title: Isoflurane sensitizes the cardiac sarcolemmal adenosine triphosphate-sensitive potassium channel to pinacidil.
abstract: BACKGROUND
  Cardioprotective effects of isoflurane are partially mediated by the sarcolemmal adenosine triphosphate-sensitive potassium (sarcK ATP ) channel. The authors tested the hypothesis that isoflurane sensitizes sarcK ATP channels to a potassium channel opener, pinacidil, adenosine- and phospholipid-mediated pathways.
  
  
  METHODS
  Activation by pinacidil of the K ATP current (I KATP ) was monitored in guinea pig ventricular myocytes at 0.5 and 5 mm intracellular ATP in the whole cell configuration of the patch clamp technique. The sensitization effect was evaluated by pretreating each myocyte with isoflurane (0.57 +/- 0.04 mm) before application of pinacidil (5 micro m) in the continued presence of the anesthetic. To investigate whether intracellular signaling pathways may be involved in isoflurane sensitization, the authors used the adenosine receptor antagonist theophylline (100 micro m) and the phosphatidylinositol kinase inhibitor wortmannin (100 micro m).
  
  
  RESULTS
  The density of pinacidil-activated I KATP was higher at 0.5 mm ATP (20.7 +/- 3.2 pA/pF) than at 5 mm ATP (2.0 +/- 0.3 pA/pF). At 0.5 mm ATP, pretreatment with isoflurane caused an increase in density of pinacidil-activated I KATP (42.4 +/- 6.2 pA/pF) and accelerated the rate of current activation (from 5.4 +/- 1.2 to 39.0 +/- 7.9 pA. pF(-1). min(-1) ). Theophylline attenuated current activation by pinacidil (9.4 +/- 3.9 pA/pF) and abolished the sensitization effect of isoflurane on I KATP (10.0 +/- 2.5 pA/pF). Wortmannin did not alter pinacidil activation of I KATP (13.2 +/- 1.7 pA/pF) but prevented sensitization by isoflurane (15.8 +/- 4.5 pA/pF).
  
  
  CONCLUSIONS
  These results suggest that isoflurane increases sensitivity of cardiac sarcK ATP channels to the potassium channel opener pinacidil. Blockade of adenosine receptors or phosphatidylinositol kinases abolishes the sensitization effect, suggesting that the adenosine and phospholipid signaling pathways may be involved in the actions by isoflurane.
authors.affiliation: Department of Anesthesiology. double dagger Assistant Professor, Medical College of Wisconsin, Milwaukee, Wisconsin 53226, USA.
authors.forename: Susanne
authors.initials: S
authors.lastname: Gassmayr
authors.forename: Anna
authors.initials: A
authors.lastname: Stadnicka
authors.forename: Akihiro
authors.initials: A
authors.lastname: Suzuki
authors.forename: Wai-Meng
authors.initials: WM
authors.lastname: Kwok
authors.forename: Zeljko J
authors.initials: ZJ
authors.lastname: Bosnjak
mesh_terms: D018528:ATP-Binding Cassette Transporters; D000730:Androstadienes / Q000494:pharmacology; D018685:Anesthetics, Inhalation / Q000494:pharmacology*; D000818:Animals; D005260:Female; D005905:Glyburide / Q000494:pharmacology; D006168:Guinea Pigs; D006321:Heart / Q000187:drug effects*; D007004:Hypoglycemic Agents / Q000494:pharmacology; D066298:In Vitro Techniques; D007530:Isoflurane / Q000494:pharmacology*; D054086:KATP Channels; D008297:Male; D008564:Membrane Potentials / Q000187:drug effects; D018408:Patch-Clamp Techniques; D010743:Phospholipids / Q000502:physiology; D020110:Pinacidil / Q000037:antagonists & inhibitors / Q000494:pharmacology*; D015221:Potassium Channels / Q000819:agonists* / Q000378:metabolism*; D024661:Potassium Channels, Inwardly Rectifying; D012508:Sarcolemma / Q000187:drug effects* / Q000378:metabolism*; D015398:Signal Transduction / Q000187:drug effects; D014665:Vasodilator Agents / Q000037:antagonists & inhibitors / Q000494:pharmacology*; D000077191:Wortmannin
chemical_list: D018528:ATP-Binding Cassette Transporters; D000730:Androstadienes; D018685:Anesthetics, Inhalation; D007004:Hypoglycemic Agents; D054086:KATP Channels; D010743:Phospholipids; D015221:Potassium Channels; D024661:Potassium Channels, Inwardly Rectifying; D014665:Vasodilator Agents; C092520:uK-ATP-1 potassium channel; D020110:Pinacidil; D007530:Isoflurane; D005905:Glyburide; D000077191:Wortmannin