Scavenging Free Radicals by Low-Dose Carvedilol Prevents Redox-Dependent Ca2+ Leak Via Stabilization of Ryanodine Receptor in Heart Failure
Mamoru Mochizuki, MD*,
Masafumi Yano, MD, PhD*,*,
Tetsuro Oda, MD, PhD*,
Hiroki Tateishi, MD*,
Shigeki Kobayashi, MD, PhD*,
Takeshi Yamamoto, MD, PhD*,
Yasuhiro Ikeda, MD, PhD*,
Tomoko Ohkusa, MD, PhD*,
Noriaki Ikemoto, PhD , and
Masunori Matsuzaki, MD, PhD, FACC*
* Department of Medicine and Clinical Science, Division of Cardiology, Yamaguchi University Graduate School of Medicine, Ube, Japan
Boston Biomedical Research Institute, Watertown, Massachusetts
Department of Neurology, Harvard Medical School, Boston, Massachusetts

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Figure 1 Hemodynamics and Echocardiograms
(A) Acute concentration-dependent effect of carvedilol (CV) on resting and isoproterenol-stimulated hemodynamic in normal conscious dogs. Isoproterenol (0.80 µg·kg-1·min1 intravenously) was used to produce inotropic response. Data represent mean ± SD obtained from 4 dogs. (B) Representative M-mode echocardiograms. Note that left ventricular (LV) end-diastolic and -systolic diameters were each smaller in the CV-treated dog than in the CV-untreated () dog (both 4-week paced). HR = heart rate; LVPSP = left ventricular peak-systolic pressure; +dP/dt = peak (+) dP/dt of LV pressure. *p < 0.05; **p < 0.01 versus CV ().
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Figure 2 Redox State in RyR2
(A) Monobromobimane (mBB) fluorescence intensity of the ryanodine receptor (RyR)2 (corresponding to the content of free thiols) in the presence or absence of 100 µmol/l 3-morpholinosydnonimine (SIN-1). The relative content of free thiols in the RyR2 was obtained as the ratio of fluorescence intensity of the mBB to protein abundance of RyR2 and then expressed as a percentage of that in normal sarcoplasmic reticulum. (B) Acute concentration effect of carvedilol (CV) on SIN-1 (100 µmol/l)induced decrease in mBB fluorescence intensity of the RyR2. (C) Acute effect of CV (100 µmol/l) on the mBB fluorescence intensity of the RyR2 in the presence or absence of SIN-1 (100 µmol/l) and/or DPc10 (a synthetic peptide corresponding to Gly2460-Pro2495 of RyR) (30 µmol/l).
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Figure 3 Ca2+ Leak, Ser2808-Phosphorylation Level in RyR2, and FKBP12.6
(A) Representative time courses of Ca2+ uptake and the ensuing Ca2+ leak from SR vesicles in the presence or absence of 30 µmol/l FK506 and/or 100 µmol/l carvedilol (CV) (left). Summarized data of Ca2+ leak in normal, CV-untreated, and CV-treated sarcoplasmic reticulum (SR) vesicles (right). (B) Protein kinase A phosphorylation level of RyR2. (C) The amount of RyR2-bound FKBP12.6. To see the direct acute effect of CV on phosphorylation level of RyR2-pSer2808 or amount of RyR2-bound FKBP 12.6 in failing SR vesicles, the SR vesicles were mixed with CV (100 µmol/l) for 30 min and then centrifuged, followed by immunoprecipitation and Western blotting. 4W-pacing = pacing at 250 beats/min for 4 weeks; ATP = adenosine triphosphate; other abbreviations as in Figure 2.
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Figure 4 Ca2+ Leak and Interdomain Interaction Within RyR2
(A, top) Representative time courses of Ca2+ uptake and Ca2+ leak from SR vesicles in presence of SIN-1 (100 µmol/l), CV (100 µmol/l), or DPc10 (30 µmol/l). Summarized data of Ca2+ leak (bottom). (B) Stern-Volmer plots of the fluorescence quenching data with QSY-bovine serum albumin (BSA). The top panel shows the effect of SIN-1 (100 µmol/l) in the presence or absence of CV (100 µmol/l) or CV (100 µmol/l) plus DPc10 (30 µmol/l) in normal SR. Bottom panel shows Stern-Volmer plots of QSY-BSA fluorescence quenching data of normal, failing (CV-untreated/paced), and CV-treated/paced groups. (C) Effect of SIN-1 (100 µmol/l) on phosphorylation level of RyR2-pSer2808
(top) or amount of RyR2-bound FKBP12.6 (bottom), in the presence of CV (100 µmol/l) or DPc10 (30 µmol/l). Before immunoprecipitation of RyR, SR vesicles were mixed with CV or DPc10 for 30 min and then centrifuged, followed by Western blotting. Abbreviations as in Figures 2 and 3.
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Figure 5 SR Ca2+-ATPase, Ca2+ Uptake, and Phospholamban
(A) Representative Western blot of sarcoplasmic reticulum (SR) Ca2+-ATPase (top panel) and the densitometric analysis of the Western blot (bottom panel). (B) The rate of Ca2+ uptake. (C) Representative Western blot of Ser16-phosphorylated phospholamban (p-PLB) and total PLB (t-PLB) (top panel) and the densitometric analysis of the Western blot (bottom panel). The p-PLB values (sum of pentamer and monomer, in arbitrary units) were normalized with respect to the t-PLB values (sum of pentamer and monomer, in arbitrary units). Data are presented as means ± SD. Abbreviations as in Figure 3.
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Figure 6 Cell Shortening and the Corresponding Ca2+ Transient in Cardiomyocytes
(A) Dose-dependent effect of CV on cell shortening in normal and failing (4W-paced) cardiomyocytes. (B and C) Effect of forskolin (500 nmol/l) on cell shortening and Ca2+ transient in normal (B) and failing cardiomyocytes (C), in the presence of CV (30 nmol/l, incubated for 12 h) or DPc10-incorporation. (D) Estimated SR Ca2+ content by caffeine (20 mmol/l) application in the presence of CV (30 nmol/l, incubated for 12 h) or DPc10-incorporation. (E) 2',7'-dichlorofluorescin diacetate (DCFH-DA) fluorescence images in normal and failing cardiomyocytes in presence of CV (30 nmol/l, incubated for 12 h) or DPc10-incorporation. Confocal microscopy clearly detects the DCFH-DA fluorescence signal indicated as green in failing cardiomyocytes. Cell surface membrane was fluorescently labeled as red by wheat germ agglutinin (Alexa Fluor 633 conjugate; Molecular Probes). Abbreviations as in Figure 3.
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