Background
Aberrant calcium signaling is considered as one of the key mechanisms contributing to arrhythmias, especially in the context of heart failure. In human heart failure, there is significant down-regulation of the sarcoplasmic reticulum protein junctin and junctin deficiency in mice is associated with stress-induced arrhythmias.
Objective
This study was designed to determine whether the increased SR Ca2+ leak and arrhythmias, associated with junctin ablation, may be associated with increased CaMKII activity and phosphorylation of the cardiac ryanodine receptor (RyR2) and whether pharmacological inhibition of CaMKII activity may prevent these arrhythmias.
Methods
Using a combination of biochemical, cellular and in vivo approaches, we tested the ability of KN-93 to reverse aberrant CaMKII phosphorylation of RyR2. Specifically, we performed protein phosphorylation analysis, in vitro cardiomyocyte contractility and Ca2+ kinetics, and in vivo ECG analysis in the junctin deficient mice.
Results
In the absence of junctin, RyR2 channels displayed CaMKII-dependent hyperphosphorylation. Notably, CaMKII inhibition by KN-93 reduced the in vivo incidence of stress-induced ventricular tachycardia by 65% in junctin null mice. At the cardiomyocyte level, KN-93 reduced the percentage of junctin null cells exhibiting spontaneous Ca2+ aftertransients and aftercontractions under stress conditions, by 35% and 37% respectively. At the molecular level, KN-93 blunted the CaMKII mediated hypephosphorylation of RyR2 and PLN under stress conditions.
Conclusion
Our data suggest that CaMKII inhibition is effective in preventing arrhythmogenesis in the setting of junctin ablation, through modulation of both SR Ca2+ release and uptake. Thus, it merits further investigation as promising molecular therapy.