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Leaky RyR2 trigger ventricular arrhythmias in Duchenne muscular dystrophy

2010; National Academy of Sciences; Volume: 107; Issue: 4 Linguagem: Inglês

10.1073/pnas.0908540107

1091-6490

Jérémy Fauconnier, Jérôme Thireau, Steven Reiken, Cécile Cassan, Sylvain Richard, Stéfan Matecki, Andrew R. Marks, Alain Lacampagne,

Neuroscience and Neural Engineering

Patients with Duchenne muscular dystrophy (DMD) have a progressive dilated cardiomyopathy associated with fatal cardiac arrhythmias. Electrical and functional abnormalities have been attributed to cardiac fibrosis; however, electrical abnormalities may occur in the absence of overt cardiac histopathology. Here we show that structural and functional remodeling of the cardiac sarcoplasmic reticulum (SR) Ca 2+ release channel/ryanodine receptor (RyR2) occurs in the mdx mouse model of DMD. RyR2 from mdx hearts were S-nitrosylated and depleted of calstabin2 (FKBP12.6), resulting in “leaky” RyR2 channels and a diastolic SR Ca 2+ leak. Inhibiting the depletion of calstabin2 from the RyR2 complex with the Ca 2+ channel stabilizer S107 (“rycal”) inhibited the SR Ca 2+ leak, inhibited aberrant depolarization in isolated cardiomyocytes, and prevented arrhythmias in vivo. This suggests that diastolic SR Ca 2+ leak via RyR2 due to S-nitrosylation of the channel and calstabin2 depletion from the channel complex likely triggers cardiac arrhythmias. Normalization of the RyR2-mediated diastolic SR Ca 2+ leak prevents fatal sudden cardiac arrhythmias in DMD.