Abstract
Trifluoperazine (TFP), a phenothiazine, is a commonly used antipsychotic drug whose therapeutic effects are attributed to its central anti-adrenergic and anti-dopaminergic actions. However, TFP is also a calmodulin (CaM) antagonist and alters the Ca2+ binding properties of calsequestrin (CSQ). The CaM and CSQ proteins are known modulators of sarcoplasmic reticulum (SR) Ca2+ release in ventricular myocytes. We explored TFP actions on cardiac SR Ca2+ release in cells and single type-2 ryanodine receptor (RyR2) channel activity in bilayers. In intact and permeabilized ventricular myocytes, TFP produced an initial activation of RyR2-mediated SR Ca2+ release and over time depleted SR Ca2+ content. At the single channel level, TFP or nortryptiline (NRT; a tricyclic antidepressant also known to modify CSQ Ca2+ binding) increased the open probability (Po) of CSQ-free channels with an EC50 of 5.2 µM or 8.9 µM (respectively). This Po increase was due to elevated open event frequency at low drug concentrations while longer mean open events sustained Po at higher drug concentrations. Activation of RyR2 by TFP occurred in the presence or absence of CaM. TFP may also inhibit SR Ca uptake as well as increase RyR2 opening. Our results suggest TFP and NRT can alter RyR2 function by interacting with the channel protein directly, independent of its actions on CSQ or CaM. This direct action may contribute to the clinical adverse cardiac side effects associated with these drugs.
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Acknowledgments
This work was supported by National Institutes of Health Grants HL80101 & HL62231 (to LAB), HL57832 & AR54098 (to MF), and an American Heart Association Grant AHA0530309Z (to AVZ). We are very thankful to Drs. Pompeo Volpe and Alessandra Nori for kindly providing the CSQ protein. We would also like to thank Dr. Josefina Ramos-Franco and Ms. Alma Nani for their expert assistance.
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Qin, J., Zima, A.V., Porta, M. et al. Trifluoperazine: a rynodine receptor agonist. Pflugers Arch - Eur J Physiol 458, 643–651 (2009). https://doi.org/10.1007/s00424-009-0658-y
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DOI: https://doi.org/10.1007/s00424-009-0658-y