Key result
Levcromakalim and SR 47063 cannot activate K-ATP channels at pH 6 due to receptor protonation.
Intracellular protons allosterically modulate the interaction between potassium-channel openers and K-ATP channels, preventing drug binding when the receptor is protonated.
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May limit K-ATP opener efficacy during acidosis; hypothesis-generating for ischemic settings and requires clinical validation.
Levcromakalim, a potential antihypertensive agent, is known to activate potassium channels dependent on intracellular ATP (K-ATP channels). In inside-out patches excised from frog skeletal muscle, levcromakalim or a related compound, SR 47063, caused a strong and persistent activation of K-ATP channels at a cytoplasmic pH of 7.1. However, at pH 6, these activators could no longer affect the K-ATP currents. Conversely, in the continuous presence of activator, lowering pH from 7.1 to 6 returned channel activity to its level in pH 6 alone. After wash-out of the activator, recovery from activation took minutes at pH 7.1 but only seconds at pH 6, thus ruling out an effect of protons on the activators in solution. These experiments suggest that K-channel-activators are unable to bind to their receptor when it is protonated, and more generally, they provide evidence at the microscopic level for proton-induced allosteric modulation of drug-receptor interaction.
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Forestier et al. (1993) studied this question. Levcromakalim or SR 47063 was evaluated on K-ATP channel activation. Levcromakalim and SR 47063 strongly activated K-ATP channels at pH 7.1 but had no effect at pH 6, suggesting that K-channel-activators cannot bind to their receptor when protonated.
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