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Am J Physiol Heart Circ Physiol 285: H90-H96, 2003. First published March 13, 2003; doi:10.1152/ajpheart.01018.2002
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Age-related functional effects linked to phosphatase activity in ventricular myocytes

Elizabeth M. Grey, Chun K. Chan, Yi Chen, and Polly A. Hofmann

Department of Physiology, University of Tennessee, Memphis, Tennessee 38163

Submitted 25 November 2002 ; accepted in final form 12 March 2003


    ABSTRACT
 TOP
 ABSTRACT
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 REFERENCES
 
Conflicting reports exist regarding the influence of {beta}-adrenergic stimulation on the maximum velocity of shortening (Vmax) in ventricular myocytes. This may be due to an unrecognized effect of maturation. In the present study, the effects of {beta}-adrenergic receptor stimulation on myocytes from hearts of juvenile nonbred and young adult retired breeder female rats were compared. Ventricular myocytes from young adults had a {beta}-adrenergic-dependent increase in Vmax and Ca2+-dependent actomyosin ATPase that was not observed in myocytes from juveniles. Myocytes from young adults had both an increase in {beta}-myosin heavy chain (MHC) and higher basal serine/threonine phosphatase activity compared with juvenile rats. Additional studies established moderate increases in {beta}-MHC induced by hypothyroidism do not confer myocardial {beta}-adrenergic responsiveness, whereas inhibition of the higher phosphatase activity in myocytes from young adults blocks the age-dependent, {beta}-adrenergic-induced increase in cross-bridge cycling rates. We propose that the higher phosphatase activity of myocytes from young adults compared with juveniles allows for a greater functional response of the myocardium to {beta}-adrenergic stimulation.

{beta}-adrenergic; heart; maturation; velocity of shortening


{beta}-ADRENERGIC RECEPTOR STIMULATION of the heart has both positive inotropic and lusitropic effects. These effects have been primarily attributed to changes in the duration of Ca2+ transients (for reviews, see Refs. 1 and 17). Evidence suggests that the rates of actin-myosin association and dissociation also influence the rates of myocardial contraction and relaxation. For example, {beta}-adrenergic-induced increases in the relaxation rate may be due, in part, to an increase in the rate of dissociation of Ca2+ from troponin C caused by phosphorylation of troponin I (15). {beta}-Adrenergic-induced increases in the rate of contraction may also be due, in part, to an increased rate of actin-myosin cycling. However, studies examining the influence of {beta}-adrenergic-protein kinase A (PKA) stimulation on cardiac cross-bridge cycling rates in myocardial preparations appear to conflict (3, 7, 8, 18).

De Tombe and ter Keurs (3) demonstrated that {beta}-adrenergic receptor stimulation did not alter the maximum unloaded sarcomere shortening velocity (Vmax) in rat intact trabeculae. Consistent with this, Hofmann and Lange (7) demonstrated that PKA exposure did not affect Vmax in skinned ventricular myocytes. However, Strang et al. (18) found that {beta}-adrenergic receptor activation increased Vmax in ventricular myocytes from rats. In addition, Hoh et al. (8) using analysis of the frequency at which stiffness of the muscle is at a minimum (fmin), thought to reflect the rate of cross-bridge cycling, found a {beta}-adrenergic receptor-dependent increase in fmin in papillary muscle. The disparity in findings may have been the result of strain, age, gender, or breeding history differences. Thus the goals of the present study were to examine the effect, if any, of age/breeding history on the ability of the {beta}-adrenergic-PKA pathway to influence cross-bridge cycling rates of ventricular myocytes and to link the observed effects with either developmental changes in myofilament protein expression or the level of myofilament protein phosphorylation.


    MATERIALS AND METHODS
 TOP
 ABSTRACT
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 REFERENCES
 
Animals. Hearts from juvenile and young adult Wistar female rats were used to examine the role of maturation on {beta}-adrenergic receptor activation on cross-bridge cycling rates in isolated ventricular myocytes. Female juvenile rats were 3–4 mo of age, weighed 245–295 g, and had not been bred. Juvenile rats in the present study were of similar strain, age, weight, and breeding history as those used in the study of Hofmann and Lange (7). Female young adult rats were 9–10 mo of age, weighed 340–380 g, and were retired breeders. Retired breeders, rather than nonbred adults, were used to duplicate conditions of the studies of Strang et al. (18). Similar conditions to past studies (7, 18) were used to establish or refute the existence of a developmental difference on the effect of {beta}-adrenergic stimulation on Vmax and rule out rat strain or technical variance as the cause for differences in the results of past studies. Experiments using animals were reviewed and approved by the University of Tennessee.

Enzymatic isolation of ventricular myocytes. Ventricular myocyte isolation procedures were identical to Lester et al. (11). Quiescent, rectangular myocytes in Ringer solution containing 1.25 mM Ca2+ accounted for >50% of the total cells.

32P incorporation. Isolated myocytes were exposed to [32P]orthophosphate for 1 h. Myocytes were then treated for 5 min with 100 nM isoproterenol (a {beta}-adrenergic receptor agonist), untreated, or exposed for 20 min to 4.5 mM dibutyryl-cAMP (a cell-permeable activator of PKA). Dibutyryl-cAMP was used at a high concentration to facilitate and speed entry into the cytosol. After drug treatment, cells were exposed to a relaxing solution (11) containing 0.3% Triton X-100 for 6 min. A urea-containing sample buffer was added, and electrophoretic separation of proteins was carried out (5, 11).

Myofibrillar Ca2+-dependent ATPase. After enzymatic isolation, ventricular myocytes were pretreated with 1 µM okadaic acid or vehicle for 20 min and exposed to 100 nM isoproterenol or vehicle for 5 min. Myofibrils were then isolated from these cells using the protocol of Murphy and Solaro (12). Myofibrils were stored in an ice-cold phosphate buffer solution plus 100 nM calyculin A to stop all phosphatase activity. Ca2+-dependent actomyosin ATPase was determined as previously described (14). In brief, myofibrils were incubated at 32°C in solutions containing calcium of either high (pCa 4.0) or low (pCa 9.0) concentrations plus 5 mM MgCl2, 3 mM ATP, 2 mM EGTA, 20 mM imidazole (pH 7.0), and enough KCl to bring the final ionic strength to 60 mM. After a 10-min incubation, the reaction was quenched with 20% trichloroacetic acid, and inorganic phosphate levels were determined according to the method of Fiske and SubbaRow. Protein concentration was determined with a Biuret assay. Inorganic phosphate production was found to be linear with respect to time under conditions of 32°C with a final protein concentration <2.0 mg/ml (data not shown).

Western blot analysis of {beta}-myosin heavy chain. Ventricles were excised, homogenized, and centrifuged, and the pellet was immediately washed and placed on ice. Samples were electrophoresed on SDS-PAGE gels using the methods of Fritz et al. (5) or Talmadge and Roy (19). Both methods of SDS-PAGE utilized a 5% acrylamide stacking gel. The acrylamide resolving gel was either a 12% gel at a 200:1 acrylamide-to-bis ratio, with 0.75 M Tris at pH 9.3, 0.1% SDS, and 10% glycerol (5), or an 8% gel at a 50:1 acrylamide-to-bis ratio, with 0.2 M Tris at pH 8.8, 0.4% SDS, and 5% glycerol (19). The two methods were used to examine the effect of optimizing myosin heavy chain (MHC) separation. Gel proteins were transferred to polyvinylidene difluoride (PVDF) membranes. Coomassie staining of SDS gels and blots indicated the protein load and extent of transfer of MHC to PVDF membrane were similar in myocardial samples from juvenile and young rats.

Immunoblotting was performed as described in the protocol included with NEN/DuPont chemiluminescent reagents (NEL-102, NEN/DuPont). PVDF membranes were incubated with either a monoclonal anti-{beta}-MHC antibody isolated against skeletal muscle slow MHC (1:100 dilution, catalog number MAB1628, Chemicon International; Temecula, CA), a monoclonal anti-{beta}-MHC antibody isolated from an immunogen of human ventricular myosin and recognizing a light meromyosin fragment (1:50 dilution, catalog number MAB1552, Chemicon International), or a monoclonal anti-{alpha}-MHC antibody isolated from an immunogen of purified human atrial myosin (1:10 dilution, catalog number BS-1170-S, Alexis).

Induction of hypothyroidism. Juvenile rats, 3 mo of age, were given 0.8 mg/ml propylthiouracil (PTU) in their drinking water for 2 or 4 days.

Velocity of unloaded shortening. Isolated myocytes were treated for 5 min with 100 nM isoproterenol, untreated, or treated for 20 min with 4.5 mM dibutyryl-cAMP. Myocytes were then skinned with a relaxing solution containing 0.3% Triton X-100, washed, and placed on ice. Vmax was determined using equipment and procedures identical to Hofmann and Lange (7). In brief, a cell was glued at its ends to micropipettes projecting from a piezo electric translator and force transducer. Sarcomere length was set to ~2.2 µm using a microscope micrometer. Cells are activated in a maximally activating Ca2+-containing saline solution of pCa 4.5 (7). Once steady-state tension was achieved, cells were slackened by a given amount, causing tension to fall to zero. Tension redevelopment was observed when the activated cell had take up the imposed slack. Multiple slackening steps were induced in one cell and plotted as a change in length (slack length) versus duration of unloaded shortening (time until onset of tension redevelopment). The slope of this relationship, in muscle lengths per second, is a measure of Vmax. Data from cells that met the following criteria were included in the final analysis: striations were clearly visible in the photomicrographs taken in pCa 9.0 and pCa 4.5 solution, sarcomere length between these pCa solutions differed by <0.25 µm, final maximum contraction value was 70% or greater of the initial maximum contraction value, and the goodness of fit to the slack versus duration plot was ≥0.80.

Statistics. All values are reported as means ± SE, and P < 0.05 was chosen to indicate statistical significance. All data were analyzed by ANOVA and Fisher's least-significant difference post hoc test.


    RESULTS
 TOP
 ABSTRACT
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 REFERENCES
 
Age on {beta}-adrenergic-dependent functional effects. Vmax was determined in myocytes treated and subsequently skinned from juvenile and young adult female rats. Pretreatment of intact myocytes with either isoproterenol or dibutyryl-cAMP did not alter Vmax in ventricular myocytes from juvenile female rats (Fig. 1), but increased Vmax in myocytes from young adult female rats. Vmax was not significantly different between unstimulated (control) myocytes from juvenile and young adults.



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Fig. 1. Cumulative maximum velocity of unloaded shortening (Vmax) comparing control (Con), 100 nM isoproterenol (Iso)-treated, and 4.5 mM dibutyryl-cAMP-treated ventricular myocytes. Myocytes were isolated from hearts of rats that were either juvenile (3 mo old) or young adults (9–10 mo old). Values are expressed as means ± SE. *P < 0.05 compared with same-age control myocytes.

 

Isometric tension as a function of Ca2+ concentration was also determined in myocytes treated and subsequently skinned from juvenile and young adult female rats. Maximum isometric tension did not change in any of the preparations or treatment groups (Table 1). Ca2+ sensitivity of tension as determined by the negative log of the Ca2+ concentration at which 50% tension is observed (pCa50) increased after PKA activation to a similar extent in myocytes from juvenile and young adult female rats (Table 1 and Fig. 2). No significant differences in the Hill coefficients (steepness) of the tension-pCa relationship occurred between any groups (Table 1).


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Table 1. Characteristics of tension-pCa relationships of ventricular myocytes

 


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Fig. 2. Cumulative tension-pCa relationships comparing Con, 100 nM Iso-treated, and 4.5 mM dibutyryl-cAMP-treated ventricular myocytes. Myocytes were isolated from hearts of rats that were either juveniles (A) or young adults (B). Additional information and statistics can be found in Table 1 and in the text. Values are expressed as means ± SE.

 

Role of phosphorylation on age effects. Dibutyryl-cAMP increased phosphorylation of C protein and troponin I in ventricular myocytes from juvenile and young adult female rats (Fig. 3). Isoproterenol stimulation also increased C protein and troponin I phosphorylation in myocytes from young adults with a trend to increased phosphorylation observed in myocardium from juvenile female rats compared with controls (Fig. 3). Myocytes from young adults had a significantly lower level of phosphorylation of troponin I and C-protein under all conditions compared with myocytes from juvenile rats.



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Fig. 3. Cumulative analysis of phosphate incorporation into troponin I (A) and C protein (B) normalized to the Coomassie stain density. Ventricular myocytes were isolated from hearts of rats that were either juvenile (n = 7) or young adults (n = 6). 32P incorporation of myocytes was brought about by exposure to 100 nM Iso and 4.5 mM dibutyryl-cAMP. Values are expressed as means ± SE. *P < 0.05 compared with same-age control myocytes; {dagger}P < 0.05 compared with different age but same treatment group.

 

In a separate series of experiments, we confirmed that ventricular myocytes from young adults had a significantly lower level of basal/unstimulated phosphate incorporation into troponin I and C protein compared with myocytes from juvenile rats (Fig. 4). Basal phosphorylation of troponin I was unaffected by PKA inhibition with H89 in myocytes from both juveniles and young adults, whereas phosphatase inhibition using 1 µM okadaic acid increased basal phosphorylation of troponin I in myocytes from young adults but not juveniles (Fig. 4).



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Fig. 4. Cumulative analysis of basal phosphate incorporation into troponin I normalized to the Coomassie stain density. Ventricular myocytes were untreated (Con), exposed to 10 µM H89, or exposed to 1 µM okadaic acid (Oka) for 20 min. H89 is a protein kinase A inhibitor, whereas okadaic acid inhibits protein phosphatase 1 and 2a. Myocytes were isolated from hearts of rats that were either juveniles (n = 3) or young adults (n = 3). Values are expressed as means ± SE. *P < 0.05 compared with same-age control myocytes; {dagger}P < 0.05 compared with same treatment.

 

To establish the contribution of phosphatase activity to {beta}-adrenergic reactivity, Ca2+-dependent actomyosin ATPase was determined in myocytes that were pretreated with 1 µM okadaic acid or vehicle and then stimulated with isoproterenol or vehicle, and myofibrils isolated. In the absence of phosphatase inhibition, isoproterenol did not alter Ca2+-dependent actomyosin ATPase in cardiac myofibrils from juvenile female rats (Fig. 5A) but increased Ca2+-dependent actomyosin ATPase in cardiac myofibrils from young adult female rats (Fig. 5B). In the presence of phosphatase inhibition, isoproterenol did not increase Ca2+-dependent actomyosin ATPase in cardiac myofibrils from either juvenile or young adult female rats compared with controls. Myofibrils isolated from young adult rat hearts that were pretreated with okadaic acid had a significantly higher Ca2+-dependent actomyosin ATPase than those not treated with okadaic acid (Fig. 5B).



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Fig. 5. Cumulative Ca2+-dependent actomyosin ATPase comparing Con and 100 nM Iso-treated ventricular myocytes in the presence (+) or absence (-) of 1 µM Oka. Myocytes were isolated from hearts of rats that were either juvenile (A) or young adults (B), cells were treated as noted, and myofibrils were isolated. Values are normalized to Con myofibrils not treated with Oka and expressed as means ± SE; n = 6 isolations for all groups. *P < 0.05 compared with Con myocytes of the same treatment group; {dagger}P < 0.05 compared with Con myocytes with no Oka treatment.

 

Role of {beta}-MHC on age effects. {beta}-MHC expression was higher in ventricular myocardium from young adult compared with juvenile female rats. Figure 6 presents typical Western blots using MHC antibodies against ventricular myocardium from juvenile (J1–J3) and young adult rats (A1–A3). Membranes were incubated with either a monoclonal anti-{alpha}-MHC (Fig. 6A, top) or a monoclonal anti-{beta}-MHC antibody (Fig. 6, A, bottom, and B). Myocardial samples from five young adult and four juvenile rats gave similar results as those shown in Fig. 6.



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Fig. 6. Western blots using antibodies to {alpha}-myosin heavy chain (MHC) and {beta}-MHC on myocardial homogenates that were electrophoresed on 12% (A) or 8% (B) SDS-polyacrlyamide gels (see MATERIALS AND METHODS for a description of additional differences). Homogenates were from the ventricles of three young adult (A1–A3) and three juvenile (J1–J3) female rats.

 

Myocardial samples were also electrophoresed using a protocol that optimizes MHC separation (Fig. 6B) (13). Two {beta}-MHC-reactive bands were observed in myocardium from young adults. This was consistently observed using either a monoclonal antibody directed to slow skeletal muscle {beta}-MHC (Fig. 6B) or a monoclonal antibody directed to the light meromyosin portion of {beta}-MHC. The lower-molecular-mass band in Fig. 6B did not increase in density in samples intentionally processed to increase proteolysis by leaving the homogenized heart at room temperature for 3 h (data not shown).

To determine the contribution of {beta}-MHC to {beta}-adrenergic reactivity, short-term hypothyroidism was induced. Juvenile rats that had access to drinking water with 0.8% PTU for 4 days had an increase in the {beta}-MHC-immunoreactive band similar (Fig. 7A) to that seen in young adult rats (Fig. 6A). Ventricular myocytes from these rats were stimulated with isoproterenol or vehicle, and myofibrils were isolated. Isoproterenol did not alter the Ca2+-dependent actomyosin ATPase of myofibrils from either euthyroid (control) or hypothyroid (PTU) juvenile rats (Fig. 7B).



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Fig. 7. A: {beta}-MHC content in cardiac homogenates from juvenile rats treated with propylthiouracil (PTU) for 2 or 4 days. B: cumulative Ca2+-dependent actomyosin ATPase comparing Con and 100 nM Iso-treated ventricular myocytes of Con and PTU-treated juvenile rats. Myofibrillar ATPase data were obtained from myocytes isolated from hearts of juvenile rats that had access to plain drinking water (Con rats) or water with 0.8 mg/ml PTU for 4 days (PTU rats). Values are normalized to Con myofibrils from Con rats and expressed as means ± SE; n = 3 isolations for all groups. No statistically significant differences were found.

 


    DISCUSSION
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 ABSTRACT
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 REFERENCES
 
The present study demonstrates the existence of an age/breeding history-dependent, {beta}-adrenergic-cAMP-induced increase in Vmax in cardiac myocytes. This observation is novel and may explain apparent contradictions in the literature regarding the effect of the {beta}-adrenergic pathway on cardiac Vmax and cross-bridge interaction rates (3, 7, 8, 18). In the present study (summarized in Fig. 8), a higher basal phosphatase activity in hearts from young adults compared with juveniles was demonstrated by a decrease in phosphorylation of endogenous phosphoproteins troponin I and C protein. Elimination of the higher phosphatase levels in myocytes from young adults blocked the ability of {beta}-adrenergic stimulation to increase cross-bridge interaction rates. Age-dependent increases in {beta}-MHC did not appear to confer {beta}-adrenergic responsiveness. Thus we propose developmental changes in serine/threonine phosphatase activity can influence the functional reactivity of myocardium to stimuli.



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Fig. 8. Hypothesized pathways and figure citations supporting or refuting steps by which {beta}-adrenergic stimulation may cause an increase in the rate of actomyosin interaction in ventricular myocytes from young adults. Data are consistent with the hypothesis that an age-dependent increase in phosphatase activity, rather than an increase in {beta}-MHC, leads to {beta}-adrenergic responsiveness.

 

Past studies have demonstrated that stimulation of the {beta}-adrenergic pathway increases (8, 18) or causes no change (3, 7) in the cross-bridge cycling rate. We hypothesized that the apparent conflict in the data arose out of age or breeding history differences. For example, Vmax data from cardiac myocytes of 3-mo-old females that were not bred (7) appears to conflict with data using 8- to 9-mo-old retired breeder females (18). The present study confirms the hypothesis that age/breeding history has an effect on {beta}-adrenergic-induced changes in cardiac myocyte Vmax and actomyosin ATPase.

Maximum tension was not affected by activation of the {beta}-adrenergic-PKA pathway in myocytes from either juvenile or young adults. This finding is consistent with previous studies using skinned myocytes (7, 18). A decrease in the Ca2+ sensitivity of tension in all myocytes was seen on {beta}-adrenergic receptor stimulation and dibutyryl-cAMP exposure. The magnitude of the {beta}-adrenergic-dependent decrease in pCa50 was not statistically different in myocytes from juveniles and young adults. {beta}-Adrenergic-induced decreases in Ca2+ sensitivity of tension have previously been shown to be related to troponin I phosphorylation (6).

Maturation of rats from 3 to 9 mo of age caused a 7–15% decrease in {alpha}-MHC with similar increase in {beta}-MHC (2, 4). Our findings are qualitatively consistent with these observations. In addition, we subjected juvenile rats to short-term hypothyroidism to cause a modest increase in {beta}-MHC independent of the aging process. We observed that Ca2+-dependent actomyosin ATPase activity was unchanged in isoproterenol-stimulated cardiac myocytes from hypothyroid and euthyroid juvenile rats. Thus increases in {beta}-MHC do not appear to account for the observed {beta}-adrenergic-dependent increase in cross-bridge cycling rates of cardiac myocytes from young adult rats.

Norepinephrine-induced phosphorylation of cardiac troponin I is reduced in hearts of 24- versus 6-mo-old rats (10). However, this study and others (9, 16, 20) were designed to examine the role of senescence (>24 mo of age in rats) rather than maturation/development. We are unaware of any past study that compares the levels of basal or {beta}-adrenergic-induced phosphorylations of cardiac myofilament proteins in juvenile and young adult rats. In the present study, a decrease in the extent of phosphorylation of troponin I and C protein occurred in myocytes from young adults under basal and {beta}-adrenergic-stimulated conditions compared with juveniles. An age-dependent decrease in the {beta}-adrenergic receptor-adenylate cyclase pathway was not responsible for this observation since both isoproterenol stimulation, a {beta}-adrenergic receptor agonist, and direct stimulation of PKA with dibutyryl-cAMP lead to lower stimulated levels of myofilament phosphate incorporation in young adults compared with juveniles.

The decrease in basal phosphorylation of myocytes from young adults could be due to decreased kinase activity or increased phosphatase activity under resting conditions. Our results using phosphatase and PKA inhibitors demonstrate that only phosphatase inhibitors have a significant effect on basal phosphorylations of troponin I and C protein in myocytes from young adults. Basal myofilament protein phosphorylation in juveniles was not altered by either phosphatase or PKA inhibitors. These observations indicate that young adults have a higher level of myocardial phosphatase activity than juveniles rats. Past studies have demonstrated that activation of estrogen receptors on cardiac myocytes increase phosphatase expression and may contribute to gender-based differences in cardiac disease (13). This raises the possibility that in our studies the increased phosphatase activity in myocardium of young adult, retired breeder, female rats was due to hormones associated with past pregnancies or menstrual cycling rather than age in and of itself.

Ca2+-dependent actomyosin ATPase activity increased with isoproterenol stimulation of cardiac myocytes from young adult rats. {beta}-Adrenergic stimulation of myocytes from juvenile rats did not affect the Ca2+-dependent actomyosin ATPase activity. These findings are consistent with our measurements of Vmax. In addition, myocytes from young adults that were pretreated with a phosphatase inhibitor had an increase in basal actomyosin ATPase and an inhibition of {beta}-adrenergic receptor-dependent increase in Ca2+-dependent actomyosin ATPase activity. Cardiac myocytes and isolated myofibrils from juvenile rats demonstrated no change in actomyosin ATPase with phosphatase inhibition. These findings suggest that age-and/or breeding history-dependent increases in phosphatase activity enhance the functional response of the myocardium to {beta}-adrenergic stimulation as animals mature from juveniles to young adults.

The mechanism by which increased phosphatase activity allows for {beta}-adrenergic responsiveness in myocytes is unclear. One possibility is that there is a myocardial protein that is phosphorylated, by a kinase other than PKA, under resting conditions, and that this phosphorylation inhibits PKA-dependent effects. Under conditions of high basal phosphatase activity, this inhibition is removed and {beta}-adrenergic-PKA activation leads to an increase in the rate of actomyosin association. More simply stated, a higher phosphatase activity changes the "gain" on the system to unmask a {beta}-adrenergic effect. Our data are consistent with such a mechanism, but do not identify the hypothesized inhibitory protein. What can be definitively stated from our studies is that Ser/Thr phosphatases are not static "housekeeping" enzymes but modulate how second messengers influence cardiac function.


    ACKNOWLEDGMENTS
 
This study was supported by National Heart, Lung, and Blood Institute Grant HL-48839 and an American Heart Association Established Investigatorship (to P. A. Hofmann).


    FOOTNOTES
 

Address for reprint requests and other correspondence: P. A. Hofmann, Dept. of Physiology, Univ. of Tennessee, 894 Union Ave., Memphis, TN 38163 (E-mail: phofmann{at}physio1.utmem.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.


    REFERENCES
 TOP
 ABSTRACT
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 REFERENCES
 

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