Heart failure is a major cause of death and disability. Impairments in blood circulation that accompany heart failure can be traced, in part, to alterations in the activity of the sarcoplasmic reticulum Ca2+ pump that are induced by its interactions with phospholamban, a reversible inhibitor. If phospholamban becomes superinhibitory or chronically inhibitory, contractility is diminished, inducing dilated cardiomyopathy in mice and humans. In mice, phospholamban seems to encumber an otherwise healthy heart, but humans with a phospholamban-null genotype develop early-onset dilated cardiomyopathy.

We have cloned and sequenced complementary DNA encoding a Ca2+-ATPase of rabbit muscle sarcoplasmic reticulum. We propose a model of the protein which has 3 cytoplasmic domains joined to a set of 10 transmembrane helices by a narrow, penta-helical stalk. In this model, ATP bound to one cytoplasmic domain would phosphorylate an aspartate in an adjoining cytoplasmic domain, inducing translocation of Ca2+ from binding sites on the stalk.

Calreticulin is a ubiquitous Ca2+ binding protein, located in the endoplasmic reticulum lumen, which has been implicated in many diverse functions including: regulation of intracellular Ca2+ homeostasis, chaperone activity, steroid-mediated gene regulation, and cell adhesion. To understand the physiological function of calreticulin we used gene targeting to create a knockout mouse for calreticulin. Mice homozygous for the calreticulin gene disruption developed omphalocele (failure of absorption of the umbilical hernia) and showed a marked decrease in ventricular wall thickness and deep intertrabecular recesses in the ventricular walls. Transgenic mice expressing a green fluorescent protein reporter gene under the control of the calreticulin promoter were used to show that the calreticulin gene is highly activated in the cardiovascular system during the early stages of cardiac development. Calreticulin protein is also highly expressed in the developing heart, but it is only a minor component of the mature heart. Bradykinin-induced Ca2+ release by the InsP3-dependent pathway was inhibited in crt −/− cells, suggesting that calreticulin plays a role in Ca2+ homeostasis. Calreticulin-deficient cells also exhibited impaired nuclear import of nuclear factor of activated T cell (NF-AT3) transcription factor indicating that calreticulin plays a role in cardiac development as a component of the Ca2+/calcineurin/NF-AT/GATA-4 transcription pathway.

Phospholamban (PLN), a homopentameric, integral membrane protein, reversibly inhibits cardiac sarcoplasmic reticulum Ca 2؉ -ATPase (SERCA2a) activity through intramembrane interactions. Here, alaninescanning mutagenesis of the PLN transmembrane sequence was used to identify two functional domains on opposite faces of the transmembrane helix. Mutations in one face diminish inhibitory interactions with transmembrane sequences of SERCA2a, but have relatively little effect on the pentameric state, while mutations in the other face activate inhibitory interactions and enhance monomer formation. Double mutants are monomeric, but loss of inhibitory function is dominant over activation of inhibitory function. These observations support the proposal that the SERCA2a interaction site lies on the helical face which is not involved in pentamer formation. Four highly inhibitory mutants are effectively devoid of pentamer, suggesting that pentameric PLN represents a less active or inactive reservoir that dissociates to provide inhibitory monomeric PLN subunits. A model is presented in which the degree of PLN inhibition of SERCA2a activity is ultimately determined by the concentration of the inhibited PLN monomer⅐SERCA2a heterodimeric complex. The concentration of this inhibited complex is determined by the dissociation constant for the PLN pentamer (which is mutation-sensitive) and by the dissociation constant for the PLN/SERCA2a heterodimer (which is likely to be mutation-sensitive). Phospholamban (PLN)1 is a 52-amino acid, integral membrane protein (1) that interacts with and reversibly inhibits the activity of the cardiac sarcoplasmic reticulum Ca 2ϩ -ATPase (SERCA2a). In this role, it is a major regulator of the kinetics of cardiac contractility (2). PLN has the mobility of a homopentamer in SDS gels, but the pentamer is dissociated to monomers by boiling in SDS (3). It is an open question whether the functional inhibitory unit is a pentamer or a monomer and whether pentamers and monomers are in dynamic equilibrium in the sarcoplasmic reticulum membrane.Much attention has been directed toward the phosphorylation sites on Ser 16 and Thr 17 in cytoplasmic domain Ia of PLN and their role in regulating the inhibitory function of PLN (4,5). In earlier studies we showed that the PLN cytoplasmic interaction site is formed by charged and hydrophobic amino acids 1-20 (6), while the complementary SERCA2a interaction site consists of amino acids Lys-Asp-Asp-Lys-Pro-Val 402 (7). In a later evaluation of potential transmembrane interaction sites (8), we coexpressed SERCA2a with PLN transmembrane sequences 31-52 (PLN domain II) or with PLN domain II constructs to which NH 2 -terminal, cytoplasmic epitopes such as PLN 1-20 or hemagglutinin were fused. We found that the inhibitory interaction site lies entirely in the transmembrane sequences of PLN and SERCA2a, but can be modulated, through long range interactions, by the noninhibitory cytoplasmic interaction site. We also discovered the phenomenon of "supershifting," in which the apparen...

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Molecular etiologies of heart failure, an emerging cardiovascular epidemic affecting 4.7 million Americans and costing 17.8 billion health-care dollars annually, remain poorly understood. Here we report that an inherited human dilated cardiomyopathy with refractory congestive heart failure is caused by a dominant Arg --> Cys missense mutation at residue 9 (R9C) in phospholamban (PLN), a transmembrane phosphoprotein that inhibits the cardiac sarcoplasmic reticular Ca2+-adenosine triphosphatase (SERCA2a) pump. Transgenic PLN(R9C) mice recapitulated human heart failure with premature death. Cellular and biochemical studies revealed that, unlike wild-type PLN, PLN(R9C) did not directly inhibit SERCA2a. Rather, PLN(R9C) trapped protein kinase A (PKA), which blocked PKA-mediated phosphorylation of wild-type PLN and in turn delayed decay of calcium transients in myocytes. These results indicate that myocellular calcium dysregulation can initiate human heart failure-a finding that may lead to therapeutic opportunities.

dilated cardiomyopathy ͉ heart failure ͉ calcium cycling ͉ mutation ͉ phosphorylation

Function Ca2ϩ pumps, together with Ca 2ϩ release channels, form ubiquitous Ca 2ϩ regulatory systems in muscle and non-muscle cells. The sarco(endo)plasmic reticulum Ca 2ϩ -ATPases (SERCA) 1 and the plasma membrane Ca 2ϩ -ATPases have the highest affinity for Ca 2ϩ removal from the cytoplasm and, together, set resting cytoplasmic Ca 2ϩ concentrations. Three differentially expressed genes encode SERCA proteins (1). SERCA1a and -1b are expressed in fast-twitch skeletal muscle, but loss of SERCA1 function in Brody disease is sufficiently compensated to preserve life (2). SERCA2a is the cardiac/slow-twitch isoform, whereas SERCA2b, with a C-terminal extension, is expressed in smooth muscle and non-muscle tissues. It is almost certainly an essential gene. SERCA3 is expressed in a limited set of non-muscle tissues, including endothelial, epithelial, and lymphocytic cells and platelets, and its knockout is not lethal (3).SERCA enzymes are typical of the class of P-type ATPases, which form a phosphoprotein intermediate and undergo conformational changes during the course of ATP hydrolysis (4, 5). Some of the conformational states can be stabilized, either by adjustment of reaction conditions or through mutagenesis, and characterized as intermediates in the overall reaction cycle (Fig. 1A). The phosphorylated intermediate, E 1 P(Ca) 2 , can phosphorylate ADP, whereas E 2 P can only react with water. The formation of E 1 P requires that two high affinity Ca 2ϩ binding sites be occupied. The enzyme is then phosphorylated by ATP and, concomitantly, the two Ca 2ϩ ions are occluded and can no longer exchange with cytoplasmic Ca 2ϩ . The rate-limiting transition to E 2 P is accompanied by loss of Ca 2ϩ into the lumen, the affinity having fallen by 3 orders of magnitude. Hydrolysis of E 2 P and regeneration of the high affinity Ca 2ϩ binding sites (E 1 (Ca) 2 ) complete the reversible cycle. High lumenal Ca 2ϩ drives the formation of E 1 P from phosphate (P i ), and its effect on the level of E 1 P led Jencks (5, 6) to postulate a second set of Ca 2ϩ