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current in
endothelin-1-induced contraction in rabbit basilar artery
Department of Neurosurgery, University of Mississippi Medical Center, Jackson, Mississippi 39216
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ABSTRACT |
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Cl
efflux induces
depolarization and contraction of smooth muscle cells. This study was
undertaken to explore the role of Cl
channels in
endothelin-1 (ET-1)-induced contraction in rabbit basilar artery. Male
New Zealand White rabbits (n = 26), weighing 1.8-2.5 kg, were euthanized by an overdose of pentobarbital. The basilar arteries were removed for isometric tension recording. ET-1
produced a concentration-dependent contraction of the rabbit basilar
artery in the normal Cl
Krebs-Henseleit bicarbonate
buffer (123 mM Cl
). The ET-1-induced contraction was
reduced by the following manipulations: 1) inhibition of
Na+-K+-2Cl
cotransporter with
bumetanide (3 × 10
5 and 10
4 M),
2) bicarbonate-free solution to disable
Cl
/HCO
channel blockers
niflumic acid, 5-nitro-2-(3-phenylpropylamino)benzoic acid, and
indanyloxyacetic acid 94. The ET-1-induced contraction was
enhanced by substitution of extracellular Cl
(10 mM) with
methanesulfonic acid (113 mM). Cl
channels are involved
in ET-1-induced contraction in the rabbit basilar artery.
Cl
channels; Na+-K+-2
Cl
cotransporter; Cl
/HCO
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INTRODUCTION |
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ION FLUX AND
FLUORESCENT DYE STUDIES have demonstrated that the
intracellular Cl
concentration
([Cl
]i) is in the range of 39-107 mM
and accumulates by at least three processes, including
Na+-K+-2Cl
cotransporter,
Cl
/HCO
(ECl), calculated by 60 log
[Cl
]i and extracellular Cl
concentration ([Cl
]o), is between
20 and
30 mV, which is roughly 15-30 mV more positive than the resting
membrane potential. Consequently, the opening of Cl
channels causes Cl
efflux, drives the membrane potential
toward ECl, depolarizes the cell membrane, and
contracts smooth muscle cells. Cl
channels are found in
many types of cells, including portal venous cells (20),
ear artery cells (2), and esophageal smooth muscle cells
(1). Three kinds of Cl
channels were
identified in smooth muscle cells: voltage-dependent large-conductance
Cl
channels (33), volume-sensitive
Cl
channels (13), and
Ca2+-dependent Cl
channels.
Ca2+-activated Cl
channels are the most
frequently studied Cl
channels. Many agonists, including
norepinephrine (NE), methacholine, and histamine, also activate
Ca2+-activated Cl
channels (15, 16,
32). These agonists release Ca2+ from the
intracellular Ca2+ store, which, in turn, activates the
Ca2+-dependent Cl
current, thus depolarizing
the cell membrane and ultimately resulting in contraction. Elevation of
intracellular Ca2+ also activates
Ca2+-dependent K+ channels, which in turn
hyperpolarize membrane potentials. The type of channel that plays a
dominant role decides the outcome, that is, either contraction by the
activation of Ca2+-dependent Cl
channels or
relaxation by the activation of Ca2+-dependent
K+ channels. Cl
channel blockers,
i.e., niflumic acid, 4,4'-diisothiocyanostilbene-2,2'-disulfonic acid
(DIDS), and 5-nitro-2-(3-phenylpropylamino)benzoic acid
(NPPB), have been shown to inhibit NE or phenylephrine-induced
Ca2+-dependent Cl
current in rat portal vein
(20) and contraction of rat pulmonary arteries (18,
20, 29).
Endothelin-1 (ET-1) causes profound vasoconstriction in both arterial
and venous smooth muscle. Because ET-1 is a potent and long-lasting
vasoconstrictor, it has been regarded as a mediator of vasospasm and
hypertension (39, 40). Activation of the ETA
receptors in vascular smooth muscle cells exerts the well-recognized contractile effect of ET-1 by inducing depolarization and
resulting in increased intracellular Ca2+ because of either
mobilization of D-myo-inositol
1,4,5-trisphosphate-sensitive Ca2+ store or an influx of
extracellular Ca2+ via dihydropyridine-sensitive
Ca2+ channels. Increased Ca2+ not only leads to
a contractile response but might also activate Ca2+-dependent ion channels (27), including
Ca2+-activated Cl
channels such as in rat
pulmonary arterial smooth muscle cells (31), porcine
coronary arteries (20), human mesenteric arteries (32), and rat renal resistance arteries (11).
Ca2+-activated Cl
channels have been
identified in rabbit cerebral artery by electrophysiology
(18), although their contribution to contraction in
cerebral arteries by agonists such as ET-1 remains undetermined. The
current investigation was conducted to investigate whether
Cl
channels play a role in the ET-1-induced
contraction in the rabbit basilar arteries. The following strategies
were used: 1) inhibiting the
Na+-K+-2Cl
cotransporter and the
HCO
exchanger to decrease
[Cl
]i and to reposition the
ECl more negatively (hyperpolarization), 2) decreasing the [Cl
]o to
reposition ECl more positively (depolarization),
and 3) blocking Cl
channels (or
Cl
efflux) using Cl
channel inhibitors to
reposition ECl more negatively (hyperpolarization).
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MATERIALS AND METHODS |
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Tissue Preparation
Male New Zealand White rabbits (n = 26) weighing 4-5 lb were anesthetized by intravenous injection of 5 mg acepromazine, 50 mg ketamine, and 25 mg xylazine and were euthanized with 250 mg pentobarbital sodium. The brain was removed, and the basilar arteries were cut into 2-mm rings in an ice-cold modified Krebs-Henseleit bicarbonate solution containing (in mM) 120 NaCl, 4.5 KCl, 1 MgSO4, 27 NaHCO3, 1.2 KH2PO4, 2.5 CaCl2, and 10 dextrose and bubbled with 95% O2-5% CO2.Isometric Tension
The rings were suspended at a resting tension of 400 mg (Radnoti transducer, Radnoti Glass) between stainless steel hooks in 10-ml water-jacketed tissue baths (Radnoti Glass) in modified Krebs-Henseleit biocarbonate buffer with 95% O2-5% CO2 at 37°C. Rings were incubated for 90 min until a stable rest tension was achieved, and the solution was changed every 20 min to remove metabolites. The tissues were challenged with KCl (60 mM) twice at 30-min intervals before the experiment. Isometric force transducers were connected to arterial rings and the contraction was recorded with an eight-channel MacLab 8E and stored on a Power Macintosh computer. We removed endothelial cells in some of the studies by gently rubbing the rings with a steel hook. The removal of endothelium was confirmed by a loss of relaxation from 30 to 50 µM acetylcholine (rings precontracted with 30 µM 5-hydroxytryptamine).The low-Cl
solution was prepared by the replacement of
120 mM NaCl with 120 mM NaOH. The pH of the buffer was titrated to 7.4 with the use of methanesulfonic acid while the solution was prewarmed
and preaerated.
In all experiments, while the [Cl
]o was
being changed, the low-level Cl
solution was prewarmed
and preaerated in a 37°C water bath, mixed with the agonists at the
designated concentration, and injected slowly into the water bath. The
control group with normal Cl
solution was done in the
same way. The Ca2+-free solution was prepared by omitting
the 2.5 mM Ca2+ and adding 2 mM EGTA. The
Ca2+-free low-Cl
solution was prepared by the
omission of Ca2+, and the extracellular Cl
was reduced as mentioned before. The HEPES buffer was made by replacing
27 mM NaHCO3 with 20 mM HEPES and titrating the pH to 7.4 using 1 M NaOH solution. The measured osmolality of the normal Cl
buffer and the low-[Cl
] buffer was 284 and 288 osmol/kgH2O, respectively, and the osmolality of
the Ca2+-free buffer was 280 osmol/kgH2O.
Chemicals
ET-1 was purchased from Alexis; stock solution was 10
5 M in distilled water. NPPB, a nonselective
Cl
channel blocker, was from Tocris; stock solution was
10
2 M in dimethyl sulfoxide (DMSO). Niflumic acid, a
Ca2+-dependent Cl
channel blocker, was
purchased from Sigma; stock solution was 0.1 M in DMSO.
Indanyloxyacetic acid (IAA-94), a nonselective Cl
channel
blocker, was purchased from Alexis; stock solution was 10
2 M in DMSO. Bumetanide, a
Na+-K+-2Cl
cotransporter
inhibitor, was purchased from Sigma; stock solution was
10
2 M in ethyl alcohol. The dosage of DMSO and ethyl
alcohol used was <0.1% and produced no effects on the resting tension.
Statistics
All data are displayed as means ± SE, and n represents the number of arterial rings in each group. One-way analysis of variance and t-test were used as analysis methods, and a value of P < 0.05 was considered to be significantly different.| |
RESULTS |
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ET-1-Induced Contraction in Rabbit Basilar Artery
In several previous reports (40), we have established that ET-1 produces concentration-dependent contraction in rabbit basilar arteries by activating the ETA receptor. The ETA receptor antagonist BQ-610, but not the ETB receptor antagonist BQ-788, reduced the contraction to ET-1. The EC50 and maximum normalized response (to 120 mM KCl) of ET-1 from 0.1 to 100 nM are 8.10 ± 1.54 nM and 199 ± 11.2%, respectively.Effect of
Na+-K+-2Cl
Cotransporter Inhibitor on ET-1-Induced Contraction
5 M
(n = 7) and 10
4 M (n = 7)
bumetanide (Na+-K+-2Cl
cotransporter inhibitor) for 30 min before application of ET-1 from
10
10 to 10
7 M. Bumetanide significantly
suppressed the contraction in a concentration-dependent and reversible
manner (Fig. 1). The EC50 and
maximum normalized response (to 120 mM KCl) of ET-1 in the presence of
the Na+-K+-2Cl cotransporter inhibitor
bumetanide at 30 µM are 11.1 ± 0.68 nM and 109 ± 2.45%,
respectively. The EC50 and maximum normalized response (to
120 mM KCl) of ET-1 in the presence of bumetanide at 100 µM are
10.5 ± 1.18 nM and 87.2 ± 3.14%, respectively.
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Effect of Cl
/HCO
2 M,
HCO
10 to 10
7 M. The
HEPES solution significantly suppressed the contraction induced by ET-1
(Fig. 2). The EC50 and
maximum normalized response (to 120 mM KCl) of ET-1 in the presence of
HEPES solution (HCO
exchanger
inhibitor) are 1.94 ± 0.16 nM and 98.5 ± 1.40%,
respectively.
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Effect of Decreasing
[Cl
]o on
ET-1-Induced Contraction
Initial contraction.
Prewarmed and preaerated low-concentration Cl
(10 mM
Cl
) buffer mixed with ET-1 at 10
8 M
elicited contractions that were compared with those obtained in
response to 10
8 M ET-1 in normal Cl
buffer.
The contractile response to ET-1 dissolved at 10
8 M was
potentiated in low-Cl
(10 mM Cl
) buffer.
Figure 3 shows the original trace of
initial contraction to ET-1 in low and normal Cl
solutions.
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Sustained contraction.
The rings were contracted first in a normal 123 mM Cl
solution by ET-1 at 10
8 M for at least 20 min. After
tension attained the stable and plateau phase, the normal
Cl
buffer was quickly drained and exchanged for either a
fresh normal Cl
buffer (123 mM Cl
) or
low-Cl
(methanesulfonate ion and 10 mM Cl
)
buffer containing the same concentration of ET-1. No significant change
in tension was observed when normal Cl
solution was
changed to fresh normal Cl
solution (Fig.
4A). In contrast, tension was
markedly enhanced when low-Cl
buffer was used (Fig.
4B). Figure 5 summarized the
effect of low-Cl
buffer on the initiation and sustained
contraction of ET-1.
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|
Ca2+-free solution.
A more concentrated solution of ET-1 (10
7 M vs.
10
8 M) in a Ca2+-free buffer was used to
achieve a similar degree of contraction (of ET-1 10
8 M in
normal Ca2+ buffer). After a stable contraction was
attained, the buffer was replaced by Ca2+-free and
low-concentration Cl
buffer with 10
7 M
ET-1. Instead of being potentiated, the contraction caused by ET-1
decreased significantly (Fig. 6), thus
indicating that a low-Cl
solution enhances ET-1
contraction by depolarization and extracellular Ca2+
influx.
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Effects of Cl
Channel Blockers on
ET-1-Induced Contraction
Preincubation with Cl
channel
blockers.
Rings were pretreated with niflumic acid, NPPB, and IAA-94 at 3 × 10
5 or 10
4 M, respectively, for 30 min
before ET-1 applications in the range of
10
10-10
7 M. The Cl
channel blockers had no effect on the resting tension. Pretreatment with niflumic acid, NPPB, and IAA-94 attenuated ET-1-induced
contraction in a concentration-dependent and reversible manner (Fig.
7).
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Relaxant effect of Cl
channel
blockers.
ET-1 (10
8 M) was used first to achieve a sustained
contraction. The relaxant effect of niflumic acid, NPPB, and IAA-94 was tested in solutions in the range of
10
6-10
4 M. All inhibitors induced a
concentration-dependent relaxation. Figure
8 shows the original tracing of the
effect of Cl
channel blockers. Figure
9 summarizes the dose-dependent effect of
IAA-94 (n = 12), NPPB (n = 10), and
niflumic acid (n = 7) on ET-1 (10
8
M)-elicited contraction on endothelium intact rings. The 50% inhibitory concentration (IC50) values of the
Cl
channel blockers NPPB, IAA-94, and niflumic acid on
ET-1-induced contractions averaged 39.0 ± 2.96, 43.9 ± 6.81, and 58.6 ± 8.54 µM, respectively.
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DISCUSSION |
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Our present study supports the hypothesis that Cl
channels are involved in ET-1-induced contraction and modulation of
Cl
channels alters ET-1-induced contraction in cerebral
arteries. The evidence established by this study is as follows. First,
the Na+-K+-2Cl
cotransporter
inhibitor bumetanide depresses the ET-1-induced contraction. Second,
the HCO
solution
enhances both initial and sustained phases of contraction induced by
ET-1. Extracellular Ca2+ influx causes the potentiation
effect of low-extracellular Cl
. Fourth, pretreatment with
NPPB, niflumic acid, and IAA-94 attenuates the ET-1-induced contraction
in endothelially intact rings. Fifth, the Cl
channel
blockers NPPB, niflumic acid, and IAA-94 relax the sustained ET-1-induced contraction in endothelially intact rings.
Role of
Na+-K+-2Cl
Cotransporter and
Cl
/HCO
cotransporter
is one of three mechanisms responsible for the accumulating
intracellular Cl
in smooth muscle cells
(23). The receptor agonist NE activates the
Na+-K+-2Cl
cotransporter to
increase intracellular Cl
and depolarizes the membrane
potential in rat femoral arterial smooth muscle cells (7,
21). Bumetanide, a
Na+-K+-2Cl
cotransporter
inhibitor, decreases intracellular Cl
and hyperpolarizes
membrane potential. Bumetanide relaxes NE-induced contractions in the
rat aorta (7, 21).
Na+-K+-2Cl
cotransporter activity
is more active in arterial smooth muscle in the deoxycorticosterone
acetate/salt model of hypertension than in normotensive control rats
(4, 8). Consequently, the level of intracellular
Cl
is higher, and the ECl is more positive in
hypertension, thus contributing to the hypertensive depolarization and
maintenance. Those studies indicate that the
Na+-K+-2Cl
cotransporter plays a
role in vascular smooth muscle cells, which modulates the membrane
potential and contraction. Our study showed that bumetanide depresses
ET-1-induced contraction and consistently demonstrated that
Cl
current and the
Na+-K+-2Cl
cotransporter are
involved in the ET-1 contractile response in cerebral arteries.
It has been reported that except for its function of modulating
intracellular pH, the Cl
/HCO
above ECl. Accumulating Cl
via the
Cl
/HCO
cotransporter; moreover, the two effects are additive (6). The bicarbonate-free solution depresses NE-induced contraction in rat
aortas, thus indicating the functional role of the
Cl
/HCO

/HCO

Role of [Cl
]o in
ET-1-Induced Contraction
channel
anion. Because of its negligible permeability and apparent lack of
interaction with Cl
, it is used as the preferred
impermeant Cl
substitute in substitution studies of
membrane conductance (21, 30). We found that both at the
initial and sustained contraction phases, the low-Cl
solution significantly enhanced ET-1-induced contraction compared with
contraction in the normal Cl
solution. This enhanced
contraction in low-Cl
solution disappeared when the
normal Cl
and Ca2+-free solution was changed
to the low-Cl
and Ca2+-free solution. This
study suggests that the low [Cl
]o might
induce Cl
efflux and depolarization while triggering
Ca2+ entry from the extracellular space. The alteration of
ECl is probably the mechanism of the potentiating effect of
a low-Cl
buffer. Given the assumption that the internal
Cl
is 54 mM (the value in the rabbit choroid smooth
muscle cells) (5) and that the extracellular
Cl
is normally 123 mM, as used in this study,
extracellular Cl
decreasing from 123 to 10 mM results in
membrane depolarization. Other investigators have also observed
enhanced pressure-induced myogenic tone (26) and that a
low-Cl
buffer potentiates NE-induced contraction in rat
aortas (21). In contrast, a Cl
-free buffer
inhibits phenylephrine-induced contraction and Ca2+ influx
in the rat caudal artery (33). Variation in experimental procedure or contractile mechanism of the caudal artery might possibly
explain these differences. In the rat aorta, we exposed low-Cl
solution and NE to the arterial rings at the same
time by premixing NE with the low-Cl
buffer
(21). Under such circumstances, the intracellular
Cl
was not depleted (21). However, in rat
caudal artery preparations (33), the arterial rings were
washed with Cl
-free buffer and allowed to equilibrate for
30 min in Cl
-free solution before application of
phenylephrine. At the time that phenylephrine was administered, the
intracellular Cl
had already been depleted. The
differences in the two experimental conditions might explain the
controdictory responses to the low-Cl
solution by NE and phenylephrine.
Low Cl
has caused some minor potentiation differences
between NE-induced contraction and ET-1-induced contraction.
Low-Cl
buffer enhances NE-induced contraction more
markedly at the initial contraction point than during the
sustained contraction phase (21). In contrast,
low-Cl
buffer enhances ET-1 markedly during both the
initial contraction and the sustained contraction, indicating a
different contractile response mechanism with respect to these
agonists. Recent studies (25) have demonstrated
that concentrations of ET-1 >10
8 M activate both
nonselective cation channels and store-operated Ca2+
channels. The voltage-dependent Ca2+ channel plays a minor
role in ET-1-induced contraction but plays a major role in NE-induced
contraction (12, 25). Furthermore, in the microvascular
smooth muscle cells of choroidal arteries, Cl
channels
participate in ET-1-induced activation of the store-depletion-dependent Ca2+ channel, and Cl
serves to protect smooth
muscle cells from Ca2+ overload (5).
Another issue is the "long-term" effect of Cl
channels, especially the Ca2+-activated Cl
channels operant in smooth muscle contraction. After intracellular Ca2+ levels rise, Ca2+-activated
Cl
channels activate and decay rapidly in smooth muscle
cells (28). Channel inactivation, resulting from
phosphorylated channel protein by calcium/calmodulin-dependent kinase
II, terminates the Ca2+-activated Cl
channel
(37). Thus, to prolong the effect of Cl
channels in enhancing ET-1-induced cerebral arterial contraction, other
Cl
channels might need to be involved.
Role of Cl
Channel Blockers in
ET-1-Induced Contraction
channels are
the most frequently studied Cl
channels in smooth muscle
cells. Using isolated cerebral arteries, Nelson et al.
(26) suggested that Cl
channels play a role
in pressure-induced cerebral arterial myogenic tone and that the
nonselective Cl
channel blockers IAA-94 and DIDS
displayed dilatated pressurized rat cerebral arteries. However, Nelson
et al. (26) reported that the Ca2+-activated
Cl
channel blocker niflumic acid failed to show any
inhibitory effect on the developed tone. Several groups of
investigators studied the possible function of
Ca2+-activated Cl
channels in cerebral
arteries and reported contradictory results. When Salter et al.
(31) used single smooth muscle cells from rat posterior
cerebral arteries, ET-1 or photorelease of caged Ca2+
failed to evoke inward current, thus suggesting either that rat cerebral arteries do not possess Ca2+-activated
Cl
channels or that Ca2+-activated
Cl
channels do not play a major role. Kamouchi et al.
(17), however, used the perforated patch technique and
histamine to trigger Ca2+-activated Cl
currents in rabbit basilar arteries. The expression of
Ca2+-activated Cl
channels and their role in
modulating membrane potential in cerebral smooth muscle cells might be
species and tissue specific. In the current study, although the
Ca2+-activated Cl
channel blocker niflumic
acid reduces the contraction of rabbit basilar arteries exposed to ET-1
and relaxes the sustained contraction induced by ET-1, whether
Ca2+-activated Cl
channels mediated the
effect of niflumic acid remains yet to be determined. Because the other
Cl
channel inhibitors used in this study are
nonselective, the involvement of other Cl
channels or
other ionic channels, such as Ca2+ channels, cannot be
excluded. In the current study, we used the [Cl
]
channel blockers that were reported to selectively block
Cl
channels in other studies (9, 23, 26).
For example, in rat cerebral arteries (26), IAA-94 at 300 µM relaxed myogenic response by 92 ± 6% (IC50 = 26 ± 1.5 µM). NPPB (at 100 µM) completed blocked 45 mM
K+ depolarization-induced isometric tension
(IC50: 10.0 ± 0.76 µM). IAA-94 (200 µM) completed
relaxed 45 mM K+ depolarization-induced isometric tension
(IC50: 17.0 ± 1.2 µM) (9). In
pulmonary arterial rings, niflumic acid and NPPB relaxed ET-1 (30 nM)-induced contraction (IC50: 35.8 µM for niflumic acid and IC50: 21.1 µM for NPPB). Because there is no evidence
for a direct coupling between Cl
channels and
ETA receptors in the cerebral arteries, and the Na+-K+-2Cl cotransporter inhibitor bumetanide,
the HCO
exchanger inhibitor HEPES
solution, and the Cl
channel blockers are not the
competitive antagonists to ETA receptors, the antagonist
affinity value equilibrium dissociation constant is not reported here.
Although several investigative groups reported that many compounds
might block the Cl
current, none of those compounds is
selective for a particular subtype of Cl
current.
Previously, Doughty et al. (9) and Toma et al.
(35) indicated that the inhibitive effect of
Cl
channel blockers, such as niflumic acid, operate by
opening K+ channels. Furthermore, Cl
channel
blockers directly affect voltage-dependent Ca2+ channels in
isometric tension and patch-clamp studies. Kato et al.
(18) reported that NPPB and niflumic acid relax
ET-1-induced contraction in pulmonary arteries but that the mechanism
is independent of the Cl
channel blocking action. Doughty
et al. (9) observed a direct inhibitory effect of NPPB and
IAA-94 on KCl-induced contraction in rat cerebral artery. These reports
indicate that the relaxant effect of Cl
channel blockers
is nonselective and at least partially results from blocking the
voltage-dependent Ca2+ channels. The endothelium is another
possible source of the "nonselective" relaxant effect of the
Cl
channel blockers. Vasoactive agents released from the
endothelium regulate vascular tone in cerebral arteries. In a recent
study, Lamb et al. (22) indicated that nitric oxide
released from endothelial cells might regulate both the resting
Cl
conductance and the ability of agonists to activate
the Cl
channel.
Perspective
To our knowledge, this is the first investigation of the effect of Cl
channels in ET-1-induced contraction in cerebral
arteries. We used various approaches to demonstrate that modulation of
Cl
channels alters ET-1-induced contraction in rabbit
basilar arteries. We use in a schematic diagram to summarize the role
of Cl
channels in ET-1-induced contraction (Fig.
10). ET-1 activates ETA
receptors and, by unknown mechanisms, ET-1 activates the
Ca2+-activated or other Cl
channels, all of
which result in contraction. Varying Cl
levels,
intracellularly or extracellularly, affect ET-1-induced contraction.
The Cl
channel inhibitors NPPB, IAA-94, and niflumic acid
attenuate ET-1-induced contraction.
|
In conclusion, the mechanism regulating Cl
current
responses to ET-1, however, remains unknown, although it is presumed
that an elevation of intracellular Ca2+, released either
from internal stores or drawn from extracellular space, might initiate
some Cl
channel activation, especially the
Ca2+-activated Cl
channels. The possible
involvement of other Cl
channels and how they are
involved remains to be explored. The interaction between
Cl
channels and Ca2+ or K+
channels after ET-A receptor activation warrants further study. A clear
understanding of the mechanism of ET-1-induced contraction is critical
to some clinical situations such as cerebral vasospasm and
hypertension, in which ET-1 is involved (3, 41).
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ACKNOWLEDGEMENTS |
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We thank Dr. John C. Kermode for assistance in statistical analysis.
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FOOTNOTES |
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This work was supported in part by a grant-in-aid (to J. H. Zhang) from the American Heart Association Bugher Foundation for Stroke Research.
Address for reprint requests and other correspondence: J. H. Zhang, Dept. of Neurosurgery, Univ. of Mississippi Medical Center, 2500 N. State St., Jackson, MS 39216 (E-mail: jzhang{at}neurosurgery.umsmed.edu).
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.
Received 12 March 2001; accepted in final form 2 August 2001.
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