Sarcalumenin alleviates stress-induced cardiac dysfunction by improving Ca2+ handling of the sarcoplasmic reticulum.

AIMS: Sarcalumenin (SAR) is a Ca(2+)-binding protein expressed in the longitudinal sarcoplasmic reticulum (SR) of striated muscle cells. Although its Ca(2+)-binding property is similar to that of calsequestrin, its role in the regulation of Ca(2+) cycling remains unclear. METHODS AND RESULTS: To investigate whether SAR plays an important role in maintaining cardiac function under pressure overload stress, SAR-knockout (SAR-KO) mice were subjected to transverse aortic constriction (TAC). To examine the relation of SAR with cardiac type of SR Ca(2+) pump, SERCA2a, we designed cDNA expression using cultured cells. We found that SAR expression was significantly downregulated in hypertrophic hearts from three independent animal models. SAR-KO mice experienced higher mortality than did wild-type (WT) mice after TAC. TAC significantly downregulated SERCA2a protein but not mRNA in the SAR-KO hearts, whereas it minimally did so in hearts from WT mice. Accordingly, SR Ca(2+) uptake and cardiac function were significantly reduced in SAR-KO mice after TAC. Then we found that SAR was co-immunoprecipitated with SERCA2a in cDNA-transfected HEK293T cells and mouse ventricular muscles, and that SERCA2a-mediated Ca(2+) uptake was augmented when SAR was co-expressed in HEK293T cells. Furthermore, SAR significantly prolonged the half-life of SERCA2a protein in HEK293T cells. CONCLUSION: These findings suggest that functional interaction between SAR and SERCA2a enhances protein stability of SERCA2a and facilitates Ca(2+) sequestration into the SR. Thus the SAR-SERCA2a interaction plays an essential role in preserving cardiac function under biomechanical stresses such as pressure overload.

Reverse perfusion-metabolism mismatch predicts good prognosis in patients undergoing cardiac resynchronization therapy: a pilot study.

BACKGROUND: Cardiac resynchronization therapy (CRT) improves glucose metabolism in the septum of patients with heart failure, so in the present study the predictive value of combined fluorodeoxyglucose (FDG)-positron emission tomography (PET) and metoxy-isobutyl isonitrile (MIBI)-single photon emission computed tomography (SPECT) for the prognosis of patients undergoing CRT was investigated. METHODS AND RESULTS: Fourteen patients (70.3+/-8.2 years) who underwent FDG-PET and MIBI-SPECT before implantation of a biventricular pacemaker were enrolled. The total number of matches, mismatches, reverse mismatches, summed difference score (SDS: sum total of FDG - MIBI scores) and SDS per segment (%SDS) in each of 5 areas of myocardium (septum, anterior, lateral, inferior area, apex) was calculated and compared between the survival groups (all survival: survival group; survival without ischemic heart disease (IHD): non-IHD survival group) and non-survival group. Both the number of reverse mismatch segments and the %SDS in the septum in the non-IHD survival group were significantly greater than in the non-survival group (3.2+/-1.6 vs 0.5+/-0.6, p<0.05; 0.62+/-0.61 vs -0.11+/-0.19, p<0.05). The receiver-operating characteristics curves for prognosis showed that the area under the curve for the number of reverse mismatch segments in the septum (0.93; confidence interval 0.61-0.98) was significantly greater. CONCLUSION: A reverse mismatch pattern in the septum can predict a good prognosis for patients treated with CRT.

Suppression of atrial fibrillation by atrial pacing.

BACKGROUND: Atrial fibrillation (AF) is a common arrhythmia in patients with an implanted pacemaker, but the role of atrial pacing in preventing AF is still unclear. METHODS AND RESULTS: Sixty-six patients (67.8+/-12.1 years) were enrolled: 54 with sick sinus syndrome (SSS), 11 with atrioventricular blocks (AVB), and 1 with SSS and AVB. The prevalence of AF was investigated. In 22 patients with AF, the AF burden was estimated under "back-up pacing" (40-50 beats/min), then under "atrial pacing" (60-85 beats/min). The prevalence of AF in the SSS group tended to be higher than that in the AVB group (48.1% vs 18.2%, p=0.06). The AF burden in patients with a percentage of atrial pacing (% atrial pacing) <50% was significantly greater than that in patients with % atrial pacing >or=50% (12.5+/-21.1% vs 4.2+/-10.3%, p<0.05). AF disappeared immediately after "atrial pacing" in 4 patients (18.2%). In 9 patients (40.9%), the AF burden decreased gradually, and AF disappeared in 6 patients (27.3%) after 207.9+/-130.2 days. CONCLUSION: The prevalence of AF may be higher in patients with SSS than in those with AVB. Atrial pacing has a preventive effect on AF, and the effect of atrial pacing is not always immediate but is progressive in some patients.

Mechanical stress-dependent transcriptional regulation of sarcolipin gene in the rodent atrium.

Sarcolipin, a homologue of phospholamban, regulates Ca2+ uptake through the interaction with sarcoplasmic reticulum Ca2+ ATPase (SERCA) and is predominantly expressed in the atrial muscle. Although the atrial chamber-specific expression of sarcolipin could be primarily regulated at the transcriptional level, the transcriptional regulation remains poorly understood. Since mechanical stress plays an important role in transcriptional regulation of a gene involved in cardiac hypertrophy and remodeling, we generated left-sided or right-sided pressure-overload models by transverse aortic constriction (TAC) in ddY mice or by monocrotaline administration in Wistar rats, respectively. TAC significantly decreased the expression of sarcolipin, SERCA2a, and phospholamban mRNAs in the left atrium (LA) than those in the right atrium (RA). By contrast, monocrotaline administration significantly decreased the expression of sarcolipin, SERCA2a, and phospholamban mRNAs in the RA than those in the LA. The two independent complementary experiments unequivocally demonstrated that mechanical stress down-regulates the transcription of the sarcolipin gene.

Impaired Ca2+ store functions in skeletal and cardiac muscle cells from sarcalumenin-deficient mice.

Sarcalumenin (SAR), specifically expressed in striated muscle cells, is a Ca2+-binding protein localized in the sarcoplasmic reticulum (SR) of the intracellular Ca2+ store. By generating SAR-deficient mice, we herein examined its physiological role. The mutant mice were apparently normal in growth, health, and reproduction, indicating that SAR is not essential for fundamental muscle functions. SAR-deficient skeletal muscle carrying irregular SR ultrastructures retained normal force generation but showed slow relaxation phases after contractions. A weakened Ca2+ uptake activity was detected in the SR prepared from mutant muscle, indicating that SAR contributes to Ca2+ buffering in the SR lumen and also to the maintenance of Ca2+ pump proteins. Cardiac myocytes from SAR-deficient mice showed slow contraction and relaxation accompanied by impaired Ca2+ transients, and the mutant mice exhibited a number of impairments in cardiac performance as determined in electrocardiography, ventricular catheterization, and echocardiography. The results obtained demonstrate that SAR plays important roles in improving the Ca2+ handling functions of the SR in striated muscle.

Locally advanced mucinous carcinoma of the breast with sudden growth acceleration: a case report.

We report a 35-year-old woman with locally advanced mucinous carcinoma of the breast with sudden growth acceleration. A pea-sized mass developed into an ulcerated large tumor within 1 month. After the combination of chemotherapy, radiation and hyperthermia, a radical mastectomy was performed, followed by repair of the skin defect by latissimus dorsi and rectus abdominis musculocutaneous flaps. Histological examination revealed a pure mucinous carcinoma with axillary lymph node involvement. Estrogen and progesterone receptors were not detected in the tumor. Twenty-five months after treatment, there is no sign of recurrent disease. Pure mucinous carcinoma generally has a less aggressive growth pattern as defined by tumor size, adherence to the overlying skin/bottom fasciae, estrogen and progesterone receptor positive and primary lymph axillary lymph node metastases. This case showed completely opposite features to all of these typical biological features of pure mucinous carcinomas.