James T. Stull works in Heart Failure / Cardiomyopathy affiliated with The University of Texas Southwestern Medical Center.
James T. Stull is affiliated with the Department of Physiology at The University of Texas Southwestern Medical Center. His research focuses on cardiomyopathy and myosin studies as well as related areas in molecular biology and cell biology. He holds ORCID 0000-0002-2993-7206.
262 pubs · 18,396 cites · h-index 77
PhD
Emory University
1971
Professor
The University of Texas Southwestern Medical Center · 1982 - Present
Affiliate
University of Vermont · 2016 - 2016
Provides mechanistic insight into ACTA2 variant penetrance; hypothesis-generating and should not yet change practice.

Contractile force development of smooth muscle is controlled by balanced kinase and phosphatase activities toward the myosin regulatory light chain (RLC). Numerous biochemical and pharmacological studies have investigated the specificity and regulatory activity of smooth muscle myosin light-chain phosphatase (MLCP) bound to myosin filaments and comprised of the regulatory myosin phosphatase target subunit 1 (MYPT1) and catalytic protein phosphatase 1cβ (PP1cβ) subunits. Recent physiological and biochemical evidence obtained with smooth muscle tissues from a conditional MYPT1 knockout suggests that a soluble, MYPT1-unbound form of PP1cβ may additionally contribute to myosin RLC dephosphorylation and relaxation of smooth muscle. Using a combination of isoelectric focusing and isoform-specific immunoblotting, we found here that more than 90% of the total PP1c in mouse smooth muscles is the β isoform. Moreover, conditional knockout of PP1cα or PP1cγ in adult smooth muscles did not result in an apparent phenotype in mice up to 6 months of age and did not affect smooth muscle contractions ex vivo . In contrast, smooth muscle–specific conditional PP1cβ knockout decreased contractile force development in bladder, ileal, and aortic tissues and reduced mouse survival. Bladder smooth muscle tissue from WT mice was selectively permeabilized to remove soluble PP1cβ to measure contributions of total (α-toxin treatment) and myosin-bound (Triton X-100 treatment) phosphatase activities toward phosphorylated RLC in myofilaments. Triton X-100 reduced PP1cβ content by 60% and the rate of RLC dephosphorylation by 2-fold. These results are consistent with the selective dephosphorylation of RLC by both MYPT1-bound and -unbound PP1cβ forms in smooth muscle.
Heterozygous mutations in Myh11 compromise contractile function primarily in aortic smooth muscle, providing a mechanistic basis for their association with human thoracic aortic disease.

Preclinical models relying on bath-applied agonists may not recapitulate neural responses; leaves open translation to human airway disease.
The importance of maintaining contractile function in aortic smooth muscle cells (SMCs) is evident by the fact that heterozygous mutations in the major structural proteins or kinases controlling contraction lead to the formation of aneurysms of the ascending thoracic aorta that predispose to life-threatening aortic dissections. Force generation by SMC requires ATP-dependent cyclic interactions between filaments composed of SMC-specific isoforms of α-actin (encoded by ACTA2) and myosin heavy chain (MYH11). ACTA2 and MYH11 mutations are predicted or have been shown to disrupt this cyclic interaction predispose to thoracic aortic disease. Movement of the myosin motor domain is controlled by phosphorylation of the regulatory light chain on the myosin filament, and loss-of-function mutations in the dedicated kinase for this phosphorylation, myosin light chain kinase (MYLK) also predispose to thoracic aortic disease. Finally, a mutation in the cGMP-activated protein kinase (PRKG1) results in constitutive activation of the kinase in the absence of cGMP, thus driving SMC relaxation in part through increased dephosphorylation of the regulatory light chain and predisposes to thoracic aortic disease. Furthermore, SMCs cannot generate force without connections to the extracellular matrix through focal adhesions, and mutations in the major protein in the extracellular matrix, fibrillin-1, linking SMCs to the matrix also cause thoracic aortic disease in individuals with Marfan syndrome. Thus, disruption of the ability of the aortic SMC to generate force through the elastin-contractile units in response to pulsatile blood flow may be a primary driver for thoracic aortic aneurysms and dissections.
Animal data indicate dual-kinase cardiac RLC regulation; leaves open human disease relevance and therapeutic targeting.
Ileal force relies on MLCK/MLCP balance without MYPT1 shifts; leaves open relevance to human motility disorders.
May caution interpretation of force potentiation in muscle studies; leaves open translation to human concentric contractions.
α1A agonism may augment failing RV force; leaves open clinical translation from this animal model.
Mouse muscle findings warrant no clinical translation yet; leaves open skMLCK-independent crossbridge mechanisms for mechanistic studies.
Constitutive RLC phosphorylation may maintain cardiac performance; leaves open therapeutic targeting in human heart failure.
Animal data on MYPT1 sites require human validation; leaves open distinct roles in vascular smooth muscle regulation.
Hypothesis-generating for crossbridge modulation of force potentiation in mice; human studies required before clinical relevance.
Preclinical mouse data do not support changes in hypertension management; leaves open whether MYPT1 phosphorylation is required for NO-mediated relaxation in humans.
MYPT1 depletion yields modest effects on murine bladder contractility; leaves open its necessity in human smooth muscle disorders.
Does not inform neuregulin use in patients; leaves open cMLCK dependence in cardiac models.
The study demonstrates that MLCK content is limiting for contraction in aortic smooth muscle, providing a potential mechanism for how MLCK haploinsufficiency may lead to human thoracic aorta dissections.
Key points Parasympathetic nerves release the neurotransmitters ATP and acetylcholine that activate purinergic and muscarinic receptors, respectively, to initiate contraction of urinary bladder smooth muscle. Although both receptors mediate Ca 2+ influx for myosin regulatory light chain (RLC) phosphorylation necessary for contraction, the muscarinic receptor may also recruit cellular mechanisms affecting the Ca 2+ sensitivity of RLC phosphorylation. Using transgenic mice expressing Ca 2+ /calmodulin sensor myosin light chain kinase (MLCK) in smooth muscles, the effects of selective purinergic or muscarinic receptor inhibition were examined on neurally stimulated tissues in relation to signalling pathways converging on RLC phosphorylation. Purinergic‐mediated Ca 2+ signals provide the initial Ca 2+ /calmodulin activation of MLCK with muscarinic receptors supporting sustained responses. Activation of muscarinic receptors leads phosphorylation of myosin light chain phosphatase inhibitor CPR‐17 to enhance Ca 2+ sensitivity while also initiating phosphorylation‐dependent Ca 2+ desensitization of MLCK. The interplay between Ca 2+ sensitization and desensitization mechanisms fine tunes the contractile signalling module for force development. Abstract Urinary bladder smooth muscle contraction is triggered by parasympathetic nerves, which release ATP and acetylcholine (ACh) that bind to purinergic and muscarinic receptors, respectively. Neuronal signalling may thus elicit myosin regulatory light chain (RLC) phosphorylation and contraction through the combined, but distinct contributions of these receptors. Both receptors mediate Ca 2+ influx whereas muscarinic receptors may also recruit Ca 2+ ‐sensitization mechanisms. Using transgenic mice expressing calmodulin sensor myosin light chain kinase (MLCK) in smooth muscles, the effects of suramin/α,β‐methyleneATP (α,β‐meATP) (purinergic inhibition) or atropine (muscarinic inhibition) on neurally stimulated elevation of [Ca 2+ ] i , MLCK activation, force and phosphorylation of RLC, myosin light chain phosphatase (MLCP) targeting subunit MYPT1 and MLCP inhibitor protein CPI‐17 were examined. Electric field stimulation (EFS) increased [Ca 2+ ] i , MLCK activation and concomitant force in a frequency‐dependent manner. The dependence of force on [Ca 2+ ] i and MLCK activation decreased with time suggesting increased Ca 2+ sensitization in the late contractile phase. RLC and CPI‐17 phosphorylation increased upon stimulation with maximal responses at 20 Hz; both responses were attenuated by atropine, but only RLC phosphorylation was inhibited by suramin/α,β‐meATP. Antagonism of purinergic receptors suppressed maximal MLCK activation to a greater extent in the early contractile phase than in the late contractile phase; atropine had the opposite effect. A frequency‐ and time‐dependent increase in MLCK phosphorylation explained the desensitization of MLCK to Ca 2+ , since MLCK activation declined more rapidly than [Ca 2+ ] i . EFS elicited little or no effect on MYPT1 Thr696 or 850 phosphorylation. Thus, purinergic Ca 2+ signals provide the initial activation of MLCK with muscarinic receptors supporting sustained responses. Activation of muscarinic receptors recruits CPI‐17, but not MYPT1‐mediated Ca 2+ sensitization. Furthermore, nerve‐released ACh also initiates signalling cascades leading to phosphorylation‐dependent desensitization of MLCK.
Hypothesis-generating for MYH11 variant effects on human vascular remodeling; leaves open clinical relevance pending translational studies.
MLCK knockout lowers basal BP and blunts salt hypertension in mice; leaves open whether MLCK inhibition is a viable antihypertensive target.