Rapamycin and FK506 augment spontaneous SR Ca2+ release in bladder smooth muscle, leading to Ca2+-activated K+ channel opening and membrane hyperpolarization, which explains their smooth muscle relaxing effects.
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May explain mTOR inhibitor relaxant effects in bladder; leaves open translation to human detrusor disorders.
The immunosuppressants rapamycin and FK506 are known to relax smooth muscle despite facilitating Ca(2+) release through ryanodine-receptors of the sarcoplasmic reticulum (SR). The apparent contradiction was studied in isolated guinea-pig urinary bladder myocytes. 2. Modulation of spontaneous SR Ca(2+) release was monitored by means of spontaneous transient outward currents (or STOCs) in isolated smooth muscle cells voltage-clamped to -20 mV. Rapamycin (10 microM, n=18) significantly increased amplitude (50+/-12%, mean+/-s.d.), life time (77+/-19%), and time integral of STOCs (113+/-22%), and it reduced the interval between STOCs (20+/-7%). FK506 (20 microM, n=24) increased amplitude (15+/-7%), life time (50+/-7%), time integral (104+/-26%). Cyclosporin A (20 microM, n=18) had no significant effects on STOCs. 3. The basal cytoplasmic Ca(2+) concentration ([Ca(2+)](c)) measured by Indo1-fluorescence was insensitive to rapamycin or FK506. Pretreatment with rapamycin (20 microM, 2 min) did not impair the SR Ca(2+) load as can be concluded from caffeine-induced Ca(2+)-transients. 4. As it was expected from the enhanced STOC activity, the non-clamped membrane was hyperpolarized by rapamycin (15+/-2 mV) or by FK506 (15+/-3 mV). 5. The data are consistent with the idea that rapamycin and FK506 augment spontaneous SR Ca(2+) release by removal of FK-binding proteins from the RyR-complex. Smooth muscle relaxation is interpreted as negative Ca(2+) feedback: augmented Ca(2+) activation of STOCs induces membrane hyperpolarization that reduces Ca(2+) influx through voltage gated channels.
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Weidelt et al. (2000) studied this question.
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