 5.4 µM.
The phosphorylation reaction was initiated by the addition of
[
-32P]ATP after
preincubation of the rest of the assay components for 3 min at
37°C. The reaction was terminated after 2 min by the addition of 15 µl of SDS-sample buffer, and the samples were analyzed in 4-18%
SDS-polyacrylamide gels. The gels were stained with Coomassie brilliant
blue, dried, and autoradiographed (18). Quantification of
phosphorylation was carried out by liquid scintillation counting after
excision of the radioactive bands from the gels (18). The
Ca2+- and calmodulin-dependence of
phosphorylation was monitored in parallel assays in which
Ca2+ (1 mM EGTA present)
and/or calmodulin was lacking in the assay medium.
Determination of
Ca2+ uptake.
ATP-dependent, oxalate-facilitated
Ca2+ uptake was determined in
cardiac SR using the Millipore filtration technique as detailed elsewhere (30). The standard incubation medium (total volume 250 µl)
contained 50 mM HEPES (pH 7.2), 120 mM KCl, 5 mM
NaN3, 5 mM ATP, 6 mM
MgCl2, 0.1 mM EGTA, 25 µM
ruthenium red, 5 mM potassium oxalate, SR membranes (7.5 µg protein),
and differing amounts of
45CaCl2
to yield the desired free Ca2+
concentration. The initial concentration of free
Ca2+ in the assay medium was
determined using the computer program of Fabiato (11). To evaluate the
effect of endogenous CaM kinase-mediated phosphorylation on
Ca2+ uptake, the assays were
performed in the absence of calmodulin and in the presence of 1 µM
calmodulin in the incubation medium. The
Ca2+-uptake reaction was initiated
by the addition of SR to the rest of the assay components preincubated
for 3 min at 37°C and was allowed to proceed for 2 min, during
which the Ca2+-uptake rates were
found to be linear. In separate experiments (using
[
-32P]ATP and
nonradioactive CaCl2), it was
established that the Ca2+-uptake
assay conditions used permitted maximal phosphorylation of SR proteins
within the first 45 s after incubation in the presence of calmodulin.
Treatment of SR with anti-phospholamban monoclonal antibody. In some experiments, the SR membranes were treated with anti-phospholamban monoclonal antibody (38) before the effects of Ca2+/calmodulin-dependent phosphorylation on Ca2+ uptake were determined. The SR membranes (60 µg protein) were incubated in a medium (total volume 110 µl) containing 10 mM Tris-maleate (pH 6.8), 120 mM KCl, and 40 µg anti-phospholamban monoclonal antibody for 10 min at 24°C and for an additional 20 min at 4°C. Subsequently, the SR membranes were recovered by centrifugation (at 15,000 rpm for 40 min in a microcentrifuge) and used for phosphorylation and Ca2+-uptake assays. SR membranes subjected to the same experimental protocol in the absence of anti-phospholamban monoclonal antibody in the incubation medium served as the control for these experiments.
Data analysis. Results are presented as means ± SE. Statistical significance was evaluated with the Student's t-test; P < 0.05 was taken as the level of significance.
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RESULTS |
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SR Ca2+-cycling proteins in adult and aged hearts. Major Ca2+-cycling proteins in the SR include the RyR-CRC, through which Ca2+ is released into the cytosol on myocyte excitation to induce muscle contraction (5); Ca2+-ATPase, which actively sequesters Ca2+ back into the SR lumen to promote muscle relaxation (28); calsequestrin, which serves to bind and store Ca2+ within the SR lumen (28); and phospholamban, which serves to regulate Ca2+-ATPase function (7, 28, 40). In the present study, we utilized monoclonal antibodies specific for each of these SR Ca2+-cycling proteins to perform Western immunoblotting analysis of their relative amounts in cardiac SR isolated from adult and aged rats. The results from these experiments are summarized in Fig. 1. No significant age-related difference was evident in the relative amounts of RyR-CRC, Ca2+-ATPase, calsequestrin, or phospholamban in cardiac SR. Similar findings were also obtained in experiments in which Western immunoblotting analysis of these proteins was performed using unfractionated cardiac muscle homogenates from adult and aged rats (results not shown). Analysis of the phospholamban-to-Ca2+-ATPase ratio in individual experiments showed variation in the range of 3 to 25% (data pooled from 10 separate experiments yielded an average value of 14 ± 3%); this variation was found to be independent of age.
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CaM kinase and SR protein phosphorylation in adult and aged hearts.
CaM kinase II, associated with the SR (and present in the cytosol), is
implicated in the regulation of the
Ca2+-uptake and -release functions
of cardiac SR through phosphorylation of phospholamban (7, 20, 35, 40),
RyR-CRC (14, 42, 45), and
Ca2+-ATPase (15, 44, 47, 48). In
the present study, we utilized a CaM kinase II polyclonal antibody
(specific for the
-isoform predominantly expressed in the heart) to
perform Western blotting analysis of this enzyme in adult and aged rat
hearts. The relative amount of CaM kinase II in cardiac muscle
homogenates and SR membranes was found to be significantly lower
(~50%) in the aged compared with adult rat heart (Fig.
2).
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Effect of CaM kinase-mediated phosphorylation on Ca2+ uptake by SR. To assess the effect of endogenous CaM kinase-mediated phosphorylation on Ca2+ uptake, ATP-dependent, oxalate-facilitated Ca2+ uptake by SR was determined in the absence and presence of calmodulin in the assay medium (see METHODS). Under the experimental conditions employed, the addition of calmodulin to the Ca2+-uptake assay medium promotes phosphorylation of CaM kinase substrates in the SR (RyR-CRC, Ca2+-ATPase, and phospholamban) through activation of the endogenous enzyme (15, 47). As shown in Fig. 5, the presence of calmodulin (1 µM) in the assay medium resulted in stimulation of Ca2+ uptake by SR from adult and aged hearts. This stimulatory effect of calmodulin was observed when assays were performed with a subsaturating (0.6 µM) or saturating (8.2 µM) concentration of free Ca2+. The Ca2+-uptake rates measured in the absence and presence of calmodulin were significantly lower in the aged (30-40%) compared with adult heart. The calmodulin-induced stimulation of Ca2+ uptake by SR was ~36-38% in the aged compared with ~60-65% in the adult heart.
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DISCUSSION |
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The results presented here demonstrate that the contents of the SR
Ca2+-cycling proteins RyR-CRC,
Ca2+-ATPase, calsequestrin, and
phospholamban are not altered significantly during postmaturational
aging in the rat heart. On the other hand, it is shown that significant
age-associated decrements occur in 1) the amount of
-CaM kinase II
in the rat heart, 2) the endogenous CaM kinase-mediated phosphorylation of SR
Ca2+-cycling proteins, and
3) the phosphorylation-dependent
stimulation of SR Ca2+
sequestration. These findings are of considerable significance in the
context of analyzing the mechanisms associated with the well-documented
age-related alterations in intrinsic contractile properties of the
heart and the physiological regulation of heart function.
In the rat, altered contractile properties of cardiac muscle with aging include prolonged contraction duration caused by increases in time to peak tension and relaxation time (12, 17, 22) and attenuation of developed peak tension at high-frequency (>120 beats/min) stimulation (17) but not at low-frequency (<100 beats/min) stimulation (3, 13, 22). An age-associated decrease in the speed of Ca2+ cycling between the myofilaments and the Ca2+ reservoirs (SR compartment and extracellular fluid) is a likely factor underlying the altered contractile properties of the senescent myocardium (22, 23). Our finding that the content of RyR-CRC remains unaltered with aging in the rat heart suggests that the age-related increase in time to peak tension and decrease in developed peak tension cannot be attributed to a decrease in the density of RyR-CRC in the SR. At present, it is not known whether aging alters the functional properties of RyR-CRC in cardiac muscle. A recent study (6) has reported twitch prolongation and altered Ca2+ and caffeine sensitivity of RyR-CRC, but not RyR-CRC content, with aging in fast-twitch tibialis anterior muscle of the rat.
Consistent with previous reports from this (18, 30, 31) and other laboratories (12, 43), the ATP-dependent Ca2+-uptake activity of SR was found to be significantly lower in the aged heart. The observed age-related decline in the Ca2+-uptake activity of SR is likely a major factor contributing to the slow rate of cardiac muscle relaxation seen with aging. A previous study attributed the age-associated decline in Ca2+-uptake activity of rat cardiac SR to an age-related decrease in the SR Ca2+-ATPase content (41). We did not observe any significant age-related difference in the immunoreactive SR Ca2+-ATPase content in the rat heart in studies using SERCA2-specific monoclonal (this report) or polyclonal (17) antibodies. Our earlier studies have shown an age-related decline in Ca2+ uptake but not Ca2+-stimulated ATP hydrolysis by the SR Ca2+-ATPase in the rat heart (30, 31) and slow-twitch soleus muscle (33). These observations support the view that age-associated changes might occur in the efficacy of coupling ATP hydrolysis to Ca2+ transport in the SR, resulting in reduced Ca2+ sequestration. Apparent uncoupling of ATP hydrolysis from Ca2+ transport may be observed because of an age-related increase in Ca2+ efflux through RyR-CRC, "downhill" movement of Ca2+ mediated by the Ca2+-ATPase (29), and/or an age-related decrease in the Ca2+ storage capacity of the SR. A significant age-related increase in Ca2+ efflux from the SR caused by any of these factors, however, seems unlikely in view of the lack of significant age-related changes in the contents of RyR-CRC, Ca2+-ATPase, and calsequestrin reported here.
To our knowledge, this report is the first to describe the effects of
aging on Ca2+/calmodulin-dependent
SR protein phosphorylation in the myocardium. Our results have revealed
a significant age-related decrease in the phosphorylation of RyR-CRC,
Ca2+-ATPase, and phospholamban by
the endogenous SR-associated CaM kinase. Because aging did not
significantly alter the levels of CaM kinase substrates, this decrease
in phosphorylation may be attributed to the observed age-related
decrease in the amount of
-CaM kinase II, which is the predominant
CaM kinase II isoform present in cardiac cytosol (10, 36) and SR (2,
48). The functional consequence of cardiac RyR-CRC phosphorylation has not yet been clearly established. In reconstituted lipid vesicles, phosphorylation of RyR-CRC by CaM kinase II has been shown to either
increase or decrease channel openings (14, 26, 45). Because CaM kinase
II has been found to phosphorylate a single serine residue
(Ser2809) in the cardiac RyR-CRC
(45), it is unclear how such divergent effects on
Ca2+ release would ensue on
phosphorylation of the same site. Recently, CaM kinase II inhibitors as
well as protein phosphatases have been found to reduce SR
Ca2+-release channel activity in
intact cardiomyocytes (9, 25). These findings are consistent with an
increased SR Ca2+-release channel
activity on RyR-CRC phosphorylation by CaM kinase II. In any case, the
observed age-related decline in RyR-CRC phosphorylation can be expected
to impact on the modulation of SR
Ca2+ release and, therefore,
myofilament activation.
Phosphorylation of phospholamban by PKA (at Ser16) and CaM kinase (at Thr17) is well known to stimulate Ca2+ uptake by SR, apparently by relieving an inhibitory effect exerted by dephosphorylated phospholamban on the Ca2+-ATPase (4, 7, 28, 39, 40). Recently, Ser38 phosphorylation of the cardiac SR Ca2+-ATPase by CaM kinase also has been shown to result in stimulation of ATP hydrolysis and Ca2+ transport (15, 44, 47). Some studies have, however, questioned the physiological role of Ca2+-ATPase phosphorylation. Thus a study by Odermatt et al. (34) showed CaM kinase-mediated phosphorylation of Ca2+-ATPase in native rabbit cardiac SR as well as of the cardiac isoform of Ca2+-ATPase (SERCA2a) expressed in HEK-293 cells but failed to observe a significant stimulatory effect on Ca2+-ATPase function. Another study, by Reddy et al. (35), reported the failure to observe phosphorylation of the Ca2+-ATPase in canine cardiac SR or of purified Ca2+-ATPase reconstituted in lipid vesicles. These studies have attributed the stimulatory effect of CaM kinase on SR Ca2+ uptake [i.e., an increase in Ca2+ affinity but not maximum velocity of Ca2+ transport (Vmax)] solely to the phosphorylation of phospholamban. We have, however, observed stimulation of Ca2+ uptake by SR (increase in Vmax) under experimental conditions in which the Ca2+-ATPase, but not phospholamban, underwent selective phosphorylation by CaM kinase (32). The present observations showing age-related decrements in CaM kinase-mediated phosphorylation of phospholamban and Ca2+-ATPase as well as in the stimulatory effect of phosphorylation on Ca2+ uptake suggest attenuation of this regulatory pathway in the aging heart. This might impact adversely on the speed of muscle relaxation in aging. Whether the age-associated decline in the phosphorylation of CaM kinase substrates observed in the isolated SR membranes in vitro also holds true under in vivo conditions, however, remains to be established. Furthermore, age-associated decrements in CaM kinase-mediated phosphorylation of Ca2+-ATPase and calmodulin-stimulated Ca2+ uptake were observed under conditions in which the inhibitory interaction of phospholamban with Ca2+-ATPase was completely disrupted and phospholamban phosphorylation was abolished (Figs. 6 and 7). These findings imply age-associated diminution in the regulation of SR Ca2+-pump function through CaM kinase-mediated phosphorylation of the Ca2+-ATPase. In this regard, it is noteworthy that evidence from recent studies has revealed acceleration of cardiac muscle relaxation caused by a CaM kinase-mediated increase in SR Ca2+-pump activity, independent of phospholamban phosphorylation (16, 24).
Besides its influence on SR Ca2+ cycling, CaM kinase likely plays a critical role in modulating Ca2+ influx though L-type Ca2+ channels in the sarcolemma during membrane depolarization (25, 46). Therefore, it is conceivable that the observed age-related decrease in CaM kinase content in the cardiomyocyte may also adversely impact on this crucial excitatory event, contributing to some of the alterations in the excitation-contraction coupling process seen in the aging heart (23).
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ACKNOWLEDGEMENTS |
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We thank Dr. H. A. Singer, Weis Center for Research, Danville, PA,
for the generous gift of anti-
-CaM kinase II antibody. We also thank
Bruce Arppe for preparing photographs of illustrations and Lily Jiang
for secretarial assistance.
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FOOTNOTES |
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This work was supported by grant T-3682 from the Heart and Stroke Foundation of Ontario.
Address for reprint requests: N. Narayanan, Dept. of Physiology, Health Sciences Center, Univ. of Western Ontario, London, Ontario, Canada N6A 5C1.
Received 21 July 1997; accepted in final form 14 August 1998.
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